Non-antiarrhythmic interventions in new onset and paroxysmal sepsis-related atrial fibrillation

Excerpt

Although rarely the primary diagnosis, atrial fibrillation (AF) occurs frequently in critically-ill patients. For instance, in 1341 patients without pre-existing cardiac disease admitted to an intensive care unit, 8.4% exhibited supraventricular arrhythmia, representing AF in 77% of cases [1]. Patients with sepsis appear to be at highest risk; cumulative risk for de novo AF has been reported as 10, 22 and 40% in patients with sepsis, severe sepsis and septic shock, respectively [2]. AF mainly occurs in the first 3 days following admission and is associated with increased ICU-, 30 days-, 90 days-, and 1 year-mortality, even after adjusting for such confounding factors as age, gender, scores of severity, malignancy, and cardiovascular diseases [2]. In 8356 consecutive critically-ill adult patients admitted in medical and surgical ICU, Moss et al. recently reported that de novo AF is associated with increased hospital mortality and length of stay [3]. …