Postoperative antiarrhythmic effects of diltiazem in patients undergoing coronary bypass grafting.
Hemodynamic problems resulting from cardiac arrhythmias often occur in patients undergoing coronary bypass grafting in the early postoperative period. Therefore, in this study the antiarrhythmic effects of the calcium channel antagonist diltiazem were evaluated in coronary bypass grafting. Forty patients were randomly assigned either to a therapy with diltiazem or nitroglycerin. Hemodynamic measurements were established by Swan-Ganz catheter, and long-term ECG analyses were performed preoperatively and 1, 3 and 5 days after operation. There were significantly fewer ventricular arrhythmias (Lown class IV) in the diltiazem groups than in the nitroglycerin groups (p < 0.05). Supraventricular tachycardias were significantly more often observed in the nitroglycerin groups on all 3 days (p < 0.05). As a result, the calcium channel antagonist diltiazem is recommended as a standard adjunct to perioperative medication in cardiac surgery.
Department of Thoracic and Cardiovascular Surgery, University of Frankfurt am Main, Germany.
M
M
el-Sadek
E
E
Krause
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D004110:Diltiazem / Q000494:pharmacology / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009211:Myoglobin / Q000187:drug effects; D005996:Nitroglycerin / Q000494:pharmacology / Q000627:therapeutic use*; D011182:Postoperative Care; D011300:Preoperative Care; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D009211:Myoglobin; D004110:Diltiazem; D005996:Nitroglycerin