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General

PHARMACOLOGIC PROPHYLAXIS OF POSTOPERATIVE ATRIAL FIBRILLATION

L. Demirevska and D. Gotchev

Clinic of Cardiology, Military Medical Academy – Sofia

Summary: Post-operative atrial fibrillation (POAF) is a frequent complication after surgery. It is associated with an increased risk of mortality and morbidity, predisposes patients to a higher risk of stroke and increases the costs of the post-operative care. The aim of this review is to present the current state of knowledge about the prevention of this complication. Evidence-based guidelines support the use of beta-blockers as standard prophylaxis of POAF, whereas amiodarone can be added in high-risk patients. There is evidence suggesting that angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, statins, corticosteroids, may be effective in preventing POAF. Additional large-scale, adequately powered clinical studies are needed to determine the benefit of these agents.

Keywords: postoperative atrial fibrillation, prophylaxis

Address for correspondence: Liliya Demirevska, MD, Clinic of Cardiology, Military Medical Academy, 3, Sv. G. Sofiiski St., 1606 Sofia, Bulgaria

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