18. We recommend that POAF might be appropriately treated with either a ventricular response rate control strategy or a rhythm control strategy (Strong Recommendation, Moderate-Quality Evidence). Values and preferences. This recommendation places a high value on the RCTs that investigated rate control as an alternative to rhythm control for AF, including 1 trial that specifically addressed the cardiac postoperative period. Choice of strategy should therefore be individualized on the basis of the degree of symptoms experienced by the patient.
19. We suggest that patients who have a contraindication to b-blocker therapy and to amiodarone before or after cardiac surgery be considered for prophylactic therapy to prevent POAF with intravenous magnesium (Conditional Recommendation, Low-Quality Evidence) or colchicine (Conditional Recommendation, Low- Quality Evidence) or with biatrial pacing (Conditional Recommendation, Low-Quality Evidence).

Values and preferences. This recommendation places a high value on preventing POAF using novel therapies that are supported by lower-quality data; with a higher value on the lower probability of adverse effects from magnesium vs colchicine. The use of biatrial pacing needs to be individualized according to patient and institution, because the potential for adverse effects might outweigh benefit according to local expertise.