Turan, Oguzhan EkremAydin, MehmetOdabasi, Ahmet YenerInc, MustafaPayzin, SerdarHasdemir, Can2023-01-122023-01-1220221075-27651536-3686https://doi.org/10.1097/MJT.0000000000001372https://hdl.handle.net/11454/77402Background: 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.en10.1097/MJT.0000000000001372info:eu-repo/semantics/closedAccesspremature ventricular contractionidiopathic ventricular arrhythmiaantiarrhythmic drugsmetoprolol succinatecarvedilolproarrhythmiaOutflow TractTachycardiaSuppressionManagementArticle291E34E42WOS:0007399217000042-s2.0-8512322213633883430Q2Q2