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Atrial fibrillation - Management
Who should not receive a beta-blocker?
- Beta-blockers are contraindicated in people with:
- A history of asthma or bronchospasm.
- Severe bradycardia.
- Second- or third-degree heart block.
- Uncontrolled heart failure.
- Severe hypotension.
- Severe peripheral vascular disease (including intermittent claudication).
- Sick sinus syndrome.
- Cardiogenic shock or phaeochromocytoma (without a concomitant alpha-blocker).
- Beta-blockers can be used in people with chronic obstructive pulmonary disease, but caution should be used if disease is severe.
Basis for recommendation
This information is taken from the manufacturers' Summary of Product Characteristics [ABPI Medicines Compendium, 2007a; ABPI Medicines Compendium, 2007e; ABPI Medicines Compendium, 2008b; ABPI Medicines Compendium, 2010].
History of asthma or bronchospasm
- The Commission on Human Medicines (formerly the Committee on Safety of Medicines) has advised that beta-blockers (including those considered to be cardioselective) should not be given to people with a history of asthma or bronchospasm [CSM, 1996; BNF 57, 2009].
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