Using Mirabegron to Control Arrhythmia-1 (MACH-1)

Inclusion Criteria:

• In order to be eligible to participate in this study, an individual must meet all the following criteria:

  1. Provision of signed and dated informed consent form.
  2. Age > 18 years old.

  3. Documented VT on ICD.

     1. with > 2 episodes of VT per month (on average) over the past 2 months.
     2. despite guideline-recommended medical therapy (GRMT).

Exclusion Criteria:

• An individual who meets any of the following criteria will be excluded from participation in this study:

  1. Patients who are pacemaker-dependent because the pacing artifacts will complicate skin sympathetic nerve activity (SKNA) analysis.
  2. Clinically unstable (for example, acute myocardial infarction, decompensated heart failure, undergoing cancer chemotherapy, and other acute illness requiring hospitalization)
  3. Uncontrolled hypertension (systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg, or both)25
  4. Active thyrotoxicosis
  5. Any experimental medication concomitantly or within 4 weeks of participation in the study
  6. Currently participating in a different clinical trial
  7. Severe renal impairment (CrCl < 30 ml/min)
  8. Hepatic disease (Child-Pugh Class C)
  9. Pregnant
  10. Breastfeeding
  11. Cannot speak, write, and answer questions in English
  12. Does not have the capacity to consent
  13. Severe renal impairment (CrCl < 30 ml/min)
  14. Hepatic disease (Child-Pugh Class C)
  15. Pregnant
  16. Breastfeeding
  17. Cannot speak, write, and answer questions in English
  18. Does not have the capacity to consent
  19. Patients who are known to be allergic to mirabegron or skin patch electrodes
  20. Patients taking codeine, oxycodone, thioridazine, flecainide, propafenone, and digoxin. (see explanation below)