Key result
Atenolol reduces postoperative atrial fibrillation ~45% vs. saline in cardiac surgery patients.
Why the study?
Only a limited number of studies had evaluated the efficacy of atenolol in preventing atrial fibrillation following cardiac surgery.
Does atenolol reduce the incidence of postoperative atrial fibrillation in adult patients undergoing cardiac surgery?
Meta-Analysis (n=870)
Does atenolol reduce the incidence of postoperative atrial fibrillation in adult patients undergoing cardiac surgery?
Prophylactic atenolol effectively reduces postoperative atrial fibrillation compared to placebo in cardiac surgery patients, though it is less effective than sotalol.
Supports atenolol for POAF prophylaxis versus placebo in cardiac surgery; extends RCT meta-analysis evidence but is inferior to sotalol.
Prior research has conducted a limited number of studies on the efficacy of atenolol in preventing atrial fibrillation following cardiac surgery (CS). Consequently, a comprehensive evaluation and meta-analysis were undertaken to assess the effectiveness and safety of atenolol in patients undergoing CS for the prevention of postoperative atrial fibrillation (POAF). A meta-analysis of randomized controlled trials was performed. Searches were conducted across multiple databases up to December 1, 2024. The primary focus was the incidence of POAF. Risk ratios (RRs) for treatment effects on dichotomous variables were calculated. The data analysis encompassed 6 randomized controlled trials involving a total of 870 patients. The meta-analysis revealed that atenolol significantly reduces the incidence of POAF in adult patients undergoing CS (RR, 0.55; 95% confidence interval [CI]: 0.32–0.93; P = .03) with moderate heterogeneity ( I2 = 57%; P = .10). Atenolol did not demonstrate superiority over sotalol in reducing POAF (RR, 2.39; 95% CI: 1.41–4.04; P = .001) with moderate heterogeneity ( I2 = 40%; P = .19). Furthermore, no significant difference was observed between atenolol and the control group (comprising propafenone, metoprolol, nebivolol, and digoxin) in the prevention of POAF (RR, 1.28; 95% CI: 0.76–2.16; P = .35) with moderate heterogeneity ( I2 = 43%; P = .15). Recent studies suggest that atenolol could be a safe and effective intervention for the prevention of POAF in adult patients undergoing CS.
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Deng et al. (2026) conducted a meta-analysis in Postoperative atrial fibrillation (n=870). Atenolol vs. Saline or active controls (sotalol, propafenone, metoprolol, nebivolol, digoxin) was evaluated on Incidence of postoperative atrial fibrillation (POAF) compared to saline (RR 0.55, 95% CI 0.32-0.93, p=.03). Atenolol significantly reduced the incidence of postoperative atrial fibrillation compared to saline in adult patients undergoing cardiac surgery (RR 0.55, 95% CI 0.32-0.93, p=0.03).
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