Comparison of propafenone to atenolol for the prophylaxis of postcardiotomy supraventricular tachyarrhythmias: a prospective trial.
To compare the efficacy of propafenone to atenolol in the prevention of supraventricular tachyarrhythmias (SVT) following cardiac surgery, 207 consecutive patients were randomly allocated to receive either propafenone 300 mg twice daily (105 patients) or atenolol 50 mg once daily (102 patients) orally for 7 days after operation. Double blinding was achieved using placebos. The end point was the development of a SVT which was symptomatic, recurrent, or lasting over 2 minutes, or the occurrence of adverse effects possibly attributable to the drugs. The groups were well matched for age, sex, bypass- and cross-clamp times, and other data. Thirteen patients in the propafenone group and 11 in the atenolol group developed SVT during the first week after operation. (P = 0.89, non significant, chi-squared with Yates' correction). In our study propafenone and atenolol were of approximately equal efficacy in preventing post cardiotomy SVT. Propafenone may have an advantage in being less negatively inotropic than atenolol; it could therefore be used in patients with poor left ventricular function or marginal haemodynamics when a beta blocker is contraindicated.
Merrick
A F
AF
Department of Cardiothoracic Surgery, Manchester Royal Infirmary, UK.
Odom
N J
NJ
Keenan
D J
DJ
Grotte
G J
GJ
D000328:Adult; D000368:Aged; D001262:Atenolol / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011405:Propafenone / Q000008:administration & dosage* / Q000009:adverse effects; D013617:Tachycardia, Supraventricular / Q000517:prevention & control*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D001262:Atenolol; D011405:Propafenone