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Correspondence  |   September 2003
New Atrial Fibrillation and Elective Surgery
Author Notes
  • University of Washington School of Medicine, Seattle, Washington.
Article Information
Correspondence
Correspondence   |   September 2003
New Atrial Fibrillation and Elective Surgery
Anesthesiology 9 2003, Vol.99, 756. doi:
Anesthesiology 9 2003, Vol.99, 756. doi:
To the Editor:—
I read with interest Dr. Amar's 1 Clinical Concepts and Commentary article on perioperative atrial tachyarrhythmias. I believe, however, that caution must be exercised when proceeding with elective surgery in a patient with newly diagnosed atrial fibrillation, a controlled ventricular response, and no evidence of structural heart disease.
Current practice is to anticoagulate such patients if atrial fibrillation persists longer than 48 h. If the surgery to be embarked on precludes such a strategy, it would be prudent to consider delaying surgery until either sinus rhythm can be restored, or it is decided that atrial fibrillation is entrenched.
Clearly, if the surgery is urgent or emergent, one must proceed recognizing the added risk.
Reference
Reference
Amar D: Perioperative atrial tachyarrhythmias. A nesthesiology 2002; 97: 1618–23Amar, D