Summary
To evaluate the effect of atenolol on suppressing chronic ventricular arrhythmias in a mixed cardiac population, 12 patients (2 female, 10 male; mean age 57 ± 6 years) underwent a 15- day single- blind inpatient trial in a clinical research unit. The first 3 days of placebo were followed by 3 days each of 50mg, then 100mg, then 200mg of atenolol given orally once daily, the final 3 days being placebo. Ambulatory electro- cardiographic (Holter) monitoring was performed on each day of the 15- day study. The study population included patients with a mixed response to previous antiarrhythmic agents. Seven of the 12 patients (58%) with simple ventricular premature complexes had a statistically significant suppression in which 4 had this response at 50 mg/day and 3 at 100 mg/day of atenolol. Five of 7 patients (71%) with ventricular couplets had a significant suppression (4 at 50 mg/day and 1 at 100 mg/day), whereas only 2/5 (40%) of those patients with ventricular tachycardia had significant suppression. Plasma levels of atenolol did not correlate with antiarrhythmic effect and there were no important side effects.
The 50% response rate in individual patients with chronic ventricular ectopy on atenolol is similar to the approximate 50% response rate seen with other β- blockers such as propranolol, metoprolol, acebutolol and nadolol. The precise mechanism of action of β- blockers in the treatment of chronic ventricular arrhythmias is yet to be defined.
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Morganroth, J. Short Term Evaluation of Atenolol in Hospitalised Patients with Chronic Ventricular Arrhythmias. Drugs 25 (Suppl 2), 181–185 (1983). https://doi.org/10.2165/00003495-198300252-00053
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DOI: https://doi.org/10.2165/00003495-198300252-00053