Benefits of beta-blocker prophylaxis against supraventricular arrhythmias following aortocoronary bypass surgery in routine clinical practice.
OBJECTIVE
To determine the effectiveness of beta-blocker therapy for suppression of supraventricular arrhythmias (SVA) following aortocoronary bypass surgery (ACBS) in routine clinical practice.


METHODS
Prospective data collection and retrospective assessment of the occurrence of SVA following ACBS.


METHODS
Cardiovascular surgery intensive care unit and hospital patient ward with electrocardiogram (ECG) monitoring facilities.


METHODS
Ninety-two consecutive patients without contraindication to beta-blockade admitted for elective ACBS.


METHODS
Patients having persistent SVA requiring drug therapy during a minimum of four days of ECG monitoring were identified, and the use of beta-blocker therapy following ACBS was noted.


RESULTS
Persistent SVA developed in 24 of 92 patients. Beta-blockers were taken by 11 of 24 patients with SVA compared with 49 of 68 without SVA (P = 0.02). Characteristics were similar for SVA and non-SVA patients including sex, left ventricular function, number of bypass grafts, preoperation beta-blocker use and postoperation intravenous esmolol therapy. SVA occurred 48 +/- 6 h (mean +/- SD) post-ACBS lasting 47 +/- 11 h. Patients with SVA were older than those without (64 +/- 2 versus 57 +/- 1 years, P = 0.002). Hospital stay after ACBS was increased (P < 0.001) in SVA versus non-SVA patients (8.7 +/- 0.7 versus 6.5 +/- 0.1 days).


CONCLUSIONS
Oral beta-blocker prophylaxis is effective in preventing SVA after ACBS when used routinely in unselected patients. Failure to develop standardized approaches to beta-blocker therapy following ACBS may result in prolonged hospitalization.
Myers
M G
MG
Department of Medicine, Sunnybrook Health Science Centre, Toronto, Ontario.
al-Shaikh
T
T
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists