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August 7, 2002

Preoperative β-Blockade and Risk of Postoperative Atrial Fibrillation

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(5):573-574. doi:10.1001/jama.288.5.571

To the Editor: In their study on the effect of preoperative β-blocker therapy on coronary artery bypass graft (CABG) surgery outcomes, Dr Ferguson and colleagues1 did not address its effect on the incidence of postoperative atrial fibrillation (AF). Atrial fibrillation has been reported in 5% to 40% of patients undergoing CABG,2 is associated with increased length of hospital stay3 and increased incidence of perioperative stroke,4 and generally occurs 2 to 3 days after CABG and seldom earlier.5 Although a meta-analysis of randomized controlled trials in 1991 showed that prophylactic β-blocker therapy had a protective effect against the development of postoperative AF,6 its routine preoperative use is still not universally adopted. Furthermore, it would be interesting to know if the trend toward a decrease in stroke that Ferguson et al observed among patients treated with β-blockers was due to a decreased incidence of postoperative AF.