Mechanisms, Prevention, and Treatment of Atrial Fibrillation After Cardiac Surgery: A Narrative Review

J Cardiothorac Vasc Anesth. 2021 Nov;35(11):3394-3403. doi: 10.1053/j.jvca.2020.11.030. Epub 2020 Nov 19.

Abstract

New onset of postoperative atrial fibrillation (AF) generally is recognized as a frequent and debilitating complication after cardiac surgery, contributing to a considerable health- care cost. Extensive research has been conducted to study the underlying mechanisms and risk factors of AF in the perioperative period. Many options have been suggested to lower the incidence, and the concurrent cost in health resources. This review attempts to synthesize the large body of existing literature on AF, as well as expand and illustrate the available knowledge on its management strategies. The latter incorporates recent developments in the anesthesthetic approach as well as in the pharmacologic arsenal. In addition, the current review provides a tool for understanding the pathophysiology of AF and for reducing the occurrence after cardiac surgery. By using it, clinicians can manage patients with AF in the perioperative period of cardiac surgery and minimize the relatively high economic cost that accompanies it.

Keywords: atrial fibrillation; cardiac surgery; preventive strategies; risk factors; treatment.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Cardiac Surgical Procedures* / adverse effects
  • Humans
  • Incidence
  • Perioperative Care
  • Risk Factors