Beta blockade to prevent atrial dysrhythmias following coronary bypass surgery.

Autor: Paull DL; Section of Cardiothoracic Surgery, Virginia Mason Medical Center, Seattle, Washington, USA., Tidwell SL, Guyton SW, Harvey E, Woolf RA, Holmes JR, Anderson RP
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 1997 May; Vol. 173 (5), pp. 419-21.
DOI: 10.1016/S0002-9610(97)00077-9
Abstrakt: Background: Atrial fibrillation and atrial flutter (AF) frequently complicate coronary artery bypass surgery (CABG) and increase hospital stay as well as morbidity. Studies of drug prophylaxis to prevent AF with beta-adrenergic blocking agents administered in fixed doses have had conflicting results.
Methods: One hundred patients were randomized to receive metoprolol or placebo following CABG. A dosing algorithm was used to achieve clinically significant beta-adrenergic blockade.
Results: There was no significant difference between the incidence of AF in the metoprolol (24%) and placebo (26%) groups. However, the incidence of AF in all patients having CABG at this institution declined over the period of the study from 31% to 23% (P < .025), in association with the adoption of a continuous technique of cardioplegia delivery.
Conclusions: Metoprolol is not efficacious for the prevention of post-CABG AF even when dosage is titrated to achieve clinical evidence of beta blockade. It is likely that the adoption of a continuous cardioplegia technique caused a reduction in our incidence of post-CABG AF.
Databáze: MEDLINE
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