What is the recommended preoperative therapy to reduce post-operative atrial fibrillation?

The recommended preoperative therapy to reduce the incidence of postoperative atrial fibrillation typically includes the administration of a beta blocker or amiodarone, alongside a statin. This approach is grounded in clinical evidence that suggests preoperative beta blocker therapy can decrease heart rate and improve cardiac stability, which is beneficial in preventing atrial fibrillation following cardiac surgery. Beta blockers have been shown to reduce the overall incidence of post-operative atrial fibrillation by modulating the autonomic nervous system's influence on cardiac rhythm.

Amiodarone is also an effective antiarrhythmic agent that can be utilized in patients at high risk for atrial fibrillation. It plays a significant role in preventing arrhythmias due to its multifaceted mechanism, including effects on adrenergic receptors and ion channels. The use of statins contributes to cardiovascular protection through their lipid-lowering effects and potential anti-inflammatory properties, which may improve overall heart function and reduce arrhythmogenic triggers.

The combination of these therapies targets different pathways associated with the development of atrial fibrillation and has been supported by studies showing reduced rates of this complication in patients undergoing surgery. Therefore, this combination approach is recommended as a comprehensive strategy to mitigate the risk of post-operative atrial fibrillation.