Rate Control Vs Rhythm Control For Atrial Fibrillation After Cardiac Surgery: Review Of Current Literature

Syed Rafay Ali Sabzwari, MD; Dhanunjaya Lakkireddy, MD, FACC, FHRS

Atrial fibrillation (AF) after cardiac surgery is a common phenomenon reaching an incidence of 20-50% with a significant toll on postoperative complications, hospital stay, readmission and utilization of resources. Such patients have increased morbidity from stroke, myocardial infarction, congestive heart failure, arrhythmias from antiarrhythmic drugs and bleeding caused by anticoagulant use. Although there have been multiple studies done in the past to address post cardiac surgery atrial fibrillation majority of them focused on prevention strategies using prophylactic measures. The AFFIRM trial⁷ addressed rate vs rhythm control in nonsurgical patients, however conclusive evidence of whether this could be extrapolated to post cardiac surgery atrial fibrillation was lacking. This article explores the current literature on post cardiac atrial fibrillation rate versus rhythm control.