# Transdermal bisoprolol for prevention of postoperative atrial fibrillation: A systematic review and meta‐analysis

## TL;DR

A review finds that transdermal bisoprolol is effective in reducing postoperative atrial fibrillation, possibly better than the oral version.

## Contribution

First systematic review and meta-analysis on transdermal bisoprolol for postoperative atrial fibrillation prevention.

## Key findings

- Transdermal bisoprolol reduced postoperative atrial fibrillation risk by 57% compared to control groups.
- The analysis included three studies with 551 patients, showing no heterogeneity among results.
- The findings suggest transdermal bisoprolol may be more effective than oral formulations.

## Abstract

The transdermal patch of bisoprolol available in Japan has been reported to demonstrate superior efficacy in preventing postoperative atrial fibrillation, possibly surpassing its oral counterpart. However, there has been no systematic review and meta‐analysis assessing the efficacy of transdermal bisoprolol.

A comprehensive systematic literature search was conducted on PubMed, Embase, and Cochrane to identify all relevant studies assessing the efficacy of transdermal bisoprolol in preventing postoperative atrial fibrillation. The search covered studies from inception up to December 4, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random‐effects model to calculate risk ratios (RR) and 95% confidence intervals (CI).

Three studies, comprising a total of 551 patients (transdermal bisoprolol 228 and control 323), were included. There was a decreased risk of postoperative atrial fibrillation or atrial tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43, 95% CI 0.27–0.67, p = .0002, I
2 = 0%).

Transdermal administration of bisoprolol has consistently shown efficacy, and this pooled analysis supports its effectiveness. The heterogeneity of the included studies limits certain interpretations. Future randomized clinical trials may elucidate the superiority of transdermal administration over oral administration.

Transdermal bisoprolol effectively reduces postoperative atrial fibrillation, potentially outperforming oral formulations.