July 2, 2002Circulation
Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery
Key result
Beta-blockers (OR 0.39), sotalol (OR 0.35), amiodarone (OR 0.48), and biatrial pacing (OR 0.46) all effectively reduced the risk of postoperative atrial fibrillation compared to controls.
Why the study?
Do prophylactic therapies (beta-blockers, sotalol, amiodarone, or pacing) prevent postoperative atrial fibrillation in patients undergoing heart surgery?
Population
Patients undergoing heart surgery (pooled from 52 randomized trials)
Comparison
Prophylactic therapies including beta-blockers… vs Placebo or routine treatment
Design
Meta-analysis
Follow-up
Postoperative period
Authors
Discussion
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Implication
Supports routine prophylaxis in cardiac surgery patients; confirms Level 1 efficacy across agents and biatrial pacing.
Study Design
Type
Systematic Review
Structured PICO
Do prophylactic therapies (beta-blockers, sotalol, amiodarone, or pacing) prevent postoperative atrial fibrillation in patients undergoing heart surgery?
P
Population
Patients undergoing heart surgery (pooled from 52 randomized trials)
I
Intervention
Prophylactic therapies including beta-blockers, sotalol, amiodarone, or pacing (including biatrial pacing)
C
Comparator
Placebo or routine treatment
O
Outcome
Postoperative atrial fibrillation (AF)hard clinical
Main Result
Effect estimate: OR 0.39 (beta-blockers), 0.35 (sotalol), 0.48 (amiodarone), 0.46 (biatrial pacing) (95% CI 0.28-0.52 (beta-blockers), 0.26-0.49 (sotalol), 0.37-0.61 (amiodarone), 0.30-0.71 (biatrial pacing))
Prophylactic use of beta-blockers, sotalol, amiodarone, and biatrial pacing effectively reduces the incidence of postoperative atrial fibrillation and hospital length of stay after cardiac surgery.
Limitations
- Data on stroke are incomplete
- Incomplete data on stroke
Cite This Study
Crystal et al. (2002) conducted a systematic review in Postoperative atrial fibrillation in patients undergoing heart surgery. Beta-blockers, sotalol, amiodarone, or pacing vs. Placebo or routine treatment was evaluated on Postoperative atrial fibrillation (OR 0.39 (beta-blockers), 0.35 (sotalol), 0.48 (amiodarone), 0.46 (biatrial pacing), 95% CI 0.28-0.52 (beta-blockers), 0.26-0.49 (sotalol), 0.37-0.61 (amiodarone), 0.30-0.71 (biatrial pacing)). Beta-blockers (OR 0.39), sotalol (OR 0.35), amiodarone (OR 0.48), and biatrial pacing (OR 0.46) all effectively reduced the risk of postoperative atrial fibrillation compared to controls.