POAF Score

Post-Operative Atrial Fibrillation Prediction After Cardiac Surgery

Predicts the risk of new-onset atrial fibrillation following cardiac surgery. Guides prophylactic amiodarone, beta-blocker, and monitoring decisions perioperatively.

Age ≥ 60 yearsSingle strongest predictor of POAF

Age ≥ 70 yearsAdditional point if ≥70 (cumulative with ≥60)

COPDChronic obstructive pulmonary disease

eGFR < 60 mL/min/1.73m²Chronic kidney disease

Emergent surgeryNon-elective/urgent procedure

Valve surgery (with or without CABG)Combined or isolated valve operation

LA enlargement (LAVi > 34 mL/m² or LA > 4.0 cm)Left atrial dilation on echocardiography

Results

POAF Score 0

Estimated POAF Risk —

Enter patient data above

Prophylaxis Guidance

Low risk (0–1): Perioperative beta-blockers. Standard telemetry monitoring.
Moderate risk (2–3): Consider prophylactic amiodarone (in addition to beta-blockers). Extended telemetry.
High risk (4+): Strongly consider prophylactic amiodarone. Posterior pericardiotomy in select cases. Prepare for rate/rhythm control.

Reference

Mariscalco G et al. (2014) — Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery. Heart. 100:1531–1537.