Impact of a Perioperative Prophylaxis Guideline on Post–Cardiothoracic Surgery Atrial Fibrillation:

Background: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). Objective: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. Methods: Data were retrospectively collected on 400 adults (200 patients pre–guideline implementation and 200 patients post–guideline implementation) with a CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS. Data were collected on the incidence of POAF lasting more than 5 minutes and secondary outcomes, including the length of hospitalization, guideline adherence rate, adverse events, and timeliness of POAF treatment. Results: Guideline implementation increased prophylactic amiodarone (P < 0.0001), statin (P = 0.029), and high-intensity...