Combined Amiodarone and Electrical Cardioversion for Postoperative Atrial Fibrillation After Cardiac Surgery

New-onset atrial fibrillation (AF) after cardiac surgery is a well-recognized phenomenon
with significant outcome implications. Incidence after coronary artery bypass grafting
(CABG) is estimated at 26-33%, while those undergoing valvular surgery bear a greater burden
at 33-49%. Clinical and socioeconomic complications resulting from postoperative atrial
fibrillation include an increased risk of death (10%), congestive heart failure (4%),
prolonged hospital stays, and increased rate of discharge to care facilities over those who
remain in sinus rhythm, (7%). Although a body of evidence exists for electrical or
pharmacological cardioversion to sinus rhythm postoperatively, there is a marked paucity in
the literature regarding efficacy and outcomes combining the two. More specifically, we seek
to evaluate the efficacy of DC cardioversion when combined with amiodarone. Improved
outcomes with multimodal cardioversion may decrease the postoperative clinical burden of
atrial fibrillation on cardiac surgery patients.

This will be a prospective observational study, posing minimal risk to subjects.

Inclusion Criteria:

- Subjects who underwent CABG and/or cardiac valve surgery involving cardiopulmonary
bypass and develop postoperative atrial fibrillation within 7 days after surgery

Exclusion Criteria:

- Subjects who had any form of atrial fibrillation prior to surgery

- Subjects who were on antiarrhythmic medications preoperatively, including but not
limited to procainamide and amiodarone