Antiarrhythmic mechanisms of beta blocker therapy

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19 Scopus citations


Sympathetic activity plays an important role in modulation of cardiac rhythm. Indeed, while exerting positive tropic effects in response to physiologic and pathologic stressors, β-adrenergic stimulation influences cardiac electrophysiology and can lead to disturbances of the heart rhythm and potentially lethal arrhythmias, particularly in pathological settings. For this reason, β-blockers are widely utilized clinically as antiarrhythmics. In this review, the molecular mechanisms of β-adrenergic action in the heart, the cellular and tissue level cardiac responses to β-adrenergic stimulation, and the clinical use of β-blockers as antiarrhythmic agents are reviewed. We emphasize the complex interaction between cardiomyocyte signaling, contraction, and electrophysiology occurring over multiple time- and spatial-scales during pathophysiological responses to β-adrenergic stimulation. An integrated understanding of this complex system is essential for optimizing therapies aimed at preventing arrhythmias.

Original languageEnglish (US)
Article number104274
JournalPharmacological Research
StatePublished - Aug 1 2019


  • Arrhythmia
  • Autonomic drugs
  • Beta-blockers
  • Heart failure
  • Sympathetic stimulation

ASJC Scopus subject areas

  • Pharmacology


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