Comparison of the effect of nebivolol and sotalol on the functional state of patients with paroxysmal supraventricular tachycardia

Background. Paroxysmal supraventricular tachycardia (SVT) is subjectively poorly tolerated by patients and may be a predictor of a negative prognosis. The issue of optimizing its drug therapy remains relevant. Taking into account the multidirectional effects of antiarrhythmic drugs on the functional state of the body, a stepwise integrated approach to determine the effectiveness of treatment of patients with paroxysmal SVT is required. Objective. Determination of the effect of therapy with nebivolol or sotalol on the functional state of patients with paroxysmal SVT. Methods. The study involved 60 patients with paroxysmal SVT associated with stage II - III arterial hypertension (AH) and/or coronary artery disease (CAD), randomized into two groups for treatment with nebivolol (6.5±2.1 mg/day, n=30) or sotalol (164.3±46.8 mg/ day, n=30). As part of the combination therapy, lisinopril was prescribed (13.8±4.5 and 14.4±4.9 mg day), and if indicated, atorvastatin (12.9±4.3mg/day, n=14 and 14.2±4.6mg/day, n=15) andacetylsalicylicacid(95.8±14.4 mg/day, n=16and94.8±15.8mg/day, n=18), or rivaroxaban (Xarelto, Bayer, Germany) - 20 mg/day (n=2 and n=2, respectively). At baseline and 24 weeks after therapy, a quantitative assessment of the regulatory-adaptive status (RAS), echocardiography, treadmill test, 6-minute walk test, 24-hour Holter monitoring, and subjective assessment of the quality of life were performed. Results. Both schemes of combined pharmacotherapy significantly improved the structural and functional state of the heart, effectively suppressed SVT paroxysms, and improved the quality of life. At the same time, nebivolol had a positive effect on RAS and increased exercise tolerance to a greater extent. Conclusion. In patients with paroxysmal SVT associated with stage II-III arterial hypertension and/or coronary artery disease, the use of nebivolol compared to sotalol as part of a combination therapy may be preferable due to the positive effect on functional status.

functional state, paroxysmal supraventricular tachycardia, nebivolol, sotalol