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Atrial fibrillation (AF) occurs after cardiac surgery in up to 50% of patients. In a study funded by the NIH and the Canadian Institutes of Health Research, investigators compared aggressive rhythm-control treatment with simpler rate-control treatment of postoperative AF.
Of 2109 patients without prior AF undergoing cardiac surgery at 23 U.S. and Canadian sites, 695 developed AF (33%) an average of 2.4 days after surgery, and 523 were randomized to standard therapy for rate control or to amiodarone with cardioversion if needed for rhythm control. Anticoagulation was recommended for all patients with persistent or recurrent AF within 48 hours after randomization.
In the rate-control group, 27% of patients received amiodarone and 9.2% underwent…