• Takahiko Tamura, Tomoaki Yatabe, and Masataka Yokoyama.
• Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
• J Clin Anesth. 2017 Nov 1; 42: 1-6.

Study ObjectiveAtrial fibrillation (AF) is associated with mortality after cardiac surgery. Several studies have reported that landiolol might help to prevent postoperative AF. The objective of this study was to investigate whether low-dose landiolol is useful in terms of balance of benefit and risk.DesignWe conducted a meta-analysis after systematically searching the PubMed, the Cochrane library and the ICHUSHI to identify randomized, controlled trials investigating the preventive effect of landiolol on incidence of AF after cardiac surgery.PatientsSix randomized trial with 571 patients were included.MeasurementsThe primary outcome was incidence of AF after surgery, while secondary outcomes were mortality and complications.Main ResultsIncidence of AF within 1week after surgery was significantly lower in the landiolol group than in the control group (odds ratio, 0.27; 95% confidence interval, 0.18-0.42; p<0.001). Three of the 6 studies reported data regarding in-hospital mortality and complications, showing no significant differences between groups (0.7 vs 3.0%; OR, 0.45; 95% CI, 0.07-2.74; p=0.39; and 4.5 vs 9.7%; OR, 0.45; 95% CI, 0.16-1.23; p=0.12, respectively).ConclusionsOur systematic review revealed that low-dose landiolol might help to prevent AF after cardiac surgery and further large trials are needed to evaluate safety because mortality and morbidity rate were very low in included studies.Copyright © 2017 Elsevier Inc. All rights reserved.

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