Atrial Fibrillation Preoperative Management

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What is the primary goal of preoperative management in patients with preexisting atrial fibrillation (AF) needing surgery?

Ensure hemodynamic stability and optimize anticoagulation

What should be continued perioperatively in patients with recurrent AF despite rhythm-controlling medications?

Rhythm-controlling medications

When is electrical cardioversion typically used in patients with atrial fibrillation?

In hemodynamically unstable patients

Why is interrupting anticoagulation necessary for most surgeries?

To decrease the risk of surgical bleeding Signup and view all the answers

How long before surgery should direct oral anticoagulants (DOACs) be discontinued?

1-3 days, depending on the surgery, specific DOAC, and renal function Signup and view all the answers

In which type of procedures can anticoagulation be continued?

Low-risk procedures such as dermatologic, dental, or ophthalmologic procedures Signup and view all the answers

What are the primary goals of preoperative management for patients with atrial fibrillation (AF) requiring surgery?

Rate control and anticoagulation Signup and view all the answers

What is the criterion for proceeding with surgery in patients with atrial fibrillation (AF)?

Rate-controlled, stable AF with no symptoms Signup and view all the answers

Why is electrical cardioversion not preferred for patients with atrial fibrillation (AF) requiring surgery?

It requires delaying surgery for 4 weeks to allow for blood thinners Signup and view all the answers

What is the role of amiodarone in preoperative management of atrial fibrillation (AF)?

Rate control in some cases Signup and view all the answers

What is the alternative to electrical cardioversion in patients with atrial fibrillation (AF)?

Pharmacologic cardioversion with medications Signup and view all the answers

Why is bridging with low molecular weight heparin sometimes necessary for patients taking warfarin?

For high or moderate stroke risk patients Signup and view all the answers

What is the primary concern in patients with atrial fibrillation undergoing surgery that requires interrupting anticoagulation?

Bleeding Signup and view all the answers

What is the significance of the 4-week delay in surgery for patients undergoing electrical cardioversion?

To allow for discontinuation of blood thinners Signup and view all the answers

What is the difference in restarting anticoagulation therapy between DOACs and warfarin after surgery?

DOACs can be restarted quickly without bridging, whereas warfarin may require bridging with low molecular weight heparin Signup and view all the answers

Why may bridging with low molecular weight heparin be necessary for patients taking warfarin?

For high or moderate stroke risk patients Signup and view all the answers

What is the key consideration in managing anticoagulation therapy perioperatively for patients with atrial fibrillation?

Balancing the risk of bleeding with the risk of stroke Signup and view all the answers

Atrial Fibrillation Preoperative Management

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