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Medicine Consult Series: Ep. 1 - Postoperative Atrial Fibrillation

EP. 784Sep. 16, 202429:06
Cardiothoracic+1
Cardiothoracic+1
OverviewTranscript
You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards. 

Hosts
- Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska 
- Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95

Learning Objectives
- Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting. 
- Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation. 
- Identify common risk factors for atrial fibrillation in the post-operative setting. 
- Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery.

References
1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004
https://pubmed.ncbi.nlm.nih.gov/23194493/
2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143
https://pubmed.ncbi.nlm.nih.gov/25117130/
3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921.
https://pubmed.ncbi.nlm.nih.gov/14678921/
4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328
https://pubmed.ncbi.nlm.nih.gov/12466506/

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