Postoperative atrial fibrillation: new directions in prevention and treatment.
Postoperative atrial fibrillation (POAF) is the most common and vexing complication of cardiac surgeries in adults. The consequences of this dysrhythmia are numerous and include hemodynamic instability, increased risk for embolic stroke, increased length of hospital stay, increased cost of hospitalization, significant resource utilization, and decreased long-term survival. While some progress has been made in prevention of POAF, the multiple mechanisms involved in its genesis are yet to be elucidated. This article reviews our current understanding of these mechanisms, predictors of POAF, drug therapy for prevention and treatment, and new uses for pacing and internal cardioversion for the prevention and treatment of POAF.
Kern
Leslie S
LS
Research Program Development, Heart and Vascular Institute, Long Beach Memorial Medical Center, Long Beach, CA 90806, USA. Lkern@memorialcare.org
D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D004554:Electric Countershock; D004562:Electrocardiography; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011237:Predictive Value of Tests; D011322:Primary Prevention / Q000379:methods; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D020521:Stroke / Q000209:etiology; D015996:Survival Rate
D000889:Anti-Arrhythmia Agents