The use of atenolol in the prevention of supraventricular arrhythmias following coronary artery surgery

Sixty patients undergoing coronary artery bypass surgery were studied prospectively in order to investigate the effect of a cardioselective beta-blocker on the incidence of postoperative supraventricular arrhythmias. Patients with good left ventricular function were randomly divided into two groups: 30 patients treated with atenolol and 30 patients acting as controls. Atrial fibrillation was seen in 11 patients and frequent premature atrial extrasystoles were noted in one. Eleven (37%) patients in the control group experienced arrhythmias whilst atenolol significantly reduced this incidence to 3% (one patient), P = 0.001. There was no significant relationship between the development of supraventricular arrhythmias and the following variables: age, sex, severity of preoperative symptoms, previous myocardial infarction, extent of coronary artery disease, technique of myocardial preservation used, ischaemic time, number and site of saphenous vein grafts, endarterectomies performed and perioperative serum potassium levels. It is concluded that the use of atenolol (started 72 h before operation) is effective in reducing the incidence of supraventricular arrhythmias following elective coronary artery bypass operations in patients with good left ventricular function.