Atrial fibrillation (AF), a cardiac complication following non-cardiothoracic surgery, is more common and better characterized following cardiac surgery. Postoperative AF often prompts surgeons to consult hospitalists because it can be associated with serious surgical complications such as sepsis and venous thromboembolism. Although typically self-limited, AF can persist to discharge and can lead to an increased length of stay. Furthermore, conditions that are associated with AF contribute to increased mortality. The following module addresses the frequency and risk factors for AF, initial management and evaluation of postoperative AF, and the management of persistent postoperative AF that is still present at discharge.

To provide hospitalists with current information and guidelines for the treatment of postoperative atrial fibrillation.

This module is intended for hospitalists. No prerequisites required.

After completing the module, the participant should be able to:

1. Recognize the incidence and identify the risk factors for atrial fibrillation (AF) following noncardiac surgery.
2. Propose management plans for postoperative AF.
3. Identify and evaluate for underlying conditions associated with postoperative AF.
4. Describe the impact of postoperative AF.
5. Propose management plans for persistent postoperative AF.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: December 1, 2009. Expiration date: December 1, 2011.

Estimated time to complete activity: 2 hours

Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

^*Assistant Professor of Medicine, Director, Medicine Consult Service, University of Colorado Denver School of Medicine, Denver, Colorado.

Conflict of Interest: Dr Carter reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Off-Label Product Discussion: The author has indicated that he has not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Jeffrey Carter, MD, Assistant Professor of Medicine Director, Medicine Consult Service, University of Colorado Denver School of Medicine, Mail Stop F782, 12401 East 17th Avenue, 9th floor, Aurora, CO 80045. E-mail Jeffrey.Carter@ucdenver.edu.

Click here to download the references for this educational activity.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, a study activity, and a CME post-test. All 3 sections must be completed to receive CME credit.

Supported by an educational grant from Merck & Co., Inc.