Eleven RCTs (n=1,294) were included.
The quality scores ranged from 2 to 5. No statistically significant heterogeneity was found.
Calcium-channel blockers (4 RCTs, n=618) significantly reduced the risk of AT compared with placebo (RR 0.50, 95% CI: 0.34, 0.73). For every 100 patients treated, 11 episodes of AT were averted (95% CI: -17, -5). Calcium-channel blockers carried a slightly greater risk of adult respiratory distress syndrome (ARDS) than placebo, but this difference was not statistically significant (RR 1.31, 95% CI: 0.46, 3.72).
Beta-blockers (2 RCTs, n=129) significantly reduced the risk of AT compared with placebo (RR 0.40, 95% CI: 0.17, 0.95). For every 100 patients treated, 14 episodes of AT were averted (95% CI: -26, -2). Beta-blockers increased the risk of pulmonary oedema, although this was not statistically significant (RR 2.15, 95% CI: 0.74, 6.23).
Magnesium (1 RCT, n=194) significantly reduced the risk of AT compared with placebo (RR 0.40, 95% CI: 0.21, 0.78). For every 100 patients treated, 16 episodes of AT were averted (95% CI: -27, -5). No information on severe pulmonary complications with magnesium was reported.
Digitalis (3 RCTs, n=285) significantly increased the risk of AT compared with placebo (RR 1.51, 95% CI: 1.00, 2.28). No data on severe pulmonary complications with digitalis were reported.
The one RCT (n=30) of flecainide found no statistically significant difference between flecainide and placebo for AT (RR 0.16, 95% CI: 0.01, 2.89). No severe pulmonary complication events were reported
The one RCT (n=62) of amiodarone found no statistically significant difference between amiodarone and placebo for AT (RR 0.14, 95% CI: 0.02, 1.10). There was a greater risk of ARDS in the amiodarone group than the placebo group, but this difference was not statistically significant (RR 7.00, 95% CI: 0.38, 130.26).
Further analyses of the outcomes hypotension, bradycardia, myocardial ischaemia and mortality were presented.