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Postoperative atrial fibrillation: Target for stroke prevention?
Vincent Thijs1,2, Robin Lemmens3,4,5, Omar Farouque6,7
1Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
European Stroke Journal
|April 23, 2019
Summary
Postoperative atrial fibrillation (AF) increases long-term risks for future AF episodes, stroke, and mortality. Further research is needed to define optimal prevention strategies for these adverse outcomes.
Area of Science:
- Cardiology
- Clinical Medicine
- Epidemiology
Background:
- Postoperative atrial fibrillation (POAF) affects numerous patients without prior history.
- POAF occurs within days of surgery and its long-term implications are significant.
Purpose of the Study:
- To investigate if transient postoperative atrial fibrillation is a risk factor for future atrial fibrillation, stroke, and death.
- To review current literature and guidelines regarding POAF management.
Main Methods:
- A narrative review of existing literature on POAF epidemiology and mechanisms.
- Analysis of studies on the risk of atrial fibrillation, stroke, and death post-POAF.
- Review of antithrombotic guidelines and identification of management gaps.
Main Results:
- Patients experiencing POAF face a heightened risk of long-term atrial fibrillation and increased mortality.
- Observational studies suggest a higher risk of stroke in patients with POAF.
- Optimal antithrombotic strategies and the role of lifestyle changes or surgical interventions remain undefined.
Conclusions:
- Transient postoperative atrial fibrillation is associated with significant long-term risks.
- Further research is essential to establish optimal preventive strategies for adverse outcomes following POAF.
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