An international survey of the management of atrial fibrillation in critically unwell patients

Brian W Johnston, Andrew A Udy, Daniel F McAuley, Martin Mogk, Ingeborg D Welters, Stephanie Sibley

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To evaluate the current management of new-onset atrial fibrillation and compare differences in practice regionally. Cross-sectional survey. United States, Canada, United Kingdom, Europe, Australia, and New Zealand. Critical care attending physicians/consultants and fellows. None. 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. 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.
Original languageEnglish
Article numbere1069
Number of pages10
JournalCritical Care Explorations
Issue number4
Publication statusPublished - 01 Apr 2024


  • anticoagulation
  • long-term follow-up
  • arrhythmia
  • prophylaxis
  • atrial fibrillation


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