Evidence map›Paper›PMID 37445569›Full record

ReviewJournal of clinical medicine2023

Rhythm vs. Rate Control in Patients with Postoperative Atrial Fibrillation after Cardiac Surgery: A Systematic Review and Meta-Analysis.

Muneeb Ahmed, Emilie P Belley-Coté, Yuan Qiu, Peter Belesiotis, Brendan Tao, Alex Wolf, Hargun Kaur, Alex Ibrahim, Jorge A Wong, Michael K Wang and 5 more

Open access · goldAbstract readReview
In one paragraph

Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Improving atrial fibrillation or flutter detection and management by smartphone-based photoplethysmography rhythm monitoring following cardiac surgery: a pragmatic randomized trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Trial
  3. Article
  4. Perioperative atrial fibrillation after non-cardiac surgery - A narrative review.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Review
  5. Article
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  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Muneeb AhmedFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Emilie P Belley-CotéFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Yuan QiuOttawa Heart Institute, University of Ottawa, Ottawa, ON K1Y 4W7, Canada.ORCID 0000-0002-9572-9106
Peter BelesiotisFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Brendan TaoDepartment of Medicine, University of British Columbia, Vancouver, BC V6T 1Z1, Canada.
Alex WolfDepartment of Medicine, Western University, Hamilton, ON N6A 5C1, Canada.
Hargun KaurFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Alex IbrahimDepartment of Medicine, Western University, Hamilton, ON N6A 5C1, Canada.
Jorge A WongFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Michael K WangFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Jeff S HealeyFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
David ConenFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Philip James DevereauxFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
Richard P WhitlockFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.
William F McintyreFaculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.ORCID 0000-0001-6082-7542
McMaster University · CAWestern University · CAUniversity of British Columbia · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery; it is associated with morbidity and mortality. We undertook this review to compare the effects of rhythm vs. rate control in this population.

methodsWe searched MEDLINE, Embase and CENTRAL to March 2023. We included randomized trials and observational studies comparing rhythm to rate control in cardiac surgery patients with POAF. We used a random-effects model to meta-analyze data and rated the quality of evidence using GRADE.

resultsFrom 8,110 citations, we identified 8 randomized trials (990 patients). Drug regimens used for rhythm control included amiodarone in four trials, other class III anti-arrhythmics in one trial, class I anti-arrhythmics in four trials and either a class I or III anti-arrhythmic in one trial. Rhythm control compared to rate control did not result in a significant difference in length of stay (mean difference -0.8 days; 95% CI -3.0 to +1.4, I

conclusionsAlthough atrial fibrillation is common after cardiac surgery, limited low-quality data guide its management. Limited available evidence suggests no clear advantage to either rhythm or rate control. A large-scale randomized trial is needed to inform this important clinical question.

Indexed as

atrial fibrillationcardiac surgerylength of stayrate controlrhythm control

Identifiers

PMID37445569
PMCPMC10342940
OpenAlexW4383535412

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.