Incidence of postoperative atrial fibrillation in transdermal β-blocker patch users is lower than that in oral β-blocker users after cardiac and/or thoracic aortic surgery

• Published in: General thoracic and cardiovascular surgery Vol. 67; no. 12; pp. 1007 - 1013
• Main Authors: Okamura, Homare, Arakawa, Mamoru, Miyagawa, Atsushi, Adachi, Hideo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.12.2019; Springer Nature B.V
• Subjects: Administration, Oral; Adrenergic beta-Antagonists - administration & dosage; Aged; Atrial Fibrillation - drug therapy; Atrial Fibrillation - epidemiology; Blood pressure; Body mass index; Cardiac arrhythmia; Cardiac Surgery; Cardiac Surgical Procedures - adverse effects; Cardiology; Cardiovascular disease; Chronic obstructive pulmonary disease; Coronary vessels; Creatinine; Databases, Factual; Diabetes; Drug dosages; Ejection fraction; Female; Heart rate; Heart surgery; Hemodialysis; Hospitalization; Hospitals; Humans; Hypertension; Incidence; Ischemia; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Metabolic disorders; Mortality; Original Article; Patients; Peptides; Postoperative Complications - drug therapy; Postoperative Complications - epidemiology; Regression analysis; Retrospective Studies; Stroke; Surgical Oncology; Thoracic Surgery; Transdermal Patch; Variables; Japan; New York; United States > US; β-blocker; Atrial fibrillation; Cardiac surgery
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-019-01131-5

Objective Postoperative atrial fibrillation (POAF) after open heart surgery is associated with a high risk of mortality and morbidity. Although oral β-blockers are usually recommended to prevent POAF, the efficacy of a transdermal β-blocker patch in preventing POAF is unclear. We compared the incidence of POAF between users of oral and transdermal bisoprolol. Methods We investigated 108 patients who underwent cardiac and/or thoracic aortic surgery between April 2016 and February 2018. We compared perioperative clinical and hemodynamic variables between 49 patients treated with a transdermal bisoprolol patch and 59 patients treated with an oral bisoprolol fumarate. Results POAF occurred in 24% of patients in the transdermal and in 46% of patients in the oral bisoprolol groups ( p  = 0.027). No intergroup difference was observed in in-hospital mortality, perioperative blood pressures and heart rates, and other morbidities. Multivariable logistic regression analysis revealed that the use of transdermal bisoprolol was independently associated with a lower rate of POAF (odds ratio 0.21, 95% confidence interval 0.05–0.84, p  = 0.027). Conclusions A transdermal bisoprolol patch is an effective and safe β-blocker drug delivery system. The incidence of POAF in this group was lower than that in users of oral bisoprolol.