Different beta-blockers for preventing arrhythmic events in patients with long QT syndrome: a network meta-analysis.

Dose–response analysis further showed ( Table 3 , Figure 5a ): nadolol and propranolol showed a non-significant trend of risk reduction with increasing dose (nadolol: β = −0.00783, p = 0.422, R 2 = 0.133; propranolol: β = −0.00363, p = 0.397, R 2 = 0.104); Atenolol showed a trend of risk increase with increasing dose ( β = 0.01530, p = 0.113, R 2 = 0.622), though not statistically significant; metoprolol had no obvious dose–effect relationship ( β = −0.00049, p = 0.892, R 2 = 0.005).

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For patients with LQT2 (HERG/KCNH2 channel defects) and LQT3 (SCN5A sodium channel functional gain), the overall efficacy of beta-blockers showed a decreasing trend, and the differences between drugs did not reach statistical significance.

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In a network meta-analysis of the LQT3 patient subgroup, with atenolol as the reference group (RR = 1.00), nadolol showed a numerical trend toward reduced risk (RR = 0.40, 95% CI: 0.06–2.80), but this did not reach statistical significance ( p = 0.36) ( Figures 2c , b , 3 ).

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Analysis of the efficacy of beta-blockers in patients with LQT2 In the LQT2 patient subgroup, a network meta-analysis showed that the differences in efficacy among different beta-blockers did not reach statistical significance ( Figures 2b , 3b ).

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