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

Daudon, P.; Corcos, Thierry; Gandjbakhch, I; Levasseur, J. P.; Cabrol, A; Cabrol, C

doi:10.1016/s0002-9149(86)80014-5

Cited by 83 publications

(17 citation statements)

References 17 publications

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“…Atrial arrhythmias occur frequently after cardiac surgery, with an incidence as high as 25%-40% after coronary artery bypass grafting (CABG) [1]. Postoperative atrial fibrillation (AF) has been associated with a complicated postoperative course, increased incidence of stroke [2], increased length of hospital stay, increased hospital costs [3], and in hospital and long-term mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery

Açıkel

Bozbaş

Gültekin

et al. 2008

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery

Açıkel

Bozbaş

Gültekin

et al. 2008

International Journal of Cardiology

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“…That is why the ESC guidelines for the management of atrial fibrillation recommend that treatment should be started at least 1 week before surgery with a beta 1 -blocker without intrinsic sympathomimetic activity (Camm et al, 2010). The beta-blockers used in studies assessing atrial fibrillation prevention in cardiac surgery were propranolol (Matangyi et al, 1985), atenolol (Lamb et al, 1988), metoprolol (Lucio et al, 2004Kamei et al, 2006;Celik et al, 2009), acebutolol (Daudon et al, 1986), timolol (White et al, 1984), carvedilol (Kamei et al, 2006;Celik et al, 2009), betaxolol (Iliuta et al, 2009), either compared to control or to another beta-blocker.…”

Section: Discussionmentioning

confidence: 99%

Ivabradine Versus Beta-Blockers in Patients with Conduction Abnormalities or Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting

Iliuță¹,

Enache²

2012

Perioperative Considerations in Cardiac Surgery

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“…Morcover, some of the beta-blocker trials showed conflicting results (8,9,30). In one study with a high douse of sotalol, there was a marked reduction in supraventricular tachyarrhythmias (22).The present report confirms the results of Suttorp ct al (23) and extends it to an unselected group of patients showing that a low dose of sotalol is sufficient to prevent supraventricular tachyarrhythmias in a large proportion of patients.…”

Section: Incidence and Predictors Of Supraventricular Tachyarrhythmiasmentioning

confidence: 99%

“…It has been suggested that this complication could be reduced by modern cardioprotection during general anesthesia (3,4). Several antiarrhythmic drugs have been used to treat or prevent these supraventricular arrhythmias such as digoxine (6,7), beta-adrenergic blocking drugs (8)(9)(10), calcium antagonists (11), quinidine (12), propafenone (13), flecainide (14), procainamide (15), amiodarone (16,17), and magnesium (18). Whereas there are conflicting results from different studies for most of these drugs, this is not true for beta-blocking drugs.…”

mentioning

confidence: 99%

Significance of Supraventricular Tachyarrhythmias After Coronary Artery Bypass Graft Surgery and Their Prevention by Low-Dose Sotalol: A Prospective Double-Blind Randomized Placebo-Controlled Study

Weber¹,

Oßwald²,

Buser³

et al. 1998

J Cardiovasc Pharmacol Ther

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BACKGROUND: The single most frequent complication after coronary artery bypass graft surgery is the occurrence of supraventricular tachyarrhythmias leading to a prolonged hospital stay. Although several drugs have been used to treat these arrhythmias, effective prevention was only possible with beta-blocking drugs in selected patients. It was, therefore, the aim of the present study to evaluate the significance of supraventricular tachyarrhythmias in presence of today's cardioprotective management in a broad spectrum of patients and to assess the possible preventive effect and safety of low-dose sotalol after coronary artery bypass graft surgery. METHODS AND RESULTS: In a prospective randomized double-blind placebo-controlled trial, 220 consecutive patients referred for elective coronary artery bypass graft surgery were randomized to 80 mg sotalol twice daily (n = 110) or matching placebo (n = 110) for 3 months with the first dose given 2 hours before surgery. There were no significant differences in baseline characteristics between the two groups. Low-dose sotalol reduced the rate of supraventricular arrhythmias from 43% (placebo) to 25% (sotalol, P <.01), which was atrial fibrillation in 83%, flutter in 7%, and other supraventricular arrhythmias in 10%. Only 7% of all arrhythmias were observed after day 9. Hospital stay was 11 +/- 4 days in patients with supraventricular arrhythmias versus 9 +/- 2 days (P <.001) in patients without. On the fourth postoperative day, heart rate was lower in the sotalol group (75 +/- 12 versus 86 +/- 14 beats per min; P <.0001), but QTc was not significantly prolonged (sotalol, 0.44 +/- 0.03; placebo, 0.43 +/- 0.03; P, ns). Study medication had to be discontinued due to side effects in 6.4% of sotalol and 3.6% of placebo patients (P, ns), but relevant side effects occurred only in two sotalol patients late after surgery. CONCLUSIONS: These data show that without antiarrhythmic therapy the incidence of supraventricular arrhythmias after coronary artery bypass graft surgery is high (43%) and that supraventricular arrhythmias were associated with a prolonged hospital stay (+/-2 days). Prophylactic treatment with low-dose sotalol reduced the incidence of supraventricular arrhythmias significantly (by 40%), thereby reducing overall hospital stay in treated patients. Because more than 90% of all supraventricular arrhythmic episodes occurred within 10 days after surgery and considering the small proarrhythmic effect of sotalol late after surgery, prophylactic treatment with sotalol may be recommended for the first 10 postoperative days to safely reduce supraventricular tachyarrhythmias.

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

Cited by 83 publications

References 17 publications

Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery

Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery

Ivabradine Versus Beta-Blockers in Patients with Conduction Abnormalities or Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting

Significance of Supraventricular Tachyarrhythmias After Coronary Artery Bypass Graft Surgery and Their Prevention by Low-Dose Sotalol: A Prospective Double-Blind Randomized Placebo-Controlled Study

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