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Postoperative atrial fibrillation

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.

New onset postoperative atrial fibrillation following non-cardiac surgery is associated with a 2.5 fold increase in the risk of stroke (Kosher AN).

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).

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