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01-09-2012 | Review Article

Postoperative atrial fibrillation: mechanism, prevention, and future perspective

Authors: Yasushige Shingu, Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui

Published in: Surgery Today | Issue 9/2012

Abstract

Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, despite improvements in anesthesia, surgical techniques, and medical therapies. Although beta-blockers have been proven to be effective, the incidence of POAF is around 20 % even with these agents. The mechanism of POAF is not fully elucidated and no optimal strategy has been established for POAF. There are two important elements of “structural” and “electrical” remodelling of the atrium in the mechanism of POAF. A patient’s age and preoperative left atrial fibrosis can predict POAF associated with structural remodelling. Although inflammation and oxidative stress during cardiac surgery may be the underlying mechanisms for electrical remodelling causing POAF, there are no reliable clinical parameters for their detection. Nonetheless, postoperative P-wave dispersion and electromechanical delay, which reflects excitation–contraction coupling abnormalities, could be new parameters for POAF. In conclusion, despite the importance of prevention of POAF, there are only a few parameters for predicting POAF. It is therefore necessary to consider both disease-mediated structural remodeling before surgery and electrical remodeling caused by cardiac surgery.

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Title: Postoperative atrial fibrillation: mechanism, prevention, and future perspective
Authors: Yasushige Shingu
Suguru Kubota
Satoru Wakasa
Tomonori Ooka
Tsuyoshi Tachibana
Yoshiro Matsui
Publication date: 01-09-2012
Publisher: Springer Japan
Published in: Surgery Today / Issue 9/2012
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0199-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative atrial fibrillation: mechanism, prevention, and future perspective

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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