The statin therapy to prevent atrial fibrillation after cardiac surgery: Shakespearean dilemma

Surgical and perioperative care are much improved in the last years but postoperative complications after cardiac surgery remain frequent, which are directly involved to increase the mortality, morbidity, and costs (1). Atrial arrhythmias and atrial fibrillation (AF) in particular are well-known complications after cardiac surgery with a reported incidence between 10% and 60% (2). Postoperative atrial arrhythmias extend the hospitalization, decreasing the hemodynamic condition and increasing the risk of stroke and mortality (3). The incidence is higher in patients undergoing valve surgery than in patients undergoing coronary artery bypass surgery (CABG) (4). Despite lower, post-operative atrial arrhythmias also occur after non-cardiac surgery (from 0.3% to 29%) (5,6), especially after oesophagectomy (7), lung surgery (6), and large abdominal surgery (8).