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Circulating biomarkers predictive of postoperative atrial fibrillation
Cardiology in review
  • Mohit Turagam, Aurora Health Care
  • Mahek Mirza, Aurora Health Care
  • Paul H Werner, Aurora Health Care
  • Jasbir Sra, Aurora Health Care
  • David C Kress, Aurora Health Care
  • A Jamil Tajik, Aurora Health Care
  • Arshad Jahangir, Aurora Health Care
Aurora Affiliations

Aurora University of Wisconsin Medical Group, Aurora Research Institute, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers

Publication Date

Postoperative atrial fibrillation (PoAF), a common complication of cardiac surgery, contributes significantly to morbidity, mortality, and increasing health care costs. Despite advances in surgical and medical management, the overall incidence of PoAF has not changed significantly, partly due to the limited understanding of mechanisms underlying acute surgery-related factors, such as myocardial injury, inflammation, sympathetic activation, and oxidative stress, which play an important role in the initiation of PoAF, while a preexisting atrial substrate appears to be more important in the maintenance of this dysrhythmia. Thus, in a majority of patients, PoAF becomes a manifestation of an underlying arrhythmogenic substrate that is unmasked following acute surgical stress. As such, the ability to identify which patients have this proarrhythmic substrate and are, therefore, at high risk for developing AF postoperatively, is important for the improved selection for prophylactic interventions, closer monitoring for complications, and establishing the probability of AF in the long term. This review highlights the role of the underlying substrate in promoting PoAF, proposed mechanisms, and the potential role of serum biomarkers to identify patients at risk for PoAF.

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Citation Information
Turagam MK, Mirza M, Werner PH, et al. Circulating Biomarkers Predictive of Postoperative Atrial Fibrillation. Cardiol Rev. 2016;24(2):76-87.