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Atrial fibrillation after cardiac surgery: where are we now?

Dimpi Patel1, Marc A Gillinov, Andrea Natale

  • 1St. David's Medical Center,Austin, TX 78744, USA. dimpi.patel@stdavids.com

Indian Pacing and Electrophysiology Journal
|November 5, 2008
PubMed

Insights

Postoperative atrial fibrillation (POAF) affects 25-60% of cardiac surgery patients, increasing risks. Prophylaxis is recommended, with specific strategies for symptomatic or unstable patients versus others.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery.
  • It significantly increases patient morbidity, mortality, and hospital length of stay.

Purpose of the Study:

  • To comprehensively review the pathophysiology, risk factors, prophylaxis, and treatment of POAF.
  • To outline future research directions in POAF management.

Main Methods:

  • A systematic literature search was conducted using Medline database from January 1966 to September 2008.
  • Keywords included "Atrial fibrillation," "Postoperative atrial fibrillation," "Coronary Artery Bypass," and "antiarrhythmic agents."
  • References from relevant articles were also reviewed.

Main Results:

  • POAF incidence ranges from 25% to 60%, varying with the type of cardiac surgery.
  • POAF typically manifests on postoperative days 2 or 3.
  • POAF is linked to elevated risks of complications and prolonged hospitalization.

Conclusions:

  • Prophylactic interventions can decrease the incidence of POAF.
  • Symptomatic and hemodynamically unstable patients with POAF should receive rhythm control strategies.
  • Asymptomatic or stable patients with POAF are best managed with rate control strategies.
Abstract

Keywords:
Atrial fibrillationantiarrhythmic agentscoronary artery bypasspostoperative atrial fibrillation

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