Safety and efficacy of flestolol, a new ultrashort-acting beta-adrenergic blocking agent, for supraventricular tachyarrhythmias

Document Type

Journal Article

Publication Date

11-1-1986

Journal

The American Journal of Cardiology

Volume

58

Issue

10

DOI

10.1016/S0002-9149(86)80028-5

Abstract

Flestolol, a new ultrashort-acting (half-life 6.9 minutes) β-blocking drug, was administered by intravenous infusion to 18 patients with new-onset atrial fibrillation or flutter and rapid ventricular response (120 beats/min or more for at least 30 minutes). Drug dose of flestolol was progressively increased until at least 1 of 3 endpoints was achieved: (1) at least a 20% reduction in heart rate from baseline, (2) heart rate 100 beats/min or less, or (3) conversion to normal sinus rhythm. Flestolol was then administered as a maintenance infusion up to 24 hours. When flestolol was discontinued, patients were monitored for 1 additional hour. The mean ventricular response at baseline of 133 ± 12 beats/min decreased to 103 ± 20 beats/min at the end of flestolol titration (p <0.0001). Fourteen patients (78%) achieved defined endpoints. All 14 patients who continued to receive maintenance infusion had a sustained response. When flestolol was discontinued, ventricular response increased 33 ± 23% within 60 minutes. The only adverse effect seen was hypotension in 2 patients. Flestolol is effective in slowing ventricular response in new-onset atrial fibrillation and flutter, maintains a therapeutic effect during continuous infusion and rapidly loses therapeutic effect when discontinued. © 1986.

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