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Waterford et al. Vessel Plus 2022;6:28 Vessel Plus
DOI: 10.20517/2574-1209.2021.115

Review Open Access

Amiodarone and postoperative atrial fibrillation

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Stephen D. Waterford , Lindsey Prescher , Michal Ad , Lee Ann Santore , Cordell Spellman , Niv Ad 6
1
Division of Cardiac Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
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Division of Cardiac Surgery, Yale New Haven Hospital, New Haven, CT 06510, USA.
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Inova Fairfax Hospital General Surgery Program, Rockville, MD 20852, USA.
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Renaissance School of Medicine at Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8434, USA.
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Medical College of Wisconsin, Wauwatosa, WI 53226, USA.
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White Oak Medical Center, Adventist HealthCare, University of Maryland, Division of Cardiac Surgery, Takoma Park, MD
20904, USA.
Correspondence to: Niv Ad, White Oak Medical Center, Adventist HealthCare, University of Maryland, Division of Cardiac
Surgery, 7901 Maple Street, Takoma Park, MD 20904, USA. E-mail: nivadmd14@gmail.com
How to cite this article: Waterford SD, Prescher L, Ad M, Santore LA, Spellman C, Ad N. Amiodarone and postoperative atrial
fibrillation. Vessel Plus 2022;6:28. https://dx.doi.org/10.20517/2574-1209.2021.115
Received: 19 Aug 2021 First Decision: 24 Sep 2021 Revised: 2 Nov 2021 Accepted: 15 Nov 2021 Published: 13 May 2022
Academic Editors: Annie Laurie W. Shroyer, Frank W. Sellke, Alexander D. Verin Copy Editor: Yue-Yue Zhang Production
Editor: Yue-Yue Zhang

Abstract
New-onset postoperative atrial fibrillation (POAF) develops in 10%-50% of patients after cardiac surgery. In this
review, we focus on risk factors associated with POAF and the different pharmacological strategies used for
prophylaxis, with special attention to amiodarone. The use of amiodarone will be discussed both as a prophylactic
regimen used before and following cardiac surgery, but also as a rhythm control treatment in patients who develop
POAF. Finally, we conclude by reviewing gaps in the literature on amiodarone and further studies which could close
these gaps.

Keywords: Amiodarone, atrial fibrillation, postoperative, cardiac surgery

INTRODUCTION
New-onset postoperative atrial fibrillation (POAF) may develop in 10%-50% of patients after cardiac
surgery. The rate of occurrence is highly related to the primary cardiac pathology and certain co-
[2]
morbidities . The peak incidence is around days 2-4 postoperatively . POAF is associated with increased
[1]
[3,4]
morbidity and mortality as well as increased healthcare costs and resource utilization . The mechanism of

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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