Table 3. Summary of practical recommendations and appropriate candidates.
Phase of care | Treatment/intervention | POAF prevention | AF/POAF treatment | Stroke prevention |
---|---|---|---|---|
Preoperative | Oral beta-blocker | XX | ||
Preoperative amiodarone in patients at high risk of POAF | XX | |||
Perioperative amiodarone | XX | |||
Intraoperative | Posterior pericardiotomy | XX | ||
Surgical ablation for atrial fibrillation | XX | XX | ||
Surgical occlusion of the LAA may be considered in patients with AF undergoing cardiac surgery as part of the overall heart team approach | XX | |||
Postoperative | Beta-blocker for rate control | XX | ||
Nondihydropyridine calcium channel blocker for rate control | XX | |||
Restoration of sinus rhythm by electrical cardioversion of antiarrhythmic drugs recommended for POAF with hemodynamic instability | XX | |||
Asymptomatic AF initially managed with rate control and anticoagulation | XX | |||
Long-term anticoagulation should be considered in patients with POAF, considering individual stroke and bleeding risk | XX | |||
Antiarrhythmic drugs or cardioversion for symptomatic POAF to restore NSR | XX | |||
Prophylactic sotalol to prevent POAF after cardiac surgery | XX | |||
Colchicine to reduce POAF | XX |
XX indicates that the guidelines include this recommendation. POAF, postoperative atrial fibrillation; AF, atrial fibrillation; LAA, left atrial appendage; NSR, normal sinus rhythm.