Aidan at 16:21, 7 May 2021

2021-05-07T16:21:25Z

Aidan: Created page with "== Background == * Refers to atrial fibrillation that occurs during or immediately following non-cardiac surgery ** Excludes patients with known persistent or paroxysmal..."

2021-05-07T16:19:10Z

Created page with "== Background == * Refers to atrial fibrillation that occurs during or immediately following non-cardiac surgery ** Excludes patients with known persistent or paroxysmal..."

New page

== Background ==

* Refers to [[atrial fibrillation]] that occurs during or immediately following non-cardiac surgery
** Excludes patients with known persistent or paroxysmal [[atrial fibrillation]]

== Clinical Manifestations ==

* Irregularly irregular heart rhythm with atrial fibrillation on ECG
* High rates of spontaneous cardioversion

== Management ==

* Screen patients with known atrial fibrillation with telemetry for 24 to 48 hours after surgery
* If hemodynamically unstable, consider electric cardioversion as per typical [[atrial fibrillation]]
* Rate control with β blockers to target HR <100 bpm (alternatives include [[calcium channel blockers]] or [[digoxin]])
* Unclear whether long-term anticoagulation is indicated; the ASPIRE-AF will hopefully answer this question
** Consider evaluating with CHA<sub>2</sub>DS<sub>2</sub>-VASc, though not validated in the patient population
** Timing of anticoagulation would need to be discussed with the surgeon
* Arrange outpatient echocardiogram and extended Holter monitor (14 days)

[[Category:Perioperative medicine]]
[[Category:Cardiology]]

← Older revision		Revision as of 16:21, 7 May 2021
Line 1:		Line 1:
	== Background ==		==Background==

	* Refers to [[atrial fibrillation]] that occurs during or immediately following non-cardiac surgery		*Refers to [[atrial fibrillation]] that occurs during or immediately following non-cardiac surgery
	** Excludes patients with known persistent or paroxysmal [[atrial fibrillation]]		**Excludes patients with known persistent or paroxysmal [[atrial fibrillation]]
			*Occurs in 30% after thoracic surgery and in 1-20% of non-thoracic, non-cardiac surgery

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Irregularly irregular heart rhythm with atrial fibrillation on ECG		*Irregularly irregular heart rhythm with atrial fibrillation on ECG, usually within the first 4 days postoperatively
	* High rates of spontaneous cardioversion		*High rates of spontaneous cardioversion

	== Management ==		==Management==

	* Screen patients with known atrial fibrillation with telemetry for 24 to 48 hours after surgery		*Screen patients with known atrial fibrillation with telemetry for 24 to 48 hours after surgery
	* If hemodynamically unstable, consider electric cardioversion as per typical [[atrial fibrillation]]		*If hemodynamically unstable, consider electric cardioversion as per typical [[atrial fibrillation]]
	* Rate control with β blockers to target HR <100 bpm (alternatives include [[calcium channel blockers]] or [[digoxin]])		*Rate control with β blockers to target HR <100 bpm (alternatives include [[calcium channel blockers]] or [[digoxin]])
	* Unclear whether long-term anticoagulation is indicated; the ASPIRE-AF will hopefully answer this question		*Unclear whether long-term anticoagulation is indicated; the ASPIRE-AF will hopefully answer this question
	** Consider evaluating with CHA<sub>2</sub>DS<sub>2</sub>-VASc, though not validated in the patient population		**Consider evaluating with CHA<sub>2</sub>DS<sub>2</sub>-VASc, though not validated in the patient population
	** Timing of anticoagulation would need to be discussed with the surgeon		**Timing of anticoagulation would need to be discussed with the surgeon
	* Arrange outpatient echocardiogram and extended Holter monitor (14 days)		*Arrange outpatient echocardiogram and extended Holter monitor (14 days)

	[[Category:Perioperative medicine]]		[[Category:Perioperative medicine]]

Perioperative atrial fibrillation - Revision history

Aidan at 16:21, 7 May 2021

Aidan: Created page with "== Background == * Refers to atrial fibrillation that occurs during or immediately following non-cardiac surgery ** Excludes patients with known persistent or paroxysmal..."