Control of Lethal Arrhythmias Associated with Coronary Heart Disease. A Feasibility Study of Propranolol Prophylaxis - A Double Blind Design.

摘要

The authors conducted a double blind antiarrhythmic trial to determine the feasibility of prophylaxis to control potentially,lethal arrhythmias in ischemic heart disease. Patients were studied with recent myocardial infarction and followed for two years;propranolol was chosen as treatment. A 130item form was recorded from the history,physical examination,and laboratory work up and six hours of ECG analyzed. Patients were begun on trial material and followed with examinations and ambulatory ECG recordings every three months;also,plasma propranolol concentrations and exercise ECG were obtained. The frequency of ventricular arrhythmias remained stable in most patients over one to two years. Nearly all of the target events occurred in the first six months after infarction. The blood levels of propranolol were markedly variable. The authors conclude that future trials should not be blinded and dose should be adjusted to obtain therapeutic plasma concentrations.