Atrial Fibrillation Following Coronary Artery Bypass Graft: Where Do We Stand?

Atrial fibrillation (AF) is the most common atrial arrhythmia following coronary artery bypass graft (CABG). Its prevalence is 15–45% and is associated with poor long-term prognosis. Risk factors can be patient-related, intraoperative, and/or postoperative. Therapeutic and preventive strategies have been developed to curtail AF burden. Cardioversion is recommended for unstable or symptomatic patients and rate control if asymptomatic. Anticoagulation is challenging with risk of thromboembolism and bleeding. However, patients should be anticoagulated after cardioversion or if AF persists >48 h and risk factors of stroke exist. A minimum of 4 weeks is recommended but longer duration should be considered in patients at high risk of stroke irrespective of recurrence of AF. •Atrial fibrillation: most common complication after coronary artery bypass graft•Poor inpatient and long-term outcomes if atrial fibrillation postoperatively•Identify risk factors of atrial fibrillation after revascularization•Cardioversion in unstable/asymptomatic; rate control alternative strategy•Weigh in stroke risk to decide long-term anticoagulation