The American College of Chest Physicians (ACCP) has released the first evidence-based clinical practice guidelines for the prevention and management of postoperative atrial fibrillation (AF) after cardiac surgery.
Published in the August issue of CHEST, the peer-reviewed journal of the ACCP, the guidelines offer specific recommendations on cardiac pacing, anticoagulation therapy, pharmaceutical prophylaxis, intraoperative interventions, and pharmacologic control of ventricular rate and rhythm. Atrial fibrillation, or irregular heartbeat, is a common condition that occurs increasingly with age and is one of the most frequent complications of cardiac surgery.
"Over one third of patients suffer from AF after cardiac surgery, which is associated with a higher risk of operative morbidity, increased hospital stay, and increased hospital cost," said Guidelines Co-Chair Peter P. McKeown, MBBS, MPH, MPA, FCCP, Veterans Affairs Medical Center, Asheville, NC. "Although previous guidelines have focused on the management of chronic AF, our guidelines are the first to address AF associated with cardiac surgery."
Through the Health and Science Policy Committee of the ACCP, the guidelines were developed by a multidisciplinary panel of experts in the fields of cardiothoracic surgery, cardiology, anesthesiology, and epidemiology. The panel included representatives from the ACCP, the American College of Cardiology, the Society of Thoracic Surgeons, and the American College of Surgeons. Based on a systematic review of randomized, controlled trials, panel members made graded recommendations based on the quality of evidence available and the net benefit of the intervention.