Epidemiology of new-onset paroxysmal atrial fibrillation in the General Intensive Care Unit population and after discharge from ICU. A retrospective epidemiological study

Koyfman, Leonid; Brotfain, Evgeni; Kutz, Ruslan; Frenkel, Amit; Schwartz, A.; Boniel, Avi; Zlotnik, Alexander; Klein, Moti

doi:10.5603/ait.a2015.0040

Cited by 17 publications

(11 citation statements)

References 35 publications

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“…Thirty-six studies reported on the incidence of AF (Table 2). 16, 17, 22–55 One study was published in Hebrew, while all others were in English. Twenty-three studies evaluated patients in an ICU, and 13 studies evaluated patients in a hospital ward setting.…”

Section: Resultsmentioning

confidence: 99%

Atrial fibrillation detected initially during acute medical illness: A systematic review

McIntyre

Cheung

et al. 2018

European Heart Journal: Acute Cardiovascular Care

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Objective: There is uncertainty about the incidence of and prognosis associated with atrial fibrillation that is documented for the first time in the setting of an acute stressor, such as surgery or medical illness. Our objective was to perform a systematic review of the incidence and long-term recurrence rates for atrial fibrillation occurring transiently with stress in the setting of acute medical illness. Data sources: Medline, Embase and Cochrane Central to September 2017. Study selection: We included retrospective and prospective observational studies, and randomised controlled trials. The population of interest included patients hospitalised for medical (i.e. non-surgical) illness who developed newly diagnosed atrial fibrillation. Studies were included if they included data on either the incidence of atrial fibrillation or the rate of atrial fibrillation recurrence in atrial fibrillation occurring transiently with stress patients following hospital discharge. Data extraction: Two reviewers collected data independently and in duplicate. We characterised each study’s methodology for ascertainment of prior atrial fibrillation history, atrial fibrillation during hospitalisation and atrial fibrillation recurrence after hospital discharge. Data synthesis: Thirty-six studies reported the incidence of atrial fibrillation. Ten used a prospective design and included a period of continuous electrocardiographic (ECG) monitoring. Atrial fibrillation incidence ranged from 1% to 44%, which was too heterogeneous to justify meta-analysis ( I2=99%). In post-hoc meta-regression models, the use of continuous ECG monitoring explained 13% of the variance in atrial fibrillation incidence, while care in an intensive care unit explained none. Two studies reported the long-term rate of atrial fibrillation recurrence following atrial fibrillation occurring transiently with stress. Neither of these studies used prospective, systematic monitoring. Recurrence rates at 5 years ranged from 42% to 68%. Conclusions: The incidence of atrial fibrillation with medical illness may be as high as 44%, with higher estimates in reports using continuous ECG monitoring. Within 5 years following hospital discharge, atrial fibrillation recurrence is documented in approximately half of patients; however, the true rate may be higher. Protocol registration PROSPERO CRD42016043240

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Section: Resultsmentioning

confidence: 99%

Atrial fibrillation detected initially during acute medical illness: A systematic review

McIntyre

Cheung

et al. 2018

European Heart Journal: Acute Cardiovascular Care

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“…However, Koyfman et al [46] found no difference in ICU mortality rate between septic patients who had previous AF episodes and patients with no previous past medical history of any type of cardiac arrhythmias.…”

Section: Morbidity and Mortalitymentioning

confidence: 98%

Cardiac Arrhythmias in a Septic ICU Population: A Review

Schwartz

Brotfain

Koyfman

et al. 2015

The Journal of Critical Care Medicine

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Progressive cardiovascular deterioration plays a central role in the pathogenesis of multiple organ failure (MOF) caused by sepsis. Evidence of various cardiac arrhythmias in septic patients has been reported in many published studies. In the critically ill septic patients, compared to non-septic patients, new onset atrial fibrillation episodes are associated with high mortality rates and poor outcomes, amongst others being new episodes of stroke, heart failure and long vasopressor usage. The potential mechanisms of the development of new cardiac arrhythmias in sepsis are complex and poorly understood. Cardiac arrhythmias in critically ill septic patients are most likely to be an indicator of the severity of pre-existing critical illness.

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“…[24] study mortality rates were also higher in individuals with severe sepsis and new onset AF (56.3%) compared to patients with preexisting AF (43.8%) and without new onset AF (38.2%). However, Koyfman et al [46] found no difference in ICU mortality rate between septic patients who had previous AF episodes and patients with no previous past medical history of any cardiac arrhythmias.…”

Section: Morbidity and Mortalitymentioning

confidence: 97%

New Tachycarrhythmias in Critical Care Population

Brotfain¹,

Kuts²,

Klein³

et al. 2018

Clinical Anesthesiology and Intensive Care

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Прогрессирующее сердечно-сосудистое ухудшение играет главную роль в патогенезе множественной органной недостаточности, вызванной сепсисом. Доказательства наличия различных сердечных аритмий у септических пациентов были продемонстрированы несколькими клиническими отчетами и наблюдениями. Описаны различные типы тахиаритмий у тяжелых пациентов с сепсисом.Новые эпизоды фибрилляции предсердий были связаны с высокой смертностью и плохими результатами (инсульт, сердечная недостаточность, длительное использование вазопрессора и т. д.) у пациентов с тяжелыми заболеваниями септического типа по сравнению с несептическими больными. Потенциальные механизмы развития новых сердечных аритмий при сепсисе сложны и недостаточно изучены. Сердечные аритмии у критически больных с сепсисом, скорее всего, являются показателем тяжести предшествующей болезни.Ключевые слова: сердечные аритмии, фибрилляция предсердий нового типа, сепсис, септический шок.

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Epidemiology of new-onset paroxysmal atrial fibrillation in the General Intensive Care Unit population and after discharge from ICU. A retrospective epidemiological study

Cited by 17 publications

References 35 publications

Atrial fibrillation detected initially during acute medical illness: A systematic review

Atrial fibrillation detected initially during acute medical illness: A systematic review

Cardiac Arrhythmias in a Septic ICU Population: A Review

New Tachycarrhythmias in Critical Care Population

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