Medical and Surgical Treatment of Atrial Fibrillation

Abstract

tory surgical centers and cardiac catheterization, endoscopy, and radiological suites, and less often in operating rooms. An increasing percentage of proceduralists are not surgeons and non-operating room nursing and support staff are often employed, adding another layer of separation from conventional practice. In most clinical scenarios, anesthesia personnel are still required to be present to ensure the safety of sedation, immediate resuscitation for unexpected events, and overall patient well-being. Anesthesia providers are expected to provide comprehensive services for complex or critically ill patients in these locations, all within the constraints of normal working hours.Atrial fibrillation (AF) is a common medical condition in the geriatric population and presents unique challenges [1]. As the world's leading cause of atrial arrhythmia, this disease affects an increasing percentage of the population and places this group of patients at an increased risk of periprocedural complications, mainly related to thromboembolic phenomena. In addition to presenting with significant comorbidities, this subset of patients uses unique medication therapies that can complicate anesthetic planning for surgery. Novel procedures for the management and treatment of AF require specialized care and can provide a cure in some cases. However, rare but serious complications are being reported as the number of procedures has increased over the past decade. Knowledge of these sequelae is essential and can prove life-saving as many of these patients will re-present in extreme circumstances. Medical Treatment of AF and Conflict with SurgeryA disease that primarily affects the elderly, AF is very rare below the age of 50 but the incidence increases to 10% at the age of 80 [2]. Risk factors include alcohol use, obstructive sleep apnea, obesity, diabetes mellitus, hypertension, cardiac valvular diseases, and coronary artery disease. These comorbidities decrease a patient's overall quality of life and, unfortunately, decrease the chances of successful treatments for an arrhythmia [3]. The disorganized activity of AF is thought to originate