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[Arrhythmia;Perioperative Management and the Prevention].

Masayoshi Inoue1

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Kyobu Geka. the Japanese Journal of Thoracic Surgery
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Summary

Postoperative atrial fibrillation and flutter (POAF) affects 12.6% of patients after pulmonary resection. Management involves rate/rhythm control and anticoagulation for prolonged cases, but prevention requires further research.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Postoperative atrial fibrillation and flutter (POAF) is a frequent complication following pulmonary resection, with reported incidence rates of 12.6%.
  • POAF typically manifests 2-3 days postoperatively.
  • Potential etiologies include atrial overload (left and right), systemic inflammation, and postoperative hypoxia.

Purpose of the Study:

  • To review the current understanding of perioperative/postoperative atrial fibrillation and flutter (POAF) after pulmonary resection.
  • To discuss current management strategies for POAF.
  • To highlight the need for further research into POAF prevention.

Main Methods:

  • Literature review of perioperative/postoperative atrial fibrillation and flutter (POAF) after pulmonary resection.
  • Analysis of current therapeutic options for rate and rhythm control.
  • Evaluation of anticoagulant therapy recommendations for prolonged POAF.

Main Results:

  • Postoperative atrial fibrillation and flutter (POAF) occurs in 12.6% of patients undergoing pulmonary resection.
  • Current treatments focus on rate and rhythm control using Na channel blockers, β-blockers, and Ca blockers.
  • Anticoagulation is recommended for POAF lasting over 48 hours to prevent thromboembolism.

Conclusions:

  • Postoperative atrial fibrillation and flutter (POAF) is a significant complication after pulmonary resection.
  • Effective management strategies exist for rate, rhythm, and thromboembolism prevention.
  • Further clinical trials are essential to develop effective POAF prevention methods.