Postoperative atrial fibrillation: incidence, mechanisms, and clinical correlates

Cardiol Clin. 2014 Nov;32(4):627-36. doi: 10.1016/j.ccl.2014.07.002. Epub 2014 Aug 28.

Abstract

Atrial fibrillation is the most commonly encountered arrhythmia after cardiac surgery. Although usually self-limiting, it represents an important predictor of increased patient morbidity, mortality, and health care costs. Numerous studies have attempted to determine the underlying mechanisms of postoperative atrial fibrillation (POAF) with varied success. A multifactorial pathophysiology is hypothesized, with inflammation and postoperative β-adrenergic activation recognized as important contributing factors. The management of POAF is complicated by a paucity of data relating to the outcomes of different therapeutic interventions in this population. This article reviews the literature on epidemiology, mechanisms, and risk factors of POAF, with a subsequent focus on the therapeutic interventions and guidelines regarding management.

Keywords: Atrial fibrillation; Beta-blockers; Coronary artery bypass grafting; Postoperative atrial fibrillation.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Atrial Fibrillation* / prevention & control
  • Cardiovascular Agents / therapeutic use*
  • Humans
  • Incidence
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / prevention & control
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / methods
  • Thromboembolism* / epidemiology
  • Thromboembolism* / etiology
  • Thromboembolism* / prevention & control

Substances

  • Anticoagulants
  • Cardiovascular Agents