Review Article
Management Strategies in Cardiac Surgery for Postoperative Atrial Fibrillation: Contemporary Prophylaxis and Futuristic Anticoagulant Possibilities
Table 2
Overview of the included nonpharmacological studies.
| | Intervention | Author |
Ref. | Year | Design | Outcomes of interest | Study N Design | Patients N | Results | P value |
NNT (95% CI) | Bottom line | | Intervention | Control | Odds ratio (95% CI) |
| | Posterior pericardiotomy |
Arsenault et al. |
[43] |
2013 |
MA | POAF | 6 RCTs | 379 | 384 | 0.35 (0.18 to 0.67) |
0.001 | 6 (4–8) | Posterior pericardiotomy is beneficial | | Lengte of hospital stay | 3 RCTs | 229 | 234 | 0.57 days (−1.99 to 3.12) | 0.66 | NA | No decrease in lengte of hospital stay | | Mortality | 1 RCT | 100 | 100 | 1.00 (0.06 to 16.44) | 1.00 | NA | No significant decrease in mortality | |
Biancari and Mahar |
[44] |
2010 |
MA | POAF | 6 RCTs | 379 | 384 | 0.33 (0.16 to 0.69) | 0.003 | 6 (4–8) | Posterior pericardiotomy is beneficial |
| | Atrial pacing |
Arsenault et al. |
[43] |
2013 |
MA | POAF | 21 RCTs | 1446 | 1487 | 0.47 (0.36 to 0.61) | <0.00001 | 8 (6–9) | Atrial pacing is beneficial | | Stroke | 6 RCTs | 419 | 413 | 0.72 (0.36 to 1.46) | 0.36 | NA | No significant decrease in stroke | | CV mortality | 2 RCTs | 98 | 100 | 0.0 (0.0 to 0.0) | <0.00001 | NA | No significant decrease in CV mortality | | Length of stay | 18 RCTs | 742 | 783 | −1.13 days (−1.72 to −0.55) | 0.00015 | NA |
Shorter length of stay | |
Burgess et al. |
[45] |
2006 |
MA | POAF | 14 RCTs | 923 | 962 | 0.60 (0.47–0.77) | <0.001 | 8 (6–9) | Atrial pacing is beneficial | | POAF in biatrial group | 10 RCTs | 367 | 387 | 0.44 (0.31–0.64) | <0.001 | 7 (5–10) | Biatrial pacing is beneficial | | Stroke | 5 RCTs | 268 | 282 | 0.61 (0.20 to 1.9) | 0.48 | NA | No significant decrease in stroke | | Length of stay | 5 RCTs | 268 | 282 | −1.3 days (−2.55 to −0.08) | 0.04 | NA | Shorter length of stay |
|
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POAF: postoperative atrial fibrillation; NA: not applicable; NNT: number needed to treat; NNH: number needed to harm; hrs: hours; ref.: reference; postop: postoperative; preop: preoperative; RCT: randomized control trial; MA: meta-analysis.
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