Cardiothoracic & vascular anesthesia
Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study*
Authors' conclusion
In ICU patients, AF occurred in one of six and was associated with different conditions. AF was associated with worse outcomes while not statistically significantly associated with 90-day mortality in the adjusted analyses.
Study context
- Population
- Adult, acutely admitted ICU patients without history of persistent/permanent atrial fibrillation (AF) or recent cardiac surgery; 44 ICUs in 12 countries, October 2020 to June 20211,415 (99.4%) analysed
- Participants
- 1,423 participants
- Exposure
- AF vs no AF
- AFn = 221
- Outcome
- Incidence of AF in the ICU
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Incidence of AF
Incidence of AF
15.6%
95% CI 13.8–17.6
Incidence of newly developed AF (11.5-15.1)
13.3%
Observational data: associations, not effects.
Further findings
| Outcome | AF | No AF | Adjusted cause-specific HR (95% CI) | |
|---|---|---|---|---|
| Mortality90-day mortality | 41.2% | 25.2% | 1.38 (0.95–1.99) | |
| 0.512Adjusted cause-specific hazard ratio (log scale) |
Risk factors for AF
- History of arterial hypertension, paroxysmal AF, sepsis, or high disease severity at ICU admission associated with AF
Interventions used to manage AF
- Fluid bolus
- 19% (95% CI 16-23)
- Magnesium (13-20)
- 16%
- Potassium (12-19)
- 15%
- Amiodarone (47-55)
- 51%
- Beta-1 selective blockers (30-38)
- 34%
- Calcium channel blockers (2-6)
- 4%
- Digoxin (12-19)
- 16%
- Direct current cardioversion (2-6)
- 4%
Safety
Thromboembolic events
Severe bleeding events
Thromboembolic events
- More ischemic events with AF
Original publication
Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study*. Crit Care Med. Published 20 April 2023. doi:10.
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