Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review
Abstract
1. Introduction
2. Prevention of POAF
2.1. Amiodarone: A Dead Man Walking [22]
2.2. Perioperative Optimization of Beta-Blockers
2.3. Other Interventions
3. Treatment of POAF
3.1. Treatment of Associated Factors
3.2. Considering a Rate Control Strategy
3.3. Which Place for a Rhythm Control Strategy in the Acute Care Setting?
3.4. Prevention of Thromboembolic Events
4. Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
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First Author | Journal | Study Design |
---|---|---|
Gillinov AM [2] | N Engl J Med 2016 | Multicenter RCT comparing rate control vs. rhythm control for POAF after cardiac surgery |
Mathew JP [5] | JAMA 2004 | Large cohort study showing a significant association between perioperative optimization of beta-blockers and POAF |
Isiadinso I [30] | J Heart Lung Transplant 2011 | Retrospective study showing the association between amiodarone and mortality in POAF after heart–lung transplantation |
Couffignal C [33] | Anesthesiology 2020 | Prospective multicenter cohort study assessing timing of beta-blockers reintroduction and POAF after cardiac surgery |
Blessberger H [34] | Cochrane Database Syst rev 2019 | Meta-analysis reporting the role of beta-blockers for preventing morbidity and mortality after noncardiac surgery |
Cafaro T [36] | Can J Anesth 2023 | Meta-analysis of RCTs showing the efficacy of landiolol in preventing POAF after cardiac surgery |
Kaminohara J [37] | JTCVS Open 2022 | Propensity score-matched analysis showing the efficacy of landiolol in preventing POAF after cardiac surgery |
Gaudino M [38] | Lancet 2021 | RCT showing the efficacy of posterior left pericardiotomy for the prevention of POAF after cardiac surgery |
Curran J [41] | Plos One 2023 | Meta-analysis showing the conflicting results regarding magnesium prophylaxis of new-onset atrial fibrillation |
O’Brien B [42] | JAMA 2024 | Multicenter RCT showing the lack of effect of potassium supplementation to prevent POAF after cardiac surgery |
Conen D [43] | Lancet 2023 | International RCT showing the lack of effect of colchicine to prevent POAF after noncardiac surgery |
Taha A [51] | JAHA 2021 | Population-based nationwide registry studying POAF and long-term outcome after cardiac surgery |
Neves IA [52] | Vascul Pharmacol 2022 | Meta-analysis on the use of anticoagulation in POAF after cardiac surgery |
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Fellahi, J.-L.; Fischer, M.-O.; Ruste, M.; Jacquet-Lagreze, M. Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review. J. Clin. Med. 2025, 14, 6835. https://doi.org/10.3390/jcm14196835
Fellahi J-L, Fischer M-O, Ruste M, Jacquet-Lagreze M. Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review. Journal of Clinical Medicine. 2025; 14(19):6835. https://doi.org/10.3390/jcm14196835
Chicago/Turabian StyleFellahi, Jean-Luc, Marc-Olivier Fischer, Martin Ruste, and Matthias Jacquet-Lagreze. 2025. "Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review" Journal of Clinical Medicine 14, no. 19: 6835. https://doi.org/10.3390/jcm14196835
APA StyleFellahi, J.-L., Fischer, M.-O., Ruste, M., & Jacquet-Lagreze, M. (2025). Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review. Journal of Clinical Medicine, 14(19), 6835. https://doi.org/10.3390/jcm14196835