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Comprehensive Review of Approaches to Postoperative Atrial Fibrillation: Current Strategies and Future Directions
Journal article   Open access   Peer reviewed

Comprehensive Review of Approaches to Postoperative Atrial Fibrillation: Current Strategies and Future Directions

Jasmine K. Dugal, Arpinder S. Malhi, Darren Nguyen, Randeep Gill, Arsalan Siddiqui, Ala Abdallah, Nazanin Houshmand and Tahir Tak
The Heart surgery forum, Vol.28(6), pp.E476-E493
06/30/2025
DOI: 10.59958/hsf.8443
url
https://doi.org/10.59958/hsf.8443View
Published (Version of record) Open Access

Abstract

Postoperative atrial fibrillation (POAF) is a prevalent complication in the inpatient setting, commonly occurring after surgery. While various risk factors contribute to the development of POAF, distinct postoperative mechanisms can trigger its onset, regardless of whether cardiac surgery is involved. Thus, early detection and appropriate management of POAF are critical in mitigating additional postoperative complications, improving patient outcomes, reducing the risk of prolonged hospital stays, and minimizing downstream consequences such as stroke. Most current literature emphasizes the prevention of POAF through a combination of pharmacological interventions, non-pharmacological strategies, and other experimental treatments, which are examined in this review. This paper also analyzes the management of acute POAF, including rate and rhythm control, as well as anticoagulation (AC) therapy. It further explores the complications associated with POAF, including thromboembolic risks, its impact on recovery, and its influence on hospital length of stay. Meanwhile, special considerations are given to specific populations, such as older adult populations, those with pre-existing heart disease, obese patients, and individuals from certain racial backgrounds. The guidelines from the European Society of Cardiology and the American College of Cardiology (ACC)/American Heart Association (AHA) for POAF are also discussed. Finally, this review highlights emerging trends, including novel therapies, technologies, and the potential role of artificial intelligence (AI) in predicting and managing POAF.
 postoperative atrial fibrillation (POAF) atrial fibrillation (AF) rate control rhythm control coronary artery bypass graft (CABG) beta-blocker amiodarone ablation thromboembolism anticoagulation (AC)

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