Amiodarone-metoprolol co-administration enhances heart rate variability and suppresses inflammatory cytokines in tachyarrhythmia patients.

Abstract

Objective: To elucidate the efficacy of amiodarone (AMD)-metoprolol (MET) co-administration in tachyarrhythmia patients, and to assess its impact on heart rate (HR) variability (HRV) and serum inflammatory cytokines (SICs).

Methods: This study included 188 tachyarrhythmia patients who were treated at the Qinghai Provincial Fourth People's Hospital, including 88 patients treated with AMD (control group) and 100 patients treated with AMD+MET (research group). We compared the following clinical data between groups: curative effects, frequency and duration of arrhythmia episodes, vital signs, cardiac function (left ventricular [LV] ejection fraction [LVEF], LV systolic diameter [LVSD], LV end-diastolic diameter [LVEDD]), HRV, SICs, oxidative stress (superoxide dismutase [SOD], malondialdehyde [MDA]), and side effects. In addition, we explored factors influencing patients' curative effects.

Results: A higher total effective rate was observed in the research group compared with the control group (91.00% vs. 79.55%, P=0.025). In addition, the research group experienced fewer arrhythmia episodes with shorter durations (P<0.001), and a lower incidence of total adverse events (9.00% vs. 23.86%, P=0.006). A more pronounced drop in post-treatment vital signs, LVSD, LVEDD, various SICs, and MDA (all P<0.001), as well as a rise in LVEF (P<0.001), HRV indices (P<0.001), and SOD (P=0.002), were determined in the research group. LVEF, SDNN, and LF at baseline, as well as therapeutic method, independently influenced patients' efficacy.

Conclusion: AMD in combination with MET yields superior efficacy in tachyarrhythmia patients, significantly improving HRV and suppressing SICs.