Atrial Fibrillation: Current Evidence and Management Strategies During the Perioperative Period. (January 2020)

• Record Type: Journal Article
• Authors: Karamchandani, Kunal; Khanna, Ashish K.; Bose, Somnath; Fernando, Rohesh J.; Walkey, Allan J.
• Is Part Of: Anesthesia & analgesia. Volume 130:Number 1(2020)
• Publication Date: 2020-01
• Subjects: Anesthesiology -- Periodicals; Anesthesia; Anesthesiology; Analgesia; Analgesics; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1213/ANE.0000000000004474
• Languages: English
• ISSNs: 0003-2999

Abstract

Abstract : Atrial fibrillation (AF) is the most common arrhythmia in the perioperative period. Previously considered a benign and self-limited entity, recent data suggest that perioperative AF is associated with considerable morbidity and mortality and may predict long-term AF and stroke risk in some patients. Despite known risk factors, AF remains largely unpredictable, especially after noncardiac surgery. As a consequence, strategies to minimize perioperative risk are mostly supportive and include avoiding potential arrhythmogenic triggers and proactively treating patient- and surgery-related factors that might precipitate AF. In addition to managing AF itself, clinicians must also address the hemodynamic perturbations that result from AF to prevent end-organ dysfunction. This review will discuss current evidence with respect to causes, risk factors, and outcomes of patients with AF, and address current controversies in the perioperative setting.