Management of Atrial Fibrillation After Cardiac Surgery

I Made Adi Permana, Herdono Poernomo

Abstract


Post-operative atrial fibrillation (POAF) is the most common complication encountered after cardiac surgery. The incidence of POAF reported in previous studies varies between 20% and 50%, depends on definitions and methods of detection. The peak incidence of POAF is between postoperative days 2 and 4 and it is seldom seen after the first week of surgery.

Although generally well tolerated and seen as a temporary problem related to surgery, POAF can be life threatening, particularly in elderly patients and those with left ventricular dysfunction. POAF associated with increased post-operative thromboembolic risk and stroke, hemodynamic compromise, ventricular dysrhythmias, and iatrogenic complications associated with therapeutic interventions.

The pathophysiology of POAF after heart surgery is not precisely known, but the mechanisms are thought to be multifactorial. Different risk factors have been reported, and many studies have evaluated the prophylactic effect of different pharmacologic or physical interventions. Thus, optimal preventive and treatment strategies are importance to reduce the impact of POAF.

Keywords: atrial fibrillation, cardiac surgery, postoperative management


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