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Pardo et al. Vessel Plus 2022;6:36 https://dx.doi.org/10.20517/2574-1209.2021.120 Page 7 of 20

Table 3. POAF imaging and duration
Criteria - subcomponents Number of publications
EKG finding Irregular RR intervals 20
Absence of P waves 17
Fluctuating baseline 4
No consistent P waves before QRS 3
Episode duration > 30 s 22
> 5 min 14
> 10 min 4
> 15 min 3
> 30 min 3
> 1 min 2
> 60 min 2
> 10 s 1
> 2 min 1
Several minutes 1
< 5 min 1
> 6 min 1
> 10 min 1
< 60 min 1
> 12 h 1

Criteria used to define POAF from 56 publications. These criteria are broken down into subcomponents along with the number of publications
mentioning a specific subcomponent. One publication may mention more than one subcomponent, but each subcomponent is composed of
different publications. The time frame for this table spans from 1995-2020 [19-21,23-25,27-34,36,38-43,45-51,54-56,60,62-64,66,66,67,70-89] .

congestive heart failure, pericarditis, advancing age, male gender, and chronic lung disease. Advanced age
had the greatest level (75%) of consensus among societies; advanced age as a risk for POAF has been
identified by the literature . Three thoracic surgery procedures that drew consensus between STS and
[14]
AATS and identified a high incidence of POAF (> 15%) were pneumonectomy, pleurectomy, and lung
transplantation. As a modifiable risk factor, HTN was mentioned but only rarely.

Across the eight prophylactic guidelines evaluated, the greatest level of consensus was found for the use of
B-blockers (n = 5 society-based guidelines) and amiodarone (n = 6 society-based guidelines). Unlike the risk
assessment guidelines, 68% (n = 17/25) of the prophylactic recommendations were provided by procedural
societies. Between these two procedural societies, AATS & STS, though only two were jointly
recommended, “Avoid B-blocker withdrawal” and “Magnesium supplementation”.

Management guidelines were similarly reported (65%; n = 42/64) primarily by procedural societies.
Agreement was seen broadly among categories used. Eight societies provided guidelines and of these, eight
provided guidance for anticoagulation, six provided guidance to ensure hemodynamic stability, six provided
guidance for the sub-group of hemodynamic unstable POAF patients, five for all POAF patients, five for
rhythm control POAF patients, and two for rate control POAF patients. These categories once expanded
upon [Table 6] showed 58 recommendations of which only five were used by more than one society (n =
5/58; 8%).

DISCUSSION
This literature review summarized the guidelines and guideline key references evaluated. The purpose of
this review was to describe the current POAF landscape. Through careful examination of definitions, risks,