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. 2019 Sep 23;2019(9):CD013435. doi: 10.1002/14651858.CD013435

White 1984.

Methods RCT, parallel design
Participants Total number of randomized participants: 41
Inclusion criteria: undergoing CABG surgery
Exclusion criteria: contraindications to beta‐blockers; 2nd‐ or 3rd‐degree atrioventricular block; resting sinus bradycardia < 56 bpm; diabetes mellitis; spontaneous hypoglycaemia; allergic rhinitis; bronchospasm of any cause; COPD; treatment with digitalis
Type of surgery: elective CABG
Baseline characteristics
Intervention group (timolol)
  • Age, mean (SD): 55 (± 9) years

  • Gender, M/F: 17/4

  • Ejection fraction, mean (SD), %: 63 (± 11)

  • Preoperative use of beta‐blockers, %: 100


Control group (placebo)
  • Age, mean (SD): 56 (± 10) years

  • Gender, M/F: 17/3

  • Ejection fraction, mean (SD), %: 62 (± 12)

  • Preoperative use of beta‐blockers, %: 90


Country: USA
Setting: single centre; hospital
Interventions Intervention group (timolol)
  • Randomized, n = 21; losses = 0; analysed, n = 21 (use of ITT analysis was not reported)

  • Details: existing beta‐blocker therapy stopped at least 12 h before surgery; timolol 0.5 mg diluted in 10 mL saline, given IV over 1 min twice daily starting 3‐7 h after surgery. When oral medication could be given, timolol 10 mg was given twice daily for 7 days


Control group (placebo)
  • Randomized, n = 20; losses = 0; analysed, n = 20 (use of ITT analysis was not reported)

  • Details: placebo given same as intervention group

Outcomes Outcomes measured/reported by study authors: supraventricular tachyarrhythmias (to include AF), mortality, death due to cardiac causes (MI)
Outcomes relevant to the review: AF, mortality
Notes Funding/declarations of interest: primary author supported by Odlin Research Fellowship of the Royal Australasian College of Physicians
Study dates: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not specified
Allocation concealment (selection bias) Unclear risk Not specified
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Randomized, placebo‐controlled, double‐blind trial
Blinding of outcome assessors (detection bias) 
 All outcomes Unclear risk Not specified
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No apparent losses
Selective reporting (reporting bias) Unclear risk Study authors did not report prospective clinical trial registration or publication of a protocol. It was not feasible to effectively assess risk of reporting bias
Other bias Low risk Not detected