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Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey

Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in up to half of patients. Post-operative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first 4 weeks after cardiac surgery. POAF is associated with short-term mortal...

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Autor principal: McIntyre, William F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027741/
https://www.ncbi.nlm.nih.gov/pubmed/36960472
http://dx.doi.org/10.3389/fcvm.2023.1156626
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author McIntyre, William F.
author_facet McIntyre, William F.
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description Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in up to half of patients. Post-operative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first 4 weeks after cardiac surgery. POAF is associated with short-term mortality and morbidity, but its long-term significance is unclear. This article reviews existing evidence and research challenges for the management of POAF in patients who have had cardiac surgery. Specific challenges are discussed in four phases of care. Pre-operatively, clinicians need to be able to identify high-risk patients, and initiate prophylaxis to prevent POAF. In hospital, when POAF is detected, clinicians need to manage symptoms, stabilize hemodynamics and prevent increases in length of stay. In the month after discharge, the focus is on minimizing symptoms and preventing readmission. Some patients require short term oral anticoagulation for stroke prevention. Over the long term (2–3  months after surgery and beyond), clinicians need to identify which patients with POAF have paroxysmal or persistent AF and can benefit from evidence-based therapies for AF, including long-term oral anticoagulation.
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spelling pubmed-100277412023-03-22 Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey McIntyre, William F. Front Cardiovasc Med Cardiovascular Medicine Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in up to half of patients. Post-operative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first 4 weeks after cardiac surgery. POAF is associated with short-term mortality and morbidity, but its long-term significance is unclear. This article reviews existing evidence and research challenges for the management of POAF in patients who have had cardiac surgery. Specific challenges are discussed in four phases of care. Pre-operatively, clinicians need to be able to identify high-risk patients, and initiate prophylaxis to prevent POAF. In hospital, when POAF is detected, clinicians need to manage symptoms, stabilize hemodynamics and prevent increases in length of stay. In the month after discharge, the focus is on minimizing symptoms and preventing readmission. Some patients require short term oral anticoagulation for stroke prevention. Over the long term (2–3  months after surgery and beyond), clinicians need to identify which patients with POAF have paroxysmal or persistent AF and can benefit from evidence-based therapies for AF, including long-term oral anticoagulation. Frontiers Media S.A. 2023-03-07 /pmc/articles/PMC10027741/ /pubmed/36960472 http://dx.doi.org/10.3389/fcvm.2023.1156626 Text en Copyright © 2023 McIntyre. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
McIntyre, William F.
Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title_full Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title_fullStr Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title_full_unstemmed Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title_short Post-operative atrial fibrillation after cardiac surgery: Challenges throughout the patient journey
title_sort post-operative atrial fibrillation after cardiac surgery: challenges throughout the patient journey
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027741/
https://www.ncbi.nlm.nih.gov/pubmed/36960472
http://dx.doi.org/10.3389/fcvm.2023.1156626
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