Dexmedetomidine Reduces Atrial Fibrillation After Adult Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials

  • Yang Liu
  • Lei Zhang
  • Suozhu Wang
  • Feiping Lu
  • Jie Zhen
  • Wei ChenEmail author
Original Research Article



Dexmedetomidine has been shown to have antiarrhythmic effects by exhibiting sympatholytic properties and activating the vagus nerve in preclinical studies. Results from clinical trials of dexmedetomidine on atrial fibrillation (AF) following adult cardiac surgery are controversial.

Materials and methods

We searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the antiarrhythmic effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery. The primary outcome was the incidence of AF. The secondary outcomes were ventricular arrhythmias [ventricular fibrillation (VF), ventricular tachycardia (VT)], mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay, and hospital length of stay, and all-cause mortality.


Thirteen trials with a total of 1684 study patients were selected. Compared with controls, dexmedetomidine significantly reduced the incidence of postoperative AF [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.58–0.97; P = 0.03] and VT (OR 0.23; 95% CI 0.11–0.48; P < 0.0001). No significant difference for the incidence of VF existed (OR 0.80; 95% CI 0.21–3.03; P = 0.74). There was no significant difference between groups in MV duration [weighted mean difference (WMD) − 0.10; 95% CI − 0.42 to 0.21; P = 0.52], postoperative ICU stay (WMD − 0.49; 95% CI − 2.64 to 1.66; P = 0.65), hospital stay (WMD − 0.01; 95% CI − 0.16 to 0.13; P = 0.88) and mortality (OR 0.59; 95% CI 0.15–2.37; P = 0.46).


Perioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery reduced the incidence of postoperative AF and VT. But there was no significant difference in incidence of VF, MV duration, ICU stay, hospital stay and mortality.


Authors contributions

Study design: YL and WC; data acquisition: LZ and JZ; data analyses/interpretation: YL, FPL and SZW; supervision or mentorship: WC. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. YL and WC take responsibility that this study has been reported honestly, accurately, and transparently. All authors approved the final manuscript.

Compliance with Ethical Standards


No external funding was used in the preparation of this article.

Conflict of Interest

The authors, Yang Liu, Lei Zhang, Suozhu Wang, Feiping Lu, Jie Zhen and Wei Chen, declare that they have no potential conflicts of interest that might be relevant to the contents of this article.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Yang Liu
    • 1
  • Lei Zhang
    • 2
  • Suozhu Wang
    • 1
  • Feiping Lu
    • 1
  • Jie Zhen
    • 1
  • Wei Chen
    • 1
    Email author
  1. 1.Department of Intensive Care Unit, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of anesthesiologyBeijing Daxing Maternal and Child Care HospitalBeijingChina

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