ABSTRACT
Fast atrial fibrillation (AF) identified preoperatively may be due to a multitude of conditions. The important feature of this rhythm is whether it causes haemodynamic instability. The surgical procedure can often wait until the patient has been optimised and the rhythm either treated or at least the rate reduced. Fast AF results in increased myocardial oxygen demand and reduced myocardial oxygen supply. In non-lifesaving surgery the patient must be optimised prior to anaesthesia.
