Abstract
For patients with atrial fibrillation undergoing surgery, decisions regarding the use of antiplatelet medications and anticoagulants must balance the risk of arterial thromboembolism (especially stroke) versus the risk of postop bleeding. Direct acting oral anticoagulants do not typically require bridging with heparin when interrupted for surgery, and the timing of these interruptions depends on the patient’s renal function and on the bleeding risk of the procedure. Some patients taking warfarin who are at very high risk for stroke require bridging with heparin perioperatively. The perioperative consultant must also manage rate and/or rhythm control and be prepared to manage the new onset of atrial fibrillation postoperatively.
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Acknowledgments
Dr. Kai-Chun (Daniel) Yang, Acting Assistant Professor, Division of Cardiology, Department of Medicine, University of Washington, and Staff Cardiologist at VA Puget Sound Health Care System.
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Johnson, K.M., Cornia, P.B. (2020). Atrial Fibrillation. In: Jackson, M., Huang, R., Kaplan, E., Mookherjee, S. (eds) The Perioperative Medicine Consult Handbook. Springer, Cham. https://doi.org/10.1007/978-3-030-19704-9_9
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DOI: https://doi.org/10.1007/978-3-030-19704-9_9
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