Abstract
The results of the Cardiac Arrhythmia Suppression Trial warn against the use of class Ia and Ic antiarrhythmic agents as first-line therapy for arrhythmia. The objective of the present study was to evaluate the efficacy of celiprolol, a β-blocker, in patients with supraventricular arrhythmia. Celiprolol (200 mg/day) was administered for a mean duration of 90 days (range: 32 to 128 days) to 30 patients with supraventricular arrhythmia, including 7 with chronic atrial fibrillation associated with bradycardia, 18 with paroxysmal atrial fibrillation, and 5 with premature atrial contraction (PAC). The antiarrhythmic effect of celiprolol was assessed based on changes in symptoms and heart rate determined by Holter ECG. After celiprolol therapy, arrhythmic symptoms improved in 60% of the patients. The post-treatment Holter ECG showed a decrease in the daily maximum, but not minimum, heart rate, a good control of heart rate in patients with atrial fibrillation, and a decrease of PACs. Importantly, bradycardia improved even in patients with chronic atrial fibrillation who concomitantly received digitalis. Celiprolol exerted an adequate antihypertensive effect in hypertensive patients but did not affect normal blood pressure. In conclusion, celiprolol may be used as first-line therapy for the treatment of patients with supraventricular arrhythmia.
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