Seminars in Cardiothoracic and Vascular Anesthesia

 

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 9, No. 1, 77-85 (2005)
DOI: 10.1177/108925320500900108

Atrial Fibrillation After Cardiac Surgery: An Evidence-Based Approach to Prevention

Rajagopal Kailasam, MBBS

Christopher A. Palin, MBBS

Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Washington University School of Medicine, St Louis, MO

Charles W. Hogue, Jr, MD

Campus Box 8054, 660 S. Euclid Avenue, St. Louis, MO 63110-1093hoguec{at}wustl.edu

A number of advances in surgical and anesthetic techniques have reduced the risk for patients undergoing cardiac surgery. However, postoperative atrial fibrillation remains common, with an incidence ranging between 25% and 40%. It is associated with an increased incidence of congestive heart failure, renal insufficiency, and stroke that prolongs hospitalization and increases rates of readmission after discharge. Consequently, there has been great interest in strategies to prevent this arrhythmia. When both safety and efficacy are considered, the available evidence to date suggests that only ßblockers can be recommended for the prevention of atrial fibrillation after cardiac surgery. Other treatments might be considered on an individual basis after careful consideration of the patient's potential for side effects.


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