Current Treatments Options of Postoperative Atrial Fibrillation


The current treatment regimens for POAF, a combination of intravenous (IV) antiarrhythmic drugs and external electrocardioversion, are in general successful in restoring sinus rhythm. However, there are a number of serious side effects and drawbacks inherent to these treatments.

  • The drugs used to treat POAF are administered intravenously (IV) and may be associated with serious systemic side effects. This is because the drugs must be administered in concentrations high enough to raise blood levels to a therapeutic level sufficient enough to affect the atrial tissue of the heart.
  • Short-term and long-term side effects are very possible and may include: nausea, vomiting, dizziness, fatigue, lung and kidney issues.

 

External electrical cardioversion subjects the patient to a large amount of electrical energy (100- 360 joules). A joule (J) is a way to measure electrical energy in the International System of Units (SI), much like Celsius is used to measure temperature. As a comparison, 1J is equal to 1 watt/second. That is, a 100W light bulb uses 100J of electrical energy every second. The electrical energy needed to successfully cardiovert a patient is significant and the patient is normally sedated during the procedure.

  • Cardioversion is highly effective, but it may cause severe discomfort and it may cause potentially life-threatening ventricular arrhythmias.
  • May cause pain and burns to the chest
  • Patient needs to be sedated; requires an anesthesia team