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 oldDiagnosed with coronary heart disease or myocardial infarction and scheduled for coronary artery bypass surgeryExclusion Criteria:History of Ventricular arrhythmia, atrial fibrillation, atrial flutter, left bundle block, AV block grade II/IIIHistory of Sick sinus syndrome, sinoatrial heart blockHistory of valve replacementPermanent PacemakerLVEF less than 30%Unstable Heart failureCardiogenic shockSustained systolic blood pressure less than 100 mmHg or HR less than 50 bpm at recruitmentSevere chronic obstructive airway diseaseSevere asthma unless was on previously tolerated bisoprolol doseUncontrolled diabetes mellitus unless was on previously tolerated bisoprolol dosePregnant/LactationPrevious recent strokeCreatinine clearance less than 30 ml/minEnd stage liver disease (liver cirrhosis)Drug dependance historyUntreated phaeochromocytomaVasospastic anginaThyrotoxicosisHistory of advanced staged of peripheral vascular diseaseHypersensitivityPatients on any other beta-blocker other than bisoprololPatients on bisoprolol higher than 5 mg/day.