Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review.
Atrial Fibrillation (AF) is the most common arrhythmia occurring after cardiac surgery. Its incidence varies depending on type of surgery. Postoperative AF may cause hemodynamic deterioration, predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as reduces hospitalization and overall morbidity. Beta-blockers, have been proved to prevent effectively atrial fibrillation following cardiac surgery and should be routinely used if there are no contraindications. Sotalol may be more effective than standard b-blockers for the prevention of AF without causing an excess of side effects. Amiodarone is useful when beta-blocker therapy is not possible or as additional prophylaxis in high risk patients. Other agents such as magnesium, calcium channels blocker or non-antiarrhythmic drugs as glycose-insulin--potassium, non-steroidal anti-inflammatory drugs, corticosteroids, N-acetylcysteine and statins have been studied as alternative treatment for postoperative AF prophylaxis.
Cardiothoracic Surgery Department, Patras University, School of Medicine, Rion Patras, Greece. iokoniari@yahoo.gr
Ioanna
I
Koniari
Efstratios
E
Apostolakis
Christina
C
Rogkakou
Nikolaos G
NG
Baikoussis
Dimitrios
D
Dougenis
D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D018890:Chemoprevention; D006801:Humans; D011292:Premedication
D000889:Anti-Arrhythmia Agents