Atrial fibrillation following myocardial revascularization

Atrial fibrillation following coronary artery surgery is common, especially in elderly patients but despite numerous studies its pathophysiological basis is still incompletely understood. It is usually benign and self-limiting, but may be associated with haemodynamic compromise, prolonged hospitalization and embolic stroke. No risk factors (apart from age and preoperative beta-blocker withdrawal) have been shown to be associated with its occurrence. Conventional treatment is usually effective but no prophylactic regime has been identified. Until such a regime is found the incidence of atrial fibrillation following myocardial revascularization may only be reduced by continuing treatment in patients on beta-blockers in the preoperative period and re-establishing this therapy after surgery.