Continued Propranolol Administration Following Coronary Bypass Surgery

Abel, Ronald M.; Gelder, Hugh M. van; Pores, Ira H.; J, Liguori; Gielchinsky, Isaac; Parsonnet, Victor

doi:10.1001/archsurg.1983.01390060045010

Cited by 54 publications

(20 citation statements)

References 35 publications

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“…The efficacy and safety of intravenous propranolol 18 and intravenous timolol 19 have been studied earlier in the prevention of AF after cardiac surgery. These studies concluded that both ␤-blockers were effective in AF prophylaxis when compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

“…However, a trend toward more frequent adverse effects in the propranolol treatment group was reported. 18 The feasibility of atrial pacing, oral or intravenous amiodarone and magnesium supplementation have also been studied in the prevention of AF after cardiac surgery. There are conflicting results concerning the efficacy of atrial pacing in the prevention of postoperative AF.…”

Section: Discussionmentioning

confidence: 99%

“…Because adverse effects associated with intravenous ␤-blocker therapy have been reported after cardiac surgery, 17,18 we excluded all patients at risk for development of complications associated with intravenous metoprolol therapy. For example, we excluded 11 patients because the functioning of a temporary pacemaker was not reliable at the time of randomization.…”

Section: Halonen Et Al Atrial Fibrillation After Cardiac Surgery I-3mentioning

confidence: 99%

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Intravenous Administration of Metoprolol Is More Effective Than Oral Administration in the Prevention of Atrial Fibrillation After Cardiac Surgery

et al. 2006

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Background-Atrial fibrillation (AF) is the most common arrhythmia to occur after cardiac surgery, with an incidence of 20% to 40%. AF is associated with postoperative complications, including increased risk of stroke and need of additional treatment, as well as prolonged hospital stay and increased costs. It has been shown that prophylactic oral administration of ␤-blocker therapy reduces the incidence of postoperative AF after cardiac surgery. However, it is possible that absorption of drugs is impaired after cardiopulmonary perfusion associated with cardiac surgery. The purpose of this prospective, controlled, randomized trial was to study compare intravenous and per oral metoprolol administration in the prevention of AF after cardiac surgery. Methods and Results-240 consecutive patients who were scheduled to undergo their first on-pump coronary artery bypass graft (CABG), aortic valve replacement, or combined aortic valve replacement and CABG were randomized to receive 48-hour infusion of metoprolol or oral metoprolol starting on the first postoperative morning. Patients were excluded if they had contraindications for ␤-blocker or had to stay Ͼ1 day in the intensive care unit. Dosage of metoprolol was adjusted according to heart rate. The dosage was 1 to 3 mg/h in the intravenous group and from 25 mg twice per day to 50 mg 3 times per day in the oral group. The incidence of postoperative AF was significantly lower in the intravenous group than in the oral group (16.8% versus 28.1%, Pϭ0.036). No serious adverse effects were associated with intravenous metoprolol therapy. Conclusions-Our study suggests that intravenous metoprolol is well-tolerated and more effective than oral metoprolol in the prevention of AF after cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Halonen Et Al Atrial Fibrillation After Cardiac Surgery I-3mentioning

confidence: 99%

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Intravenous Administration of Metoprolol Is More Effective Than Oral Administration in the Prevention of Atrial Fibrillation After Cardiac Surgery

et al. 2006

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“…11,24,25 In trials published after 1995, the proportion of patients undergoing ␤-blocker therapy preoperatively was 61% to 80%. 12,13,33 The timing of initiation of study treatment varied between the trials, starting before, 9,10,18,19,25,38,39,41,43,45,48,49 during, 44 or after 6,11-17,20 -24,26 surgery. In 2 trials, 16,31 the intervention drug was administered at the end of ICU stay.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery

et al. 2002

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Background-Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery and has been associated with increased incidence of other complications and increased hospital length of stay (LOS). Prevention of AF is a reasonable clinical goal, and, consequently, many randomized trials have evaluated the effectiveness of pharmacological and nonpharmacological interventions for prevention of AF. To better understand the role of various prophylactic therapies against postoperative AF, a systematic review of evidence from randomized trials was performed. Methods and Results-Fifty-two randomized trials (controlled by placebo or routine treatment) of ␤-blockers, sotalol, amiodarone, or pacing were identified by systematic literature search.

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“…Investigations also suggest that continuation of chronic HR control medications in the immediate postoperative period may decrease the risk of arrhythmias. 13,18,19 Affirming the relative similarity of groups with respect to baseline characteristics and medical therapy increases the probability that primary end point achievement resulted from administration of diltiazem.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Metoprolol Versus Diltiazem for Rate Control in Noncardiac, Nonthoracic Postoperative Atrial Fibrillation

et al. 2014

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Continued Propranolol Administration Following Coronary Bypass Surgery

Cited by 54 publications

References 35 publications

Intravenous Administration of Metoprolol Is More Effective Than Oral Administration in the Prevention of Atrial Fibrillation After Cardiac Surgery

Intravenous Administration of Metoprolol Is More Effective Than Oral Administration in the Prevention of Atrial Fibrillation After Cardiac Surgery

Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery

Intravenous Metoprolol Versus Diltiazem for Rate Control in Noncardiac, Nonthoracic Postoperative Atrial Fibrillation

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