Document Detail

Presence and development of atrial fibrillation in chronic heart failure. Experiences from the MERIT-HF Study.
MedLine Citation:
PMID:  16567126     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atrial fibrillation is common in heart failure, but data regarding beta-blockade in these patients and its ability to prevent new occurrence of atrial fibrillation are scarce.
METHODS: Baseline ECGs in MERIT-HF were coded regarding baseline rhythm, and outcome was analyzed in relation to rhythm. Occurrence of atrial fibrillation during follow-up was also analyzed.
RESULTS: At baseline atrial fibrillation was diagnosed in 556 patients (13.9%). Mean metoprolol CR/XL dose in patients in atrial fibrillation (154 mg) and sinus rhythm (158 mg) was similar, as well as decrease in heart rate (14.8 and 13.7 bpm, respectively). Only 61 (total of 362) deaths occurred in those in atrial fibrillation at baseline, 31 on placebo and 30 on metoprolol (RR 1.0; 95% CI 0.61-1.65). During follow-up, new atrial fibrillation was observed in 85 patients on placebo and 47 patients on metoprolol (RR 0.53; 95% CI 0.37-0.76; p=0.0005).
CONCLUSION: First, given the wide confidence interval, it was impossible to detect an interaction between metoprolol and mortality in patients with atrial fibrillation and heart failure. Second, in patients with sinus rhythm at baseline, metoprolol reduced the incidence of atrial fibrillation during follow-up. However, we must be extremely cautious in over-interpreting effects in these subgroups.
Dirk J van Veldhuisen; Halfdan Aass; Dia El Allaf; Peter H J M Dunselman; Lars Gullestad; Matti Halinen; John Kjekshus; Lis Ohlsson; Hans Wedel; John Wikstrand;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2006-03-29
Journal Detail:
Title:  European journal of heart failure     Volume:  8     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-18     Completed Date:  2006-12-12     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  539-46     Citation Subset:  IM    
Department of Cardiology, Thoraxcenter, University Medical Center Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands.
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MeSH Terms
Adrenergic beta-Antagonists / administration & dosage*
Atrial Fibrillation / epidemiology*,  mortality,  prevention & control
Heart Failure / epidemiology*,  mortality
Metoprolol / administration & dosage,  analogs & derivatives*
Middle Aged
Prospective Studies
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/metoprolol succinate; 37350-58-6/Metoprolol

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