Currently, there are no ICU specific management guidelines for the new onset of atrial fibrillation (AF). This article provides a proposed treatment algorithm for paroxysmal AF that is based on recent separate consensus guidelines for the management of AF and for throbophrophylaxis. The AF treatment algorithm provides the intensivist with a decision tree approach based on the patients clinical findings at the time of ICU admission.
FusterVRydénLECannomDS; American College of Cardiology Foundation/American Heart Association Task Force. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011;123:e269-e367.
2.
CammAJKirchhofPLipGY. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace. 2010;12:1360-1420.
3.
CurtisAB. Update on the clinical management of atrial fibrillation: guidelines and beyond. Postgrad Med. 2011;123:7-20.
4.
SeguinPLauneyY. Atrial fibrillation is not just an artefact in the ICU. Crit Care. 2010;14:182.
5.
Rivero-AyerzaMScholteOpReimerWLenzenM. New-onset atrial fibrillation is an independent predictor of in-hospital mortality in hospitalized heart failure patients: results of the EuroHeart Failure Survey. Eur Heart J. 2008;29:1618-1624.
6.
GoodmanSShirovTWeissmanC. Supraventricular arrhythmias in intensive care unit patients: short and long-term consequences. Anesth Analg. 2007;104:880-886.
7.
ZusmanOAmitGGilutzHZahgerD. The significance of new onset atrial fibrillation complicating acute myocardial infarction. Clin Res Cardiol. 2012;101:17-22.
8.
JabrePJouvenXAdnetF. Atrial fibrillation and death after myocardial infarction: a community study. Circulation. 2011;123:2094-2100.
9.
AlqahtaniAA. Atrial fibrillation post cardiac surgery trends toward management. Heart Views. 2010;11:57-63.
10.
MerrittREShragerJB. Prophylaxis and management of atrial fibrillation after general thoracic surgery. Thorac Surg Clin. 2012;22:13-23.
11.
HenriCGiraldeauGDoraisM. Atrial fibrillation after pulmonary transplantation: incidence, impact on mortality, treatment effectiveness, and risk factors. Circ Arrhythm Electrophysiol. 2012;5:61-67.
12.
TisdaleJEWroblewskiHAKeslerKA. Prophylaxis of atrial fibrillation after noncardiac thoracic surgery. Semin Thorac Cardiovasc Surg. 2010;22:310-320.
13.
BrathwaiteDWeissmanC. The new onset of atrial arrhythmias following major noncardiothoracic surgery is associated with increased mortality. Chest. 1998;114:462-468.
14.
SohnGHShinDHByunKM. The incidence and predictors of postoperative atrial fibrillation after noncardiothoracic surgery. Korean Circ J. 2009;39:100-104.
15.
AnterEJessupMCallansDJ. Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation. 2009;119:2516-2525.
16.
KimMHJohnstonSSChuBCDalalMRSchulmanKL. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313-320.
17.
ValderrabanoM. Atrial fibrillation: the mother rotor and its rebellious offspring take turns sustaining the family. Heart Rhythm. 2009;6:1018-1019.
18.
AldhoonBMelenovskyVPeichlPKautznerJ. New insights into mechanisms of atrial fibrillation. Physiol Res. 2010;59:1-12.
19.
BrenyoAJAktasMK. Non-pharmacologic management of atrial fibrillation. Am J Cardiol. 2011;108:317-325.
20.
WalkeyAJWienerRSGhobrialJMCurtisLHBenjaminEJ. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA. 2011;306:2248-2254.
21.
WatanabeHWatanabeTSasakiSNagaiKRodenDMAizawaY. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: The Niigata preventive medicine study. Am Heart J. 2009;158:629-636.
22.
JessupMAbrahamWTCaseyDE. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119: 1977-2016.
23.
GageBFWatermanADShannonWBoechlerMRichMWRadfordMJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864-2870.
24.
LipGYNieuwlaatRPistersRLaneDACrijnsHJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263-272.
25.
LipGY. Stroke in atrial fibrillation: epidemiology and thromboprophylaxis. J Thromb Haemost. 2011;9(suppl 1):344-351.
26.
De CaterinaRHylekEM. Stroke prevention in atrial fibrillation: current status and near-future directions. Am J Med. 2011;124:793-799.
27.
GuyattGHAklEACrowtherMGuttermanDDSchunemannHJ. Executive Summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 suppl):7S-47S.
28.
MichotaFA. Prevention of venous thromboembolism after surgery. Cleve Clin J Med. 2009;76(suppl 4):S45-S52.
29.
ShirolkarSCFiuzatMBeckerRC. Dronedarone and vitamin K antagonists: a review of drug-drug interactions. Am Heart J. 2010;160:577-582.
30.
GillisAMSkanesAC. Comparing the 2010 North American and European atrial fibrillation guidelines. Can J Cardiol. 2011;27:7-13.
31.
MendelsonTBMeltzerMCampbellEGCaplanALKirkpatrickJN. Conflicts of interest in cardiovascular clinical practice guidelines. Arch Intern Med. 2011;171:577-584.