Document Detail


Atrial fibrillation post-cardiac surgery: changing perspectives.
MedLine Citation:
PMID:  16870069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Perioperative atrial fibrillation (AF) is one of the most frequent complications of cardiac surgery. Its development is associated with an increased morbidity and mortality, for example from perioperative stroke, as well as ventricular arrhythmias, postoperative myocardial infarction, congestive cardiac failure, renal failure, increased use of inotropic medications and the need for intra-aortic balloon pump. Furthermore, AF after cardiac surgery results in prolonged hospitalization after the procedure, as well as an excess utilization of hospital resources and increased hospital costs. Given the importance of AF for patient outcome, a wide variety of prophylactic pharmacologic strategies have been evaluated. The risk of post-operative AF should be reduced by the administration of amiodarone, a beta-blocker, sotalol or rate-limiting calcium antagonists. In addition, in patients undergoing cardiac surgery on pre-existing beta-blocker therapy, this treatment should be continued unless contraindications develop (such as post-operative bradycardia or hypotension). Unless contraindicated, a rhythm control strategy is recommended as the initial option for the treatment of post-operative AF following cardiothoracic surgery. More recently, some data regarding magnesium, statins and n-3 polyunsaturated fatty acids in reducing post-op AF are available. Clearly, perspectives are changing in our management of this common arrhythmia.
Authors:
Eduard Shantsila; Timothy Watson; Gregory Y H Lip
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current medical research and opinion     Volume:  22     ISSN:  0300-7995     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-27     Completed Date:  2007-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  1437-41     Citation Subset:  IM    
Affiliation:
University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Anti-Inflammatory Agents / therapeutic use
Atrial Fibrillation / drug therapy,  etiology*
Cardiac Surgical Procedures / adverse effects*
Endocarditis / drug therapy,  etiology
Humans
Magnesium / therapeutic use
Postoperative Complications / etiology
Sotalol / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Anti-Inflammatory Agents; 1951-25-3/Amiodarone; 3930-20-9/Sotalol; 7439-95-4/Magnesium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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