Comparison of the efficacy and safety of esmolol, a short-acting beta blocker, with placebo in the treatment of supraventricular tachyarrhythmias. The Esmolol vs Placebo Multicenter Study Group.
The efficacy and safety of esmolol, a short-acting intravenous beta-adrenergic-blocking agent, and placebo were compared in patients with supraventricular tachyarrhythmias (heart rate greater than 120 bpm) in a multicenter, double-blind, partial-crossover study. Seventy-one patients were randomized to receive either esmolol (n = 36) or placebo (n = 35) as initial treatment. Therapeutic failures were crossed over to the other study medication. Therapeutic response was defined as greater than or equal to 20% reduction in heart rate, heart rate less than 100 bpm, or conversion to normal sinus rhythm. The therapeutic response to esmolol during the initial treatment period (72%) was similar to that obtained when esmolol was given as a second agent. The average esmolol dosage producing a therapeutic response was 97.5 micrograms/kg/min. Four patients (6%) converted to normal sinus rhythm during esmolol infusion. In the majority of patients (80%), therapeutic response was lost within 30 minutes following discontinuation of esmolol infusion, a finding indicative of rapid reversal of beta-adrenoceptor blockade. The most prevalent adverse effect during esmolol infusion was hypotension which occurred in eight patients (12%). Hypotension and associated symptoms resolved within 30 minutes after discontinuation of esmolol infusion, which is consistent with the short duration of action of esmolol (elimination half-life of 9.2 minutes).
Anderson
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Blanski
L
L
Byrd
R C
RC
Das
G
G
Engler
R
R
Laddu
A
A
Lee
R
R
Rajfer
S
S
Schroeder
J
J
Steck
J D
JD
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000188:drug therapy; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D011412:Propanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D011897:Random Allocation; D013610:Tachycardia / Q000150:complications* / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; C036604:esmolol