Update on Management of Postoperative Atrial Fibrillation After Cardiac Surgery

World Congress on Heart Congress and Surgery

October 21, 2021 | Webinar

Samir Rafla

Emeritus professor of cardiology, Alexandria University, Egypt

Scientific Tracks Abstracts: J Cardiovasc Dis Diagn

Abstract :

Postoperative atrial fibrillation (POAF) after cardiac surgery remains the most prevalent arrhythmia in perioperative cardiac surgery, having great clinical impact. The purpose of this presentation is to show the causes, prevention and management of this subject according to recent guidelines. The primary objectives of POAF management are to maintain hemodynamic stability, control the symptoms, and prevent thromboembolism and recurrence. The antiarrhythmic strategy showed a tendency (P=0.08) to reduce the time to sinus rhythm reversion. There was also reduced length of hospital stay in the group receiving antiarrhythmic drugs (P=0.05). The control of ventricular response during AF can be performed with various drugs, including digitalis, beta-blockers, and calcium channel blockers. The option of electrical cardioversion for rhythm control should be used in the presence of hemodynamic instability, acute cardiac insufficiency, or myocardial ischemia. The beta-blocking action is particularly effective for heart rate control in the postoperative period. Anticoagulation Strategies for the Management POAF: With respect to prevention of thromboembolic phenomena, POAF is associated with a higher risk of stroke, ranging from 1.9% to 18.2%, that emphasizes the use of therapeutic anticoagulation. The American College of Chest Physicians (ACCP) recommends the use of anticoagulation particularly for high-risk patients, such as those with a history of stroke or transient ischemic. The merit of anticoagulation in postoperative patients after cardiac surgery should be carefully weighed against the increased risk of bleeding. This risk may even exceed the benefits in reducing stroke in some patients. Biography and Expertise - The previous head of the cardiology department, Faculty of Medicine, Alexandria University, Egypt - Published 55 papers listed in Google Scholar, H index 3 , Citations 29, Researchgate score 20.38 - Reviewer in National council for the promotion of professors in cardiology and critical care, reviewer of some journals, grader of abstracts of the European Society of Cardiology conference, and EHRA European Heart Rhythm Association conference. - Worked in ablation and device implantation in Alexandria Faculty of Medicine - Chairperson or speaker in Many conferences inside and outside Egypt