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Published on: February 26, 2013
Relationship between β-receptor blocker and atrial fibrillation in patients with heart failure: an observational
1Department of Cardiology, Ningbo Medical Center LiHuiLi Hospital, No. 57 Xingning Road, Yinzhou District, Ningbo, 315000, Zhejiang, China.
Insights
Beta-blocker use increases atrial fibrillation risk in heart failure patients. However, beta-blockers and myocardial infarction show an antagonistic effect against atrial fibrillation development.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Research
Background:
- Beta-receptor blockers are standard heart failure treatments.
- The impact of beta-blockers on atrial fibrillation in heart failure patients remains unclear.
Purpose of the Study:
- To investigate the association between beta-receptor blocker use and atrial fibrillation incidence in heart failure patients.
- To explore potential interactions between beta-blocker use and other factors in atrial fibrillation development.
Main Methods:
- Analysis of data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database.
- Logistic regression and Random Forest machine learning for variable importance.
- Interaction analysis to assess modifying effects on the beta-blocker and atrial fibrillation relationship.
Main Results:
- Beta-blocker use was associated with an increased risk of atrial fibrillation (OR: 2.821 [2.014, 3.951]).
- A significant interaction was observed between beta-blocker use and myocardial infarction (MI) regarding atrial fibrillation.
- Beta-blocker use and MI demonstrated an antagonistic effect in the development of atrial fibrillation (OR: 0.374 [0.184, 0.772]).
Conclusions:
- Beta-receptor blocker use is a significant risk factor for atrial fibrillation in heart failure patients.
- Beta-blocker therapy and myocardial infarction exhibit an antagonistic relationship in the context of atrial fibrillation within heart failure.
Background:
The β-receptor blocker is used to treat heart failure (HF), and its role in the occurrence of atrial fibrillation (AF) is unclear in patients with HF. This study aimed to investigate the relationship between β-receptor blocker use and AF in patients with HF.
Methods:
All data was collected from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The relationship between β-receptor blocker and AF was analyzed by univariate logistic regression, multivariate logistic regression, and subgroup analysis. The machine learning algorithm including logistic and Random forest was used to analyze the importance of variables in AF. The interaction analysis was conducted to determine whether other factors influence the relationship between β-receptor blocker and AF.
Results:
A total of 953 participants were involved. We found that the use of beta-blockers increased the risk of AF this result was not affected by confounding factors (OR (95%CI): 2.821[2.014,3.951], p < 0.01). The interaction analysis showed that myocardial infarction (MI) and β-receptor blocker had an interaction on AF (p for interaction < 0.001). The results of additive and multiplicative interaction analysis indicated that β-receptor-blocker use and infarction are antagonistic in the development of AF in patients with HF ((S (95% CI): 0.283[0.142, 0.563]; AP (95% CI): -1.187[-2.020, -0.354]; RERI (95% CI): -2.237[-3.722, -0.752], OR (95% CI):0.374[0.184, 0.772]).
Conclusion:
This study found that β-receptor blocker use was an important risk factor for AF in patients with HF. β-receptor blocker use was antagonistic to MI in AF in patients with HF.
Clinical Trial:
Not applicable.
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