title: The significance of preoperative atrial fibrillation in patients undergoing cardiac surgery: preoperative atrial fibrillation--still underestimated opponent.
abstract: Atrial fibrillation (AF) has been described as an 'epidemic' due to its increasing prevalence in the ageing population. The prevalence of AF in the UK has risen from 0.78% in 1994 to 1.42% in 2006. The pathogenesis of AF seems to be multifactorial, and includes electrical and structural remodelling, and inflammation. As a result of recent developments in invasive cardiology together with improved pharmacological treatments, cardiac surgeons are increasingly operating on elderly patients with very advanced heart disease and other co-existent diseases. Therefore, AF is often present before cardiac surgery, increasing the risk of surgery and the occurrence of postoperative complications. According to available data, preoperative AF (pre-AF) should be considered as a high-risk marker of postoperative complications, which also significantly reduces long-term patient survival. However, although some multivariate models have concluded that pre-AF seems to be an independent predictor of outcome, this does not prove a cause-effect relationship. Therefore, such a link would need to be proven in prospective randomized studies, yet to be undertaken.
authors.affiliation: Department of Cardionephrology and Hypertension, Medical University of Lodz, Lodz, Poland. maciejbanach@aol.co.uk
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.forename: Murat
authors.initials: M
authors.lastname: Ugurlucan
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: Marcin
authors.initials: M
authors.lastname: Barylski
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
mesh_terms: D001281:Atrial Fibrillation / Q000401:mortality* / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality*; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors