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

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.