Postoperative Atrial Fibrillation: Target for Stroke Prevention?

Overview

Journal Eur Stroke J

Specialties Cardiology & Vascular Diseases
Neurology

Date 2019 Apr 23

PMID 31008315

Citations 5

Authors

Vincent Thijs

Robin Lemmens

Omar Farouque

Geoffrey Donnan

Hein Heidbuchel

Affiliations

Soon will be listed here.

Abstract

Purpose: A substantial number of patients without a history of atrial fibrillation who undergo surgery develop one or more episodes of atrial fibrillation in the first few days after the operation. We studied whether postoperative transient atrial fibrillation is a risk factor for future atrial fibrillation, stroke and death.

Method: We performed a narrative review of the literature on epidemiology, mechanisms, risk of atrial fibrillation, stroke and death after postoperative atrial fibrillation. We reviewed antithrombotic guidelines on this topic and identified gaps in current management.

Findings: Patients with postoperative atrial fibrillation are at high risk of developing atrial fibrillation in the long term. Mortality is also increased. Most, but not all observational studies report a higher risk of stroke. The optimal antithrombotic regimen for patients with postoperative atrial fibrillation has not been defined. The role of lifestyle changes and of surgical occlusion of the left atrial appendage in preventing adverse outcomes after postoperative atrial fibrillation is not established.

Conclusion: Further studies are warranted to establish the optimal strategy to prevent adverse long-term outcomes after transient, postoperative atrial fibrillation.

Citing Articles

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Evaluation of the effect of crocin on prevention of atrial fibrillation after coronary artery bypass grafting or heart valve replacement: A double-blind, randomized, placebo-controlled trial.

Hashemi Shahri S, Soltani G, Abbasi Teshnizi M, Moeinipour A, Tayyebi M, Javidi Dasht Bayaz R Avicenna J Phytomed. 2022; 12(6):589-601.

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Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study.

Lowres N, Hillis G, Gladman M, Kol M, Rogers J, Chow V Int J Cardiol Heart Vasc. 2020; 29:100566.

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Postoperative atrial fibrillation and ischemic stroke: The role of homocysteine.

Acampa M, Lazzerini P, Martini G Eur Stroke J. 2019; 3(1):92-93.

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Autonomic Nervous System and Stress to Predict Secondary Ischemic Events after Transient Ischemic Attack or Minor Stroke: Possible Implications of Heart Rate Variability.

Guan L, Collet J, Mazowita G, Claydon V Front Neurol. 2018; 9:90.

PMID: 29556209 PMC: 5844932. DOI: 10.3389/fneur.2018.00090.

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