Postoperative treatment with carvedilol, a beta-adrenergic blocker, prevents paroxysmal atrial fibrillation after coronary artery bypass grafting.
BACKGROUND
Arrhythmias following cardiovascular surgery lead to unstable hemodynamics, along with myocardial ischemia and decreased cardiac output. The purpose of the present case cohort study compared the control group with no carvedilol administered and the other group of patients given carvedilol and determined whether postoperative treatment with carvedilol, a beta-adrenergic blocker, prevents paroxysmal atrial fibrillation after coronary artery bypass grafting (CABG).


RESULTS
Of 160 patients who underwent scheduled isolated CABG, 80 received postoperative carvedilol and 80 did not. Postoperative paroxysmal atrial fibrillation was defined as episodes of atrial fibrillation persisting for over 10 min and confirmed by 12-lead electrocardiography. The incidence of paroxysmal atrial fibrillation was significantly lower in patients given carvedilol (12/80:15%) than in those who were not (27/80:34%) (p=0.0094). Logistic regression analysis showed that only postoperative carvedilol was significantly associated with the development of postoperative atrial fibrillation (95% confidence interval, 0.169-0.832; p=0.0159).


CONCLUSIONS
Postoperative treatment with carvedilol prevented paroxysmal atrial fibrillation after CABG.
Tsuboi
Junichi
J
Department of Cardiovascular Surgery, Iwate Medical University, Memorial Heart Center, 1-2-1 Chuodori, Morioka 020-8505, Japan. j_tsuboi@imu.ncvc.go.jp
Kawazoe
Kohei
K
Izumoto
Hiroshi
H
Okabayashi
Hitoshi
H
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D016022:Case-Control Studies; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects; D023921:Coronary Stenosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011412:Propanolamines / Q000627:therapeutic use*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol