There are a series of articles suggesting that in patients without irreversible asthma such as COPD, beta-blockers can be utilized. But it may prove a challenge to sort out how much of the disease is reversible. Selective beta blockers such as metoprolol, bisoprolol and atenolol are better tolerated than non-selective beta blockers. Obviously, one has to carefully balance risk against the benefits of beta-blockers. For example, in advanced systolic dysfunction and congestive heart failure, their life-saving properties may justify use, whereas heart rate control in patients with AF can often be managed with other agents.