ArticleCritical care (London, England)2016
Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Managing new-onset atrial fibrillation in critically ill patients: a systematic narrative review.BMJ open · 2020Pooled it
- Definitions and outcomes reported in studies investigating the management of new onset atrial fibrillation in acutely unwell patients admitted to the intensive care unit: a scoping review.European heart journal open · 2026Review
- Evaluation of Amiodarone Administration in Patients with New-Onset Atrial Fibrillation in Septic Shock.Medicina (Kaunas, Lithuania) · 2024Review
- Landiolol for Treatment of New-Onset Atrial Fibrillation in Critical Care: A Systematic Review.Journal of clinical medicine · 2024Review
- Article
- Comparative effectiveness of common treatments for new-onset atrial fibrillation within the ICU: Accounting for physiological status.Journal of critical care · 2022Article
- Clinical characteristics and prognostic factors of atrial fibrillation at a tertiary center of Pakistan - From a South-Asian perspective - A cross-sectional study.Annals of medicine and surgery (2012) · 2022Article
- Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report.The Korean journal of internal medicine · 2021Article
- Clinical prediction scores and early anticoagulation therapy for new-onset atrial fibrillation in critical illness: a post-hoc analysis.BMC cardiovascular disorders · 2021Observational
- Treatment strategies for new onset atrial fibrillation in patients treated on an intensive care unit: a systematic scoping review.Critical care (London, England) · 2021Article
- Rhythm-control therapy for new-onset atrial fibrillation in critically ill patients: A post hoc analysis from the prospective multicenter observational AFTER-ICU study.International journal of cardiology. Heart & vasculature · 2021Article
- Prognostic impact of sustained new-onset atrial fibrillation in critically ill patients.Intensive care medicine · 2020Article
- [New onset atrial fibrillation in patients with sepsis].Der Anaesthesist · 2017Review
- Amiodarone in the treatment of atrial fibrillation of patients with rheumatic heart disease after valve replacement.Pakistan journal of medical sciencesArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation is a common rhythm disturbance in the general medical-surgical intensive care unit. Amiodarone is a popular drug in this setting but evidence to inform clinical practice remains scarce. We aimed to identify whether variation in the clinical use of amiodarone was associated with recurrent atrial fibrillation.
methodsThis was a retrospective audit of 177 critically ill patients who developed new-onset atrial fibrillation after admission to a tertiary level medical-surgical trauma intensive care unit. Patterns of amiodarone prescription (including dosage schedule and duration) were assessed in relation to recurrence of atrial fibrillation during the intensive care unit stay. Known recurrence risk factors, such as inotrope administration, cardiac disease indices, Charlson Comorbidity Index, magnesium concentrations, fluid balance, and potassium concentrations, were also included in adjusted analysis using forward stepwise logistic regression modelling.
resultsThe cohort had a median (interquartile range) age of 69 years (60-75), Acute Physiology and Chronic Health Evalution II score of 22 (17-28) and Charlson Comorbidity Index of 2 (1-4). A bolus dose of amiodarone followed by infusion (P = 0.02), in addition to continuing amiodarone infusion through to discharge from the intensive care unit (P < 0.001), were associated with less recurrent dysrhythmia. Recurrence after successful treatment was associated with ceasing amiodarone while an inotrope infusion continued (P < 0.001), and was more common in patients with a prior history of congestive cardiac failure (P = 0.04), and a diagnosis of systemic inflammatory response syndrome (P = 0.02).
conclusionsAmiodarone should be administered as a bolus dose followed immediately with an infusion when treating atrial fibrillation in the medical-surgical intensive care unit. Consideration should be given to continuing amiodarone infusions in patients on inotropes until they are ceased.
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