Summary
Carvedilol has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Atrial Fibrillation would be drug repurposing rather than first-in-human development. This does not mean it is approved for Atrial Fibrillation. ClinicalTrials.gov lists 8 registered trials linking Carvedilol to Atrial Fibrillation: 5 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT02391337). The largest enrolment is 2204 participants (NCT00911508). Registration activity spans 2006 to 2016. The literature layer holds 13 publications for this pair: 3 Cochrane reviews, 4 meta-analyses, 1 systematic review and 5 clinical trial publications. Publication years run from 2013 to 2024. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Atrial Fibrillation ranks 332 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Spontaneous reversion to sinus rhythm occurs in ~50% of paroxysmal AF within 24-48 hours; persistent AF almost never self-terminates; rate-control (the dominant strategy) by definition keeps the patient in AF.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 73.0 (trials 23.0, literature 30.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 5 completed, 3 other |
| Linked publications | 13 (5 clinical trial publications, 4 meta-analyses, 3 Cochrane reviews, 1 systematic review) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | inhibitor; inhibitor |
| Data sources | DGIdb |
| Linked via biomarker / target | ADRB2 |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT02391337 | Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) 2016 | completed | Phase 4 | 161 |
| NCT02251509 | Rate Control in Atrial Fibrillation 2016 | status unknown | Phase 4 | 20 |
| NCT00313157 | RATe Control in Atrial Fibrillation 2006 | completed | Phase 3 | 80 |
| NCT00589303 | AV Node Ablation and Pacemaker Therapy Compared to Drug Therapy for Atrial Fibrillation - Pilot Study 2007 | terminated | Phase 3 | 27 |
| NCT00911508 | Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial 2009 | completed | Not applicable | 2,204 |
| NCT00292162 | Curing Atrial Fibrillation in Heart Failure 2007 | completed | Not applicable | 41 |
| NCT00578617 | Ablation vs Drug Therapy for Atrial Fibrillation - Pilot Trial 2006 | completed | Not applicable | 60 |
| NCT01608893 | Carvedilol for Prevention of Paroxysmal Atrial Fibrillation 2012 | status unknown | Not applicable | 300 |
Published literature
- Clinical trial publication Efficacy and safety of once-daily carvedilol in patients with atrial fibrillation: A randomized, double-blind, placebo-controlled trialChoi JI, Park YM, Oh YS et al. · Heart rhythm · 2024 · PMID 38621497
- Clinical trial publication Ivabradine could not decrease mitral regurgitation triggered atrial fibrosis and fibrillation compared with carvedilolLee WC, Lin YW, Shih JY et al. · ESC heart failure · 2024 · PMID 37963437
- Cochrane review Which should you choose for post operative atrial fibrillation, carvedilol or metoprolol? A systemic review and meta-analysisAbouzid MR, Vyas A, Eldahtoury S et al. · Current problems in cardiology · 2024 · PMID 37989396
- Clinical trial publication Comparing the efficacy of N-acetylcysteine plus carvedilol versus carvedilol in the prevention of atrial fibrillation following coronary artery bypass graft surgeryJalalian R, Maleki M, Ghafari R et al. · Journal of cardiac surgery · 2022 · PMID 36285551
- Meta-analysis Metoprolol for prophylaxis of postoperative atrial fibrillation in cardiac surgery patients: systematic review and meta-analysisNorhayati MN, Shaiful Bahari I, Zaharah S et al. · BMJ open · 2020 · PMID 33130564
- Cochrane review Perioperative beta-blockers for preventing surgery-related mortality and morbidity in adults undergoing cardiac surgeryBlessberger H, Lewis SR, Pritchard MW et al. · The Cochrane database of systematic reviews · 2019 · PMID 31544227
- Clinical trial publication Stroke Risk in Patients With Reduced Ejection Fraction After Myocardial Infarction Without Atrial FibrillationFerreira JP, Girerd N, Gregson J et al. · Journal of the American College of Cardiology · 2018 · PMID 29447733
- Systematic review Rationale for administering beta-blocker therapy to patients undergoing coronary artery bypass surgery: a systematic reviewThaper A, Kulik A · Expert opinion on drug safety · 2018 · PMID 30037300
- Clinical trial publication Heart rate control by carvedilol in Japanese patients with chronic atrial fibrillation: The AF Carvedilol studyInoue H, Atarashi H, Okumura K et al. · Journal of cardiology · 2017 · PMID 27364549
- Cochrane review Atrial fibrillation (acute onset)Lip GY, Apostolakis S · BMJ clinical evidence · 2014 · PMID 25430048
- Meta-analysis Carvedilol for prevention of atrial fibrillation after cardiac surgery: a meta-analysisWang HS, Wang ZW, Yin ZT · PloS one · 2014 · PMID 24705913
- Meta-analysis Meta-analysis comparing carvedilol versus metoprolol for the prevention of postoperative atrial fibrillation following coronary artery bypass graftingDiNicolantonio JJ, Beavers CJ, Menezes AR et al. · The American journal of cardiology · 2014 · PMID 24332247
- Meta-analysis Prevention of post-coronary artery bypass grafting (CABG) atrial fibrillation: efficacy of prophylactic beta-blockers in the modern era: a meta-analysis of latest randomized controlled trialsKhan MF, Wendel CS, Movahed MR · Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2013 · PMID 23347027
Mechanism and notes
Recorded mechanism or class: inhibitor; inhibitor.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in DGIdb, in this case via the biomarker or target ADRB2. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Carvedilol approved for Atrial Fibrillation?
Carvedilol has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Atrial Fibrillation would be drug repurposing rather than first-in-human development. This does not mean it is approved for Atrial Fibrillation. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Carvedilol in clinical trials for Atrial Fibrillation?
ClinicalTrials.gov lists 8 registered trials linking Carvedilol to Atrial Fibrillation: 5 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT02391337). The largest enrolment is 2204 participants (NCT00911508). Registration activity spans 2006 to 2016.
What does the evidence show for Carvedilol in Atrial Fibrillation?
Carvedilol has both completed registered trials and synthesis-level publications linked to Atrial Fibrillation. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in DGIdb, in this case via the biomarker or target ADRB2. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.