An International Survey of the Management of Atrial Fibrillation in Critically Unwell Patients

被引:2
作者
Johnston, Brian W. [1 ,2 ,3 ,4 ]
Udy, Andrew A. [5 ]
McAuley, Daniel F. [6 ]
Mogk, Martin [7 ]
Welters, Ingeborg D. [1 ,2 ,3 ,4 ]
Sibley, Stephanie [8 ]
机构
[1] Univ Liverpool, Inst Life Course & Med Sci, Fac Hlth, Liverpool, England
[2] Univ Liverpool, Life Sci, Liverpool, England
[3] Univ Liverpool, Liverpool John Moores Univ, Liverpool Ctr Cardiovasc Sci, Liverpool, England
[4] Liverpool Heart & Chest Hosp, Liverpool, England
[5] Monash Univ, Alfred Hosp, Sch Publ Hlth & Prevent Med, Australian & New Zealand Intens Care Res Ctr, Melbourne, Vic, Angola
[6] Queens Univ Belfast, Wellcome Wolfson Inst Expt Med, Belfast, North Ireland
[7] moreDATA GmbH, Giessen, Germany
[8] Queens Univ, Dept Crit Care Med, Kingston, ON, Canada
关键词
anticoagulation; arrhythmia; atrial fibrillation; long-term follow-up; prophylaxis; ASSOCIATION;
D O I
10.1097/CCE.0000000000001069
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
OBJECTIVES:To evaluate the current management of new-onset atrial fibrillation and compare differences in practice regionally.DESIGN:Cross-sectional survey.SETTING:United States, Canada, United Kingdom, Europe, Australia, and New Zealand.SUBJECTS:Critical care attending physicians/consultants and fellows.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:A total of 386 surveys were included in our analysis. Rate control was the preferred treatment approach for hemodynamically stable patients (69.1%), and amiodarone was the most used antiarrhythmic medication (70.9%). For hemodynamically unstable patients, a strategy of electrolyte supplementation and antiarrhythmic therapy was most common (54.7%). Physicians responding to the survey distributed by the Society of Critical Care Medicine were more likely to prescribe beta-blockers as a first-line antiarrhythmic medication (38.4%), use more transthoracic echocardiography than respondents from other regions (82.4%), and more likely to refer patients who survive their ICU stay for cardiology follow-up if they had new-onset atrial fibrillation (57.2%). The majority of survey respondents (83.0%) were interested in participating in future studies of atrial fibrillation in critically ill patients.CONCLUSIONS:Significant variation exists in the management of new-onset atrial fibrillation in critically ill patients, as well as geographic variation. Further research is necessary to inform guidelines in this population and establish if differences in practice impact long-term outcomes.
引用
收藏
页数:10
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