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A wolf in sheep's skin? Postoperative atrial fibrillation after cardiac surgery and the risk of stroke and mortality
Postoperative Atrial Fibrillation (poAF; AF) is the most common complication after heart surgery.1 Up to 50% of patients who present preoperatively in normal sinus rhythm will develop poAF after cardiac surgery making it the most common postoperative morbidity.2 It is hypothesized that inflammation, increased sympathoadrenal activation, and oxidative stress unmask the propensity for developing poAF in at-risk patients, thereby leading to blood stasis and clot formation in the left atrium.3 Resulting thromboembolism and cerebrovascular accidents can dramatically change the postoperative course and affect patients ’ lives.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 19, 2021 Category: Anesthesiology Authors: Sergey Karamnov, Benjamin O'Brien, Jochen D. Muehlschlegel Source Type: research

Cerebral fungal infections as a cause of stroke in cardiac surgery patients: Be Cautious!!
Neurological dysfunction in the postoperative period following cardiac surgery is most commonly attributed to thromboembolism or an intracranial bleed. Fungal infection is a rare cause of cerebral infarction and hemiparesis in an otherwise healthy patient. Cerebral Aspergillus infections are common in immunocompromised patients and is not considered as the first-line differential diagnosis of cerebral infarcts in a cardiac surgery patient. The infection is usually a secondary from lung, paranasal sinuses, or heart and forms microthrombi in large or medium sized cerebral vessels.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2023 Category: Anesthesiology Authors: Avneet Singh, Arushi Goyal, Manpreet Singh, Sidharth Garg, Sandeep Moudgil, Vipin Gupta Tags: Letter to the Editor Source Type: research

The Price of Keeping the Rhythm: Increased Bleeding Risk in Patients with Atrial Fibrillation Concurrently Prescribed Amiodarone and Factor Xa Inhibitors
Atrial fibrillation is the most common sustained cardiac arrhythmia affecting nearly 2% of the population of the United States.1 Patients with atrial fibrillation are twice as likely to have a myocardial infarction and five-times as likely to have a stroke.1 Current guidelines recommend antiarrhythmic pharmacotherapy in patients with symptomatic atrial fibrillation as first-line management.2-4 Amiodarone is a very effective, and therefore, a commonly prescribed agent for this purpose.5 Anticoagulation is a key tenet in the management of atrial fibrillation due to the increased tendency of left atrial appendage clot formati...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 10, 2023 Category: Anesthesiology Authors: Nicolas Kumar, Manoj H. Iyer, Adam Dalia, Amit Bardia Tags: Editorial Source Type: research

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