Optimal Timing and Duration of Beta-Blocker Therapy for Preventing Postoperative Atrial Fibrillation: A Literature Review

Abstract

This literature review explores the intricate landscape of postoperative atrial fibrillation (POAF), a common complication that arises following heart surgery. The analysis highlights the significant risks associated with POAF, including stroke, extended hospital stay, and increased healthcare costs. POAF, together with its transient character, indicates an augmented susceptibility to atrial fibrillation in the long run. Despite extensive research on preventive measures, such as beta-blocker medication, uncertainties remain regarding the optimal timing and duration of beta-blocker therapy for preventing POAF. The existing evidence suggests that starting beta-blocker treatment early, ideally within the first 24–48 hours after surgery, may be effective in reducing the occurrence of POAF. Nevertheless, there is a noticeable absence of agreement regarding the optimal length of this therapy. Conflicting viewpoints arise, with certain research calling for brief therapies, while others propose the possible benefits linked to extended treatment. This review highlights the urgent requirement for more research to precisely adjust guidelines, taking into account patient-specific factors and considering the consequences for long-term results. The call to action entails a request for the implementation of uniform definitions, the conduct of prospective randomized controlled trials, and the utilization of larger sample sizes in future investigations. These characteristics are considered critical in providing the medical community with strong evidence, which is crucial for making well-informed therapeutic decisions.