Atrial fibrillation is a common problem following cardiac surgery. Atrial fibrillation occurs in 30% to 50% patients during postoperative period. Postoperative atrial fibrillation often results in increased length of hospital stay, increased cost of postoperative hospitalization, heart failure, and, less frequently, cerebrovascular accident and death. Because postoperative atrial fibrillation is such a significant problem, several studies have attempted to find a safe and effective treatment for its prevention. In this article, we review the evidence for various prophylactic therapies and make an attempt to answer the following: (1) Can postoperative atrial fibrillation be prevented? (2) Is prophylactic therapy for postoperative atrial fibrillation safe? (3) Does prevention of postoperative atrial fibrillation prevent adverse outcomes associated with it? Evidence for safety and efficacy or lack of beta-blockers, sotalol, amiodarone, intravenous magnesium, and atrial pacing is reviewed and current recommendations by the American College of Cardiology/American Heart Association/European Society of Cardiology are presented.

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Four patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) are described. Two patients presented with sustained ventricular tachycardia and two with cardiac arrest from which they were successfully resuscitated. All four patients had typical electrocardiographic and echocardiographic features and fulfilled the task force criteria for diagnosis of ARVD/C. All four patients had T wave inversion in chest leads V1 to V4, and two had epsilon waves, and all four had premature ventricular complexes of left bundle branch block and left axis deviation pattern. All patients showed a markedly enlarged, thin and hypokinetic right ventricle. Three patients had implantable cardioverter defibrillator (ICD) implanted and are doing well. One patient who refused an ICD died suddenly 6 months after his initial presentation. Three surviving patients are on sotalol for suppression of ventricular tachycardia episodes triggering ICD shocks. A review of the existing literature on diagnosis of ARVD/C, its clinical presentation and natural history, its genetic basis, risk stratification, treatment, and prognosis is presented.