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European Heart Journal 1986 7(3):217-222;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

The effects of metoprolol given early in acute myocardial infarction on ventricular arrhythmias

D. P. MURRAY, R. G. MURRAY and W. A. LITTLER

Department of Cardiovascular Medicine, University of Birmingham, East Birmingham Hospital Birmingham

Received 19 July 1985; revised 1 November 1985; .

Address for correspondence: Professor W. A. Littler, Department of Cardiovascular Medicine, University of Birmingham, East Birmingham Hospital, Birmingham B9 5ST, U.K.

Abstract

The effects ofmetroprolol, administered in the early stages of acute myocardial infarction was studied in 126 patients. Patients were treated in a double-blind randomized fashion, with metoprolol –15 mg, intravenously followed by 100 mg twice daily for 15 days or placebo, with a mean delay of 8.1 hours from onset of symptoms. All patients underwent 24 hour Holter monitoring on days 1, 5 and 15 after randomization. Although there was no antiarrhythmic effect on day 1, metoprolol reduced the number of hours with warning arrhythmias (>30 ventricular ectopics/hour, any R/T ectopics or ventricular tachycardia) on both days 5 (35 ± 16% vs 8 ± 11%; P<0.05) and day 15 (13±37% vs 4 ± 13%; P<0.05). Metoprolol also reduced the incidence of ventricular fibrillation and ventricular tachycardia requiring cardioversion –6% vs 0%; V = 0.058.

Metoprolol, administered in the early stages of acute myocardial infarction, had an antiarrhythmic effect which was evident only in the later phase of the study.

Key Words: ventricular fibrillation • Holter monitoring • beta-blockade


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