The management of atrial fibrillation after cardiac surgery

Posterior Pericardiotomy Reduces the Incidence of Atrial Fibrillation, Pericardial Effusion, and Length of Stay in Hospital after Coronary Artery Bypasses Surgery

“…The pathogenesis of AF after cardiac surgery is multi-factorial, and the mechanisms are still largely unknown. An increase in circulating catecholamines, heightened sympathetic and parasympathetic tone, atrial stretch, trans-cellular fluid and electrolyte shifts, metabolic abnormalities, inflammation, and pericarditis are believed to be the important factors contributing to AF after cardiac surgery (Arbatli et al 2003;Rho et al 2009). …”

What are the Predictors that Affect the Excellent Long-term Benefits of Redo Coronary Artery Bypass Grafting?

“…Postoperative AF is a recognised complication of redo coronary surgery [22] and was also found in our study to be a predictor of cardiac symptoms/events after redo coronary revascularisation. In addition to the recognised catecholamine, neuronal, metabolic and inflammatory changes seen in all cardiac operations, redo patients may suffer from postoperative AF as a result of increased mediastinal and pericardial adhesions seen at re-sternotomy [23,24]. Increased cardiac symptoms and events as a result of AF following redo coronary surgery can be due an increased risk of thromboembolic events and a poor postoperative cardiac output [25].…”

The Preoperative Neurological Evaluation

“…29,30 Less common mechanisms of perioperative stroke include hemorrhagic infarction; air, fat, and paradoxical embolism; and arterial dissection due to neck manipulation. 25,31 The risk of perioperative stroke depends on patient characteristics 26,29,32 ; the nature and timing of the procedure 25,26,[32][33][34][35] ; and certain complications in the postoperative period, including postoperative atrial fibrillation 36,37 and hypercoagulability. 35,38,39 This section will focus on the assessment and modification of patient-related (ie, preoperative) risk factors.…”