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Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

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Selective Use of Nonselective Beta-Blockers: A Tailored Antiarrhythmic Approach.

Davide Genovese¹, Giuseppe Sgarito², Donatella Ruggiero³

¹Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy.

JACC. Clinical Electrophysiology

|June 19, 2026

Summary

Beta-blockers (BBs) offer varied antiarrhythmic effects. Nonselective agents excel in channelopathies and electrical storms, while cardioselective ones suit chronic supraventricular tachycardia, optimizing patient care.

Keywords:

antiarrhythmic drugs atrial fibrillation beta-blockers channelopathies electrical storm personalized medicine ventricular arrhythmias

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Published on: April 11, 2025

Area of Science:

Cardiology
Pharmacology

Background:

Beta-blockers (BBs) are crucial for antiarrhythmic therapy.
A uniform "class effect" assumption for BBs may limit efficacy due to diverse properties.

Purpose of the Study:

To review and compare the antiarrhythmic effects of different BBs across various clinical scenarios.
To guide personalized BB selection for improved therapeutic outcomes.

Main Methods:

Systematic review of evidence comparing antiarrhythmic effects of distinct BBs.
Analysis of efficacy in specific arrhythmias and patient populations.

Main Results:

Nonselective BBs (e.g., nadolol, propranolol) show superior efficacy in inherited channelopathies and electrical storms.
Carvedilol outperforms metoprolol in preventing postoperative atrial fibrillation and reducing ICD shocks.
Cardioselective BBs are preferred for chronic supraventricular tachycardia management.

Conclusions:

Tailoring BB therapy based on distinct pharmacological properties enhances antiarrhythmic efficacy.
Moving beyond a "one-size-fits-all" approach is essential for personalized medicine.
Further research is needed to refine personalized BB selection strategies.