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, 35 (6), 789-794

Remote Ischemic Preconditioning and Its Role in the Prevention of New Onset Atrial Fibrillation Post-Cardiac Surgery. A Meta-Analysis of Randomized Control Trials


Remote Ischemic Preconditioning and Its Role in the Prevention of New Onset Atrial Fibrillation Post-Cardiac Surgery. A Meta-Analysis of Randomized Control Trials

Ashish Kumar et al. J Arrhythm.


Background: The denouement of remote ischemic preconditioning on new onset atrial fibrillation (NOAF) post-cardiac surgery is not well-established. An updated meta-analysis of randomized control trials was performed by comparing remote ischemic preconditioning with controls and the outcome of interest was NOAF.

Methods: The systemic review was performed in accordance with the PRISMA (Preferred reporting items for systemic review) and AHA (American Heart Association) guidelines. PubMed database was searched to include relevant randomized control trials from inception to July 2019. We used Mantel-Haenzsel method with random error model to calculate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using the I 2 test> 50% or χ 2 P < .05. Publication bias was visually assessed using a funnel plot.

Results: Twelve randomized control trials were included in the final analysis. Remote ischemic preconditioning did not alter the risk of NOAF post-cardiac surgery [RR: 0.95, CI: 0.83-1.09, P = .48, I 2 = 37%, χ 2 P = .09].

Conclusion: In conclusion, the present meta-analysis failed to provide any evidence for the beneficial effect of remote ischemic preconditioning in the prevention of NOAF.

Keywords: meta‐analysis; new onset atrial fibrillation; remote ischemic preconditioning.

Conflict of interest statement

Authors declare no conflict of interests for this article.


Figure 1
Figure 1
PRISMA flow chart
Figure 2
Figure 2
Forest plot for new onset atrial fibrillation(NOAF) post‐cardiac surgery. The experimental group depicted in the forest plot was the group who underwent remote ischemic preconditioning. M‐H; Mantel‐Haenzsel method,CI; confidence interval

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