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. 2022 Nov;23(4):414-424.
doi: 10.1177/17511437211022132. Epub 2021 Jun 3.

Risk factors for new-onset atrial fibrillation during critical illness: A Delphi study

Jonathan P Bedford  1 , Tessa Garside  1 , Julie L Darbyshire  1 , Timothy R Betts  2 , J Duncan Young  1 , Peter J Watkinson  1   3
Affiliations

Risk factors for new-onset atrial fibrillation during critical illness: A Delphi study

Jonathan P Bedford et al. J Intensive Care Soc. 2022 Nov.

Abstract

Background: New-onset atrial fibrillation (NOAF) is common during critical illness and is associated with poor outcomes. Many risk factors for NOAF during critical illness have been identified, overlapping with risk factors for atrial fibrillation in patients in community settings. To develop interventions to prevent NOAF during critical illness, modifiable risk factors must be identified. These have not been studied in detail and it is not clear which variables warrant further study.

Methods: We undertook an international three-round Delphi process using an expert panel to identify important predictors of NOAF risk during critical illness.

Results: Of 22 experts invited, 12 agreed to participate. Participants were located in Europe, North America and South America and shared 110 publications on the subject of atrial fibrillation. All 12 completed the three Delphi rounds. Potentially modifiable risk factors identified include 15 intervention-related variables.

Conclusions: We present the results of the first Delphi process to identify important predictors of NOAF risk during critical illness. These results support further research into modifiable risk factors including optimal plasma electrolyte concentrations, rates of change of these electrolytes, fluid balance, choice of vasoactive medications and the use of preventative medications in high-risk patients. We also hope our findings will aid the development of predictive models for NOAF.

Keywords: Atrial fibrillation; Delphi; critical care; intensive care; risk factors.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Peter Watkinson works part-time for Sensyne Health and has received grant funding from the National Institute for Health Research, Wellcome, and Sensyne Health outside the submitted work. The remaining authors confirm they have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Flow chart of Delphi process.
See this image and copyright information in PMC

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