In a randomized, double-blinded, placebo-con- trolled study of 52 patients with symptomatic VA and a mean PVC count of 21407 1740 beats per 24 hours, atenolol significantly decreased symptom frequency (P=0.03) and PVC count (P=0.001), whereas placebo had no effect on PVC count (P=0.78) or average heart rate (P=0.44).S8-8 A prospective randomized comparison of antiar- rhythmic medications versus catheter ablation, metoprolol or propafenone had modest efficacy to suppress RVOT VA although with a far higher rate of recurrence than catheter ablation.S8-9 2. In an RCT of 233 patients with 30 PVCs per hour, d-sotalol was shown to reduce frequent PVCs, but only racemic dl-sotalol is presently In a prospective randomized com- parison of antiarrhythmic medications versus catheter ablation, therapy with metoprolol or propafenone was shown to have modest effi- cacy when used to suppress RVOT PVCs although with a far higher rate of recurrence than catheter Nondihydropyridine calcium channel blockers reduce arrhythmias.S8-1,S8-2,S8-11,S8-12 8.1. Outflow Tract and Atrioventricular Annular VA Recommendations for Outflow Tract VA References that support the recommendations are summarized in Online Data Supplement 46. COR LOE Recommendations I B-NR In patients with symptomatic outflow tract VA in an otherwise normal heart for whom antiarrhythmic medications are ineffective, not tolerated, or not the patient s preference, catheter ablation is useful.S8.1-1 S8.1-3 I B-NR In patients with symptomatic outflow tract VT in an otherwise normal heart, a beta blocker or a calcium channel blocker is CLINICAL STATEMENTS AND GUIDELINES Recommendation-Specific Supportive Text 1. 