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Atrial Fibrillation: Aggressive Treatment in the Postoperative Cardiothoracic Surgery Patient

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Difficult Decisions in Cardiothoracic Critical Care Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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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.

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Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO, USA

    Jason W. Greenberg, Ralph J. Damiano Jr. MD & Spencer J. Melby MD

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  1. Jason W. Greenberg
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  2. Ralph J. Damiano Jr. MD
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  3. Spencer J. Melby MD
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Corresponding author

Correspondence to Spencer J. Melby MD .

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Editors and Affiliations

  1. University of Chicago Medicine, Chicago, IL, USA

    Vassyl A. Lonchyna

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Greenberg, J.W., Damiano, R.J., Melby, S.J. (2019). Atrial Fibrillation: Aggressive Treatment in the Postoperative Cardiothoracic Surgery Patient. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_16

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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