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Atrial Fibrillation: Aggressive Treatment in the Postoperative Cardiothoracic Surgery Patient

  • Jason W. Greenberg
  • Ralph J. DamianoJr.
  • Spencer J. MelbyEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Atrial fibrillation (AF) occurs in approximately 35% of patients following cardiac surgery and 10–30% of patients following thoracic surgery, depending on the patient’s underlying risk factors for AF and the type of surgery. Postoperative atrial fibrillation (POAF) is associated with numerous detrimental sequelae, including an increased risk of stroke, cardiac arrest, respiratory and renal failure, and all-cause mortality. Pre- and postoperative prophylaxis and treatment of POAF are centered around the use of beta blockers, amiodarone, and/or nondihydropyridine calcium channel blockers, with direct current (DC) cardioversion used as necessary in high-risk patients who develop POAF. Numerous other medications and modalities, such as biatrial pacing, have been used for POAF prophylaxis and treatment with limited success.

Keywords

Atrial fibrillation Postoperative atrial fibrillation (POAF) Thromboembolism Antiarrhythmic drugs Direct current (DC) cardioversion 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jason W. Greenberg
    • 1
  • Ralph J. DamianoJr.
    • 1
  • Spencer J. Melby
    • 1
    Email author
  1. 1.Division of Cardiothoracic SurgeryWashington University School of Medicine, Barnes-Jewish HospitalSt. LouisUSA

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