Atrial Fibrillation after Cardiac Surgery
Jonathan S. Steinberg
Springer Science & Business Media, Dec 31, 1999 - Medical - 169 pages
Cardiac surgery is performed on hundreds of thousands of patients a year, and can have an important beneficial impact on the outcomes of patients with coronary and valvular heart diseases. Despite the favorable recovery of most patients, some will have their post-operative period interrupted by the development of atrial fibrillation, with a host of potential complications including stroke. High risk subgroups may develop atrial fibrillation in more than half of cases, and often despite aggressive prophylactic measures. Treatment of atrial fibrillation and its aftermath can also add days to the hospital stay of the cardiac surgical patient. In an era of aggressive cost cutting and optimization of utilization of health care resources, the financial impact of this arrhythmic complication may be enormous.
Experimental studies have led to a greater understanding of the mechanism of atrial fibrillation and potential precipitating factors in the cardiac surgical patient. Prophylactic efforts with beta-blockers, antiarrhythmic drugs and atrial pacing are being used, or are being investigated in clinical trials. New methods of achieving prompt cardioversion with minimal disruption of patient care, and prevention of the thromboembolic complications of atrial fibrillation, are also important therapeutic initiatives. This text is designed to aid health care professionals in the treatment of their patients in the recovery period after cardiac surgery, and to instigate additional research efforts to limit the occurrence of, and the complications following, this tenacious postoperative arrhythmia.
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acebutolol AFIB amiodarone Ann Thorac Surg antiarrhythmic drugs aortic artery bypass grafting artery bypass surgery association Atrial Fibrillation atrial ﬂutter atrial refractoriness atrium beneﬁt beta blockers beta-blocker CABG cardiac arrhythmias cardiac surgery cardioplegia cardiopulmonary bypass Circulation clinical Coll Cardiol compared coronary artery bypass coronary bypass surgery deﬁned demonstrated developed atrial ﬁbrillation developed postoperative development of postoperative digoxin disease effects electrophysiologic epicardial ﬁbrillation after coronary ﬁndings ﬁrst following coronary artery incidence of atrial incidence of postoperative increased ischemia left ventricular length of stay lung magnesium MCSPI metoprolol myocardial infarction occur patients undergoing patients who developed pericarditis perioperative placebo pneumonectomy post-operative atrial tachyarrhythmias postoperative arrhythmias postoperative atrial ﬁbrillation preoperative prevention of atrial procedure prophylactic propranolol pulmonary randomized reentrant reentry circuit reported resection right atrial risk factors signiﬁcantly sinus rhythm sotalol substrate supraventricular arrhythmias supraventricular tachyarrhythmias supraventricular tachycardia surgical therapy Thorac Cardiovasc Surg timolol valve verapamil warfarin