Prevention and management of perioperative arrhythmias in the thoracic surgical population

Although bradyarrhythmias or malignant ventricular tachyarrhythmias have been reported in less than 1% of patients following noncardiac surgery, rapid atrial arrhythmias more frequently affect the elderly who undergo thoracic operations. This article focuses on new issues leading to the improved understanding of the pathophysiology and mechanisms of postoperative atrial arrhythmias. It discusses new risk factors and a prediction rule for postthoracotomy atrial fibrillation (AF), reviews prophylaxis and acute therapeutic interventions for postthoracotomy AF, and highlights the most recent recommendations of the American Heart Association Task Force on the management of patients who have AF with emphasis on preventing thromboembolic events.