Clinical efficacy of beta1 selective adrenergic blockers in the treatment of neurocardiogenic syncope – a meta-analysis

Abstract

BackgroundBeta1 (B1) selective blockers have been widely used for the treatment of neurocardiogenic syncope though clinical trials have shown conflicting degrees of efficacy.ObjectiveTo study the clinical efficacy of B1 selective blockers compared to placebo in the treatment of neurocardiogenic syncope.MethodsFour placebo controlled randomized studies were identified after search of existing English language literature. Review Manager (RevMan version 5, Oxford, England) was used for statistical calculations. Both random and fixed effects models were used for analysis.ResultsThere was no demonstrable efficacy of B1 blockers compared to placebo even after a pre-specified sensitivity analysis. There was a trend towards more adverse events in the beta blocker group compared to placebo (OR = 2.03 CI = 0.83–3.95, p = 0.12).ConclusionThere is no clinical evidence for justifying the use of B1 selective blockers in the treatment of adult neurocardiogenic syncope. These agents may in fact lead to a higher rate of adverse events compared to placebo.