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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.
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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