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
