Digoxin and propranolol in the prophylaxis of dysrhythmias after coronary artery bypass grafting

Serious tachydysrhythmias occur in 10% to 30% of patients early after coronary artery bypass grafting (CABG). We studied the effects of digoxin and propranolol in preventing these dysrhythmias over the first week after CABG (average number of grafts, 2.7/patient). Consecutive patients (n = 179) unde...

Full description

Saved in:
Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1983-09, Vol.68 (3 Pt 2), p.II222-II225
Main Authors: Mills, S A, Poole, Jr, G V, Breyer, R H, Holliday, R H, Lavender, 2nd, S W, Blanton, K R, Hudspeth, A S, Johnston, F R, Cordell, A R
Format: Article
Language:English
Subjects:
Aged
Coronary Artery Bypass - adverse effects
Digoxin - therapeutic use
Drug Evaluation
Drug Therapy, Combination
Electrocardiography
Humans
Middle Aged
Postoperative Complications
Propranolol - therapeutic use
Random Allocation
Tachycardia - etiology
Tachycardia - prevention & control
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Serious tachydysrhythmias occur in 10% to 30% of patients early after coronary artery bypass grafting (CABG). We studied the effects of digoxin and propranolol in preventing these dysrhythmias over the first week after CABG (average number of grafts, 2.7/patient). Consecutive patients (n = 179) undergoing CABG were randomized to a drug (group 1) or a control (group 2) group. Excluded were patients given digoxin before CABG and those with ejection fractions of less than 40%, those with dysrhythmias within 18 hr after CABG, those being pacer dependent, and those with low-output syndrome after CABG. Risk factors were comparable in both groups. Electrocardiographic examination showed perioperative myocardial infarction in five patients (2.8%). Digoxin (1 mg iv given over 24 hr, then 0.25 mg/day) and propranolol (10 mg given every 6 hr) were started 6 hr after CABG. Supraventricular dysrhythmias requiring treatment occurred in 3.4% of 89 group 1 patients and in 30% of 90 group 2 patients (p less than .001); ventricular dysrhythmias occurred in 1.1% of group 1 and 8.9% of group 2 patients (p less than .01). In this study, a regimen of post-CABG digoxin and propranolol significantly reduced the incidence of supraventricular and ventricular dysrhythmias without causing adverse reactions.
ISSN:0009-7322