Atrial fibrillation after cardiac surgery: Pathophysiology and treatment

Christopher A. Palin, Rajagopal Kailasam, Charles W. Hogue

Research output: Contribution to journalArticlepeer-review

Abstract

Atrial fibrillation (AF) occurs in 25% to 60% of patients after cardiac surgery. It is most consistently associated with advanced age and valvular heart operations. Despite improving knowledge of the pathophysiology of chronic AF, postoperative AF remains an obstinate clinical problem. It is associated with an increased risk of stroke, longer hospital stay, and higher hospital expenditure. Consequently, there has been great interest in strategies to prevent and treat this arrhythmia. Treatment for postoperative AF may require immediate electrical cardioversion for hemodynamically unstable patients. Heart rate control is useful in most patients, with anticoagulation considered after 48 hours. Antiarrhythmic therapy is often effective in restoring sinus rhythm but its use needs to be balanced against the patient's risk of proarrhythmic side effects such as torsade de pointes.

Original languageEnglish (US)
Pages (from-to)175-183
Number of pages9
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Volume8
Issue number3
DOIs
StatePublished - Sep 1 2004

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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