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Prophylaxis of atrial fibrillation in the immediate postoperative period of coronary artery surgery: comparison between propranolol and sotalol used in low doses

OBJECTIVE: To compare the efficacy of two therapeutical protocols using low doses of betablockers for prevention of atrial fibrillation in the immediate postoperative period of coronary artery bypass surgery (CABS). METHODS: 154 patients, submitted to coronary artery bypass surgery, were randomised into two groups: Group I (n = 72) received Sotalol (80 mg/daily) and group II (n = 82) received Propranolol (40 mg/daily), both starting in the first postoperative day. Patients were observed by continuous electrocardiographic bedside monitoring in the intensive care unit. Additionally, standard 12-lead electrocardiograms were made preoperatively, on 1st, 3rd and 6th postoperative days and in patients with complaints of palpitations or whenever signs of arrythmias appeared (i.,e., irregular pulse or a pulse rate exceeding 100 beats/min). RESULTS: Atrial fibrillation was documented in 3 (4.2%) patients of group I (Sotalol) and in 8 (9.8%) of group II (Propranolol). CONCLUSION: The overall incidence of atrial fibrillation in patients receiving low doses of Sotalol and Propranolol after CABS was low (7.1%) and, although not statistically significant (p = 0.221), it was even lower (4.2%) in patients receiving Sotalol.

Myocardial revascularization; Atrial fibrillation; Sotalol; Propranolol


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