Publication Type:

Journal Article

Authors:

Nair, S.G.

Source:

Annals of Cardiac Anaesthesia, Volume 13, Number 3, p.196-205 (2010)

URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-79951482234&partnerID=40&md5=bb6fd3e0e1df0cddf95b6fc80bc1d0d1

Keywords:

Adrenergic beta-Antagonists, amiodarone, Anti-Arrhythmia Agents, antiarrhythmic agent, anticoagulant agent, Artificial, atenolol, Atrial Fibrillation, atrioventricular block, beta adrenergic receptor blocking agent, bisoprolol, bleeding, bradycardia, Calcium Channel Blockers, calcium channel blocking agent, Cardiac Pacing, Cardiac Surgical Procedures, cardiopulmonary bypass, cardioversion, carvedilol, cerebrovascular accident, congestive heart failure, coronary artery bypass graft, digoxin, diltiazem, dipeptidyl carboxypeptidase inhibitor, disease association, Disease control, dronedarone, Electric Countershock, Electrophysiological Phenomena, forward heart failure, gastrointestinal toxicity, heart atrium fibrillation, heart atrium flutter, heart atrium pacing, heart electrophysiology, heart infarction, heart muscle ischemia, heart surgery, heart ventricle tachycardia, heparin, human, Humans, hydroxymethylglutaryl coenzyme A reductase inhibitor, hypotension, ibutilide, kidney disease, loading drug dose, lupus like syndrome, magnesium, magnesium deficiency, methylprednisolone, metoprolol, nonsteroid antiinflammatory agent, pericardiotomy, placebo, postoperative atrial fibrillation, Postoperative Complications, prediction, Predictive Value of Tests, procainamide, propafenone, ranazoline, reentry arrhythmia, review, risk factor, Risk Factors, sinus rhythm, sotalol, supraventricular tachycardia, surgical risk, thromboembolism, torsade des pointes, treatment outcome, unclassified drug, unspecified side effect, verapamil

Abstract:

Once considered as nothing more than a nuisance after cardiac surgery, the importance of postoperative atrial fibrillation (POAF) has been realized in the last decade, primarily because of the morbidity associated with the condition. Numerous causative factors have been described without any single factor being singled out as the cause of this complication. POAF has been associated with stroke, renal failure and congestive heart failure, although it is difficult to state whether POAF is directly responsible for these complications. Guidelines have been formulated for prevention of POAF. However, very few cardiothoracic centers follow any form of protocol to prevent POAF. Routine use of prophylaxis would subject all patients to the side effects of anti-arrhythmic drugs, while only a minority of the patients do actually develop this problem postoperatively. Withdrawal of beta blockers in the postoperative period has been implicated as one of the major causes of POAF. Amiodarone, calcium channel blockers and a variety of other pharmacological agents have been used for the prevention of POAF. Atrial pacing is a non-pharmacological measure which has gained popularity in the prevention of POAF. There is considerable controversy regarding whether rate control is superior to rhythm control in the treatment of established atrial fibrillation (AF). Amiodarone plays a central role in both rate control and rhythm control in postoperative AF. Newer drugs like dronedarone and ranazoline are likely to come into the market in the coming years.

Notes:

cited By (since 1996)4

Cite this Research Publication

S. G. Nair, “Atrial fibrillation after cardiac surgery”, Annals of Cardiac Anaesthesia, vol. 13, pp. 196-205, 2010.