What agents are most effective at reducing post-CABG AF incidence?
Preoperative and postoperative beta blockers (or possibly amiodarone) are most effective at reducing the incidence of post-CABG AF, with several RCTs showing that they effectively accomplish this goal. Digoxin and nondihydropyridine calcium channel blockers can be useful to control the ventricular rate in the setting of AF but are not indicated for prophylaxis. Additionally, preoperative administration of amiodarone to reduce the incidence of postoperative AF is reasonable for patients at high risk for postoperative AF who have contraindications to beta blockers.