Strategies for the management of postoperative atrial fibrillation

Atrial fibrillation is an important complication of non-cardiothoracic surgery and is associated with higher hospital costs and increased morbidity. Strategies of rate versus rhythm control have been compared in several studies and patient populations and generally result in equivalent patient outcomes. Hemodynamically unstable patients should be electrically cardioverted for immediate restoration of sinus rhythm. However, in stable patients, a variety of pharmacologic agents can be selected for either rate or rhythm control. Selection of a particular agent should be based on a patient's comorbidities and preferences, as well as specific characteristics of each agent.