Pharmacological strategies for prevention of postoperative atrial fibrillation

Authors

Mohit K Turagam
Francis X. Downey, Advocate Aurora HealthFollow
David C. Kress, Advocate Aurora HealthFollow
Jasbir Sra, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, University of Wisconsin School of Medicine and Public HealthFollow
A. Jamil Tajik, Aurora Cardiovascular Services, Advocate Aurora HealthFollow
Arshad Jahangir, Sheikh Khalifa bin Hamad Al Thani Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Advocate Aurora HealthFollow

Recommended Citation

Turagam MK, Downey FX, Kress DC, et al. Pharmacological strategies for prevention of postoperative atrial fibrillation. Expert Rev Clin Pharmacol. 2015 Mar;8(2):233-50.

Abstract

Atrial fibrillation (AF) complicating cardiac surgery continues to be a major problem that increases the postoperative risk of stroke, myocardial infarction, heart failure and costs and can affect long-term survival. The incidence of AF after surgery has not significantly changed over the last two decades, despite improvement in medical and surgical techniques. The mechanism and pathophysiology underlying postoperative AF (PoAF) is incompletely understood and results from a combination of acute and chronic factors, superimposed on an underlying abnormal atrial substrate with increased interstitial fibrosis. Several anti-arrhythmic and non-anti-arrhythmic medications have been used for the prevention of PoAF, but the effectiveness of these strategies has been limited due to a poor understanding of the basis for the increased susceptibility of the atria to AF in the postoperative setting. In this review, we summarize the pathophysiology underlying the development of PoAF and evidence behind pharmacological approaches used for its prevention in the postoperative setting.

Document Type

Article

PubMed ID

25697411