Send to

Choose Destination
Anesth Analg. 2019 Sep 27. doi: 10.1213/ANE.0000000000004474. [Epub ahead of print]

Atrial Fibrillation: Current Evidence and Management Strategies During the Perioperative Period.

Author information

From the Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Department of Anesthesiology, Section on Critical Care Medicine & Wake Forest Center for Biomedical Informatics, and the Critical Injury, Illness, and Recovery Research Center (CIIRRC), Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
Outcomes Research Consortium, Cleveland, Ohio.
Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Evans Center for Implementation and Improvement Sciences, Department of Medicine and the Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts.
Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts.


Atrial fibrillation (AF) is the most common arrhythmia in the perioperative period. Previously considered a benign and self-limited entity, recent data suggest that perioperative AF is associated with considerable morbidity and mortality and may predict long-term AF and stroke risk in some patients. Despite known risk factors, AF remains largely unpredictable, especially after noncardiac surgery. As a consequence, strategies to minimize perioperative risk are mostly supportive and include avoiding potential arrhythmogenic triggers and proactively treating patient- and surgery-related factors that might precipitate AF. In addition to managing AF itself, clinicians must also address the hemodynamic perturbations that result from AF to prevent end-organ dysfunction. This review will discuss current evidence with respect to causes, risk factors, and outcomes of patients with AF, and address current controversies in the perioperative setting.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center