Electrophysiological properties of intravenous metoprolol in man.

Rizzon, Paolo; Chiddo, A; Mastrangelo, Dominique; Sorgente, L

doi:10.1136/hrt.40.6.650

Cited by 33 publications

(19 citation statements)

References 11 publications

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“…The depressant effect of P-adrenoceptor blockade at the level of the sinus node, as indicated by heart rate, sino-atrial conduction time, sinus node recovery time and corrected sinus node recovery time, seems to be most pronounced with atenolol (di Biase etal., 1977;Robinson etal., 1978;Seipel etal., 1977). However, a prolongation of the sinus node recovery times was not observed with pindolol (di Biase et al, 1977a), oxprenolol (di Biase et al, 1977b, metoprolol (Rizzon et al, 1978), tolamolol (Alboni et al, 1977), acebutolol (Mason et al, 1978) or penbutolol (von Leitner & Biamino, 1980). A prolongation of the sino-atrial conduction times was also found with metoprolol (Rizzon et al, 1978) and acebutolol, whereas this parameter was not changed by propranolol (Seipel et al, 1977), oxprenolol (di Biase et al, 1977b and pindolol (di Biase et al, 1977a).…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological effects of cardioselective and non‐cardioselective beta‐adrenoceptor blockers with and without ISA at rest and during exercise.

Hombach¹,

Braun²,

Höpp³

et al. 1982

Brit J Clinical Pharma

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1 In 46 patients (16 female and 30 male), aged between 18 and 73 years the effect of acute P-adrenoceptor blockade with i.v. pindolol, acebutolol and atenolol has been studied at rest and during ergometric exercise, during routine intracardiac His bundle investigations. 2 At rest the functional parameters of the sinus node were impaired most markedly by atenolol. A-V nodal conduction was more depressed with acebutolol and atenolol than with pindolol. The His-Purkinje system conduction remained unaffected by all three 3-adrenoceptor blocking agents.3 During ergometric exercise the depressant action of P-adrenoceptor blockade on sinus nodal function with lower heart rates and on A-V nodal conduction with slower conduction velocities was equieffective with pindolol, acebutolol and atenolol. His-Purkinje system conduction again remained unchanged with one exception that after administration of pindolol, conduction rate during exercise was faster than before P-adrenoceptor blockade.

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Section: Discussionmentioning

confidence: 99%

Electrophysiological effects of cardioselective and non‐cardioselective beta‐adrenoceptor blockers with and without ISA at rest and during exercise.

Hombach¹,

Braun²,

Höpp³

et al. 1982

Brit J Clinical Pharma

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“…Propranolol, the most studied and most widely employed drug, increases the basic sinus cycle length, and the atrioventricular intranodal conduction time, lowers the artificial atrial rate of the Wenckebach point, and has no effect on the His-Purkinje system. The majority of beta blockers used in humans have similar effects (DiBiase er al., 1977a,b, 1978Mason et al, 1978;Nathan et al, 1982;Rizzon et al, 1978;Ruskin et al, 1975), which explains the antiarrhythmic effects of these drugs.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, many of them were studied (DiBiase et ul., 1977a(DiBiase et ul., ,b, 1978Mason et al, 1978;Nathan et ul., 1982;Rizzon et al, 1978;Ruskin et ul., 1975) and it was confirmed that they have actions that are comparable to propranolol (Seides et al, 1974), which is in wide use in several countries. However, some of them have side effects that limit their use.…”

Section: Introductionmentioning

confidence: 99%

Effects of atenolol in patients with reciprocating supraventricular tachycardia

Pimenta

Pereira

1986

Clinical Cardiology

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Summary:We studied 12 patients with crisis of paroxysmal reciprocating supraventricular tachycardia before and after intravenous injection of 5 mg of atenolol. The patients were then followed for periods ranging from 6 to 50 months (median 34 months). During this time, they received oral atenolol therapy, at 200 mg for the first two weeks, and 100 mg daily thereafter. Tachycardia was due to reciprocation within the atrioventricular node in 9 patients, and to pre-excitation in 3 patients. Atenolol slowed the sinus rate, prolonged the atrioventricular conduction time, and increased the atrial cycle length at which atrioventricular nodal Wenckebach phenomenon occurred. During the tachycardia, atenolol increased the tachycardia cycle length, due to prolongation of the intranodal atrioventricular conduction time. Of the 11 patients who were observed for the full period, 7 had no further episodes of arrhythmia. One patient (with left-sided pre-excitation) failed to respond to any antiarrhythmic medication, one patient remained free of symptoms for two years, but received an atrial pacemaker for control of the tachycardia at the end of this period. Two patients (one with dual atrioventricular nodal pathways, and one with concealed leftsided pre-excitation) await other treatment for their tachycardia, after remaining free of symptoms for one and two years, respectively. These findings suggest that atenolol is an effective beta blocker for use in controlling arrhythmias in patients with reciprocating supraventricular tachycardia, for use in once daily dosage, and is a medication largely free of side effects.

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“…Several studies have indicated that different betablockers delay impulse propagation via the normal atrioventricular conduction pathway (3,4,12). Electrophysiological studies reveal an increased sino-atrial conduction time, depressed intranodal conduction and prolongation of the refractory period of the A V node after metoprolol (11).…”

Section: A Khalsa Et Al: Metoprolol and Digitalis In Atrial Fibrillamentioning

confidence: 99%

“…50 mg of metoprolol was administered immediately after the control measurement and another 50 mg after the 30 min recording. ECGs were recorded at 1/2 hourly interval at a work load of 40 W for 4 min during a period of 3 h. Metoprolol slows atrioventricular conduction not only during sinus rhythm (11), but also during atrial fibrillation (13). Several studies have indicated that different betablockers delay impulse propagation via the normal atrioventricular conduction pathway (3,4,12).…”

Section: A Khalsa Et Al: Metoprolol and Digitalis In Atrial Fibrillamentioning

confidence: 99%

Effects of metoprolol on heart rate in patients with digitalis treated chronic atrial fibrillation

Khalsa

Edvardsson

Olsson

1978

Clinical Cardiology

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Summary: Adequate control of ventricular rate in patients with chronic atrial fibrillation (AF) may not be achieved with digitalis alone. In the present study the additional effect of two different doses (50 mg and 50 + 50 mg) of oral metoprolol, a new selective p-blocking agent, on ventricular rate in patients with longstanding AF has been studied. A decrease in the mean ventricular rate during rest and during exercise at various work loads was observed after both doses. The effect was more pronounced at the highest work load of 80 W, both after 50 mg (p < 0.002) and after 50 + 50 mg (p < 0.01) of the drug. A high initial heart rate at rest or during exercise was reduced more by the drug than a lower one. Exercise tolerance was reduced in 2 patients. These results suggest that patients with AF in whom satisfactory control of heart rate cannot be achieved with digitalis alone may benefit from addition of individualized metoprolol therapy. Keywords: atrial fibrillation, digitalis, metoprolol, heart rateThe various symptoms of cardiac disability in cases of atrial fibrillation are partly caused by the rapid ventricular response. When atrial fibrillation is associated with a high heart rate the classic therapeutic approach has been to The study has been supported with grants from The Swedish National Association against Heart & Cheast Diseases. administer increasing doses of digitalis to slow the ventricular rate to an acceptable level by its blocking effect at the atrioventricular (AV) node. "Therapeutic" plasma levels of digitalis are in many instances insufficient to evoke an adequate AV blocking effect (6). In many cases "toxic" blood levels of digitalis may be required and quite often even these are inadequate to control the ventricular rate (5,6).Patients in atrial fibrillation with an inadequate digitalis induced decrease in A V conduction may benefit from any additional drug that is able to decrease A V conduction. In this study, we have therefore attempted to evaluate the effect of different doses of metoprolol, a beta-adrenergic blocking agent (2) upon the A V conduction in patients with atrial fibrillation who were already being treated with digitalis. Patients and MethodsTen patients (7 men and 3 women) suffering from chronic atrial fibrillation were selected for the present study. Pertinent clinical details for these patients are given in Table I. The patients were between 42 and 72 years of age, with a mean age of 57.2 years. Four patients had mitral valve disease (one of whom had been operated upon for mitral stenosis), four had lone atrial fibrillation, one thyreotoxicosis and the remaining patient had hypothyroidism. All these patients were in functional group I or II according to the classification of the New York Heart Association.The duration of atrial fibrillation ranged between 2 months and 3 years. DC conversion of the atrial fibrillation had been tried in all patients but they either did not revert to sinus rhythm or relapsed rapidly into atrial fibrillation.Cardiac volume -evaluated by the ...

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Electrophysiological properties of intravenous metoprolol in man.

Cited by 33 publications

References 11 publications

Electrophysiological effects of cardioselective and non‐cardioselective beta‐adrenoceptor blockers with and without ISA at rest and during exercise.

Electrophysiological effects of cardioselective and non‐cardioselective beta‐adrenoceptor blockers with and without ISA at rest and during exercise.

Effects of atenolol in patients with reciprocating supraventricular tachycardia

Effects of metoprolol on heart rate in patients with digitalis treated chronic atrial fibrillation

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