Suppression of atrial ectopy with intravenous metoprolol in chronic obstructive pulmonary disease patients

To determine the efficacy of a cardioselective beta blocker in the treatment of atrial ectopy in patients with chronic obstructive pulmonary disease (COPD), we administered intravenous metoprolol (0.2 mg/kg) to six patients with atrial ectopic depolarizations (AEDs) and chronic partially reversible airflow limitation (FEV1 = 1.24 +/- 0.21 liter, mean +/- S.E.). Metoprolol reduced the mean frequency of AEDs from 713 +/- 237 per hour to 218 +/- 127 per hour. Furthermore, three of six patients experienced an 85 per cent or greater decrease in AEDs. No changes were observed in FEV1, FVC, or FEF25-75 over the course of the study. These data suggest that intravenous metoprolol is effective in reducing the frequency of AEDs and that it can be administered to patients with COPD without causing an increase in airflow limitation.