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ALPRENOLOL AS MAINTENANCE THERAPY FOR THE PROTECTION AGAINST ARRHYTHMIA RELAPSE IN PATIENTS WITH DC‐CONVERTED CHRONIC ATRIAL FIBRILLATION
Author(s) -
Rydén L.,
Nyberg G.,
Saetre H.,
Karlsson L.,
Lindén L.,
Sjöholm J.,
Sundquist O.
Publication year - 1972
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1972.tb00009.x
Subject(s) - alprenolol , medicine , atrial fibrillation , sinus rhythm , cardiology , propranolol , bradycardia , anesthesia , digitalis , depression (economics) , sinus (botany) , heart rate , blood pressure , heart failure , botany , biology , economics , macroeconomics , genus
There is a constant search for new drugs, free from side‐effects, to maintain sinus rhythm following DC‐conversion of atrial fibrillation. Adrenergic β ‐receptor blockers have been tried with rather disappointing results, possibly due to the relatively low dosage used. The present trial Was performed in order to evaluate the efficacy of a dose almost twice the one earlier used. By incrementing the dose, alprenolol 100 mg q.i.d. was given to 66 patients and 75 mg q.i.d. to two others. No patient converted spontaneously on alprenolol. After DC‐conversion 80% of the patients reverted to sinus rhythm. Further follow‐up showed a relapse rate of 17% after 24 hours, 65% after one month, 79% after three months, and 85% after six months. In comparison with previously reported studies, these figures are all higher than usual. Possible reasons for this are discussed. The incidence of post‐conversion arrhythmias remained low despite uninterrupted digitalis therapy. Sinus node depression following DC‐conversion, as has been reported in propranolol studies, did not occur, and in our experience it is not necessary to discontinue alprenolol prior to DC‐conversion. Ten patients who relapsed were subsequently treated with a combination of alprenolol and quinidine, but the results were disappointing. In a few cases treatment was stopped with the onset of bradycardia due to sinus node depression. Although generally, adrenergic β ‐receptor blockade appears ineffective in preventing relapse following DC‐conversion, it should be considered in selected cases where it may prove to be a valuable alternative, as illustrated by one of the treated patients.