Disease × agent evidence record

Metoprolol for Atrial Fibrillation: evidence, trials and status

Metoprolol 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.

8 registered trials 0 recruiting 13 publications Evidence tier A · Strong Score 79.5
Research Tracker › Pairs › Atrial Fibrillation › Metoprolol
Research map, not treatment advice. This page aggregates registry and literature records. It does not evaluate efficacy, dosing or safety for any individual. Discuss any treatment decision with a qualified clinician.

Summary

Metoprolol 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linking Metoprolol to Atrial Fibrillation: 1 is active or not yet recruiting; 5 have completed; 2 are terminated, withdrawn, suspended or of unknown status.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 2026. The literature layer holds 13 publications for this pair: 5 Cochrane reviews, 2 meta-analyses, 1 randomised controlled trial publication and 5 clinical trial publications. Publication years run from 2021 to 2025. 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.

Open in Repurposing ExplorerAtrial Fibrillation hubAtrial Fibrillation biomarkers & interventionsChEMBLOpen Targets

Evidence table

Evidence tierA · Strong
Evidence score79.5 (trials 29.5, literature 30.0, tier 15, approved bonus 5.0)
Registered trials8 total: 0 recruiting, 1 active / not yet recruiting, 5 completed, 2 other
Linked publications13 (5 Cochrane reviews, 5 clinical trial publications, 2 meta-analyses, 1 randomised controlled trial publication)
Agent typeDrug (Small molecule)
Development stage (any indication)Approved
Mechanism / classNot recorded
Data sourcesOpen Targets, ChEMBL
Linked via biomarker / targetABCC9
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 IDTitleStatusPhaseEnrolment
NCT02391337Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF)
2016
completedPhase 4161
NCT01914926Comparison of Diltiazem and Metoprolol in the Management of Acute Atrial Fibrillation or Atrial Flutter
2009
completedPhase 454
NCT02251509Rate Control in Atrial Fibrillation
2016
status unknownPhase 420
NCT02025465Randomized Trial Comparing Diltiazem and Metoprolol For Atrial Fibrillation Rate Control
2013
status unknownPhase 4150
NCT00313157RATe Control in Atrial Fibrillation
2006
completedPhase 380
NCT07632157MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation
2026
not yet recruitingPhase 3196
NCT01970501Genetically Targeted Therapy for the Prevention of Symptomatic Atrial Fibrillation in Patients With Heart Failure
2014
completedPhase 2267
NCT00911508Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial
2009
completedNot applicable2,204

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Published literature

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Mechanism and notes

No mechanism of action is recorded for this pair in the source databases.

OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ABCC9. The tier describes how well the drug-disease link is documented, not how well the drug works.

Frequently asked questions

Is Metoprolol approved for Atrial Fibrillation?

Metoprolol 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 Metoprolol in clinical trials for Atrial Fibrillation?

ClinicalTrials.gov lists 8 registered trials linking Metoprolol to Atrial Fibrillation: 1 is active or not yet recruiting; 5 have completed; 2 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 2026.

What does the evidence show for Metoprolol in Atrial Fibrillation?

Metoprolol 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 Open Targets and ChEMBL, in this case via the biomarker or target ABCC9. The tier describes how well the drug-disease link is documented, not how well the drug works.

Cite this page

Open Source Medicine Foundation. Metoprolol for Atrial Fibrillation: evidence, trials and status. OSMF Research Tracker. Updated 2026-07-05. https://research.opensourcemed.info/pairs/atrial-fibrillation/metoprolol.html

Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.

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This is a research map, not treatment advice. Evidence tiers and scores summarise what has been studied, not whether a treatment works or is safe for you.