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

Jonathan Bedford,James Doidge,Kim Rajappan,Paul Mouncey,Peter Watkinson,Duncan Young,Kathryn Rowan,Mark Corbett,Alistair Johnson,David Harrison,Paloma Ferrando-Vivas,Laura Drikite

doi:10.3310/hta25710

Abstract

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

Highlights

New-onset atrial fibrillation occurs in around 10% of adults treated in an intensive care unit
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
Our research shows that some new-onset atrial fibrillation treatments work better than others

Summary

Introduction

New-onset atrial fibrillation occurs in around 10% of adults treated in an intensive care unit. Current practice guidance is based on patients outside the intensive care unit; 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. We do not know how new-onset atrial fibrillation in patients treated in an intensive care unit affects heart rate and blood pressure, what the best treatments are or how treatments affect how people recover. New-onset atrial fibrillation (NOAF) is defined as atrial fibrillation (AF) that occurs in a patient with no known history of chronic or paroxysmal AF.[1] It is a common arrhythmia in critically ill patients.[2] It occurs in 5–15% of all patients admitted to a general intensive care unit (ICU),[3,4] rising to 23% of patients with septic shock.[5]. This helped us to understand how to clearly communicate our findings

Objectives

Methods

Results

Discussion

Conclusion