EDUCATION IN HEART
The management of atrial fibrillation after cardiac surgery
Correspondence to:
Robert W Rho, MD, Associate Professor, Director, Cardiac Electrophysiology Catheter Ablation Program, University of Washington School of Medicine, HSB AA 121C, 1959 NE Pacific Street, Seattle, WA 98195, USA; rrho@u.washington.edu
| The first 150 words of the full text of this article appear below. |
Atrial fibrillation (AF) is the most common arrhythmia complicating cardiac surgery. Patients who develop AF following cardiac surgery are at increased risk of stroke, congestive heart failure, and haemodynamic instability. Postoperative AF is invariably associated with increased intensive care unit stays and prolonged hospitalisations and is responsible for significant patient morbidity and health care expenditures. Management of AF after cardiac surgery can be guided by knowledge of what is known about clinical postoperative AF and the evidence available on the efficacy of treatment strategies. The following is a concise review of postoperative AF as well as an evidence based approach to the management of AF after cardiac surgery.
PREVALENCE
Postoperative AF occurs in approximately 30–40% of patients undergoing coronary artery bypass grafting (CABG) surgery and in as many as 64% of patients with concomitant valve surgery. In a prospective observational study of 4657 patients undergoing CABG surgery at 70 centres, the
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