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Prevention of atrial fibrillation or flutter by acebutolol after coronary bypass grafting

1986; Elsevier BV; Volume: 58; Issue: 10 Linguagem: Inglês

10.1016/s0002-9149(86)80014-5

1879-1913

Patrick Daudon, Thierry Corcos, I Gandjbakhch, J. P. Levasseur, Annik Cabol, C Cabrol,

Cardiac Arrhythmias and Treatments

Supraventricular tachyarrhythmias are common after coronary artery bypass graft surgery (CABG) and may have deleterious hemodynamic consequences. To determine if acebutolol, a cardioselective β-blocking drug, prevents such tachyarrhythmias after CABG, 100 consecutive patients, aged 30 to 77 years (mean ± standard deviation 53 ± 9), were entered into a randomized, controlled study. Exclusion criteria were: contraindications to β-blocking drugs, left ventricular aneurysm, major renal failure, history of cardiac arrhythmia and cardiac arrhythmia during the immediate postoperative period. From 36 hours after surgery until discharge (usually on the seventh day), 50 patients were given 200 mg of acebutolol (or 400 mg if weight was more than 80 kg) orally twice a day (dosage then modified to maintain a heart rate at rest between 60 and 90 beats/min). The 50 patients in the control group did not receive β-blocking drugs after CABG. The 2 groups were comparable in angina functional class, ejection fraction, number of diseased vessels, antianginal therapy before CABG, number of by-passed vessels and duration of cardiopulmonary by-pass. All patients were clinically evaluated twice daily and had continuous electrocardiographic monitoring and daily electrocardiograms. A 24-hour continuous electrocardiogram was recorded in the last 20 patients. Atrial tachyarrhythmias developed in 20 patients (40%) in the control group (17 patients had atrial fibrillation and 3 patients atrial flutter), but in none in the acebutolol group (p <0.001). This study reveals the efficacy of acebutolol in prevention of supraventricular tachyarrhythmias after CABG. Supraventricular tachyarrhythmias are common after coronary artery bypass graft surgery (CABG) and may have deleterious hemodynamic consequences. To determine if acebutolol, a cardioselective β-blocking drug, prevents such tachyarrhythmias after CABG, 100 consecutive patients, aged 30 to 77 years (mean ± standard deviation 53 ± 9), were entered into a randomized, controlled study. Exclusion criteria were: contraindications to β-blocking drugs, left ventricular aneurysm, major renal failure, history of cardiac arrhythmia and cardiac arrhythmia during the immediate postoperative period. From 36 hours after surgery until discharge (usually on the seventh day), 50 patients were given 200 mg of acebutolol (or 400 mg if weight was more than 80 kg) orally twice a day (dosage then modified to maintain a heart rate at rest between 60 and 90 beats/min). The 50 patients in the control group did not receive β-blocking drugs after CABG. The 2 groups were comparable in angina functional class, ejection fraction, number of diseased vessels, antianginal therapy before CABG, number of by-passed vessels and duration of cardiopulmonary by-pass. All patients were clinically evaluated twice daily and had continuous electrocardiographic monitoring and daily electrocardiograms. A 24-hour continuous electrocardiogram was recorded in the last 20 patients. Atrial tachyarrhythmias developed in 20 patients (40%) in the control group (17 patients had atrial fibrillation and 3 patients atrial flutter), but in none in the acebutolol group (p <0.001). This study reveals the efficacy of acebutolol in prevention of supraventricular tachyarrhythmias after CABG.