LATEST GUIDELINES FOR PREVENTING AND MANAGING ATRIAL FIBRILLATION FOLLOWING CARDIAC SURGERY: A UK PRACTICE SURVEY

Introduction: There are differing recommendations from various organizations for preventing post-cardiac surgery POAF. To define "usual care" for a platform trial of intervention to stop and prevent POAF following heart surgery, a survey of UK practice was carried out. All current guidelines for the prevention and management of atrial fibrillation (AF) following cardiac surgery were examined in order to set the scene for the survey. Objectives: About 30% of individuals experience postoperative atrial fibrillation (POAF), the most frequent complication following heart surgery. Design: Literature review and online survey. The survey was completed by all 35 UK National Health Service Cardiac Surgery Centers. Specialty societies' and other organizations' guidelines from North America, Europe, and the United Kingdom were examined. Participants: A link network of researchers was established. Measurements and Key Findings: The literature review found five pertinent guidelines’-blockade is advised by all guidelines to prevent AF following heart surgery. It is advised to treat AF with either rate or rhythm control. Cardio version is only advised for patients who are thermodynamically unstable. Anticoagulation should be considered for patients who stay in AF for more than 48 hours. Patients should get antiarrhythmic and anticoagulant therapy after being monitored for 60 days.31 (89%) out of 35 centers responded. Eleven out of thirty-one (35.5%) centers followed local guidelines for the prevention of POAF, four (13%), and the Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anesthesia guidelines. Guidance from the UK National Institute of Health and Care Excellence and 4 adhered to "other" guidelines. Eight (26%) of the 31 centers did not follow any protocols to prevent POAF, and 28 (90%) of the 31 centers did not risk-stratify their patients for POAF. The majority of centers (23 out of 31 and 74%), did not have a care package in place to avoid POAF, but 14 out of 31 (45%) tried to prevent AF in patients who presented with sinus rhythm. B-blocker use postoperatively (23/31,74%), magnesium (20/31,64.5%), and maintaining serum K+ ~4.5 mmol/L (26/31,84%) are the most common therapies to prevent POAF. Conclusions: B-blockade is the mainstay of advice on how to avoid AF following heart surgery. B-blockade and maintaining serum K+ and Mg2+ levels are the two main therapies utilized to avoid POAF, even though people in the UK don't seem to be at risk for it