Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Maria N. Negreva1 / Atanas P. Penev2
1First Clinic of Cardiology, Intensive Cardiology Unit, St. Marina University Hospital, Varna, Bulgaria
2 First Clinic of Cardiology, Intensive Cardiology Unit, St. Marina University Hospital, Varna, Bulgaria
Correspondence and reprint request to: M. Negreva, First Clinic of Cardiology, Intensive Cardiology Unit, St. Marina University Hospital, Varna; E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.; Mob.: (+359) 888 178 30355 Marin Drinov Str., 9002 Varna, Bulgaria

Citation Information: Folia Medica. Volume 54, Issue 2, Pages 27–31, ISSN (Online) 1314-2143, ISSN (Print) 0204-8043, DOI: 10.2478/v10153-011-0085-7, October 2012
Publication History:
Published Online:
2012-10-27

ABSTRACT

The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation.

OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone.

PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour.

RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05).

CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.