Comparative efficacy and usefulness of acebutolol and diltiazem for the prevention of atrial fibrillation during perioperative time in patients undergoing pulmonary resection.
BACKGROUND
Postthoracic surgery atrial fibrillation (AF) is the most frequently occurring arrhythmia. Strategies for preventing AF have been amply evaluated, but currently there are no clearly defined guidelines for treatment of AF after thoracic surgery.


METHODS
The study was prospective and randomized controlled trial. Acebutolol and diltiazem versus placebo were compared, among 117 patients postpneumonectomy or lobectomy at the Thoracosurgery Clinic, Poznan University of Medical Sciences in Poland. Patients who were enrolled in the study were randomly assigned to one of the three groups: those who received acebutolol (Group 1) or diltiazem (Group 2) and compared with patients without antiarrhythmic drugs (Group 0). Each group consisted of 39 patients. The patients were continuously monitored postoperatively with 24 ECG (Holter monitor) in the intensive care unit.


RESULTS
In patients receiving acebutolol AF occurred in 5% compared with 23% of patients receiving diltiazem and 20% of patients receiving placebo (difference not statistically significant).


CONCLUSIONS
Acebutolol and diltiazem appear to have been non-effective for the treatment or prevention of AF. Side effects were mild. In comparison to diltiazem, however, acebutolol had a beneficial effect on the circulatory system. Patients who had received acebutolol proved to have had fewer tachycardia episodes and supraventricular ectopy during the postoperative period. It seems that acebutolol can be useful, especially in patients with sympathetic activity dominance.
Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Poznan, Poland. cichypecet@gmail.com
Pawel
P
Ciszewski
Joanna
J
Tyczka
Jacek
J
Nadolski
Magdalena
M
Roszak
Wojciech
W
Dyszkiewicz
D000070:Acebutolol / Q000009:adverse effects / Q000627:therapeutic use*; D058671:Adrenergic beta-1 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004110:Diltiazem / Q000009:adverse effects / Q000627:therapeutic use*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011044:Poland; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D058671:Adrenergic beta-1 Receptor Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D000070:Acebutolol; D004110:Diltiazem