Pharmacological management of atrial fibrillation following cardiac surgery

Research output: Contribution to journalReview article

21 Citations (Scopus)

Abstract

Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft surgery (CABG). Post-CABG AF occurs most commonly on the second postoperative day and declines in incidence thereafter. A number of risk factors have been found to be associated with a higher frequency of post-CABG AF. These risk factors include advanced age, a prior history of AF, hypertension, and heart failure. Postoperative complications - including low cardiac output, use of an intra-aortic balloon pump, pneumonia, and prolonged mechanical ventilation - are also associated with higher rates of post-CABG AF. Post-CABG AF increases the risk of stroke, and the length and cost of hospitalization. Prophylactic administration of conventional β-adrenoceptor antagonists (β-blockers) or sotalol produces a consistent and significant reduction in the incidence of post-CABG AF; however, results with prophylactic amiodarone or magnesium are less consistent. Termination of post-CABG AF, once it occurs, can be accomplished with a number of antiarrhythmic agents. Ibutilide has been the most widely studied agent for this indication. Sotalol is not indicated for cardioversion of AF and has not been studied in the post-CABG setting. Electrical cardioversion and biatrial pacing have also been used to terminate post-CABG AF. Ventricular rate is best controlled with β-blockers and calcium channel antagonists. Esmolol has a rapid onset of action and is easily titrated to effect. Digoxin can control the ventricular rate, but has a slow onset of action. There are limited data available to guide decisions regarding the optimal management of post-CABG AF.

Original languageEnglish
Pages (from-to)361-369
Number of pages9
JournalAmerican Journal of Cardiovascular Drugs
Volume5
Issue number6
DOIs
StatePublished - 2005

Fingerprint

Atrial Fibrillation
Thoracic Surgery
Coronary Artery Bypass
Pharmacology
Transplants
Sotalol
Electric Countershock
Low Cardiac Output
Amiodarone
Digoxin
Incidence
Calcium Channel Blockers
Artificial Respiration
Adrenergic Receptors
Magnesium
Pneumonia
Hospitalization
Heart Failure
Stroke
Hypertension

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology

Cite this

Pharmacological management of atrial fibrillation following cardiac surgery. / Hilleman, Daniel E.; Hunter, Claire B.; Mohiuddin, Syed M.; Maciejewski, Stephanie.

In: American Journal of Cardiovascular Drugs, Vol. 5, No. 6, 2005, p. 361-369.

Research output: Contribution to journalReview article

@article{b4c4a129bfc54f6588ff01369e6c8942,
title = "Pharmacological management of atrial fibrillation following cardiac surgery",
abstract = "Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft surgery (CABG). Post-CABG AF occurs most commonly on the second postoperative day and declines in incidence thereafter. A number of risk factors have been found to be associated with a higher frequency of post-CABG AF. These risk factors include advanced age, a prior history of AF, hypertension, and heart failure. Postoperative complications - including low cardiac output, use of an intra-aortic balloon pump, pneumonia, and prolonged mechanical ventilation - are also associated with higher rates of post-CABG AF. Post-CABG AF increases the risk of stroke, and the length and cost of hospitalization. Prophylactic administration of conventional β-adrenoceptor antagonists (β-blockers) or sotalol produces a consistent and significant reduction in the incidence of post-CABG AF; however, results with prophylactic amiodarone or magnesium are less consistent. Termination of post-CABG AF, once it occurs, can be accomplished with a number of antiarrhythmic agents. Ibutilide has been the most widely studied agent for this indication. Sotalol is not indicated for cardioversion of AF and has not been studied in the post-CABG setting. Electrical cardioversion and biatrial pacing have also been used to terminate post-CABG AF. Ventricular rate is best controlled with β-blockers and calcium channel antagonists. Esmolol has a rapid onset of action and is easily titrated to effect. Digoxin can control the ventricular rate, but has a slow onset of action. There are limited data available to guide decisions regarding the optimal management of post-CABG AF.",
author = "Hilleman, {Daniel E.} and Hunter, {Claire B.} and Mohiuddin, {Syed M.} and Stephanie Maciejewski",
year = "2005",
doi = "10.2165/00129784-200505060-00003",
language = "English",
volume = "5",
pages = "361--369",
journal = "American Journal of Cardiovascular Drugs",
issn = "1175-3277",
publisher = "Adis International Ltd",
number = "6",

}

TY - JOUR

T1 - Pharmacological management of atrial fibrillation following cardiac surgery

AU - Hilleman, Daniel E.

AU - Hunter, Claire B.

AU - Mohiuddin, Syed M.

AU - Maciejewski, Stephanie

PY - 2005

Y1 - 2005

N2 - Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft surgery (CABG). Post-CABG AF occurs most commonly on the second postoperative day and declines in incidence thereafter. A number of risk factors have been found to be associated with a higher frequency of post-CABG AF. These risk factors include advanced age, a prior history of AF, hypertension, and heart failure. Postoperative complications - including low cardiac output, use of an intra-aortic balloon pump, pneumonia, and prolonged mechanical ventilation - are also associated with higher rates of post-CABG AF. Post-CABG AF increases the risk of stroke, and the length and cost of hospitalization. Prophylactic administration of conventional β-adrenoceptor antagonists (β-blockers) or sotalol produces a consistent and significant reduction in the incidence of post-CABG AF; however, results with prophylactic amiodarone or magnesium are less consistent. Termination of post-CABG AF, once it occurs, can be accomplished with a number of antiarrhythmic agents. Ibutilide has been the most widely studied agent for this indication. Sotalol is not indicated for cardioversion of AF and has not been studied in the post-CABG setting. Electrical cardioversion and biatrial pacing have also been used to terminate post-CABG AF. Ventricular rate is best controlled with β-blockers and calcium channel antagonists. Esmolol has a rapid onset of action and is easily titrated to effect. Digoxin can control the ventricular rate, but has a slow onset of action. There are limited data available to guide decisions regarding the optimal management of post-CABG AF.

AB - Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft surgery (CABG). Post-CABG AF occurs most commonly on the second postoperative day and declines in incidence thereafter. A number of risk factors have been found to be associated with a higher frequency of post-CABG AF. These risk factors include advanced age, a prior history of AF, hypertension, and heart failure. Postoperative complications - including low cardiac output, use of an intra-aortic balloon pump, pneumonia, and prolonged mechanical ventilation - are also associated with higher rates of post-CABG AF. Post-CABG AF increases the risk of stroke, and the length and cost of hospitalization. Prophylactic administration of conventional β-adrenoceptor antagonists (β-blockers) or sotalol produces a consistent and significant reduction in the incidence of post-CABG AF; however, results with prophylactic amiodarone or magnesium are less consistent. Termination of post-CABG AF, once it occurs, can be accomplished with a number of antiarrhythmic agents. Ibutilide has been the most widely studied agent for this indication. Sotalol is not indicated for cardioversion of AF and has not been studied in the post-CABG setting. Electrical cardioversion and biatrial pacing have also been used to terminate post-CABG AF. Ventricular rate is best controlled with β-blockers and calcium channel antagonists. Esmolol has a rapid onset of action and is easily titrated to effect. Digoxin can control the ventricular rate, but has a slow onset of action. There are limited data available to guide decisions regarding the optimal management of post-CABG AF.

UR - http://www.scopus.com/inward/record.url?scp=27744481382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27744481382&partnerID=8YFLogxK

U2 - 10.2165/00129784-200505060-00003

DO - 10.2165/00129784-200505060-00003

M3 - Review article

VL - 5

SP - 361

EP - 369

JO - American Journal of Cardiovascular Drugs

JF - American Journal of Cardiovascular Drugs

SN - 1175-3277

IS - 6

ER -