Takuo Yoshida1, Shigehiko Uchino2, Yusuke Sasabuchi3. 1. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan. Electronic address: aftericustudy@gmail.com. 2. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan. 3. Data Science Center, Jichi Medical University, Tochigi, Japan.
Abstract
PURPOSE: Epidemiological information is lacking after identification of new-onset atrial fibrillation (AF) in critically ill patients. This study aimed to describe the clinical course after the identification of new-onset AF. MATERIALS AND METHODS: This prospective cohort study enrolled adult patients with new-onset AF in 32 Japanese ICUs during 2017-2018. We collected data on patient comorbidities, physiological information before and at the AF onset, interventions for AF, cardiac rhythm transition, adverse events and in-hospital death and stroke. RESULTS: We included 423 new-onset AF patients. At the AF onset, mean arterial pressure decreased and the heart rate increased. Eighty-four patients (20%) spontaneously restored sinus rhythm and 328 patients (78%) received various pharmacological interventions (rate-control drugs, 67%; rhythm-control drugs, 34%). Anticoagulants were administered in 173 patients (40%) and 13 patients (3%) experienced bleeding complications. Twenty-four patients (6%) were still in AF at 168 h after the onset (sustained AF 4%; recurrent AF 2%). The overall hospital mortality was 26% and the incidence of in-hospital stroke was 4.5%. CONCLUSIONS: Although the proportion of patients with AF continued to decrease with various treatments, these patients had high risk of death. Further research to assess the management of new-onset AF in critically ill patients is warranted.
PURPOSE: Epidemiological information is lacking after identification of new-onset atrial fibrillation (AF) in critically illpatients. This study aimed to describe the clinical course after the identification of new-onset AF. MATERIALS AND METHODS: This prospective cohort study enrolled adult patients with new-onset AF in 32 Japanese ICUs during 2017-2018. We collected data on patient comorbidities, physiological information before and at the AF onset, interventions for AF, cardiac rhythm transition, adverse events and in-hospital death and stroke. RESULTS: We included 423 new-onset AFpatients. At the AF onset, mean arterial pressure decreased and the heart rate increased. Eighty-four patients (20%) spontaneously restored sinus rhythm and 328 patients (78%) received various pharmacological interventions (rate-control drugs, 67%; rhythm-control drugs, 34%). Anticoagulants were administered in 173 patients (40%) and 13 patients (3%) experienced bleeding complications. Twenty-four patients (6%) were still in AF at 168 h after the onset (sustained AF 4%; recurrent AF 2%). The overall hospital mortality was 26% and the incidence of in-hospital stroke was 4.5%. CONCLUSIONS: Although the proportion of patients with AF continued to decrease with various treatments, these patients had high risk of death. Further research to assess the management of new-onset AF in critically illpatients is warranted.
Authors: Samiullah Arshad; George A Davis; Muhammad Amir; Ythan H Goldberg; Vedant A Gupta; Ahmed K Abdel-Latif; Susan Smyth Journal: Cardiol Res Date: 2022-03-12