Atrial fibrillation after major thoracic surgery: new insights into underlying mechanisms.

s y t g I o p l w g n c trial fibrillation (AF) is a common complication in paients undergoing major thoracic surgery (1–3). It is most requently observed acutely after valve surgery and/or coroary artery bypass graft surgery (CABG), but it can also anifest after lung and heart transplantation procedures 1–7). Although mechanisms underlying this unique form f AF have not been adequately elucidated, it is likely that hese involve a combination of pericardial inflammation, yocardial ischemia, catecholamine surge, autonomic imalance, interstitial fluid mobilization, tissue rejection, and o forth (3–8). It is interesting to note that AF is observed ignificantly less often after cardiac transplantation than fter valve surgery and/or CABG (1,2,6). This relative