Propranolol for Prevention of Postoperative Cardiac Arrhythmias: A Randomized Study

Stephenson, Larry W.; MacVaugh, Horace; Tomasello, Donald N.; Josephson, Mark E.

doi:10.1016/s0003-4975(10)61647-5

Cited by 109 publications

(6 citation statements)

References 13 publications

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“…The incidence of AF in hospitalized patients was reported to be 24% by Goldman 13. Smith et al14 and Stephenson et al15 reported an AF incidence rate of 10% after cardiac valve surgery and open heart surgery. The highest incidence reported was 65% by Mathew et al16 but the incidence of AF after coronary artery bypass graft surgery is much lower, ranging from 3.3% to 30% 16,17.…”

Section: Resultsmentioning

confidence: 99%

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Sabzi

Zokaei

Moloudi

2011

Clin Med Insights Cardiol

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Background:Atrial fibrillation (AF) is a frequent and serious complication of coronary artery bypass graft (CABG) surgery.Methods:We undertook a retrospective review of the records of patients undergoing CABG at Imam Ali Hospital between February 1, 2003 and February 1, 2006. The patients were divided in two groups, ie, Group A (AF) and Group B (no AF). The association between the occurrence of AF following CABG and other variables was compared with respect to continuous or categorical variables by t-test and χ2-test.Results:Multivariate logistic regression analysis of potentially predictive factors in univariate analysis showed that opium use, type of operation, and crossclamp time were predictors of AF following CABG.Conclusion:This study identifies some new predictors of postoperative AF, control of which could lead to a lower incidence of AF and reduced morbidity, mortality, and resource utilization for patients undergoing cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Sabzi

Zokaei

Moloudi

2011

Clin Med Insights Cardiol

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“…Postoperative digoxin has been recommended as an effective prophylaxis against postoperative AF in some studies (1,3,(16)(17)(18) but has been rejected in others (2). Typically, digoxin itself is highly effective at controlling cardiac frequency in rapid AF, but must be combined with a ß-blocker or Ca 2+ -channel blocker when there is a decrease in vagal tone and an increase in sympathetic activity (8).…”

Section: Discussionmentioning

confidence: 99%

Atrial Pacing May Decrease the Incidence of Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery

Cohen¹,

Jf²,

Rosengarten³

1996

MJM

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At the Montreal General Hospital in 1994, the incidence of atrial fibrillation (AF) following coronaryartery bypass graft (CABG) surgery was 30%. With the goal of reducing the incidence of thiscomplication, 20 patients (15 males and 5 females) undergoing CABG surgery were studied prospectively for the occurrence of AF following a three-day "on demand" atrial pacing at 90 beats-per-minute. The age range of the group was 39 to 79 years, with a mean age of 60 and a median age of 63. Two patients were categorized in NYHA class II, 13 in class III, and five in class IV. Of the latter five, two patients received intravenous nitroglycerin preoperatively. ß-blockers were taken pre-operatively by 13 patients, Ca2+ channel blockers by 12, and ACE inhibitors by two. Only one patient had suffered a myocardial infarction within the last year. Preoperative ejection fractions ranged from15 to 60% with a mean of 45%. In all cases, the CABG operation achieved complete revascularizationusing left internal mammary artery (LIMA) grafts in addition to saphenous vein grafts. The averagenumber of bypasses performed was 3.15. Cardiac arrest was induced using intermittent cold bloodcardioplegia, and cardiopulmonary bypass time averaged 60 minutes. Aortic occlusion time averaged36 minutes. Intraoperative inotrope use was infrequent, used intraoperatively with two cases requiringneosynephrine, one case requiring levophed, and one case requiring dobutamine. Post-pacing cardiacassessment revealed non-specific T wave abnormalities in five (25%) of patients, but no patient showedany evidence of acute myocardial infarction. In no cases did any complications related to the atrialpacing develop in the postoperative period. The results reveal that only two patients (15%) experiencedAF following, and one during, the three-day regimen of atrial pacing. Thus, this study providespreliminary evidence of a decrease in the incidence of post-CABG AF using atrial pacing.

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“…MATANGI et al (9) demonstraram uma significativa diminuição da incidência: de 23%, em pacientes não tratados, para 9,8%, em doentes que receberam propranolol. Os efeitos benéficos do uso profilático de propranolol foram igualmente demonstrados em outras publicações (2)(3)(4)6,10) . JANSSEN et al (12) também observaram redução da incidência de FA com o emprego de metropolol e, maior ainda, com o uso de sotalol.…”

Section: Comentáriosunclassified

“…A FA ocorre geralmente nos cinco primeiros dias após a cirurgia e, embora seja na maioria dos casos uma complicação benigna, pode retardar a alta hospitalar e aumentar o risco de fenômenos tromboembólicos. Por isso, vários grupos têm procurado determinar o valor do uso profilático de betabloqueadores visando à redução da incidência dessa complicação (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) . Diversos esquemas terapêuticos têm sido utilizados, mas não existe ainda um consenso nem sobre qual a melhor droga, nem sua dose.…”

Section: Introductionunclassified

Profilaxia da fibrilação atrial no pós-operatório imediato de cirurgia coronária: comparação entre propranolol e sotalol utilizados em baixas doses

Wanderley¹,

Lamprea²,

Moraes³

et al. 2001

Rev Bras Cir Cardiovasc

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C A, Cavalcanti I L -Profilaxia da fibrilação atrial no pós-operatório imediato de cirurgia coronária: comparação entre propranolol e sotalol utilizados em baixas doses. RESUMO: Objetivo: Comparar a eficácia de dois protocolos terapêuticos usando baixas doses de betabloqueadores para prevenção de fibrilação atrial no pós-operatório imediato de cirurgia coronária.Métodos: 154 pacientes, submetidos à cirurgia coronária, foram randomizados em dois grupos: no grupo I (n = 72), os doentes receberam Sotalol (80 mg/dia) e, no grupo II, (n = 82) usaram Propranolol (40 mg/dia), ambos iniciados no primeiro dia de pós-operatório. Na unidade de terapia intensiva, o eletrocardiograma foi continuamente observado por monitorização à beira do leito. Adicionalmente, eletrocardiograma nas 12 derivações foi realizado no pré-operatório, nos 1º, 3º e 6º dias de pós-operatório e sempre que os pacientes apresentaram queixas de palpitações ou surgiram sinais de arritmias (pulso irregular ou freqüência cardíaca acima de 100 bpm).Resultados: Fibrilação atrial foi documentada em 3 (4,2%) pacientes do grupo I (Sotalol) e em 8 (9,8%) do grupo II (Propranolol).Conclusão: A incidência geral de fibrilação atrial em pacientes que receberam baixas doses de Sotalol e Propranolol após cirurgia coronária foi baixa (7,1%), tendo alcançado o menor valor (4,2%) no grupo de pacientes que receberam Sotalol, embora não tenha sido observada uma diferença estatisticamente significante entre os dois grupos (p= 0,221). DESCRITORES: Revascularização miocárdica, efeitos adversos. Fibrilação atrial, prevenção & controle. Sotalol, uso terapêutico. Propranolol, uso terapêutico. RBCCV 44205-561 351Wanderley J F, Lamprea D, Moraes C R, Moraes F, Tenório E, Gomes C A, Cavalcanti I L -Profilaxia da fibrilação atrial no pós-operatório imediato de cirurgia coronária: comparação entre propranolol e sotalol utilizados em baixas doses. Rev Bras Cir Cardiovasc 2001; 16(4): 305-3.

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Propranolol for Prevention of Postoperative Cardiac Arrhythmias: A Randomized Study

Cited by 109 publications

References 13 publications

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Atrial Pacing May Decrease the Incidence of Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery

Profilaxia da fibrilação atrial no pós-operatório imediato de cirurgia coronária: comparação entre propranolol e sotalol utilizados em baixas doses

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