Postoperative atrial fibrillation: Difference between revisions

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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Treating patients who develop [[AF]] after cardiac surgery with a [[beta blocker]] is recommended unless contraindicated. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[treatment|Treating]] [[patients]] who develop [[atrial fibrillation]] after [[heart|cardiac]] [[surgery]] with a [[beta blocker]] is recommended unless [[Contraindication|contraindicated]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A [[Calcium channel blocker#Non-dihydropyridine|nondihydropyridine calcium antagonist]] is recommended when a [[beta blocker]] is inadequate to achieve rate control in patients with postoperative [[AF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A [[Calcium channel blocker#Non-dihydropyridine|nondihydropyridine calcium antagonist]] is recommended when a [[beta blocker]] is inadequate to achieve rate control in [[patients]] with [[surgery|postoperative]] [[atrial fibrillation]].''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Preoperative administration of amiodarone reduces the incidence of [[AF]] in patients undergoing cardiac surgery and is reasonable as prophylactic therapy for patients at high risk for postoperative [[AF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[surgery|Preoperative]] administration of [[amiodarone]] reduces the [[incidence]] of [[atrial fibrillation]] in [[patients]] undergoing [[heart|cardiac]] [[surgery]] and is reasonable as [[Prophylaxis|prophylactic]] [[therapy]] for [[patients]] at high risk for [[surgery|postoperative]] [[atrial fibrillation]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' It is reasonable to restore [[sinus rhythm]] pharmacologically with ibutilide or direct-current [[cardioversion]] in patients who develop postoperative [[AF]], as advised for nonsurgical patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' It is reasonable to restore [[sinus rhythm]] pharmacologically with [[ibutilide]] or direct-current [[cardioversion]] in [[patients]] who develop postoperative [[atrial fibrillation]], as advised for [[surgery|nonsurgical]] [[patients]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' It is reasonable to administer [[antiarrhythmic|antiarrhythmic medications]] in an attempt to maintain [[sinus rhythm]] in patients with recurrent or refractory postoperative [[AF]], as advised for other patients who develop [[AF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' It is reasonable to administer [[antiarrhythmic|antiarrhythmic medications]] in an attempt to maintain [[sinus rhythm]] in [[patients]] with recurrent or refractory [[surgery|postoperative]] [[atrial fibrillation]], as advised for other [[patients]] who develop [[atrial fibrillation]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' It is reasonable to administer [[antithrombotic]] medication in patients who develop postoperative [[AF]], as advised for nonsurgical patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' It is reasonable to administer [[antithrombotic]] [[medication]] in [[patients]] who develop [[surgery|postoperative]] [[atrial fibrillation]], as advised for [[surgery|nonsurgical]] [[patients]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' It is reasonable to manage well-tolerated, new-onset postoperative [[AF]] with rate control and anticoagulation with cardioversion if [[AF]] does not revert spontaneously to sinus rhythm during follow-up. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' It is reasonable to manage well-tolerated, new-onset [[surgery|postoperative]] [[atrial fibrillation]] with rate control and [[Anticoagulant|anticoagulation]] with [[cardioversion]] if [[atrial fibrillation]] does not revert spontaneously to [[sinus rhythm]] during follow-up. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
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Line 86: Line 86:
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Prophylactic administration of [[sotalol]] may be considered for patients at risk of developing [[AF]] following cardiac surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Prophylactic administration of [[sotalol]] may be considered for [[patients]] at risk of developing [[atrial fibrillation]] following [[heart|cardiac]] [[surgery]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Administration of [[colchicine]] may be considered for patients postoperatively to reduce [[AF]] following cardiac surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Administration of [[colchicine]] may be considered for [[patients]] [[surgery|postoperatively]] to reduce [[atrial fibrillation]] following [[heart|cardiac]] [[surgery]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
|}


Revision as of 20:42, 1 September 2021
Resident
Survival
Guide
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Sinus rhythm
Atrial fibrillation

Atrial Fibrillation Microchapters

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]; Varun Kumar, M.B.B.S.

Overview

Postoperative Atrial fibrillation

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)[19]

Postoperative Cardiac and Thoracic Surgery

Class I
"1. Treating patients who develop atrial fibrillation after cardiac surgery with a beta blocker is recommended unless contraindicated. (Level of Evidence: A)"
"2. A nondihydropyridine calcium antagonist is recommended when a beta blocker is inadequate to achieve rate control in patients with postoperative atrial fibrillation.(Level of Evidence: B)"
Class IIa
"1. Preoperative administration of amiodarone reduces the incidence of atrial fibrillation in patients undergoing cardiac surgery and is reasonable as prophylactic therapy for patients at high risk for postoperative atrial fibrillation. (Level of Evidence: A)"
"2. It is reasonable to restore sinus rhythm pharmacologically with ibutilide or direct-current cardioversion in patients who develop postoperative atrial fibrillation, as advised for nonsurgical patients. (Level of Evidence: B)"
"3. It is reasonable to administer antiarrhythmic medications in an attempt to maintain sinus rhythm in patients with recurrent or refractory postoperative atrial fibrillation, as advised for other patients who develop atrial fibrillation. (Level of Evidence: B)"
"4. It is reasonable to administer antithrombotic medication in patients who develop postoperative atrial fibrillation, as advised for nonsurgical patients. (Level of Evidence: B)"
"5. It is reasonable to manage well-tolerated, new-onset postoperative atrial fibrillation with rate control and anticoagulation with cardioversion if atrial fibrillation does not revert spontaneously to sinus rhythm during follow-up. (Level of Evidence: C)"
Class IIb
"1. Prophylactic administration of sotalol may be considered for patients at risk of developing atrial fibrillation following cardiac surgery. (Level of Evidence: B)"
"2. Administration of colchicine may be considered for patients postoperatively to reduce atrial fibrillation following cardiac surgery. (Level of Evidence: B)"

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)[20][21]

Postoperative AF (DO NOT EDIT)[20][21]

Class I
"1. Unless contraindicated, treatment with an oral beta blocker to prevent postoperative AF is recommended for patients undergoing cardiac surgery. (Level of Evidence: A)"
"2. Administration of AV nodal blocking agents is recommended to achieve rate control in patients who develop postoperative AF. (Level of Evidence: B)"
Class IIa
"1. Preoperative administration of amiodarone reduces the incidence of AF in patients undergoing cardiac surgery and represents appropriate prophylactic therapy for patients at high risk for postoperative AF. (Level of Evidence: A)"
"2. It is reasonable to restore sinus rhythm by pharmacological cardioversion with ibutilide or direct current cardioversion in patients who develop postoperative AF as advised for nonsurgical patients. (Level of Evidence: B)"
"3. It is reasonable to administer antiarrhythmic medications in an attempt to maintain sinus rhythm in patients with recurrent or refractory postoperative AF, as recommended for other patients who develop AF. (Level of Evidence: B)"
"4. It is reasonable to administer antithrombotic medication in patients who develop postoperative AF, as recommended for nonsurgical patients. (Level of Evidence: B)"
Class IIb
"1. Prophylactic administration of sotalol may be considered for patients at risk of developing AF following cardiac surgery. (Level of Evidence: B)"

References

  1. ↑ 1.0 1.1 1.2 Chelazzi C, Villa G, De Gaudio AR (2011). "Postoperative atrial fibrillation". ISRN Cardiol. 2011: 203179. doi:10.5402/2011/203179. PMC 3262508. PMID 22347631.
  2. ↑ Soria R, Guize L, Chretien JM, Le Heuzey JY, Lavergne T, Desnos M et al. (1989) [The natural history of 270 cases of Wolff-Parkinson-White syndrome in a survey of the general population.] Arch Mal Coeur Vaiss 82 (3):331-6. PMID: 2502088
  3. ↑ Creswell LL, Schuessler RB, Rosenbloom M, Cox JL (1993) Hazards of postoperative atrial arrhythmias. Ann Thorac Surg 56 (3):539-49. PMID: 8379728
  4. ↑ 4.0 4.1 Andrews TC, Reimold SC, Berlin JA, Antman EM (1991) Prevention of supraventricular arrhythmias after coronary artery bypass surgery. A meta-analysis of randomized control trials. Circulation 84 (5 Suppl):III236-44. PMID: 1682069
  5. ↑ Davis EM, Packard KA, Hilleman DE (2010). "Pharmacologic prophylaxis of postoperative atrial fibrillation in patients undergoing cardiac surgery: beyond beta-blockers". Pharmacotherapy. 30 (7): 749, 274e–318e. doi:10.1592/phco.30.7.749. PMID 20575638.
  6. ↑ Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD et al. (2004) A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 291 (14):1720-9. DOI:10.1001/jama.291.14.1720 PMID: 15082699
  7. ↑ Dixon FE, Genton E, Vacek JL, Moore CB, Landry J (1986) Factors predisposing to supraventricular tachyarrhythmias after coronary artery bypass grafting. Am J Cardiol 58 (6):476-8. PMID: 3489405
  8. ↑ Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT; et al. (1996). "Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group". JAMA. 276 (4): 300–6. PMID 8656542.
  9. ↑ Piechowiak M, Banach M, Ruta J, Barylski M, Rysz J, Bartczak K; et al. (2006). "Risk factors for atrial fibrillation in adult patients in long-term observation following surgical closure of atrial septal defect type II". Thorac Cardiovasc Surg. 54 (4): 259–63. doi:10.1055/s-2006-923955. PMID 16755448.
  10. ↑ Morsi A, Lau C, Nishimura S, Goldman BS (1998). "The development of sinoatrial dysfunction in pacemaker patients with isolated atrioventricular block". Pacing Clin Electrophysiol. 21 (7): 1430–4. doi:10.1111/j.1540-8159.1998.tb00214.x. PMID 9670187.
  11. ↑ Kowey PR, Stebbins D, Igidbashian L, Goldman SM, Sutter FP, Rials SJ et al. (2001) Clinical outcome of patients who develop PAF after CABG surgery. Pacing Clin Electrophysiol 24 (2):191-3. PMID: 11270698
  12. ↑ Echahidi N, Pibarot P, O'Hara G, Mathieu P (2008). "Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery". J Am Coll Cardiol. 51 (8): 793–801. doi:10.1016/j.jacc.2007.10.043. PMID 18294562.
  13. ↑ Kaireviciute D, Aidietis A, Lip GY (2009). "Atrial fibrillation following cardiac surgery: clinical features and preventative strategies". Eur Heart J. 30 (4): 410–25. doi:10.1093/eurheartj/ehn609. PMID 19174427.
  14. ↑ Kowey PR, Taylor JE, Rials SJ, Marinchak RA (1992) Meta-analysis of the effectiveness of prophylactic drug therapy in preventing supraventricular arrhythmia early after coronary artery bypass grafting. Am J Cardiol 69 (9):963-5. PMID: 1347966
  15. ↑ Podrid PJ (1999) Prevention of postoperative atrial fibrillation: what is the best approach? J Am Coll Cardiol 34 (2):340-2. PMID: 10440142
  16. ↑ Clemo HF, Wood MA, Gilligan DM, Ellenbogen KA (1998) Intravenous amiodarone for acute heart rate control in the critically ill patient with atrial tachyarrhythmias. Am J Cardiol 81 (5):594-8. PMID: 9514456
  17. ↑ Reed GL, Singer DE, Picard EH, DeSanctis RW (1988) Stroke following coronary-artery bypass surgery. A case-control estimate of the risk from carotid bruits. N Engl J Med 319 (19):1246-50. DOI:10.1056/NEJM198811103191903 PMID: 3263571
  18. ↑ Taylor GJ, Malik SA, Colliver JA, Dove JT, Moses HW, Mikell FL et al. (1987) Usefulness of atrial fibrillation as a predictor of stroke after isolated coronary artery bypass grafting. Am J Cardiol 60 (10):905-7. PMID: 3661408
  19. ↑ January, C. T.; Wann, L. S.; Alpert, J. S.; Calkins, H.; Cleveland, J. C.; Cigarroa, J. E.; Conti, J. B.; Ellinor, P. T.; Ezekowitz, M. D.; Field, M. E.; Murray, K. T.; Sacco, R. L.; Stevenson, W. G.; Tchou, P. J.; Tracy, C. M.; Yancy, C. W. (2014). "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". Circulation. doi:10.1161/CIR.0000000000000041. ISSN 0009-7322.
  20. ↑ 20.0 20.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA; et al. (2011). "2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". J Am Coll Cardiol. 57 (11): e101–98. doi:10.1016/j.jacc.2010.09.013. PMID 21392637.
  21. ↑ 21.0 21.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114 (7):e257-354. DOI:10.1161/CIRCULATIONAHA.106.177292 PMID: 16908781


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