Reducing the risk of sudden death in heart failure with β-blockers

Background: Heart failure (HE) is a serious cardiovascular syndrome that affects nearly 5 million people in the United States. A review of clinical data demonstrates that sudden cardiac death (SCD) accounts for approximately one-third of all HE deaths. This fatal outcome typically involves an unexpected electrical event leading to sustained cardiac arrhythmias resulting in cardiovascular collapse. Methods and Results: A systematic review of the literature was performed to serve as the basis for this review. Factors contributing directly to incidence of SCD in the HE population may include significant remodeling of the left ventricle (hypertrophy, dilation, and fibrosis) in addition to increased sympathetic activation. Using specific therapies to limit these mechanisms are beneficial in the HF patient by preventing SCD. beta-blockers play a key role in the prevention of SCD for patients with HF by limiting the effects of circulating norepinephrine and by reducing left ventricular remodeling. Conclusions: This review outlines the potential mechanisms and contributing factors of SCD in patients with HE and the impact of beta-blocker usage in the prevention of this fatal outcome for this growing patient population.