Postoperative atrial arrhythmias and atrial fibrillation and flutter are seen in 6.1% of elderly patients undergoing noncardiothoracic surgery and in 10-40% of patients after cardiothoracic procedures.
The incidence of postoperative atrial fibrillation higher in patients 60 years and older, in those with preoperative heart rate greater than 74 beats per minute, in those who develop postoperative pneumonia or acute respiratory insufficiency.
Intravenous hydrocortisone reduces the relative risk of postoperative AF by 37% compared with placebo in patients undergoing CABG surgery, aortic valve replacement or combined CABG and aortic valve replacement.
Atrial fibrillation after non-cardiac surgery is associated with increased morbidity, mortality, and costs.
There is a high recurrence rate for atrial fibrillation after postoperative atrial fibrillation, as well as increased long-term risk of stroke.
Drug prophylaxis with amiodarone, beta blockers or statins reduces the incidence of postoperative atrial fibrillation after non-cardiac surgery (OrsterleA).
New-onset, postoperative AF after coronary artery bypass grafting is the most frequent early complication after surgery with a reported incidence of approximately 30%.
New onset AF after CABG is associated with prolonged postoperative hospitalization, costs, discomfort, and an increased long-term risk of thromboembolic stroke, heart failure, and AF recurrence.
Guidelines suggest to administer anticoagulation for 60 days after surgery and reevaluate the need for longer-term coagulation.
In a study of 198 patients having undergone CABG bypass graft and placement of a continuous ECG monitor revealed that the incidence of  postoperative AF at 1 year was higher than previously appreciated at 48%, but the AF burden after surgery is very low at 0.7% suggesting oral anticoagulation for new onset AF after CABG is unnecessary.
The median burden AF is very low within 30 days and minuscule later than 30 days after surgery.