Williams J B, Stephensen L W, Holford F D, Langer T, Dunkman W B, Josephson M E
Ann Thorac Surg. 1982 Oct;34(4):435-8. doi: 10.1016/s0003-4975(10)61406-3.
Sixty patients undergoing coronary artery bypass grafting operations with cold potassium cardioplegia as the method of myocardial preservation either received low-dose oral propranolol (10 mg every 6 hours; 28 patients) or served as controls (32 patients). The study period began after extubation and ended at the time of hospital discharge. On the fourth postoperative day, 24-hour Holter monitoring was performed to assess additional subtle differences in arrhythmias. The overall incidence of symptomatic postoperative arrhythmias was 31% in the control group: 6 patients (19%) had atrial fibrillation or flutter and 4 patients (12%), ventricular arrhythmias. By contrast, 1 patient (4%) in the propranolol group had atrial fibrillation, and no patient had ventricular arrhythmias. The difference in overall arrhythmia rates between the two groups is significant (p less than 0.025). Twenty-four-hour Holter monitoring demonstrated no additional differences in the frequency of simple or complex atrial or ventricular ectopy between the two groups. We conclude that the incidence of postoperative arrhythmias following coronary artery bypass operation is diminished by the oral administration of prophylactic low-dose propranolol. When compared with our previous study [1], in which the method of myocardial preservation was intermittent aortic cross-clamping and moderate hypothermia, there is no difference in the overall incidence of postoperative arrhythmias.
60例行冠状动脉搭桥手术并采用冷钾停搏液作为心肌保护方法的患者，其中一部分接受小剂量口服普萘洛尔治疗（每6小时10毫克；28例患者），另一部分作为对照组（32例患者）。研究期从拔管后开始，至出院时结束。术后第4天，进行24小时动态心电图监测以评估心律失常方面的其他细微差异。对照组术后有症状心律失常的总发生率为31%：6例患者（19%）发生房颤或房扑，4例患者（12%）发生室性心律失常。相比之下，普萘洛尔组有1例患者（4%）发生房颤，无患者发生室性心律失常。两组心律失常总发生率的差异具有显著性（p小于0.025）。24小时动态心电图监测显示两组在单纯或复杂房性或室性早搏的频率上无其他差异。我们得出结论，口服预防性小剂量普萘洛尔可降低冠状动脉搭桥手术后心律失常的发生率。与我们之前的研究[1]相比，之前的研究中心肌保护方法是间歇性主动脉阻断和中度低温，术后心律失常的总发生率无差异。
