Role of carvedilol in atrial fibrillation: insights from clinical trials

Atrial fibrillation affects approximately 2 million people in the United States and is a common comorbidity among patients with heart failure. Clinical studies indicate that the benefits of the β-blocker carvedilol in patients with heart failure extend to patients with heart failure complicated by atrial fibrillation. The results of the Carvedilol in Atrial Fibrillation Evaluation (CAFE) trial provide support that carvedilol has incremental benefit when added to digoxin for the management of atrial fibrillation in patients with heart failure. Additional recent studies suggest that carvedilol may be useful in managing postsurgical atrial fibrillation and also may prevent recurrence of atrial fibrillation among patients who undergo cardioversion.