title: Atrial fibrillation after cardiac surgery: where are we now?
abstract: OBJECTIVE
  To review: 1) Pathophysiology of postoperative atrial fibrillation (POAF); 2) Risk factors for POAF; 3) Prophylaxis of POAF; 4) Treatment of POAF; and 5) Future directions.
  
  
  METHODS
  We searched the Medline database for articles published between January, 1966 to September, 2008. We used the following keywords: Atrial fibrillation, Postoperative atrial fibrillation, Coronary Artery Bypass, and antiarrhythmic agents. Additionally, we searched references from all relevant articles.
  
  
  CONCLUSIONS
  POAF occurs in 25-60% of patients depending on the type of cardiac surgery performed. POAF generally occurs on postoperative day 2 or 3. POAF is associated with an increased risk of morbidity and mortality, and longer hospital stay. Prophylactic treatments reduce the likelihood of POAF. In patients who experience POAF, rhythm strategies should be used in those who are symptomatic and hemodynamically unstable. All other patients should be managed with rate strategies.
authors.affiliation: St. David's Medical Center,Austin, TX 78744, USA. dimpi.patel@stdavids.com
authors.forename: Dimpi
authors.initials: D
authors.lastname: Patel
authors.forename: Marc A
authors.initials: MA
authors.lastname: Gillinov
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale