Atrial Fibrillation after Cardiac Surgery

1. Front Matter

   Pages I-X

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2. Experimental Animal Models of Atrial Arrhythmias and Their Relevance to Post-Operative Atrial Arrhythmias that Occur in Humans Unergoing Cardiac Surgery

   • Gregory K. Feld

   Pages 1-18

3. Understanding the Pathophysiology of Atrial Fibrillation from Clinical Observations

   • Scott E. Mattson, Leonard I. Ganz

   Pages 19-35

4. Incidence, Timing and Outcome of Atrial Tachyarrhythmias After Cardiac Surgery

   • L. Brent Mitchell

   Pages 37-50

5. Risk Factors for the Development of Postoperative Atrial Fibrillation

   • Frederick A. Ehlert, Dhiraj D. Narula, Jonathan S. Steinberg

   Pages 51-80

6. The Impact of Atrial Fibrillation on Hospital Length of Stay After Cardiac Surgery

   • Jacqueline E. Tamis, Jonathan S. Steinberg

   Pages 81-93

7. Prophylactic Value of Beta Blockers

   • Javier E. Sanchez, Andrew E. Epstein

   Pages 95-107

8. Antiarrhythmic Therapy to Prevent Atrial Fibrillation after Cardiac Surgery

   • Bradley P. Knight, Fred Morady

   Pages 109-117

9. Nonpharmacologic Treatment of Postoperative Atrial Fibrillation

   • Richard J. Lewis, Jonathan S. Steinberg

   Pages 119-132

10. Therapeutic Options for Establised or Recurrent Atrial Fibrillation: Focus on Antithrombotic Therapy

    • John H. McAnulty, Jack Kron

    Pages 133-139

11. Atrial Fibrillation after Noncardic Surgery

    • Dhiraj D. Narula, Jonathan S. Steinberg

    Pages 141-164

12. Back Matter

    Pages 165-169

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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.

• arrhythmia
• atrial fibrillation
• cardiac surgery
• drugs
• heart
• heart disease
• physiology
• stroke

• St. Luke’s-Roosevelt Hospital Center, New York, USA

  Jonathan S. Steinberg

• College of Physicians and Surgeons, Columbia University, New York, USA

  Jonathan S. Steinberg

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