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B-Adrenergic Receptor Blockers (Expert Consensus Document on)

ESC Clinical Practice Guidelines

Heart Failure: Treatment
Cardiovascular Pharmacology and Pharmacotherapy
Guidelines version available to download
Published in 2004
Reference European Heart Journal (2004) 25, 1341–1362; 10.1016/j.ehj.2004.06.002
Table of contents: Full Text (ESC Clinical Practice Guidelines)


  • Definition
  • Classification of b-blockers
  • Pharmacokinetic properties: Lipophilic drugs, Hydrophilic drugs, Balanced clearance drugs
  • Mechanism of action
  • Adverse events: Cardiovascular, Metabolic, Pulmonary, Central effects, Sexual dysfunction
  • Contraindications
  • Drug interactions
  • Dosing of b-blockers

Clinical efficacy and use

  • Acute myocardial infarction (AMI)
  • Secondary prevention after myocardial infarction
  • Non-ST-segment elevation acute coronary syndromes
  • Chronic, stable ischaemic heart disease
  • Heart failure: Heart failure and preserved systolic function, Acute heart failure
  • Arrhythmias: Sinus tachycardia, Supraventricular tachycardias, Tachycardias in WPW syndrome, Atrial flutter, Atrial fibrillation, Ventricular arrhythmias
  • Prevention of sudden cardiac death: Acute myocardial infarction, Heart failure, Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Mitral valve prolapse, Myocardial bridging, Long QT syndrome (LQTS), Catecholaminergic polymorphic ventricular tachycardia, SCD in the normal heart, Other situations


Aortic dissection

Hypertrophic cardiomyopathy

Prophylactic use in non-cardiac surgery

Vasovagal syncope

b-Blockers during pregnancy




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