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Bouvy et al¹ recently reported a link between the use of sympathomimetic agents and arrhythmias in patients with congestive heart failure. As the authors pointed out, the pharmacologic properties of sympathomimetics and the physiologic features of arrhythmias and congestive heart failure make the link not wholly unexpected. The trial was well conducted and provides useful and needed information for weighing the benefits of treating one disease with the risks of worsening another. The attributed odds ratio of 2.2 for the occurrence of arrhythmias requiring hospitalization, however, may be a little high.

Not surprisingly, the use of sympathomimetics (albuterol and terbutaline) selected for a population with pulmonary disease. This was most evident by the fact that 48.0% of sympathomimetic users vs 4.8% of nonsympathomimetic users were prescribed inhaled or systemic corticosteroids. While corticosteroids are increasingly used for the treatment of chronic obstructive pulmonary disease, they remain a mainstay of therapy for . . . [Full Text of this Article]

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