* patients with pre-existing AF receiving antiarrhythmics or rate controlling agents should be continued ont hese in postop period.
* Oral beta blocker is recommended to prevent post op AF in patients undergoing cardiac surgery-- unless contraindicated
* An AV nodal blocking agent is recommended for postop rate control in patients who develop postop AF
* Preop amiodarone decreases the incidence of AF in patients undergoing cardiac surgery and represents appropriate prophylactic therapy for patients at high risk of AF
* Its reasonable to restore sinus rhythm pharmacologically or through cardioversion among patients who develop postoperative AF
* It is reasonable to administer anti-arrhytmics to maintain SR in patients with postop refractory or recurrent AF
* Antithrombotic medication is reasonable to administer in patients who develop postop AF
* Prophylactic sotalol may be considered in high risk patients.
Additional points for cardiac surgery-- evidence based
*Matching preop and postop BP may reduce the risk of perioperative stroke or death III/B
* Preop statins reduce the perioperative stroke risk in cardiac surgery IB/A
* Antiplatelet therapy eg ASA reduces the postop stroke risk without increasing the risk of bleeding complications Ia/A
* Discontinuing warfarin or antiplatelet agents in anticipation of surgery increases the risk of perioperative stroke, with the highest risk in patients with CAD
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