Preoperative Beta‐blocker Use Reduces Atrial Fibrillation in Off‐pump Coronary Bypass Surgery

Abstract

Low-dose postoperative beta-adrenergic blockade is valuable for patients who receive these medications before off-pump coronary artery bypass grafting procedures and may be beneficial against AF in all patients.

Prevention of Post–Coronary Artery Bypass Grafting (CABG) Atrial Fibrillation: Efficacy of Prophylactic Beta‐Blockers in the Modern Era

“…There was also an obvious male predominance anywhere from 60% to 80% in the individual studies . Most of the authors,, , except the two, excluded patients with ejection fraction (EF) less than 20–40% and the mean EF of the study population ranged from 50% to 65%. Only two authors included the patients undergoing valve surgery .…”

“…Another important thing to notice is the use of pretrial BB; 60–100% of these patients were already talking preenrollment BB , . Timing of initiation for BB prophylaxis was 3–4 days before the surgery in the preoperative prophylaxis studies and within 24 hours of surgery in the postoperative group , , , . Definition of post‐CABG AF in terms of duration varied slightly among the trials.…”

“…Definition of post‐CABG AF in terms of duration varied slightly among the trials. All the patients were monitored using continuous electrocardiography (ECG) or telemetry,, , however, the duration of monitoring varied among individual studies.…”

“…The quality of individual studies was assessed using Jaded score . Two studies had a score 5 each, and the remaining eight, , had a score of 3 each. A score of 3 was explained by the lack of double blindness due to a particular study design or yes/no nature of the outcome that is, AF.…”

Update on cardiac arrhythmias in the ICU

“…One of the prominent proposed mechanisms is catecholamine stimulation of irritated atria. Therefore, it is not surprising that prophylaxis with beta-blockers reduces the postoperative incidence of atrial fibrillation after both on and off-pump CABG [15]. The atrial irritation may be due to direct manipulation and surgical injury causing inflammation.…”