BACKGROUND: Prevention of postoperative arrhythmias in patients undergoing general thoracic surgery is desirable to prevent morbidity. METHODS: A randomized, double-blind, placebo controlled trial of propranolol (10 mg every 6 hours) for 5 days was undertaken in patients undergoing major thoracic operations to determine whether arrhythmias requiring treatment could be reduced. Secondary outcomes included overall arrhythmia rate, adverse events, and length of stay. Arrhythmias were assessed by 72-hour Holter monitoring. Patients with a history of heart failure, asthma, advanced heart block, preexisting arrhythmias, sensitivity to propranolol, or use of antiarrhythmic drugs were excluded. RESULTS: Using the intention-to-treat principle there was a 70% relative risk reduction from 20% to 6% in the rate of treated arrhythmias with propranolol (p = 0.071, 95% confidence interval 0.6% to 27.2%). Overall arrhythmias were common but usually benign. Adverse effects were common, although generally mild with hypotension and bradycardia being reported more often in the propranolol group. Length of stay was not different. CONCLUSIONS: There was a trend to a reduction in the risk of perioperative arrhythmias with propranolol. Moreover, propranolol was well tolerated showing a slight increase in minor adverse events.
RCT Entities:
BACKGROUND: Prevention of postoperative arrhythmias in patients undergoing general thoracic surgery is desirable to prevent morbidity. METHODS: A randomized, double-blind, placebo controlled trial of propranolol (10 mg every 6 hours) for 5 days was undertaken in patients undergoing major thoracic operations to determine whether arrhythmias requiring treatment could be reduced. Secondary outcomes included overall arrhythmia rate, adverse events, and length of stay. Arrhythmias were assessed by 72-hour Holter monitoring. Patients with a history of heart failure, asthma, advanced heart block, preexisting arrhythmias, sensitivity to propranolol, or use of antiarrhythmic drugs were excluded. RESULTS: Using the intention-to-treat principle there was a 70% relative risk reduction from 20% to 6% in the rate of treated arrhythmias with propranolol (p = 0.071, 95% confidence interval 0.6% to 27.2%). Overall arrhythmias were common but usually benign. Adverse effects were common, although generally mild with hypotension and bradycardia being reported more often in the propranolol group. Length of stay was not different. CONCLUSIONS: There was a trend to a reduction in the risk of perioperative arrhythmias with propranolol. Moreover, propranolol was well tolerated showing a slight increase in minor adverse events.
Authors: P J Devereaux; W Scott Beattie; Peter T-L Choi; Neal H Badner; Gordon H Guyatt; Juan C Villar; Claudio S Cinà; Kate Leslie; Michael J Jacka; Victor M Montori; Mohit Bhandari; Alvaro Avezum; Alexandre B Cavalcanti; Julian W Giles; Thomas Schricker; Homer Yang; Carl-Johan Jakobsen; Salim Yusuf Journal: BMJ Date: 2005-07-04
Authors: Hermann Blessberger; Sharon R Lewis; Michael W Pritchard; Lizzy J Fawcett; Hans Domanovits; Oliver Schlager; Brigitte Wildner; Juergen Kammler; Clemens Steinwender Journal: Cochrane Database Syst Rev Date: 2019-09-26
Authors: Gyorgy Frendl; Alissa C Sodickson; Mina K Chung; Albert L Waldo; Bernard J Gersh; James E Tisdale; Hugh Calkins; Sary Aranki; Tsuyoshi Kaneko; Stephen Cassivi; Sidney C Smith; Dawood Darbar; Jon O Wee; Thomas K Waddell; David Amar; Dale Adler Journal: J Thorac Cardiovasc Surg Date: 2014-06-30 Impact factor: 5.209
Authors: Florian Rader; Akshat C Pujara; Gregory Pattakos; Jeevanantham Rajeswaran; Liang Li; Laurie Castel; Mina K Chung; A Marc Gillinov; Otto Costantini; David R Van Wagoner; Eugene H Blackstone Journal: Heart Rhythm Date: 2012-10-05 Impact factor: 6.343
Authors: Hermann Blessberger; Juergen Kammler; Hans Domanovits; Oliver Schlager; Brigitte Wildner; Danyel Azar; Martin Schillinger; Franz Wiesbauer; Clemens Steinwender Journal: Cochrane Database Syst Rev Date: 2018-03-13