Sacubitril/valsartan and arrhythmic burden in patients with heart failure and reduced ejection fraction: a systematic review and meta-analysis

Pozzi, Andrew T. Del; Abete, Raffaele; Tavano, Elisa; Kristensen, Søren Lund; Rea, Federico; Iorio, Annamaria; Iacovoni, Attilio; Corrado, Giovanni; Wong, Chih M.

doi:10.1007/s10741-023-10326-1

Cited by 7 publications

(2 citation statements)

References 37 publications

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“…In a cohort of HFrEF patients with existing ICDs or CRT-Ds, the initiation of ARNI resulted in less ventricular arrhythmias and ICD interventions [ 91 ]. A recent meta-analysis of 8837 patients from four randomized and non-randomized trials of HFrEF patients showed that the ARNI was associated with a significant reduction in sustained VT, NSVT, ICD shocks and improved biventricular pacing [ 92 ]. Despite favourable prognostic outcomes with SGLT2i in HFrEF, there did not appear to be a significant effect on ventricular arrhythmias [ 93 , 94 ].…”

Section: Risk Vs Benefit Of Icdsmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Tachycardia Therapies: Past, Present and Future Directions

Leong,

Arnold,

Whinnett

2024

JCDD

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Implantable cardioverter defibrillators (ICDs) have a long history and have progressed significantly since the 1980s. They have become an essential part of the prevention of sudden cardiac death, with a proven survival benefit in selected patient groups. However, with more recent trials and with the introduction of contemporary heart failure therapy, there is a renewed interest and new questions regarding the role of a primary prevention ICD, especially in patients with heart failure of non-ischaemic aetiology. This review looks at the history and evolution of ICDs, appraises the traditional evidence for ICDs and looks at issues relating to patient selection, risk stratification, competing risk, future directions and a proposed contemporary ICD decision framework.

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Section: Risk Vs Benefit Of Icdsmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Tachycardia Therapies: Past, Present and Future Directions

Leong,

Arnold,

Whinnett

2024

JCDD

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“…Liu et al [ 61 ] found in their meta-analyses that although ARNi did not affect the incidence of VA, it did significantly reduce the risk of SCD in heart failure patients. Another meta-analysis by Pozzi et al [ 62 ] demonstrated a significant reduction in the burden of VA and ICD shock when comparing ARNi to ACEi/ARB therapy. Fernandes et al [ 63 ] reported a significant reduction in SCD, VA, and appropriate ICD therapy with ARNi.…”

Section: Angiotensin Receptor–neprilysin Inhibitormentioning

confidence: 99%

Anti-Arrhythmic Effects of Heart Failure Guideline-Directed Medical Therapy and Their Role in the Prevention of Sudden Cardiac Death: From Beta-Blockers to Sodium-Glucose Cotransporter 2 Inhibitors and Beyond

Zaher,

Della Rocca,

Pannone

et al. 2024

JCM

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Sudden cardiac death (SCD) accounts for a substantial proportion of mortality in heart failure with reduced ejection fraction (HFrEF), frequently triggered by ventricular arrhythmias (VA). This review aims to analyze the pathophysiological mechanisms underlying VA and SCD in HFrEF and evaluate the effectiveness of guideline-directed medical therapy (GDMT) in reducing SCD. Beta-blockers, angiotensin receptor–neprilysin inhibitors, and mineralocorticoid receptor antagonists have shown significant efficacy in reducing SCD risk. While angiotensin-converting enzyme inhibitors and angiotensin receptor blockers exert beneficial impacts on the renin-angiotensin-aldosterone system, their direct role in SCD prevention remains less clear. Emerging treatments like sodium-glucose cotransporter 2 inhibitors show promise but necessitate further research for conclusive evidence. The favorable outcomes of those molecules on VA are notably attributable to sympathetic nervous system modulation, structural remodeling attenuation, and ion channel stabilization. A multidimensional pharmacological approach targeting those pathophysiological mechanisms offers a complete and synergy approach to reducing SCD risk, thereby highlighting the importance of optimizing GDMT for HFrEF. The current landscape of HFrEF pharmacotherapy is evolving, with ongoing research needed to clarify the full extent of the anti-arrhythmic benefits offered by both existing and new treatments.

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Sacubitril–Valsartan Lowers Atrial Fibrillation Recurrence and Left Atrial Volume Post-catheter Ablation: Systematic Review and Meta-Analysis

de Lucena,

Freitas,

Guida

et al. 2024

Am J Cardiovasc Drugs

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Sacubitril/valsartan and arrhythmic burden in patients with heart failure and reduced ejection fraction: a systematic review and meta-analysis

Cited by 7 publications

References 37 publications

Implantable Cardioverter Defibrillator Tachycardia Therapies: Past, Present and Future Directions

Implantable Cardioverter Defibrillator Tachycardia Therapies: Past, Present and Future Directions

Anti-Arrhythmic Effects of Heart Failure Guideline-Directed Medical Therapy and Their Role in the Prevention of Sudden Cardiac Death: From Beta-Blockers to Sodium-Glucose Cotransporter 2 Inhibitors and Beyond

Sacubitril–Valsartan Lowers Atrial Fibrillation Recurrence and Left Atrial Volume Post-catheter Ablation: Systematic Review and Meta-Analysis

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