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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a

Guillaume Jondeau1, Yannick Neuder, Jean-Christophe Eicher

  • 1AP-HP, Hôpital Bichat, Service de Cardiologie, Faculté de médecine Paris VII, INSERM U698, Paris F-75018, France. guillaume.jondeau@bch.aphp.fr

European Heart Journal
|September 1, 2009
PubMed

Insights

Continuing beta-blocker therapy during acutely decompensated heart failure (ADHF) is safe and leads to better long-term adherence. This approach ensures patients receive established heart failure benefits without compromising acute recovery.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Acutely decompensated heart failure (ADHF) management often involves uncertainty regarding the continuation of beta-blocker therapy.
  • Beta-blockers are crucial for long-term heart failure management, but their role during acute decompensation requires clarification.

Purpose of the Study:

  • To determine if continuing beta-blocker therapy during ADHF impacts patient recovery.
  • To assess the non-inferiority of beta-blocker continuation versus discontinuation in patients with reduced ejection fraction.

Main Methods:

  • A randomized, controlled, open-label, non-inferiority trial was conducted.
  • 169 patients with LVEF < 40% on stable beta-blocker therapy were randomized to continue or discontinue therapy during ADHF.
  • Primary endpoint was physician-assessed improvement in dyspnea and well-being at 3 days.

Main Results:

  • Continuation of beta-blockers was non-inferior to discontinuation, with 92.8% vs. 92.3% improvement at 3 days.
  • No significant differences were observed in recovery at 8 days, plasma BNP, hospital stay, or 3-month mortality.
  • A significantly higher rate of chronic beta-blocker prescription was observed at 3 months in the continuation group (90% vs. 76%).

Conclusions:

  • Continuing beta-blocker therapy during ADHF does not delay or impair acute recovery.
  • Beta-blocker continuation is associated with improved long-term adherence to established beneficial therapy.
  • The findings support the continuation of beta-blockers in ADHF patients with reduced ejection fraction previously on stable therapy.
Abstract

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