Heart failure & cardiomyopathies
Effect of Carvedilol vs Metoprolol on Atrial and Ventricular Arrhythmias Among Implantable Cardioverter-Defibrillator Recipients
Pooled result · ATAResult — go to the resultHazard ratio 0.65 95% CI 0.53–0.81Authors' conclusion
These findings suggests that HF patients with ICDs on carvedilol treatment experience a significantly lower risk of ATA and inappropriate ICD shocks when compared to treatment with metoprolol.
Study context
- Population
- Heart failure (HF) patients with a primary prevention ICD (MADIT-II, MADIT-CRT, MADIT-RIT, MADIT-RISK, RAID)
- Participants
- 4,194 patients · 5 trials
- Comparison
- Carvedilol vs metoprolol
- Carvediloln = 2,920
- Metoprololn = 1,274reference
- Outcome
- Atrial tachyarrhythmia (ATA)
Methodological detailsFine and Gray multivariate regression, stratified by study
- Fine and Gray multivariate regression, stratified by study
Pooled result
ATA
Hazard ratio
0.65
95% CI 0.53–0.81
P < 0.001
By group
Carvedilol vs Metoprolol
HR 0.65 (95% CI 0.53–0.81); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Inappropriate ICD shocks | 0.65 (0.47–0.89) | P = 0.008 | |
| Fast VA (VT ≥200 beats/min or VF) · not significant | 0.84 (0.70–1.02) | P = 0.085 | |
| 0.512Hazard ratio (log scale) |
Original publication
Effect of Carvedilol vs Metoprolol on Atrial and Ventricular Arrhythmias Among Implantable Cardioverter-Defibrillator Recipients. JACC Clin Electrophysiol. Published 30 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it