Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis

Abstract

All five interventions reduced the incidence of AF, though the effect of BBs is less than previously thought. The significant reductions in length of stay and stroke in meta-analysis suggest that there are worthwhile benefits from aggressive prevention. Larger studies to confirm these clinical benefits and evaluate their cost-effectiveness would be worthwhile.

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…W większości z tych badań beta-adrenolityki podawano w okresie pooperacyjnym, a za takim schematem ich stosowania przemawia również niedawna metaanaliza [928]. W kilku metaanalizach stwierdzono, że amiodaron zmniejszał częstość występowania AF w okresie pooperacyjnym w porównaniu z beta-adrenolitykiem, a także skracał czas pobytu pacjentów w szpitalu [925,[929][930][931].…”

Guidelines on myocardial revascularization

“…Dosages vary widely between trials based on body size and LV function. As shown by several RCTs and meta-analyses [183,184,186], amiodarone is effective for the prophylaxis of AF. The largest RCT reported atrial tachyarrhythmias in 16.1% of amiodarone-treated patients compared with 29.5% of placebo-treated patients (HR 0.52, 95% CI 0.34 0.69), a 13.4% absolute risk reduction [184].…”

Fibrilação atrial no pós-operatório de cirurgia cardíaca

“…In a recent metanalysis, Burgess et al 56 demonstrated that patients submitted to biatrial stimulation had 17.7% of POAF, whereas the control group had 35.3% of POAF incidence. Guidelines for the prevention of postoperative AF suggest that biatrial stimulation is a Grade of recommendation A -Level of evidence B 38 .…”