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Ann Thorac Surg 1980;29:113-116
© 1980 The Society of Thoracic Surgeons


Articles

Propranolol for Prevention of Postoperative Cardiac Arrhythmias: A Randomized Study

Larry W. Stephenson, M.D.*, Horace MacVaugh, III, M.D., Donald N. Tomasello, M.D., Mark E. Josephson, M.D.

Division of Cardiothoracic Surgery and Cardiology, School of Medicine, University of Pennsylvania, Philadelphia, PA

Accepted for publication May 21, 1979.

* Address reprint requests to Dr. Stephenson, Hospital of the University of Pennsylvania, Silverstein 4, 3400 Spruce St, Philadelphia, PA 19104

Two hundred twenty-three patients were randomly selected to receive propranolol, 10 mg orally every 6 hours, or to serve as controls after coronary artery bypass grafting. The study began at the time of discharge from the intensive care unit. Patients were ineligible if they had cardiac arrhythmias while in the intensive care unit, low cardiac output requiring catecholamine support, or bradycardia requiring a pacemaker. In the control group, cardiac arrhythmias for which treatment was necessary developed in 31 of 136 patients (23%), atrial fibrillation or flutter in 24 patients (18%), and ventricular arrhythmias in 7 (5%). In the group receiving propranolol, cardiac arrhythmias requiring treatment developed in 9 of 87 patients (10%), atrial fibrillation or flutter in 7 (8%), and ventricular arrhythmias in 2 (2%). The difference in frequency with which cardiac arrhythmias occurred between the two groups is significantly different (p < 0.05).

We conclude that propranolol is effective in the prevention of cardiac arrhythmias following coronary artery bypass grafting.




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