Once Versus Twice Bisoprolol Dosage Regimen in Prevention of Atrial Fibrillation Post Coronary Artery Bypass Graft Surgery

Once Versus Twice Bisoprolol Dosage Regimen in Prevention of Atrial Fibrillation Post Coronary Artery Bypass Graft Surgery

The goal of this interventional clinical trial is compare between two different dose regimens of bisoprolol (beta-blocker) in CABG patients in terms of efficacy and safety.

Inclusion Criteria:

• Adult patients: 18 to 65 years old
• Diagnosed with coronary heart disease or myocardial infarction and scheduled for coronary artery bypass surgery

Exclusion Criteria:

• History of Ventricular arrhythmia, atrial fibrillation, atrial flutter, left bundle block, AV block grade II/III
• History of Sick sinus syndrome, sinoatrial heart block
• History of valve replacement
• Permanent Pacemaker
• LVEF less than 30%
• Unstable Heart failure
• Cardiogenic shock
• Sustained systolic blood pressure less than 100 mmHg or HR less than 50 bpm at recruitment
• Severe chronic obstructive airway disease
• Severe asthma unless was on previously tolerated bisoprolol dose
• Uncontrolled diabetes mellitus unless was on previously tolerated bisoprolol dose
• Pregnant/Lactation
• Previous recent stroke
• Creatinine clearance less than 30 ml/min
• End stage liver disease (liver cirrhosis)
• Drug dependance history
• Untreated phaeochromocytoma
• Vasospastic angina
• Thyrotoxicosis
• History of advanced staged of peripheral vascular disease
• Hypersensitivity
• Patients on any other beta-blocker other than bisoprolol
• Patients on bisoprolol higher than 5 mg/day.