Attitudes toward anticoagulation for postoperative atrial fibrillation: A nationwide survey of VA providers.

Introduction: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. Though often felt to be self‐limited, this complication has been associated with increases in both short and long‐term stroke and mortality. Several studies have also shown a high rate of AF recurr...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 43; no. 11; pp. 1295 - 1302
Autores principales: Riad, Fady S., German, Konstantin, Deitz, Sarah, Sahadevan, Jayakumar, Sundaram, Varun, Waldo, Albert L.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2020
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Attitudes toward anticoagulation for postoperative atrial fibrillation: A nationwide survey of VA providers.
      aug:
        au:
          Riad, Fady S.
          German, Konstantin
          Deitz, Sarah
          Sahadevan, Jayakumar
          Sundaram, Varun
          Waldo, Albert L.
        affil: Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland Ohio
      sug:
        subj:
          Physician Attitudes Evaluation
          Anticoagulants Therapeutic Use
          Postoperative Care
          Atrial Fibrillation Drug Therapy
          Postoperative Complications Drug Therapy
          Attitude to Medical Treatment
          Cardiac Surgery Adverse Effects
          Atrial Fibrillation Risk Factors
          Human
          Veterans Health Services
          Hospitals
          Cardiologists
          Patient Discharge
          Stroke
          Treatment Duration
      ab: Introduction: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. Though often felt to be self‐limited, this complication has been associated with increases in both short and long‐term stroke and mortality. Several studies have also shown a high rate of AF recurrence. Optimal treatment strategy is not yet defined, and the role of anticoagulation (AC) is unclear. Our objective was to determine provider attitudes toward management of this common complication. Methods: A survey consisting of 15 multiple choice questions was distributed to providers at Veterans Healthcare Administration hospitals nationwide. Results: The majority of respondents were cardiologists. Practices varied drastically with respect to AC use for patients with POAF who were discharged in normal sinus rhythm. Less variability existed for patients discharged in AF. There was no clear consensus regarding other factors to consider when deciding on AC therapy, including length of episode, or risk factors for stroke such as CHA2DS2‐VASc score. There was also no consensus on duration of therapy or need for post discharge cardiac monitoring. Conclusion: Our data indicate a wide variability in the management of POAF. This reflects conflicting recommendations in the guidelines, as well as a paucity of prospective treatment trials in this field. Nevertheless, a growing evidence base suggests that this complication carries potentially serious long‐term morbidity and mortality, and better evidence for its management is needed.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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