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

Intravenous metoprolol, 0.2 mg/kg, was given to 11 patients with stable, partially reversible chronic obstructive pulmonary disease (COPD) and frequent ventricular ectopic depolarizations (VEDs). The frequency of VEDs during 8 h of continuous ECG recording was reduced from a mean of 214/h to 86/h (p < .001). Four/11 patients had a greater than 90% reduction in VEDs. There were no adverse clinical effects during the period of drug administration. However, metoprolol produced small declines of 14% in the forced expiratory volume in 1 sec (FEB₁) and 21% in the forced expiratory flow rate between 25% and 75% of the forced vital capacity (FVC) (FEF_25-75). These data suggest that iv metoprolol is effective in reducing the frequency of VEDs in patients with COPD, although the extent of reduction in VEDs shows considerable interindividual variation. Metoprolol can be administered iv without inducing clinical bronchospasm in most patients.