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New-Onset Atrial Fibrillation in Sepsis: A Narrative Review
| Content Provider | Scilit |
|---|---|
| Author | Aibar, Jesus Schulman, Sam |
| Copyright Year | 2020 |
| Description | Atrial fibrillation (AF) is a frequently identified arrhythmia during the course of sepsis. The aim of this narrative review is to assess the characteristics of patients with new-onset AF related to sepsis and the risk of stroke and death, to understand if there is a need for anticoagulation. We searched for studies on AF and sepsis on PubMed, the Cochrane database, and Web of Science, and 17 studies were included. The mean incidence of new-onset AF in patients with sepsis was 20.6% (14.7% in retrospective studies and 31.6% in prospective). Risk factors for new-onset AF included advanced age, white race, male sex, obesity, history of cardiopulmonary disease, heart or respiratory failure, and higher disease severity score. In-hospital mortality was higher in patients with than in those without new-onset AF in 10 studies. In four studies the overall intensive care unit and hospital mortality rates were comparable between patients with and without new-onset AF, while three other studies did not provide mortality data. One study reported on the in-hospital incidence of stroke, which was 2.6 versus 0.69% in patients with or without new-onset AF, respectively. Seven of the studies provided follow-up data after discharge. In three studies, new-onset AF was associated with excess mortality at 28 days, 1 year, and 5 years after discharge of 34, 21, and 3% patients, respectively. In two studies, the mortality rate was comparable in patients with and without new-onset AF. Postdischarge stroke was reported in five studies, whereof two studies had no events after 30 and 90 days, one study showed a nonsignificant increase in stroke, and two studies demonstrated a significant increase in risk of stroke after new-onset AF. The absolute risk increase was 0.6 to 1.6%. Large prospective studies are needed to better understand the need for anticoagulation after new-onset AF in sepsis. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1714400.pdf |
| Ending Page | 025 |
| Page Count | 8 |
| Starting Page | 018 |
| ISSN | 00946176 |
| e-ISSN | 10989064 |
| DOI | 10.1055/s-0040-1714400 |
| Journal | Seminars in Thrombosis and Hemostasis |
| Issue Number | 01 |
| Volume Number | 47 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2020-09-23 |
| Access Restriction | Open |
| Subject Keyword | Journal: Seminars in Thrombosis and Hemostasis Atrial Fibrillation New-onset Atrial Fibrillation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hematology Cardiology and Cardiovascular Medicine |
