ArticleJournal of critical care2022
Comparative effectiveness of common treatments for new-onset atrial fibrillation within the ICU: Accounting for physiological status.
Article in Journal of critical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- A prospective, multi-site, observational study assessing the treatment thresholds of new onset atrial fibrillation in the critically ill.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- 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
- Guidelines for the management of atrial fibrillation in adult patients admitted to an intensive care unit.Annals of intensive care · 2026Article
- Outcomes and Management of Stressor-Associated Atrial Fibrillation: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2025Review
- Landiolol bolus application for tachycardic dysrhythmia in the prehospital EMS setting - An observational study of a novel concept.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Atrial fibrillation in critical illness: state of the art.Intensive care medicine · 2025Review
- Cardiac Injury After Traumatic Brain Injury: Clinical Consequences and Management.Neurocritical care · 2024Article
- A Comparison of the Impact of Pharmacological Treatments on Cardioversion, Rate Control, and Mortality in Data-Driven Atrial Fibrillation Phenotypes in Critical Care.Bioengineering (Basel, Switzerland) · 2024Article
- New-onset atrial fibrillation in intensive care: epidemiology and outcomes.European heart journal. Acute cardiovascular care · 2022Article
- Effectiveness of amiodarone versus digitalis for heart rate control in critically ill patients with new-onset atrial fibrillation.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundNew-onset atrial fibrillation (NOAF) is common in patients on an intensive care unit (ICU). Evidence guiding treatments is limited, though recent reports suggest beta blocker (BB) therapy is associated with reduced mortality.
methodsWe conducted a multicentre cohort study of adult patients admitted to 3 ICUs in the UK and 5 ICUs in the USA. We analysed the haemodynamic changes associated with NOAF. We analysed rate control, rhythm control, and hospital mortality associated with common NOAF treatments. We balanced admission and post-NOAF, pre-treatment covariates across treatment groups.
resultsNOAF was followed by a systolic blood pressure reduction of 5 mmHg (p < 0.001). After adjustment, digoxin therapy was associated with inferior rate control versus amiodarone (adjusted hazard ratio (aHR) 0.56, [95% CI 0.34-0.92]). Calcium channel blocker (CCB) therapy was associated with inferior rhythm control versus amiodarone (aHR 0.59 (0.37-0.92). No difference was detected between BBs and amiodarone in rate control (aHR 1.15 [0.91-1.46]), rhythm control (aHR 0.85, [0.69-1.05]), or hospital mortality (aHR 1.03 [0.53-2.03]).
conclusionsNOAF in ICU patients is followed by decreases in blood pressure. BBs and amiodarone are associated with similar cardiovascular control and appear superior to digoxin and CCBs. Accounting for key confounders removes previously reported mortality benefits associated with BB treatment.
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