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Postoperative AF After Oesophagectomy — FRCA Final MCQ

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ModeratePerioperative MedicinePostoperative AF After OesophagectomyFRCA Final

A patient develops new-onset postoperative atrial fibrillation after oesophagectomy. What is the incidence and most appropriate initial management?

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Correct answer: C — Common (15-40%) — rate control with amiodarone or beta-blocker, correct precipitants

New-onset AF after major thoracic/oesophageal surgery occurs in 15-40% of patients. Usually self-limiting within 6 weeks. Management: rate control (amiodarone or beta-blocker if haemodynamically stable), correct precipitants (hypovolaemia, hypoxia, electrolytes, pain, sepsis). Consider anticoagulation if persists >48h or high stroke risk. Most do not require lifelong anticoagulation.

Reference: ESC – 2024 – Postoperative AF management; RCOA – 2023