Landiolol hydrochloride for prevention of atrial fibrillation after cardiac surgery: a meta-analysis

Pacing Clin Electrophysiol. 2014 Jun;37(6):691-6. doi: 10.1111/pace.12379. Epub 2014 Mar 20.

Abstract

Background: Atrial fibrillation (AF) is the most common arrhythmic complication after cardiac surgery. Several studies have compared the efficacy of landiolol and placebo or other agents in preventing new-onset AF in patients after cardiac surgery. In this study, we conducted a meta-analysis to determine whether landiolol is effective in preventing new-onset AF after cardiac surgery.

Methods and results: Five randomized controlled trials and two retrospective analyses were included in this study. The clinical outcomes of interest were the occurrence of AF after cardiac surgery and major complications. Meta-analysis was performed using RevMan 5.0.18 software, and pooled estimates of the effect were reported as risk ratios (RR) with 95% confidence intervals (CI). The results of this meta-analysis indicate that landiolol is significantly associated with a decreased risk of occurrence of AF after cardiac surgery (RR = 0.33; 95% CI: 0.23-0.48; P < 0.00001) and is not associated with an increased risk of major complications (RR = 0.79; 95% CI: 0.43-1.45; P = 0.45) compared with the control group.

Conclusion: Landiolol administration in the perioperative period can reduce the occurrence of AF after cardiac surgery without increasing the risk of major complications. It can be used to prevent new-onset AF safely after cardiac surgery.

Keywords: atrial fibrillation; cardiac surgery; landiolol hydrochloride; β1-selective blocker.

Publication types

  • Meta-Analysis

MeSH terms

  • Anti-Arrhythmia Agents / administration & dosage
  • Atrial Fibrillation / mortality*
  • Atrial Fibrillation / prevention & control*
  • Cardiac Surgical Procedures / mortality*
  • Humans
  • Incidence
  • Morpholines / administration & dosage*
  • Postoperative Complications / mortality*
  • Postoperative Complications / prevention & control*
  • Premedication / methods*
  • Risk Factors
  • Survival Rate
  • Treatment Outcome
  • Urea / administration & dosage
  • Urea / analogs & derivatives*

Substances

  • Anti-Arrhythmia Agents
  • Morpholines
  • landiolol
  • Urea