title: [Rational management of atrial fibrillation in intensive care].
abstract: Atrial fibrillation (AF) occurs frequently in intensive care unit (ICU) patients and after coronary bypass graft (CABG) and valve surgery, with the peak incidence on postoperative days 2 and 3. Moreover, AF is one of the most common complications after thoracic surgery, e.g. video-assisted thoracic surgery (VATS), lobectomy or extrapleural pneumonectomy. Prophylaxis with beta-blockers can reduce postoperative incidence of AF. The acute treatment of new-onset AF involves rhythm and frequency control and depends on whether the patient is hemodynamically stable or not. Rate control can be performed with beta-blockers or calcium-channel-blockers. Amiodarone is an effective and safe drug for converting AF to sinus rhythm. Conversion of AF should not be attempted 48 h after onset without anticoagulation or transesophageal echocardiography to rule out intracardiac thrombus formation. In order to avoid thromboembolism after cardioversion, an effective anticoagulation is mandatory.
authors.forename: B
authors.initials: B
authors.lastname: Hoffmann
authors.forename: I
authors.initials: I
authors.lastname: Vilke
authors.forename: I
authors.initials: I
authors.lastname: Drevitz
authors.forename: D
authors.initials: D
authors.lastname: Steven
authors.forename: T
authors.initials: T
authors.lastname: Rostok
authors.forename: S
authors.initials: S
authors.lastname: Willems
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017115:Catheter Ablation; D000075202:Contraindications; D019091:Critical Pathways / Q000592:standards; D004334:Drug Administration Schedule; D004452:Echocardiography; D004554:Electric Countershock / Q000009:adverse effects*; D004562:Electrocardiography; D006801:Humans; D007362:Intensive Care Units; D011183:Postoperative Complications; D019616:Thoracic Surgical Procedures; D013923:Thromboembolism / Q000150:complications / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants