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Heart Rhythm Drugs - Class II - Beta-Blockers

Article Index
Heart Rhythm Drugs
Class I - Sodium Channel Blockers
Class II - Beta-Blockers
Class III - Potassium Channel Blockers
Class IV - Calcium Channel Blockers
Class V - Miscellaneous
Medication for Common Rhythm Problems
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Do beta blockers prevent heart rhythm problems?

Class II antiarrhythmics, beta blockers, are the only heart rhythm medications used to prevent heart rhythm problems from occurring in the first place. In people who have had a heart attack, beta blockers reduce the risk of dying, having another heart attack, or experiencing sudden cardiac death.10-14 The risk of dying is reduced by 25% to 40%, and sudden cardiac death specifically is lowered by 30% to 45%.11-14 This survival benefit continues for up to 6 years after the heart attack.10 It is not fully understood how beta blockers prevent heart rhythm problems: they may have a direct antiarrhythmic effect, or their ability to widen arteries and increase blood flow to the heart may indirectly lower the risk of certain heart rhythm disturbances, particularly ventricular tachyarrhythmia (a rapid irregular heart beat originating in the lower chambers of the heart).

You may be given beta blockers shortly after heart attack symptoms begin. These medications should not be used in some patients including those with a slow heart rate or signs of heart failure, so doctors often wait 24 to 48 hours to rule out these conditions before giving patients beta blockers.3 A combined analysis of studies involving nearly 54,000 men and women who had a heart attack found that taking beta-blockers for up to four years reduced the chances of dying by 23%.15 If you had a heart attack, you will likely continue to take beta blockers for the rest of your life.

Prescribed Class II Antiarrhythmics

Class II Antiarrhythmics – Beta Blockers
(check with manufacturer for specific information on each drug)

Generic

Atenolol / Betaxolol / Bisprolol / Carvedilol / Metoprolol / Nadolol / Propanolol / Timolol

Brand:

Tenorim / Kerlone / Zebeta / Coreg / Toprol-XL / Corgard / Inderal LA / Blocadren

Administration:

Oral

What are they used for:
  • Management of high blood pressure
  • Long-term management of angina (chest pain)
  • To reduce the risk of dying or having another heart attack in stable heart attack patients

You should not be treated with these medications:
  • If you have been diagnosed with:
  • Cardiogenic shock (the heart muscle is so damaged it cannot pump properly, causing a shock-like state)
  • Second- or third-degree heart block (the electrical signals between the upper and lower chambers of the heart are impaired)
  • Very slow heart beat ( bradycardia)
  • Heart failure
  • Asthma

Common side effects:
  • Excessive slowing of the heartbeat, fatigue, vivid dreams, depression, increased blood sugar and cholesterol levels

Pregnancy/nursing:
  • Pregnant women should not take atenolol because it can harm the fetus. The safety of the other beta blockers during pregnancy is not known
  • Women who are nursing should not use beta blockers; if the treatment is essential, then nursing should be discontinued.

 

Are beta blockers underprescribed?

Many heart attack patients who are eligible for beta blockers do not receive prescriptions,16 particularly women and the elderly.17, 18 A 1999 study of more than 15,000 patients (nearly half were women) found that among the 5,453 heart attack patients older than 66 years of age who were eligible for beta blockers, women were significantly less likely than men to be prescribed them at hospital discharge.19 More recent studies note that people who have had a heart attack are more likely to receive recommended medications, including beta blockers, than in previous years; however, the gender gap remains.20



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