title: 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.
abstract: 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).
authors.forename: S
authors.initials: S
authors.lastname: Anderson
authors.forename: L
authors.initials: L
authors.lastname: Blanski
authors.forename: R C
authors.initials: RC
authors.lastname: Byrd
authors.forename: G
authors.initials: G
authors.lastname: Das
authors.forename: R
authors.initials: R
authors.lastname: Engler
authors.forename: A
authors.initials: A
authors.lastname: Laddu
authors.forename: R
authors.initials: R
authors.lastname: Lee
authors.forename: S
authors.initials: S
authors.lastname: Rajfer
authors.forename: J
authors.initials: J
authors.lastname: Schroeder
authors.forename: J D
authors.initials: JD
authors.lastname: Steck
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; C036604:esmolol