Combination prophylactic amiodarone with beta-blockers versus beta-blockers in atrial fibrillation after cardiac surgery: A systematic-review and meta-analysis

•Patients given combination amiodarone and beta-blockers had significantly lower risks of developing postoperative atrial fibrillation (POAF) in comparison to those given beta-blockers alone.•Combination amiodarone and beta-blockers saw no significant difference with beta-blockers alone in terms of...

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Bibliographic Details
Published in:Heart & lung 2023-11, Vol.62, p.256-263
Main Authors: Polintan, Edgar Theodore, Monsalve, Reejeen, Menghrajani, Rajiv Hans, Sirilan, Kym Yves, Nayak, Sandeep Samethadka, Abdelmaseeh, Peter, Patarroyo-Aponte, Gabriel, Lo, Kevin Bryan, Dani, Sourbha S.
Format: Article
Language:English
Subjects:
Amiodarone
Atrial fibrillation
Beta-blockers
Postoperative, Drug prophylaxis
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Summary:•Patients given combination amiodarone and beta-blockers had significantly lower risks of developing postoperative atrial fibrillation (POAF) in comparison to those given beta-blockers alone.•Combination amiodarone and beta-blockers saw no significant difference with beta-blockers alone in terms of treatment-related drug discontinuations (TRDD) or mortality.•Amiodarone alone saw no significant difference when compared with beta-blockers in terms of POAF prevention. Guideline recommendations regarding the preferred preventive measures for postoperative atrial fibrillation (POAF) are unclear, nor have we found any review articles addressing the combination of amiodarone and beta-blockers for the prevention of POAF. To investigate the efficacy and safety of combination beta-blockers and amiodarone in the prevention of POAF while also comparing the use of amiodarone and beta-blockers individually. We used Pubmed as the primary resource. POAF incidence was the primary outcome of this study. The secondary outcomes were hospital length of stay (LOS), ICU LOS, treatment-related drug discontinuation (TRDD), and mortality. The random-effects model assessed all pooled outcomes with 95% confidence intervals. Statistical significance was set at p≤0.05. The amiodarone subgroup of POAF incidence saw a Risk Ratio (RR) of 0.81 [0.63, 1.06], p=0.12, while the combination subgroup resulted in a RR of 0.63 [0.49, 0.80], p
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2023.08.006