Statistical heterogeneity between included studies was not detected ( chi(2 ) = 1.68 , P = 0.43 , I(2 ) = 0 % ) , although significant clinical differences were found in terms of study design , patient population s , statins use and dosage and AF-monitoring capabilities .
Statins may represent a novel treatment strategy to prevent the occurrence of AF in patients with PM , especially for those who had a PM implanted due to sinus node dysfunction .
Patients with permanent pacemakers ( PM ) are at high risk of developing atrial fibrillation ( AF ) .
Minimal ventricular pacing modalities have been demonstrated to reduce AF in such patients , although they are not suitable for patients with advanced atrioventricular conduction disease .
Recent evidence s suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( i.e. statins ) may represent a new strategy to prevent AF in patients at risk .
In this article , we sought to review data regarding the effectiveness of statin therapy in preventing AF patients with a PM .
Randomized Trial of Atorvastatin for Reduction of Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: Results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) Study
Background — Atrial fibrillation ( AF ) after cardiac surgery is associated with increased risk of complications , length of stay , and cost of care . Observational evidence suggests that patients who have undergone previous statin therapy have a lower incidence of postoperative AF . We tested this observation in a r and omized , controlled trial . Methods and Results — Two hundred patients undergoing elective cardiac surgery with cardiopulmonary bypass , without previous statin treatment or history of AF , were enrolled . Patients were r and omized to atorvastatin ( 40 mg/d , n=101 ) or placebo  ( n=99 ) starting 7 days before operation . The primary end point was incidence of postoperative AF ; secondary end points were length of stay , 30-day major adverse cardiac and cerebrovascular events , and postoperative C-reactive protein ( CRP ) variations . Atorvastatin significantly reduced the incidence of AF versus placebo ( 35 % versus 57 % , P=0.003 ) . Accordingly , length of stay was longer in the placebo versus atorvastatin arm ( 6.9±1.4 versus 6.3±1.2 days , P=0.001 ) . Peak CRP levels were lower in patients without AF ( P=0.01 ) , irrespective of r and omization assignment . Multivariable analysis showed that atorvastatin treatment conferred a 61 % reduction in risk of AF ( odds ratio 0.39 , 95 % confidence interval 0.18 to 0.85 , P=0.017 ) , whereas high postoperative CRP levels were associated with increased risk ( odds ratio 2.0 , 95 % confidence interval 1.2 to 7.0 , P=0.01 ) . The incidence of major adverse cardiac and cerebrovascular events at 30 days was similar in the 2 arms . Conclusions — Treatment with atorvastatin 40 mg/d , initiated 7 days before surgery , significantly reduces the incidence of postoperative AF after elective cardiac surgery with cardiopulmonary bypass and shortens hospital stay . These results may influence practice patterns with regard to adjuvant pharmacological therapy before cardiac surgery
Statistical heterogeneity between included studies was not detected ( chi(2 ) = 1.68 , P = 0.43 , I(2 ) = 0 % ) , although significant clinical differences were found in terms of study design , patient population s , statins use and dosage and AF-monitoring capabilities .
Statins may represent a novel treatment strategy to prevent the occurrence of AF in patients with PM , especially for those who had a PM implanted due to sinus node dysfunction .
Patients with permanent pacemakers ( PM ) are at high risk of developing atrial fibrillation ( AF ) .
Minimal ventricular pacing modalities have been demonstrated to reduce AF in such patients , although they are not suitable for patients with advanced atrioventricular conduction disease .
Recent evidence s suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( i.e. statins ) may represent a new strategy to prevent AF in patients at risk .
In this article , we sought to review data regarding the effectiveness of statin therapy in preventing AF patients with a PM .