{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:06:08Z","timestamp":1783933568288,"version":"3.55.0"},"reference-count":108,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Cardiac arrhythmias complicate 20\u201350% of surgical procedures and contribute substantially to perioperative morbidity, mortality, and healthcare costs, with postoperative atrial fibrillation (POAF) being the most frequent form. Their genesis reflects the convergence of surgical stress, anaesthetic agents, autonomic imbalance, systemic inflammation, and electrolyte disturbances, explaining the limited efficacy of single-mechanism interventions. This narrative review synthesises contemporary evidence on pathophysiology, risk stratification, prevention, acute management, and emerging technologies, emphasising individualised, patient-tailored approaches. MEDLINE, Embase, and Cochrane CENTRAL were searched (January 2010\u2013January 2026), prioritising randomised trials, meta-analyses, and guidelines. Contemporary risk stratification integrates clinical scores, biomarkers, and electrocardiographic parameters; machine-learning models show moderate discrimination (pooled AUC 0.84) and may enable more personalised prediction pending external validation. Evidence-based prophylaxis\u2014beta-blockade, magnesium, selective amiodarone, and emerging anti-inflammatory strategies such as colchicine\u2014reduces POAF in high-risk populations, while acute management is guided by haemodynamic status and individual risk. Anticoagulation follows CHA2DS2-VASc stratification, although optimal timing and duration remain undefined. Wearable monitoring, AI-based detection, and atrial-selective agents show clinical promise. Systematic, personalised integration of risk assessment, prophylaxis, monitoring, and management offers the clearest path to reducing arrhythmia-associated morbidity.<\/jats:p>","DOI":"10.3390\/jpm16070367","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:01:37Z","timestamp":1783339297000},"page":"367","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Arrhythmias: Pathophysiology, Risk Stratification, Management, and Emerging Technologies\u2014A Narrative Review Toward Personalised Care"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0215-5620","authenticated-orcid":false,"given":"Daniele Salvatore","family":"Patern\u00f2","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, \u201cGiovanni Paolo II\u201d Hospital, 97100 Ragusa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-7554","authenticated-orcid":false,"given":"Luigi","family":"La Via","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Lo Presti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cUmberto I\u201d Hospital, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4929-7111","authenticated-orcid":false,"given":"Gilberto","family":"Duarte-Medrano","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Medica Sur Hospital, Mexico City 11510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Nu\u00f1o-L\u00e1mbarri","sequence":"additional","affiliation":[{"name":"Translational Research Unit, Medica Sur Clinic & Foundation, Mexico City 11510, Mexico"},{"name":"Department of Surgery, The National Autonomous University of Mexico (UNAM), Mexico City 11510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia Concetta","family":"Lo Giudice","sequence":"additional","affiliation":[{"name":"School of Anesthesia and Intensive Care, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giordana","family":"Russo","sequence":"additional","affiliation":[{"name":"School of Anesthesia and Intensive Care, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5738-2970","authenticated-orcid":false,"given":"Mattia","family":"Pratini","sequence":"additional","affiliation":[{"name":"School of Anesthesia and Intensive Care, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8181-5732","authenticated-orcid":false,"given":"Paolo","family":"Tummino","sequence":"additional","affiliation":[{"name":"School of Anesthesia and Intensive Care, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1618-5391","authenticated-orcid":false,"given":"Giuseppe","family":"Scibilia","sequence":"additional","affiliation":[{"name":"Department of Obstetric and Gynecological Surgery, \u201cGiovanni Paolo II\u201d Hospital, 97100 Ragusa, Italy"},{"name":"School of Obstetric and Gynecological Surgery, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-5437","authenticated-orcid":false,"given":"Marco","family":"Barbanti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cUmberto I\u201d Hospital, 94100 Enna, Italy"},{"name":"School of Cardiology, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9331-2788","authenticated-orcid":false,"given":"Massimiliano","family":"Sorbello","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, \u201cGiovanni Paolo II\u201d Hospital, 97100 Ragusa, Italy"},{"name":"School of Anesthesia and Intensive Care, \u201cKore\u201d University, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Shah, S., Chahil, V., Battisha, A., Haq, S., and Kalra, D.K. 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