Esmolol versus diltiazem in the treatment of postoperative atrial fibrillation/atrial flutter after open heart surgery

Aryan N. Mooss, Richard L. Wurdeman, Syed M. Mohiuddin, Antonio P. Reyes, Jeffrey T. Sugimoto, Walter Scott, Daniel E. Hilleman, Ali Seyedroudbari

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Background: Supraventricular tachyarrhythmias are common after open heart surgery. Possible causative factors for these arrhythmias include operative trauma, atrial ischemia, electrolyte imbalances, pericardial irritation, and excess catecholamines. Two agents commonly used to control ventricular rate in atrial fibrillation or atrial flutter (AF/AFL) are β- blockers and calcium channel blockers. Methods and Results: This randomized study was designed to compare the safety and efficacy of intravenous diltiazem versus intravenous esmolol in patients with postoperative AF/AFL after coronary bypass surgery and/or valve replacement surgery. A comparative cost analysis was also performed. Thirty patients received either esmolol (n = 15) or diltiazem (n = 15) for AF/AFL. During the first 6 hours of treatment, 66.6% of esmolol-treated patients converted to sinus rhythm compared with 13.3% of the diltiazem-treated patients (P <.05). At 24 hours, 66.6% of the diltiazem group converted to SR compared with 80% of the esmolol group (not significant). Drug-induced side effects, time to rate control (

Original languageEnglish
Pages (from-to)176-180
Number of pages5
JournalAmerican Heart Journal
Issue number1
Publication statusPublished - Jul 2000


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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