ReviewAmerican heart journal plus : cardiology research and practice2025
The controversies in the clinical management of β-blockers in acute heart failure induced by rapid atrial fibrillation: A narrative review.
Review in American heart journal plus : cardiology research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
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Abstract
Rapid atrial fibrillation (rapid AF) often induces or exacerbates acute heart failure (HF). However, there is controversy regarding whether β-blockers should be used to control the ventricular rate in patients during the acute HF phase. AF management guidelines generally recommend considering the addition of β-blockers when digoxin-like drugs (such as cedilanid) fail to effectively control the ventricular rate. Nevertheless, HF guidelines clearly state that β-blockers should be used with caution during the acute decompensation phase to avoid the negative inotropic effect that may exacerbate the condition. This article systematically reviews the clinical management strategies under this guideline contradiction, including: (1) Different recommendations on ventricular rate control and the use of β-blockers in domestic and international guidelines for AF and HF; (2) A pooled analysis of relevant research evidence; (3) Application strategies of β-blockers (especially short-acting agents esmolol and landiolol) in the acute phase. We focus on discussing the latest research progress and clinical application strategies of esmolol and landiolol in HF induced by rapid AF, evaluate their effectiveness and safety. Although some studies and consensus articles have focused on the management of rapid AF complicated by HF, there is currently a lack of systematic reviews on this issue. Therefore, the writing of this review has important academic value and clinical guiding significance, providing a reference for treatment decisions in this special population.
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