Postoperative Atrial Fibrillation After Cardiac Surgery

Atrial fibrillation (AF) is currently a diagnosis held by at least 10.5 million individuals in the US, more than 4.5% of the adult US population. The causes of AF in any given individual are often mysterious, and the causes underlying a particular episode at a given time are often even more inscrutable. Although identifying the exposures that might trigger an AF episode is a high priority for patients with AF and objective evidence of near-term triggers (such as alcohol) of AF has been demonstrated, there is no evidence that prevention of AF episodes by avoidance of acute triggers can truly reverse AF. In other words, patients who have episodes of alcohol-associated AF should not be deprived of the same evaluation or consideration of possible treatment modalities compared with one with more spontaneous forms of repeated AF. Indeed, the most recent clinical practice guidelines for the management of AF recommend anticoagulation to prevent stroke and thromboembolism based on other stroke risk factors, such as age and cardiovascular comorbidities, and not based on the type of AF or, generally, the circumstances under which the AF occurred.