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Atrial fibrillation and cardiac surgery.
MedLine Citation:
PMID:  17021530     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To discuss the pathophysiology, risk factors, and treatments for atrial fibrillation occurring after cardiac surgery. RECENT FINDINGS: Atrial fibrillation occurs frequently after cardiac surgery and it may lead to patient morbidity. Many variables have been suggested to be associated with this arrhythmia, but only advanced patient age can consistently identify risk for this complication. Immediate electrical cardioversion is indicated when the arrhythmia leads to hemodynamic instability or myocardial ischemia. Otherwise treatment is aimed at heart rate control, elective cardioversion with drugs or electrical means, and anticoagulation when the arrhythmia persists. Multiple investigations have evaluated methods for preventing postoperative atrial fibrillation, but only beta-adrenergic receptor blocking drugs have been consistently shown to be effective, and then not in all patients. Surgical treatments are increasingly being considered as a therapeutic means for ameliorating chronic atrial fibrillation. The use of these procedures has been simplified with the development of devices that can generate linear scars in the atrium and around the pulmonary vein orifices. These simplifications will allow for broader application of these techniques to patients undergoing other cardiac surgery (e.g. mitral valvular surgery). SUMMARY: Atrial fibrillation is one of the most common complications of cardiac surgery. There are three major aims for treating atrial fibrillation: conversion to sinus rhythm, heart rate control, and anticoagulation. Only beta-blockers can be recommended for prophylaxis against postoperative atrial fibrillation. Further refinements in surgical treatments for atrial fibrillation may allow for wider applications of this therapy with lower rates of complications.
Authors:
Sarah A McMurry; Charles W Hogue
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  17     ISSN:  0952-7907     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2006-10-05     Completed Date:  2007-06-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-70     Citation Subset:  -    
Affiliation:
Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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