title: Early management of atrial fibrillation in general surgical in-patients.
abstract: BACKGROUND
  It has been suggested that new-onset atrial fibrillation (AF) in non-cardiac surgical patients should trigger a thorough search for other morbidity. We reviewed our unit's management of new-onset AF to determine whether this target is achieved.
  
  
  METHODS
  Patients under the care of a general surgeon who developed new-onset AF during their inpatient stay were identified from a prospectively maintained database of surgical in-patients. Their case-notes were reviewed to determine whether a precipitating cause for the AF was sought or identified.
  
  
  RESULTS
  Thirty-one patients developed new-onset AF. Almost half had positive findings on cardiovascular or respiratory system examination and assessment. However, 35% of patients had no respiratory examination, 58% had no cardiovascular examination and 55% had no abdominal examination performed. Eighty-one percent had another underlying complication diagnosed within 24h of the AF. Twenty-six percent had an intra-abdominal collection. Of those with an underlying complication, 52% were not diagnosed at the time of initial assessment for AF. Twenty percent of patients died within 30 days of the AF.
  
  
  CONCLUSIONS
  New-onset AF in general surgical patients is associated with considerable morbidity. A thorough clinical evaluation and early involvement of senior surgical staff are recommended.
authors.affiliation: Department of General Surgery, West Suffolk Hospitals NHS Trust, Hardwick Lane, Bury St Edmunds, Suffolk IP22 2QZ, United Kingdom.
authors.forename: Stewart R
authors.initials: SR
authors.lastname: Walsh
authors.forename: Catrin
authors.initials: C
authors.lastname: Thomas
authors.forename: Sanjay
authors.initials: S
authors.lastname: Manohar
authors.forename: Eamonn C
authors.initials: EC
authors.lastname: Coveney