Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey
Background New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been includ...
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| Format: | Article |
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PeerJ Inc.
2017-09-01
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| Online Access: | https://peerj.com/articles/3716.pdf |
| _version_ | 1797421059426746368 |
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| author | Chung Shen Chean Daniel McAuley Anthony Gordon Ingeborg Dorothea Welters |
| author_facet | Chung Shen Chean Daniel McAuley Anthony Gordon Ingeborg Dorothea Welters |
| author_sort | Chung Shen Chean |
| collection | DOAJ |
| description | Background New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. Methods We designed a short user-friendly online questionnaire. All members of the Intensive Care Society were invited via email containing a link to the questionnaire, which comprised 21 questions. The online survey was conducted between November 2016 and December 2016. Results The response rate was 397/3152 (12.6%). The majority of respondents (81.1%) worked in mixed Intensive Care Units and were consultants (71.8%). Most respondents (39.5%) would start intervention on patients with fast new-onset AF and stable blood pressure at a heart rate between 120 and 139 beats/min. However, 34.8% of participants would treat all patients who developed new-onset fast AF. Amiodarone and beta-blockers (80.9% and 11.6% of answers) were the most commonly used anti-arrhythmics. A total of 63.8% of respondents do not regularly anti-coagulate critically ill patients with new-onset fast AF, while 30.8% anti-coagulate within 72 hours. A total of 68.0% of survey respondents do not routinely use stroke risk scores in critically ill patients with new-onset AF. A total of 85.4% of participants would consider taking part in a clinical trial investigating treatment of new-onset fast AF in the critically ill. Discussion Our results suggest a considerable disparity between contemporary practice of management of new-onset AF in critical illness and treatment recommendations for the general patient population suffering from AF, particularly with regard to anti-arrhythmics and anti-coagulation used. Amongst intensivists, there is a substantial interest in research for management of new-onset AF in critically ill patients. |
| first_indexed | 2024-03-09T07:11:28Z |
| format | Article |
| id | doaj.art-83f809830b0d4a6da1e30a3a809fa05d |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T07:11:28Z |
| publishDate | 2017-09-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-83f809830b0d4a6da1e30a3a809fa05d2023-12-03T09:07:00ZengPeerJ Inc.PeerJ2167-83592017-09-015e371610.7717/peerj.3716Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide surveyChung Shen Chean0Daniel McAuley1Anthony Gordon2Ingeborg Dorothea Welters3Intensive Care Unit, Royal Liverpool University Hospital, Liverpool, United KingdomSchool of Medicine, Dentistry and Biomedical Sciences, The Queen’s University Belfast, Belfast, United KingdomFaculty of Medicine, Department of Surgery & Cancer, Section of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, United KingdomIntensive Care Unit, Royal Liverpool University Hospital, Liverpool, United KingdomBackground New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. Methods We designed a short user-friendly online questionnaire. All members of the Intensive Care Society were invited via email containing a link to the questionnaire, which comprised 21 questions. The online survey was conducted between November 2016 and December 2016. Results The response rate was 397/3152 (12.6%). The majority of respondents (81.1%) worked in mixed Intensive Care Units and were consultants (71.8%). Most respondents (39.5%) would start intervention on patients with fast new-onset AF and stable blood pressure at a heart rate between 120 and 139 beats/min. However, 34.8% of participants would treat all patients who developed new-onset fast AF. Amiodarone and beta-blockers (80.9% and 11.6% of answers) were the most commonly used anti-arrhythmics. A total of 63.8% of respondents do not regularly anti-coagulate critically ill patients with new-onset fast AF, while 30.8% anti-coagulate within 72 hours. A total of 68.0% of survey respondents do not routinely use stroke risk scores in critically ill patients with new-onset AF. A total of 85.4% of participants would consider taking part in a clinical trial investigating treatment of new-onset fast AF in the critically ill. Discussion Our results suggest a considerable disparity between contemporary practice of management of new-onset AF in critical illness and treatment recommendations for the general patient population suffering from AF, particularly with regard to anti-arrhythmics and anti-coagulation used. Amongst intensivists, there is a substantial interest in research for management of new-onset AF in critically ill patients.https://peerj.com/articles/3716.pdfAtrial fibrillationCritical careSepsisArrhythmiaAnti-coagulationAnti-arrhythmics |
| spellingShingle | Chung Shen Chean Daniel McAuley Anthony Gordon Ingeborg Dorothea Welters Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey PeerJ Atrial fibrillation Critical care Sepsis Arrhythmia Anti-coagulation Anti-arrhythmics |
| title | Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey |
| title_full | Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey |
| title_fullStr | Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey |
| title_full_unstemmed | Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey |
| title_short | Current practice in the management of new-onset atrial fibrillation in critically ill patients: a UK-wide survey |
| title_sort | current practice in the management of new onset atrial fibrillation in critically ill patients a uk wide survey |
| topic | Atrial fibrillation Critical care Sepsis Arrhythmia Anti-coagulation Anti-arrhythmics |
| url | https://peerj.com/articles/3716.pdf |
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