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lüll Prevention of atrial fibrillation onset by beta-blocker treatment in heart failure: a meta-analysis Nasr IA; Bouzamondo A; Hulot JS; Dubourg O; Le Heuzey JY; Lechat PEur Heart J 2007[Feb]; 28 (4): 457-62AIMS: Atrial fibrillation (AF) is an important morbidity-mortality risk factor, especially in patients with heart failure (HF). Beta-blockers reduce morbidity and mortality in HF. The study was designed to estimate the preventive efficacy of beta-blocker treatment on AF occurrence in patients with HF. METHODS AND RESULTS: A systematic review of the literature was performed to identify all clinical trials evaluating beta-blockers' efficacy in HF. Eligible studies had to be randomized, placebo-controlled and providing information on the incidence of AF during follow-up among those with sinus rhythm at baseline. A total of seven studies which included 11 952 patients receiving a background treatment with angiotensin-converting enzyme-inhibitors could be found. Overall, beta-blockers significantly reduced incidence of onset of AF from 39 to 28 per 1000 patient-years: relative risk reduction=27% (95% confidence interval 14-38, P<0.001); heterogeneity test: P=0.096. A same trend of efficacy was observed in all trials except the SENIORS study. In this trial which included aged patients (>70 years) with systolic or diastolic HF, a higher prevalence of AF at baseline (35%) was observed compared with the mean baseline prevalence (13%). CONCLUSION: Beta-blockers appear to effectively prevent occurrence of AF in patients with systolic HF.|Adrenergic beta-Antagonists/*therapeutic use[MESH]|Aged[MESH]|Atrial Fibrillation/etiology/*prevention & control[MESH]|Chronic Disease[MESH]|Double-Blind Method[MESH]|Heart Failure/complications/*drug therapy[MESH]|Humans[MESH]|Middle Aged[MESH]|Randomized Controlled Trials as Topic[MESH] |