Why is Postoperative Atrial Fibrillation Difficult to Prevent and Treat: Potential Roles of Unrecognized Magnesium Deficiency and Release of Ceramide and Platelet-Activating Factor

Heart failure is a major cause of morbidity and mortality whose costs impose staggering health-care costs and often lengthy hospitalizations. Post-operative atrial fibrillation (POAF) represents a leading cause for heart failure, paricularly after cardiac and lung surgeries. Although PAOF is a common cardiac arrhythmia, it is impossible to predict. As the worldwide population is aging, the incidence and prevalence of PAOF is growing. Identifying mechanisms for PAOF is attracting a considerable amount of research with no agreement on the mechanism(s). Our research on the heart and cardiovascular system, over the past 50-plus years, leads us to believe that major causes of PAOF may be an underlying magnesium deficiency (MgD) coupled to a generation/ release of ceramides and platelet-activating factor (PAF). Herein, we review reasons behind our hypothesis and suggestions for testing its validity