Mahmood E, Khabbaz KR, Bose R, et al. - In this prospective cohort study performed at a single-center tertiary referral center, researchers investigated whether bedside cardiac ultrasound affords a valid tool to recognize patients for the risk of postoperative atrial fibrillation (POAF). Evaluation of diastolic function by a preoperative transthoracic echocardiographic inquiry was done. POAF during the first 72 hours post-surgery was the primary outcome. This study was completed by 169 patients. Among these, the development of POAF was reported in 44 (26.0%), and diastolic dysfunction was present in 39 (25.2%). A higher rate of postoperative heart failure, reintubation within 24 hours of surgery, and length of stay were observed in patients with POAF. Increasing age, left atrial volume indexed to body surface area (LAVI), and diastolic dysfunction, were identified as predictors significant for POAF. Efficient preoperative evaluation of left atrial volume was possible to achieve superior risk stratification over clinical factors and diastolic parameters alone as far as the prediction of POAF was concerned. Furthermore, the heightened risk of POAF was not properly captured by the cutoffs of chamber quantification currently used. Therefore, LAVI affords a simple means to recognize patients who require targeted prophylaxis for POAF.