Atrial Fibrillation

Created: October 01, 2023

Last Updated: November 18, 2023

Contributor(s):

Subhasis Chaterjee MD FACS FACC FCCP

ERAS Cardiac Collaborative Network

Editor(s):

Cheryl Crisafi MSN RN CNL

Amanda Rea DNP CRNP AGACNP-BC CCRN CMC CSC E-AEC

Gina McConnell RN BSN CCRN

Shannon Crotwell RN BSN CCRN

Alexander Gregory MD FRCPC

Summary

Atrial fibrillation after cardiac surgery has a significant impact on patient outcomes and healthcare utilization. Preventing AF through various strategies, including medications, surgical interventions, and vigilant post-operative care, is essential to minimize these adverse effects and improve the overall success of cardiac surgical procedures.

Atrial fibrillation (AF) after cardiac surgery is a common and significant concern with several important impacts, underscoring the need for prevention:

Increased Complication Risk:

  • AF can lead to various complications, including stroke, thromboembolism (clot formation), and heart failure. These complications can significantly worsen a patient's post-operative course, leading to longer hospital stays and a higher risk of morbidity and mortality.

Hemodynamic Instability:

  • AF can disrupt the normal rhythm of the heart, leading to irregular and often rapid heartbeats. This can result in hemodynamic instability, reducing the heart's ability to effectively pump blood. In post-operative cardiac patients, this can be especially problematic as the heart is already under stress from surgery.

Thromboembolic Events:

  • AF can increase the risk of blood clots forming in the atria of the heart, which can then dislodge and travel to other parts of the body, causing serious conditions such as stroke. Preventing AF reduces the risk of these thromboembolic events.

Prolonged Hospital Stay:

  • AF often requires medical intervention and close monitoring, which can prolong a patient's hospital stay. This increases healthcare costs and places additional physical and emotional burdens on patients and their families.

Increased Healthcare Resource Utilization:

  • The management of AF post-cardiac surgery involves medications, electrocardioversion, or, in some cases, anticoagulation therapy. These treatments require additional healthcare resources and can result in side effects and complications of their own.

Reduced Quality of Life:

  • Patients who experience AF after cardiac surgery may have a reduced quality of life due to symptoms, medication side effects, and the need for ongoing medical management. This can impact their ability to return to normal daily activities and may lead to long-term healthcare needs.

Risk of Recurrence:

  • AF can be a recurrent condition, and once it develops after cardiac surgery, patients may be at an increased risk of experiencing it again in the future. Preventing AF in the first place can reduce the likelihood of recurrence and its associated complications.

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This summary was written with assistance from artificial intelligence. All text was reviewed, edited, and supplemented by the listed editor(s). Reference: OpenAI. (2023). ChatGPT (Sept 25 version) [Large language model]. https://chat.openai.com/chat

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Educational Materials

Why Postoperative Atrial Fibrillation Matters
Watch as Dr. Chatterjee reviews the evidence behind post-operative atrial fibrillation, and its impact on outcomes and patient recovery.
Post-operative Atrial Fibrillation and Prevention
This video is a recorded session from the ERAS Cardiac Virtual Meeting in 2021. Speakers and discussants include members of our international network of ERAS experts. In this session, participants discuss post-operative atrial fibrillation (POAF), including the evidence behind prevention strategies.

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