• New-onset postoperative atrial fibrillation after heart surgery.

      Gudbjartsson, Tomas; Helgadottir, Solveig; Sigurdsson, Martin Ingi; Taha, Amar; Jeppsson, Anders; Christensen, Thomas Decker; Riber, Lars Peter Schoedt; 1 Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. 2 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3 Department of Cardiothoracic Surgery and Anaesthesia, Uppsala University Hospital, Uppsala, Sweden. 4 Department of Anaesthesia and Critical Care, Landspitali University Hospital, Reykjavik, Iceland. 5 Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 6 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7 Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 8 Department of Cardiothoracic and Vascular Surgery, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. 9 Department of Cardiothoracic and Vascular Surgery, Department of Clinical Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark. (Wiley, 2019-11-14)
      BACKGROUND: New-onset postoperative atrial fibrillation (poAF) complicates approximately 20-60% of all cardiac surgical procedures and is associated with an increased periprocedural mortality and morbitity, prolonged hospital stay, increased costs, and worse long-term survival. Unfortunately multiple advances in surgery and perioperative care over the last two decades have not led to a reduction in the incidence of poAF or associated complications in the daily clinical practice. METHODS: A narrative review of the available literature was performed. RESULTS: An extensive review of the pathophysiology of poAF following cardiac surgery, clinical, and procedural risk-factors is provided, as well as prophylactic measures and treatment. CONCLUSION: Multiple strategies to prevent and manage poAF following heart surgery already exist. Our hope is that this review will facilitate more rigorous testing of prevention strategies, implementation of prophylaxis regimens as well as optimal treatment of this common and serious complication.