BB in VT storm

Q: In patients with electrical storm or incessant Ventricular Tachycardia, along with amiodarone which beta-blocker is preferred? 

A) Metoprolol 
B) Propranolol 


 Answer: B 

 Beta-blockers reduce the adrenergic surge associated with ventricular tachyarrhythmias (VT-storm) and due to defibrillator shocks. Propranolol which is a nonselective beta-blocker is found to be more effective than beta-1 selective metoprolol. Propranolol is found to terminate VT significantly earlier than metoprolol. Also, it may decrease the incidences of implantable cardioverter-defibrillator (ICD) shocks.

#cardiology


References:

1. Gorenek B, Blomström Lundqvist C, Brugada Terradellas J, et al. Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. Europace 2014; 16:1655.

2. Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J 2011; 38:111.