title: Postbypass arrhythmias: pathophysiology, prevention, and therapy.
abstract: OBJECTIVE
  To review the medical literature on new-onset arrhythmias after cardiac bypass surgery in adults, focusing on the most recent advances on this topic.
  
  
  RESULTS
  Main attention is focused on possible predictors and prevention of postoperative atrial fibrillation, because this arrhythmia is the most common type encountered with cardiac surgery and is associated with increased morbidity and mortality and longer, more expensive hospital stays. Therapeutic management of atrial fibrillation favors class III antiarrhythmic agents like amiodarone and sotalol. Direct-current cardioversion proved to be an ineffective method for treatment of supraventricular tachyarrhythmias. In patients with persistent atrioventricular block or sinus node dysfunction after cardiac valve surgery, a risk score to predict the need for permanent pacing after cardiac valve surgery was developed. This scoring system may be useful for pre- and perioperative management of patients undergoing cardiac valve surgery.
  
  
  CONCLUSIONS
  Recent studies demonstrate a continued effort to improve our knowledge about postbypass arrhythmias. New insights in the pathophysiology of postoperative cardiac arrhythmias and advances in prevention and therapy are rapid and results are heterogeneous, so it is difficult for the clinician to keep abreast with these new findings.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Medical University Innsbruck, Austria. johann.knotzer@uibk.ac.at
authors.forename: Hans
authors.initials: H
authors.lastname: Knotzer
authors.forename: Martin W
authors.initials: MW
authors.lastname: Dünser
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Mayr
authors.forename: Walter R
authors.initials: WR
authors.lastname: Hasibeder
mesh_terms: D001145:Arrhythmias, Cardiac / Q000145:classification / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003422:Critical Care; D006801:Humans; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000517:prevention & control / Q000628:therapy