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

Abstract

Despite several limitations, this analysis confirms the efficacy of prophylactic BB against post-CABG AF in this era. We recommend continuing perioperative BB in the open heart surgery patients in the absence of contraindications.

Atrial Fibrillation After Coronary Artery Bypass Surgery: Can Ivabradine Reduce Its Occurrence?

“…8 Assuming a power (1-β) of 0.8 and a type I error (α) rate of 5%, the sample size needed would be 206 patients per group. Continuous variables were presented as mean ± SD if they were normally distributed.…”

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

“…Najczęściej oceniano propranolol, którego stosowanie wiązało się z występowaniem AF u 16,3% pacjentów w grupie leczonej w porównaniu z 31,7% w grupie kontrolnej [925]. 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].…”

Secondary Prevention After Coronary Artery Bypass Graft Surgery

“…201 A meta-analysis of contemporary clinical trials illustrated a 50% reduction in the risk of postoperative AF with prophylactic β-blocker therapy. 202 Moreover, many patients on preoperative β-blocker therapy have rebound tachycardia if β-blocker therapy is not resumed early in the postoperative period.…”

“…Two major therapy groups, β-blockers and ACE inhibitors, are routinely given for their established cardioprotective features, as much as they are used for BP reduction. 213,214 β-Blockers should be administered as soon as possible after CABG in those patients without contraindications to reduce the risk of AF 201,202 and to improve outcomes in those patients with congestive heart failure and LV dysfunction. 205 However, their effect on BP has not been systematically explored.…”