AMIODARONE FOR CONVERSION OF NEW-ONSET ATRIAL FIBRILLATION IN THE SURGICAL INTENSIVE CARE UNIT

2004 ◽  
Vol 32 (Supplement) ◽  
pp. A169
Author(s):  
Bruce W Neale ◽  
Jill A Rebuck ◽  
Mark Hamlin ◽  
Brian Marden ◽  
Bill Charash ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals Impact and treatment success of new-onset atrial fibrillation with rapid ventricular rate development in the surgical intensive care unit

2018 ◽  
Vol 229 ◽  
pp. 66-75 ◽  
Author(s):  
McKenzie Brown ◽  
Sean Nassoiy ◽  
Whitney Chaney ◽  
Timothy P. Plackett ◽  
Robert H. Blackwell ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Treatment Success ◽  
Ventricular Rate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Onset Atrial Fibrillation ◽  
Rate Development ◽  
New Onset

scholarly journals New‐onset atrial fibrillation incidence and associated outcomes in the medical intensive care unit

2021 ◽  
Author(s):  
Ryan Brunetti ◽  
Edan Zitelny ◽  
Noah Newman ◽  
Richa Bundy ◽  
Matthew J. Singleton ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Medical Intensive Care ◽  
Onset Atrial Fibrillation ◽  
New Onset

Epidemiology and outcome of new-onset atrial fibrillation in the medical intensive care unit

2016 ◽  
Vol 36 ◽  
pp. 102-106 ◽  
Author(s):  
Perliveh Carrera ◽  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Vivek N. Iyer ◽  
Teng Moua
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Medical Intensive Care ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals Pharmacological and non-pharmacological treatments and outcomes for new-onset atrial fibrillation in ICU patients: the CAFE scoping review and database analyses

2021 ◽  
Vol 25 (71) ◽  
pp. 1-174
Author(s):  
Jonathan Bedford ◽  
Laura Drikite ◽  
Mark Corbett ◽  
James Doidge ◽  
Paloma Ferrando-Vivas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Confidence Interval ◽  
Beta Blockers ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background New-onset atrial fibrillation occurs in around 10% of adults treated in an intensive care unit. New-onset atrial fibrillation may lead to cardiovascular instability and thromboembolism, and has been independently associated with increased length of hospital stay and mortality. The long-term consequences are unclear. Current practice guidance is based on patients outside the intensive care unit; however, new-onset atrial fibrillation that develops while in an intensive care unit differs in its causes and the risks and clinical effectiveness of treatments. The lack of evidence on new-onset atrial fibrillation treatment or long-term outcomes in intensive care units means that practice varies. Identifying optimal treatment strategies and defining long-term outcomes are critical to improving care. Objectives In patients treated in an intensive care unit, the objectives were to (1) evaluate existing evidence for the clinical effectiveness and safety of pharmacological and non-pharmacological new-onset atrial fibrillation treatments, (2) compare the use and clinical effectiveness of pharmacological and non-pharmacological new-onset atrial fibrillation treatments, and (3) determine outcomes associated with new-onset atrial fibrillation. Methods We undertook a scoping review that included studies of interventions for treatment or prevention of new-onset atrial fibrillation involving adults in general intensive care units. To investigate the long-term outcomes associated with new-onset atrial fibrillation, we carried out a retrospective cohort study using English national intensive care audit data linked to national hospital episode and outcome data. To analyse the clinical effectiveness of different new-onset atrial fibrillation treatments, we undertook a retrospective cohort study of two large intensive care unit databases in the USA and the UK. Results Existing evidence was generally of low quality, with limited data suggesting that beta-blockers might be more effective than amiodarone for converting new-onset atrial fibrillation to sinus rhythm and for reducing mortality. Using linked audit data, we showed that patients developing new-onset atrial fibrillation have more comorbidities than those who do not. After controlling for these differences, patients with new-onset atrial fibrillation had substantially higher mortality in hospital and during the first 90 days after discharge (adjusted odds ratio 2.32, 95% confidence interval 2.16 to 2.48; adjusted hazard ratio 1.46, 95% confidence interval 1.26 to 1.70, respectively), and higher rates of subsequent hospitalisation with atrial fibrillation, stroke and heart failure (adjusted cause-specific hazard ratio 5.86, 95% confidence interval 5.33 to 6.44; adjusted cause-specific hazard ratio 1.47, 95% confidence interval 1.12 to 1.93; and adjusted cause-specific hazard ratio 1.28, 95% confidence interval 1.14 to 1.44, respectively), than patients who did not have new-onset atrial fibrillation. From intensive care unit data, we found that new-onset atrial fibrillation occurred in 952 out of 8367 (11.4%) UK and 1065 out of 18,559 (5.7%) US intensive care unit patients in our study. The median time to onset of new-onset atrial fibrillation in patients who received treatment was 40 hours, with a median duration of 14.4 hours. The clinical characteristics of patients developing new-onset atrial fibrillation were similar in both databases. New-onset atrial fibrillation was associated with significant average reductions in systolic blood pressure of 5 mmHg, despite significant increases in vasoactive medication (vasoactive-inotropic score increase of 2.3; p < 0.001). After adjustment, intravenous beta-blockers were not more effective than amiodarone in achieving rate control (adjusted hazard ratio 1.14, 95% confidence interval 0.91 to 1.44) or rhythm control (adjusted hazard ratio 0.86, 95% confidence interval 0.67 to 1.11). Digoxin therapy was associated with a lower probability of achieving rate control (adjusted hazard ratio 0.52, 95% confidence interval 0.32 to 0.86) and calcium channel blocker therapy was associated with a lower probability of achieving rhythm control (adjusted hazard ratio 0.56, 95% confidence interval 0.39 to 0.79) than amiodarone. Findings were consistent across both the combined and the individual database analyses. Conclusions Existing evidence for new-onset atrial fibrillation management in intensive care unit patients is limited. New-onset atrial fibrillation in these patients is common and is associated with significant short- and long-term complications. Beta-blockers and amiodarone appear to be similarly effective in achieving cardiovascular control, but digoxin and calcium channel blockers appear to be inferior. Future work Our findings suggest that a randomised controlled trial of amiodarone and beta-blockers for management of new-onset atrial fibrillation in critically ill patients should be undertaken. Studies should also be undertaken to provide evidence for or against anticoagulation for patients who develop new-onset atrial fibrillation in intensive care units. Finally, given that readmission with heart failure and thromboembolism increases following an episode of new-onset atrial fibrillation while in an intensive care unit, a prospective cohort study to demonstrate the incidence of atrial fibrillation and/or left ventricular dysfunction at hospital discharge and at 3 months following the development of new-onset atrial fibrillation should be undertaken. Trial registration Current Controlled Trials ISRCTN13252515. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 71. See the NIHR Journals Library website for further project information.

scholarly journals New-onset atrial fibrillation in critically ill patients with coronavirus disease 2019 (COVID-19)

2021 ◽  
Author(s):  
BİŞAR ERGÜN ◽  
BEGUM ERGAN ◽  
Melih Kaan SÖZMEN ◽  
Mehmet Nuri YAKAR ◽  
Murat KÜÇÜK ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Independent Risk Factor ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Objectives: To determine the incidence, risk factors, and outcomes of new-onset atrial fibrillation (NOAF) in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19). Methods: We conducted a retrospective study on patients admitted to the intensive care unit (ICU) with a diagnosis of COVID-19. NOAF was defined as atrial fibrillation that was detected after diagnosis of COVID-19 without a prior history. The primary outcome of the study was the effect of NOAF on mortality in critically ill COVID-19 patients. Results: We enrolled 248 eligible patients. NOAF incidence was 14.9% (n=37), and 78% of patients (n=29) were men in NOAF positive group. Median age of the NOAF group was 79.0 (interquartile range, 71.5-84.0). Hospital mortality was higher in the NOAF group (87% vs 67%, respectively, p=0.019). However, in multivariate analysis, NOAF was not an independent risk factor for hospital mortality (OR 1.42, 95% CI 0.40–5.09, p=0.582) Conclusions: The incidence of NOAF was 14.9% in critically ill COVID-19 patients. Hospital mortality was higher in the NOAF group. However, NOAF was not an independent risk factor for hospital mortality in patients with COVID-19. Keywords: Atrial fibrillation, critical care, intensive care unit, COVID-19, mortality, hospital mortality

Incidence and predictors of new-onset atrial fibrillation in noncardiac intensive care unit patients

2014 ◽  
Vol 29 (4) ◽  
pp. 697.e1-697.e5 ◽  
Author(s):  
Stamatis S. Makrygiannis ◽  
Anastasia Margariti ◽  
Despina Rizikou ◽  
Manolis Lampakis ◽  
Spyros Vangelis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals New-onset atrial fibrillation in patients admitted to intensive care unit after receiving tumor resection surgery for colorectal cancer

2020 ◽  
Vol 43 (1) ◽  
pp. 399-400
Author(s):  
Min-Hsin Huang ◽  
Yi-Chih Wang ◽  
Shao-Chieh Lin ◽  
Wu-Wei Lai
Keyword(s):  
Colorectal Cancer ◽  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Tumor Resection ◽  
Onset Atrial Fibrillation ◽  
New Onset
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