Postoperative Antiarrhythmic Effects of Diltiazem in Patients Undergoing Coronary Bypass Grafting

Abstract

Hemodynamic problems resulting from cardiac arrhythmias often occur in patients undergoing coronary bypass grafting in the early postoperative period. Therefore, in this study the antiarrhythmic effects of the calcium channel antagonist diltiazem were evaluated in coronary bypass grafting. Forty patients were randomly assigned either to a therapy with diltiazem or nitroglycerin. Hemodynamic measurements were established by Swan-Ganz catheter, and long-term ECG analyses were performed preoperatively and 1, 3 and 5 days after operation. There were significantly fewer ventricular arrhythmias (Lown class IV) in the diltiazem groups than in the nitroglycerin groups (p < 0.05). Supraventricular tachycardias were significantly more often observed in the nitroglycerin groups on all 3 days (p < 0.05). As a result, the calcium channel antagonist diltiazem is recommended as a standard adjunct to perioperative medication in cardiac surgery.

Prevention of Atrial Fibrillation After Cardiac Surgery: A Review of Literature and Comparison of Different Treatment Modalities

“…101 Intravenous diltiazem has been compared with intravenous nitrate in the prevention of AF in 4 different studies. 104–107 In these studies, diltiazem turned out to be more effective than nitrates. On the other hand, no placebo-controlled trials with diltiazem have been carried out.…”