Therapeutic Inefficacy and Proarrhythmic Nature of Metoprolol Succinate and Carvedilol Therapy in Patients With Idiopathic, Frequent, Monomorphic Premature Ventricular Contractions

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dc.authorscopusid55523247700
dc.authorscopusid18433701600
dc.authorscopusid57419753400
dc.authorscopusid56051853500
dc.authorscopusid6604072280
dc.authorscopusid6602749604
dc.contributor.authorTuran, Oguzhan Ekrem
dc.contributor.authorAydin, Mehmet
dc.contributor.authorOdabasi, Ahmet Yener
dc.contributor.authorInc, Mustafa
dc.contributor.authorPayzin, Serdar
dc.contributor.authorHasdemir, Can
dc.date.accessioned2023-01-12T20:00:54Z
dc.date.available2023-01-12T20:00:54Z
dc.date.issued2022
dc.departmentN/A/Departmenten_US
dc.description.abstractBackground: Antiarrhythmic drugs remain the first-line therapy for treatment of idiopathic ventricular arrhythmias. Study Question: The aim of this study was to assess the therapeutic efficacy of extended-release metoprolol succinate (MetS) and carvedilol for idiopathic, frequent, monomorphic premature ventricular contractions (PVCs). Study Design: Study population consisted of 114 consecutive patients: 71 received MetS and 43 received carvedilol. Measures and Outcomes: All patients underwent 24-hour Holter monitoring at baseline and during drug therapy. PVC-burden response to drug therapy was categorized as good (>= 80% reduction), poor (either <80% reduction or <= 50% increase), and proarrhythmic responses (>50% increase) based on change in PVC burden compared with baseline. Results: Most common presenting symptom was palpitations (65.8%), followed by coincidental discovery (29%). The mean MetS and carvedilol dosages were 65.57 +/- 30.67 mg/d and 23.66 +/- 4.26 mg/d, respectively. Good, poor, and proarrhythmic responses were observed in 11.3% and 16.3%, 63.4% and 67.4%, and 25.3% and 16.3% of patients treated with MetS and carvedilol, respectively. In patients with relatively high (>= 16%) PVC burden, the sum of poor/proarrhythmic response was observed in 95.5% and 86.4% of patients treated with MetS and carvedilol, respectively. Proarrhythmic response was observed in 21.9% of the patients, particularly in the presence of relatively lower (<= 10%) baseline PVC burden. Patients with good response during beta-blocker therapy had higher baseline daily average intrinsic total heart beats compared with patients with poor/proarrhythmic response combined (96,437 +/- 26,488 vs. 86,635 +/- 15,028, P = 0.047, respectively). Side effects and intolerance were observed in 5.6% and 18.6% of patients treated with MetS and carvedilol, respectively. Conclusions: MetS and carvedilol for idiopathic, frequent, monomorphic PVCs are frequently inefficient. Therapeutic efficacy decreases further in patients with relatively high (>= 16%) PVC burden. Relatively higher baseline daily intrinsic total heart beats may be used to predict good response before beta-blocker therapy.en_US
dc.identifier.doi10.1097/MJT.0000000000001372
dc.identifier.endpageE42en_US
dc.identifier.issn1075-2765
dc.identifier.issn1536-3686
dc.identifier.issue1en_US
dc.identifier.pmid33883430en_US
dc.identifier.scopus2-s2.0-85123222136en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE34en_US
dc.identifier.urihttps://doi.org/10.1097/MJT.0000000000001372
dc.identifier.urihttps://hdl.handle.net/11454/77402
dc.identifier.volume29en_US
dc.identifier.wosWOS:000739921700004en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofAmerican Journal of Therapeuticsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectpremature ventricular contractionen_US
dc.subjectidiopathic ventricular arrhythmiaen_US
dc.subjectantiarrhythmic drugsen_US
dc.subjectmetoprolol succinateen_US
dc.subjectcarvedilolen_US
dc.subjectproarrhythmiaen_US
dc.subjectOutflow Tracten_US
dc.subjectTachycardiaen_US
dc.subjectSuppressionen_US
dc.subjectManagementen_US
dc.titleTherapeutic Inefficacy and Proarrhythmic Nature of Metoprolol Succinate and Carvedilol Therapy in Patients With Idiopathic, Frequent, Monomorphic Premature Ventricular Contractionsen_US
dc.typeArticleen_US

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