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

Makrygiannis, Stamatis S.; Margariti, Apostolia; Rizikou, Despina; Lampakis, Manolis; Vangelis, Spyros; Ampartzidou, Olga S.; Katsifa, Konstantina; Tselioti, P.; Foussas, Stefanos; Prekates, A.

doi:10.1016/j.jcrc.2014.03.029

Cited by 44 publications

(43 citation statements)

References 26 publications

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“…The vast majority of studies assessing risk and outcomes of arrhythmias in sepsis have focused on supra ventricular arrhythmias, A Fib in particular (14)(15)(16)(17). To our knowledge, the present study is the largest to use discharge diagnoses from the NIS database to validate prevalence, trends, predictors and outcomes of different arrhythmias in the septic population.…”

Section: Discussionmentioning

confidence: 98%

“…Although A fib is the most frequently reported arrhythmia (14,15,17,19), large epidemiologic studies designed to assess incidence of different arrhythmias in the septic population are lacking. Consistent with our findings, previous studies have found advanced age, male gender and comorbidities such as heart failure, HTN and valvular heart disease to predict new onset A Fib in critically ill patients (5,14,16,20,21).…”

Section: Discussionmentioning

confidence: 99%

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Severe sepsis and cardiac arrhythmias

Shahreyar¹,

Fahhoum²,

Akinseye³

et al. 2018

Ann. Transl. Med.

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Background: Although sepsis is a known risk factor for cardiac arrhythmias, data on incidence and outcomes of atrial and ventricular arrhythmias in severe sepsis is limited. The purpose of this study is to examine the association of severe sepsis with cardiac arrhythmias and their impact on outcome in this patient population. Methods:We used hospital discharge data from the Nationwide Inpatient Sample (NIS) during the year 2012. All patients 18 years or older were included in the study. The International Classification of Diseases-Clinical Modification, 9th revision (ICD-9-CM) code was used to identify patients with discharge diagnosis of severe sepsis, atrial fibrillation (A Fib), atrial flutter (AFL), ventricular fibrillation (VF) arrest and non-ventricular fibrillation (non-VF) arrest. In order to study the association of arrhythmias with severe sepsis, two groups were defined: group a-with severe sepsis was compared to group b-without severe sepsis. Univariate and multivariate logistic regression methods were used to adjust for potential confounding factors and variables associated with cardiac arrhythmias were determined.Results: A total of 30,712,524 NIS hospital discharges (weighted for national estimate) were included in our study, of which 1,756,965 (5.7%) had severe sepsis. On multivariate analysis, after adjusting for potential confounders, severe sepsis was associated with higher risk of A Fib (OR, 1.23; 95% CI, 1.21-1.24), AFL (OR, 1.34; 95% CI, 1.30-1.40), VF arrest (OR, 2.58; 95% CI, 2.38-2.79) (OR, 3.31; 95% CI, 3.07-3.57) and non-VF arrest (OR, 4.91; 95% CI,). In the severe sepsis group, cardiac arrhythmia was associated with higher in-hospital mortality (OR, 1.41; 95% CI, 1.37-1.45), length of stay (LOS) >75% quartile (OR, 1.50; 95% CI, 1.46-1.53) and total hospital charges >75% quartile (OR, 1.37; 95% CI, 1.34-1.41). Advanced age, male sex, ischemic heart disease, diabetes mellitus (DM), congestive heart failure (CHF), valvular heart disease, respiratory failure, mechanical ventilation and use of vasopressors were independently associated with cardiac arrhythmias. Conclusions:Patients with severe sepsis are at high risk of atrial and life threatening ventricular arrhythmias. Despite adjustment for potential confounding factors, patients hospitalized with severe sepsis carry a significantly higher risk for cardiac arrest and increased mortality.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Severe sepsis and cardiac arrhythmias

Shahreyar¹,

Fahhoum²,

Akinseye³

et al. 2018

Ann. Transl. Med.

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“…Thus, NOX2 is a potential target for pharmacotherapy of sepsis-induced cardiomyopathy. mon in patients admitted to the ICU with sepsis compared with other diagnoses (7). Currently, there is no therapy for sepsis-induced cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of NADPH oxidase 2 (NOX2) prevents sepsis-induced cardiomyopathy by improving calcium handling and mitochondrial function

et al. 2017

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“…A second potentially beneficial action of beta blockade on LV diastolic function could come from its anti-arrhythmic effects. For instance, sepsis is a recognized independent risk factor for developing atrial fibrillation 14 which itself causes the loss of late (atrial) contribution to LV filling during diastole. In patients with impaired LV diastolic function this loss is not always well compensated and can severely affect cardiovascular dynamics.…”

mentioning

confidence: 99%

Sepsis and beta-blockade: a look into diastolic function

Astuto

2015

Current Medical Research and Opinion

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

Cited by 44 publications

References 26 publications

Severe sepsis and cardiac arrhythmias

Severe sepsis and cardiac arrhythmias

Inhibition of NADPH oxidase 2 (NOX2) prevents sepsis-induced cardiomyopathy by improving calcium handling and mitochondrial function

Sepsis and beta-blockade: a look into diastolic function

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