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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 594-600, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Supraventricular arrhythmias following coronary artery bypass. The effect of preoperative digitalis

FB Parker Jr, C Greiner-Hayes, EL Bove, MA Marvasti, LW Johnson and RH Eich

Supraventricular arrhythmias continue to complicate the postoperative course of patients undergoing myocardial revascularization. In a previous study, we showed a decrease in arrhythmias if patients were given digitalis prior to operation. Since that time we have made two changes-- propranolol is no longer discontinued prior to operation and cold hyperkalemic cardioplegic solution is routinely used. To assess the affect of these changes on arrhythmias, we repeated the previous study. One hundred twenty patients all receiving preoperative and postoperative propranolol were randomized into a control group and a digitalis-treated group. The incidence of supraventricular arrhythmia postoperatively was 21.4% in the control group and 3.1% in the digitalis group (p less than 0.005). Therefore, we continue to advise preoperative digitalization in patients requiring coronary artery bypass and continue to maintain beta blocker and digitalis therapy in the postoperative period.

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