Key result
Managing post-cardiac surgery POAF requires individualized strategies balancing clinical status against stroke and bleeding risks.
This review highlights the importance of individualized management strategies, including rhythm or rate control and anti-thrombotic therapy, for postoperative atrial fibrillation in cardiac surgery patients.
Supports individualized POAF strategies post-cardiac surgery; leaves open optimal protocols from prospective trials.
Atrial fibrillation is one of the most frequent complications occurring after cardiac surgery. This problem became especially crucial for the last decade due to brisk growth in cardiac surgery and surgeries in the patients with high risks. Post-operative atrial fibrillation confidently increases the risk of mortality and associated complications. This disease is diagnosed first of all by ECG tests. At present in order to detect atrial fibrillation early European Heart Rhythm Association (EHRA) recommends using technologies of continuous rhythm monitoring - implanted cardiac monitors. Currently there are two main approaches to management of postoperative atrial fibrillation. These are the strategies of rhythm monitoring and heart rate monitoring supplemented anti-thrombotic therapy. A wide range of drugs is used for anti-thrombotic therapy in the patients undergoing cardiac surgery. Effective management of post-operative atrial fibrillation in those undergoing cardiac surgery is to consider clinical status of the patient, concurrent diseases and risk of stroke and hemorrhage.
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Ломиворотов et al. (2017) conducted a review in Post-operative atrial fibrillation. Management strategies (rhythm/heart rate monitoring and anti-thrombotic therapy) was evaluated. Management of post-operative atrial fibrillation following cardiac surgery requires individualized strategies considering clinical status, concurrent diseases, and risks of stroke and hemorrhage.
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