Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: In response to Dr Oh and colleagues, there was no difference between the hydrocortisone and the placebo groups with respect to the β-blocker dose in our study. We have previously shown that intravenous administration of metoprolol is more effective than oral administration in the prevention of AF after cardiac surgery.1 The most plausible explanation for this is the impaired bioavailability of metoprolol during the first days after cardiac surgery.2 We agree that further studies are warranted to investigate the combination of corticosteroids and intravenous metoprolol in the prevention of AF after cardiac surgery.
Halonen J, Hartikainen J, Hakala T. Use of Corticosteroids to Prevent Atrial Fibrillation After Cardiac Surgery—Reply. JAMA. 2007;298(3):283-284. doi:10.1001/jama.298.3.283-c