You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards.
Hosts:
- Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska
- Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95
Learning Objectives:
- Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting.
- Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation.
- Identify common risk factors for atrial fibrillation in the post-operative setting.
- Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery.
References:
1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004
https://pubmed.ncbi.nlm.nih.gov/23194493/
2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143
https://pubmed.ncbi.nlm.nih.gov/25117130/
3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921.
https://pubmed.ncbi.nlm.nih.gov/14678921/
4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328
https://pubmed.ncbi.nlm.nih.gov/12466506/
Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
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