Statins as Antiarrhythmics: A Systematic Review Part I: Effects on Risk of Atrial Fibrillation

Background. Recent studies have demonstrated that statins may possess antiarrhythmic properties in addition to their lipid-lowering effects. Methods: Studies which reported the association of statins with the incidence of atrial arrhythmias were identified through a systematic review of published literature. Results: One randomized, placebo-controlled trial Of 200 patients undergoing cardiac surgery showed that atorvastatin decreased the incidence of postoperative atrial fibrillation by 61%. Observational studies in patients with stable coronary disease, left ventricular dysfunction, or those undergoing cardiac or noncardiac surgery show that statin therapy is associated with an approximately 50% lower rate of atrial fibrillation. Two small randomized trials reported conflicting results: one showing that atorvastatin reduced the recurrence of AF after electrical cardioversion and the other finding that pravastatin did not. Conclusions: Published data suggests that statins may possess antiarrhythmic properties that reduce the propensity for atrial fibrillation. Most of this data is observational; more randomized, placebo-controlled trials are needed.