Yasui Taku, Oka Toru, Shioyama Wataru, Oboshi Makiko, Fujita Masashi
Department of Onco-Cardiology, Osaka International Cancer Institute, Osaka, Japan.
SAGE Open Med. 2020 Feb 20;8:2050312120907817. doi: 10.1177/2050312120907817. eCollection 2020.
Atrial fibrillation after surgery is associated with increased rates of heart failure and ischemic stroke, and extension of hospitalization. Bisoprolol is a β-blocker used to reduce heart rate and manage arrhythmias during atrial fibrillation. However, the safety and efficacy of bisoprolol transdermal patch treatment in patients with postoperative atrial fibrillation remain unclear.
We retrospectively assessed the electronic health records of our hospital between September 2013 and July 2018 and identified patients with postoperative atrial fibrillation who had been treated with a bisoprolol transdermal patch. We excluded patients with sinus rhythm using bisoprolol transdermal patch to prevent atrial fibrillation recurrence and those with sustained atrial fibrillation before surgery. Data on heart rhythm, heart rate, and blood pressure at the baseline and after 24 h of treatment were obtained from the electronic health records.
Of the 603 patients treated with the bisoprolol transdermal patch, 61 patients with postoperative atrial fibrillation after noncardiac surgery were included. The bisoprolol transdermal patch was discontinued due to bradycardia in two patients (3.3%). In both cases, the heart rate increased after the removal of the bisoprolol transdermal patch and no additional treatment was necessary. Among the 61 patients, sinus rhythm was restored within 24 h of bisoprolol treatment in 47 patients (77.0%). The heart rate significantly decreased from 124.8 ± 26.3 bpm at the baseline to 78.9 ± 16.6 bpm at 24 h after treatment ( < 0.001). There were no significant differences in the systolic and diastolic blood pressures between patients before and at 24 h after treatment.
The results of this study indicate that the bisoprolol transdermal patch is well tolerated and effective in patients with atrial fibrillation after noncardiac surgery.
术后房颤与心力衰竭、缺血性卒中发生率增加以及住院时间延长相关。比索洛尔是一种β受体阻滞剂，用于降低房颤时的心率并控制心律失常。然而，比索洛尔透皮贴剂治疗术后房颤患者的安全性和有效性仍不明确。
我们回顾性评估了2013年9月至2018年7月我院的电子健康记录，确定接受比索洛尔透皮贴剂治疗的术后房颤患者。我们排除了使用比索洛尔透皮贴剂预防房颤复发的窦性心律患者以及术前持续性房颤患者。从电子健康记录中获取基线及治疗24小时后的心律、心率和血压数据。
在603例接受比索洛尔透皮贴剂治疗的患者中，纳入了61例非心脏手术后发生术后房颤的患者。2例患者（3.3%）因心动过缓停用比索洛尔透皮贴剂。在这两例中，去除比索洛尔透皮贴剂后心率增加，无需额外治疗。在61例患者中，47例（77.0%）在比索洛尔治疗24小时内恢复窦性心律。心率从基线时的124.8±26.3次/分显著降至治疗后24小时的78.9±16.6次/分（<0.001）。治疗前和治疗后24小时患者的收缩压和舒张压无显著差异。
本研究结果表明，比索洛尔透皮贴剂在非心脏手术后房颤患者中耐受性良好且有效。
