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Featured Articles: Infographic

Rate, Rhythm, and Risk: Perioperative New-Onset Atrial Fibrillation

Nathan, Naveen MD

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doi: 10.1213/ANE.0000000000004558
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The development of new-onset atrial fibrillation (NOAF) represents the most common arrhythmia managed by anesthesiologists in the perioperative period. Although in many cases this entity is self-limited or is quickly ameliorated with therapy, NOAF originates an independent risk of mortality and stroke. A review by Karamchandani et al1 describes in detail the mechanisms and risk factors for the development of NOAF. This infographic summarizes their description of the management strategies for atrial fibrillation as well as the goals for perioperative optimization to prevent its occurrence. The reader is strongly encouraged to review the referenced article.

AMI indicates acute myocardial infarction; AV, atrio-ventricular; BB, beta blocker; BP, blood pressure; CCB, calcium channel blocker; CPAP, continuous positive airway pressure; CT, computed tomography; ECG, electrocardiogram; HR, heart rate; NOAF, new-onset atrial fibrillation; OSA, obstructive sleep apnea; PE, pulmonary embolism; POD, postoperative day; RVR, rapid ventricular rate; SNS, sympathetic nervous system.


1. Karamchandani K, Khanna AK, Bose S, Fernando RJ, Walkey AJ. Atrial fibrillation: current evidence and management strategies during the perioperative period. Anesth Analg. 2020;130:213.
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