title: Management of postoperative atrial fibrillation in cardiac surgery patients.
abstract: Postoperative atrial fibrillation (AF) is a common arrhythmia following cardiac surgery and contributes to patient morbidity, prolonged hospital stay, and increased financial costs. The risk of postoperative AF may increase based on patient characteristics or events that occur intraoperatively or postoperatively. An understanding of these risks may be helpful in identifying which patients would benefit from prevention strategies. Acute AF presentation may range from completely indolent to rapidly progressing hemodynamic instability. Patients without hemodynamic compromise can be managed conservatively with rate control or initiation of antiarrhythmic medications. Patients with significant hemodynamic instability should undergo direct current cardioversion. In the postoperative period, it is reasonable to initiate anticoagulation after 48 hours of sustained AF or frequent episodes of postoperative AF.
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Raiten
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Prakash A
authors.initials: PA
authors.lastname: Patel
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA jacob.gutsche@uphs.upenn.edu.
authors.forename: Jacob
authors.initials: J
authors.lastname: Gutsche
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004554:Electric Countershock / Q000379:methods; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants
keywords: anticoagulants; cardiac surgery; cardiovascular risk factors; intensive care unit; outcome; postoperative complications