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The peri‐operative management of atrial fibrillation
Author(s) -
Nathanson M. H.,
Gajraj N. M.
Publication year - 1998
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1998.465-az0558.x
Subject(s) - medicine , atrial fibrillation , cardioversion , cardiology , management of atrial fibrillation , anesthesia
Atrial fibrillation is a common arrhythmia frequently seen in surgical patients. The onset of new atrial fibrillation during the peri‐operative period is less common. There are many possible precipitating factors, although volatile agents themselves may have an antifibrillatory action. The management of atrial fibrillation includes removal of any precipitating factors and treatment of the arrhythmia itself. Immediate management of acute‐onset atrial fibrillation is usually direct current cardioversion. Alternatively, anti‐arrhythmic drugs can be used to achieve cardioversion. In patients with rapid, chronic atrial fibrillation or those refractory to cardioversion, priority is given to control of the ventricular rate. Thrombo‐embolism is a significant risk if atrial fibrillation is paroxysmal or persists for more than 48 h.