Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 79, Issue 25, Pages 2529-2539Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2022.04.029
Keywords
cardiac surgery; etiology; inflammation; pericardial effusion; POAF; postoperative atrial fibrillation
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Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, associated with adverse outcomes and increased hospital costs. Recent evidence suggests that postoperative pericardial effusion and inflammation may play a role in triggering POAF.
Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. Patients who develop POAF are more likely to experience adverse outcomes, including increased rates of death, stroke, heart failure, and hospitalizations, and higher hospital costs. Understanding the mechanisms underlying POAF is important to improve patients' outcome and optimize health systems' efficiency. Beyond classic pathogenic hypotheses, emerging evidence suggests that postoperative pericardial effusion and localized pericardial inflammation may trigger POAF. This hypothesis is supported by data from nonhuman animal models and a growing body of evidence showing that reducing postoperative pericardial effusion might reduce POAF incidence. In this review, we summarize the classic pathophysiology theories of POAF following cardiac surgery and discuss new etiologic mechanisms with a specific focus on the role of pericardial effusion and inflammation. (C) 2022 by the American College of Cardiology Foundation.
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