What is the clinical and cost effectiveness of beta-blockers in the management of chronic heart failure in people with heart failure with reduced ejection fraction (HFREF) and atrial fibrillation?
A search was conducted for randomised trials comparing the effectiveness of beta-blockers versus placebo in addition to usual care in people with chronic heart failure and atrial fibrillation. One study Chronic Heart Failure Beta-blockers in heart failure and concomitant atrial fibrillation NICE 2018 was identified. The study examined the role of beta-blockers in a specific sub-population of HREF patients who also have atrial fibrillation (AF). It examined the outcomes of all-cause mortality, health-related quality of life, unplanned hospitalisation, other adverse events (stroke, bradycardia, hypotension) and improvement of NYHA class. The results of the study failed to demonstrate the same mortality benefit of beta-blockers as had previously been seen in the overall HFREF population.