[Beta-blocker therapy in the management of malignant ventricular arrhythmia in patients with acute myocardial infarction].
OBJECTIVE
To evaluate the clinical effectiveness of beta-blocker therapy on malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI).


METHODS
Beta-blockers, atenolol or betaloc, were given at the doses of 3.125 to 12.500 mg twice or 3 times a day (Bid or Tid) for management of malignant ventricular arrhythmia in 6 patients with AMI on the basis of conventional therapy. Increasing dosage of 25 to 50 mg was later initiated according to the patients' condition. In 2 cases that failed to respond to conventional antiarrhythmic, esmolol was administered via intravenous injection (5-10 mg) to control malignant ventricular arrhythmia within approximately 30 min, followed by a 2-day course of intravenous infusion at the rate of 1 to 2 mg/min.


RESULTS
Five AMI patients survived while death occurred in 1 case due to heart failure. No deterioration of the cardiac function or proarrhythmic effect was observed in the 5 survival cases, but the occurrence of transient hypotension in 2 cases in the early stage of beta-blocker application and death due to cardioc insufficiency in one.


CONCLUSIONS
Adequate use of beta-blockers is necessary in the early stage of AMI for effective control of malignant ventricular arrhythmia and lowering the mortality.
Ma
Hui-li
HL
Department of Cardiology, Affiliated Zhongshan Hospital of Fudan University, Shanghai 200032, China. MHLLLZ@sina.com
Fang
Ye-min
YM
Ma
Yong-li
YL
Feng
Jun
J
Wang
Ke-qiang
KQ
Ge
Jun-bo
JB
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*
D000319:Adrenergic beta-Antagonists