Perioperative Management of Beta Blockers and Other Antiarrhythmic Medications

Background: Antiarrhythmic medications are an important tool in preventing recurrence of intraoperative and postoperative arrhythmias. Objective: To review current literature and recommendations for perioperative management of antiarrhythmic medications. Methods: Literature review is presented along with the pharmacology of antiarrhythmics. Results: Antiarrhythmic medications should be continued perioperatively for the prevention of arrhythmias intra- and postoperatively. However, beta blockers have had controversies regarding their perioperative safety profile. Conclusion: Continuation of antiarrhythmic medications is safe perioperatively. However, initiation of beta blockers should be patient-tailored and titrated to a target heart rate in advance surgery.