Prophylaxis of Atrial Fibrillation After Noncardiac Thoracic Surgery

Atrial fibrillation (AF) occurs commonly after noncardiac thoracic surgery, including lobectomy, pneumonectomy and esophagectomy. While not as extensively investigated as AF following cardiac surgery, some strategies for prophylaxis of AF after noncardiac thoracic surgery have been studied. Evidence from prospective, randomized controlled studies supports the use of beta-blockers, diltiazem, amiodarone or magnesium for prevention of AF after pulmonary resection. Limited evidence supports the efficacy of intravenous amiodarone for prevention of AF after esophagectomy. Further study is necessary to determine the safest and most effective methods of prophylaxis of AF after noncardiac thoracic surgery, and to identify patients most likely to benefit from AF prophylaxis.