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Atrial Fibrillation

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Treatment 28 Table 25. Postoperative Cardiac and Thoracic Surgery Recommendations COR LOE Treating patients who develop AF aer cardiac surgery with a beta blocker is recommended unless contraindicated. I A A nondihydropyridine calcium channel blocker is recommended when a beta blocker is inadequate to achieve rate control in patients with postoperative AF. I B Preoperative administration of amiodarone reduces the incidence of AF in patients undergoing cardiac surgery and is reasonable as prophylactic therapy for patients at high risk for postoperative AF. IIa A It is reasonable to restore sinus rhythm pharmacologically with ibutilide or direct-current cardioversion in patients who develop postoperative AF, as advised for nonsurgical patients. IIa B It is reasonable to administer antiarrhythmic medications in an attempt to maintain sinus rhythm in patients with recurrent or refractory postoperative AF, as advised for other patients who develop AF. IIa B It is reasonable to administer antithrombotic medication in patients who develop postoperative AF, as advised for nonsurgical patients. IIa B It is reasonable to manage well-tolerated, new-onset postoperative AF with rate control and anticoagulation with cardioversion if AF does not revert spontaneously to sinus rhythm during follow-up. IIa C Prophylactic administration of sotalol may be considered for patients at risk of developing AF following cardiac surgery. IIb B Administration of colchicine may be considered for patients postoperatively to reduce AF aer cardiac surgery. IIb B

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