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Atrial Fibrillation

Last updated: March 5, 2026

Content Type: Provider | Turnkey Order Sets
Created: September 24, 2023
Contributor: ERAS Cardiac TKO Writing Group
Editor: Subhasis Chatterjee MD FACS

Summary

To assist clinicians in bringing existing guidelines and best practice recommendations to the bedside, ERAS Cardiac has created a series of “Turnkey Order Sets”. These order sets have been created following review of the existing evidence, and provide a guide for implementation of these ERAS elements.

Turnkey Order Set (TKO) Methodology

To assist with implementation of cardiac enhanced recovery after surgery (ERAS), we have created a sample turn key order set (TKO). The order set has been translated by subject matter experts using accumulated evidence, peer-reviewed literature, and current enhanced recovery practices.

Orders derived from Class I or IIA recommendations across all referenced guidelines and consensus manuscripts appear in the TKO in bold type.

Selected orders that were inconsistently Class I or IIA, Class IIB, or supported by evidence published in peer-reviewed journals, were also included in italicized type.

Decisions regarding order inclusion were made based on estimated benefit, risk, cost, implementation complexity, and generalizability. Each of these orders should be considered based on local institutional priorities, resources, practices, and expertise.

The Turnkey Order Set PDF in this module is intended for use by ERAS Cardiac Society Members to assist in building order sets at their own institution. They are permitted to be downloaded.

Educational Materials

AFib Turnkey Order Set – Presentation

AFib Turnkey Order Set

Download PDF

ERAS Cardiac VEC Disclaimer

The Virtual Education Center (VEC) and all included content are intended to inform ERAS Cardiac Members on a wide range of topics related to enhanced recovery. The information presented has been provided by enhanced recovery experts and is for educational purposes only.

It is not intended to describe, recommend, or suggest any specific medical practice or intervention, nor should it be considered formal medical advice or consultation. The ERAS Cardiac Society cannot guarantee that the information provided is accurate or complete in every respect. Therefore, the Society is not responsible for any errors, omissions, or clinical outcomes resulting from application of the information obtained through the VEC.

All healthcare professionals should continue to exercise sound clinical judgment and base therapeutic decisions on the best available evidence and patient specific factors.

Educational materials produced by the Society for Enhanced Recovery After Cardiac Surgery (ERAS Cardiac) may be considered Open Access. Non commercial use of ERAS Cardiac educational materials, including images, audio, and video, in whole or in part, is permitted with the following conditions:

  • The content is not altered
  • The listed authors of the content and ERAS Cardiac are appropriately referenced, and
  • A URL address or hyperlink to the original material or the main web site [https://www.erascardiac.org/] is included in the reproduction

For questions or comments about the ERAS Cardiac VEC, please contact us.

References

  1. Eikelboom R, Sanjanwala R, Le ML, Yamashita MH, Arora RC. Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-Analysis. Ann Thorac Surg. 2021 Feb;111(2):544-554. PMID: 32687821.
  2. Woldendorp K, Farag J, Khadra S, Black D, Robinson B, Bannon P. Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta-Analysis. Ann Thorac Surg. 2021 Dec;112(6):2084-2093. PMID: 33340521.
  3. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al; ACC/AHA Task Force Members. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014 Dec 2;130(23):2071-104. PMID: 24682348.
  4. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019 Jul 9;74(1):104-132. PMID: 30703431.
  5. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur J Cardiothorac Surg. 2016 Nov;50(5):e1-e88. PMID: 27663299.
  6. Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al.; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur J Cardiothorac Surg. 2019 Jan 1;55(1):4-90. PMID: 30165632.
  7. Muehlschlegel JD, Burrage PS, Ngai JY, Prutkin JM, Huang CC, Xu X, et al. Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anaesthetists Practice Advisory for the Management of Perioperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery. Anesth Analg. 2019 Jan;128(1):33-42. PMID: 30550473.
  8. Andrade JG, Aguilar M, Atzema C, Bell A, Cairns JA, Cheung CC, et al. The 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Comprehensive Guidelines for the Management of Atrial Fibrillation. Can J Cardiol. 2020;36(12):1847-1948. PMID: 33191198.
  9. Ad N, Damiano RJ Jr, Badhwar V, Calkins H, La Meir M, Nitta T, et al. Expert consensus guidelines: Examining surgical ablation for atrial fibrillation. J Thorac Cardiovasc Surg. 2017;153(6):1330-1354. PMID: 28390766.
  10. Mitchell LB, Exner DV, Wyse DG, Connolly CJ, Prystai GD, Bayes AJ, et al. Prophylactic Oral Amiodarone for the Prevention of Arrhythmias that Begin Early After Revascularization, Valve Replacement, or Repair: PAPABEAR: a randomized controlled trial. JAMA. 2005;294(24):3093-100. PMID: 16380589.
  11. Whitlock RP, Belley-Cote EP, Paparella D, Healey JS, Brady K, Sharma M, et al; LAAOS III Investigators. Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke. N Engl J Med. 2021;384(22):2081-2091. doi: 10.1056/NEJMoa2101897. PMID: 33999547.
  12. Soletti GJ, Perezgrovas-Olaria R, Harik L, Rahouma M, Dimagli A, Alzghari T, et al. Effect of posterior pericardiotomy in cardiac surgery: A systematic review and meta-analysis of randomized controlled trials. Front Cardiovasc Med. 2022;9:1090102. doi: 10.3389/fcvm.2022.1090102. PMID: 36620644.
  13. Mitchell LB, Exner DV, Wyse DG, Connolly CJ, Prystai GD, Bayes AJ, et al. Prophylactic Oral Amiodarone for the Prevention of Arrhythmias that Begin Early After Revascularization, Valve Replacement, or Repair: PAPABEAR: a randomized controlled trial. JAMA. 2005;294(24):3093-100. doi: 10.1001/jama.294.24.3093. PMID: 16380589.
  14. Gillinov AM, Bagiella E, Moskowitz AJ, Raiten JM, Groh MA, Bowdish ME, et al; CTSN. Rate Control versus Rhythm Control for Atrial Fibrillation after Cardiac Surgery. N Engl J Med. 2016;374(20):1911-21. doi: 10.1056/NEJMoa1602002. PMID: 27043047.
  15. Chatterjee S, Ad N, Badhwar V, Gillinov AM, Alexander JH, Moon MR. Anticoagulation for atrial fibrillation after cardiac surgery: Do guidelines reflect the evidence? J Thorac Cardiovasc Surg. 2023:S0022-5223(23)00275-1. doi: 10.1016/j.jtcvs.2023.03.026. PMID: 37037415.