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Clinical course after identification of new-onset atrial fibrillation in critically ill patients: The AFTER-ICU study.

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.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Yoshida T,Uchino S,Sasabuchi Y,AFTER-ICU study group.

doi

10.1016/j.jcrc.2020.06.014

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

136-142

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(20)30599-2

journal_volume

59

pub_type

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