Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study

doi:10.1097/CCM.0000000000005883

Multicenter Study

. 2023 Sep 1;51(9):1124-1137.

doi: 10.1097/CCM.0000000000005883. Epub 2023 Apr 20.

Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study

Mik Wetterslev¹, Morten Hylander Møller¹, Anders Granholm¹, Christian Hassager², Nicolai Haase¹, Theis Lange³, Sheila N Myatra⁴, Johanna Hästbacka⁵, Yaseen M Arabi⁶, Jiawei Shen⁷, Maria Cronhjort⁸, Elin Lindqvist⁸, Anders Aneman^{9

10}, Paul J Young^{11

12}, Wojciech Szczeklik¹³, Martin Siegemund¹⁴, Thijs Koster¹⁵, Tayyba Naz Aslam¹⁶, Morten H Bestle^{17

18}, Mia S Girkov¹⁹, Kushal Kalvit⁴, Rakesh Mohanty⁴, Joanne Mascarenhas²⁰, Manoranjan Pattnaik²¹, Sara Vergis²², Sai Praveen Haranath²³, Mehul Shah²⁴, Ziyokov Joshi²⁵, Erika Wilkman⁵, Matti Reinikainen²⁶, Pasi Lehto²⁷, Ville Jalkanen²⁸, Anni Pulkkinen²⁹, Youzhong An⁷, Guoxing Wang³⁰, Lei Huang³¹, Bin Huang³², Wei Liu³³, Hengbo Gao³⁴, Lin Dou³⁵, Shuangling Li³⁶, Wanchun Yang³⁷, Emily Tegnell³⁸, Agnes Knight³⁹, Miroslaw Czuczwar⁴⁰, Tomasz Czarnik⁴¹, Anders Perner¹; AFIB-ICU Collaborators

Collaborators, Affiliations

Collaborators

AFIB-ICU Collaborators:
Haifaa Ibrahim Al Humedi⁴², Nuria Zellweger⁴³, Chiara Nuciforo⁴⁴, Yanjun Deng⁴⁵, Hua Luo⁴⁶, Miao Yan⁴⁷, Janus Engstrøm⁴⁸, Mette Krag⁴⁹, Frederik H Bestle⁵⁰, Lone M Poulsen⁵¹, Thomas Hildebrandt⁵², Anne Sofie Andreasen⁵³, Klaus Tjelle Kristiansen⁵⁴, Thomas Mohr⁵⁵, Hasse Møller-Sørensen⁵⁶, Kirsten Møller⁵⁷, Manoj Gorade⁵⁸, Bhavesh Gandhi⁵⁹, Tanya Jha⁵⁹, Owais Tisekar⁶⁰, Aparjeet Kar⁶⁰, Balkrishan Nimavat⁶⁰, Elina Lappi⁶¹, Jonna Heinonen⁶¹, Leena Pettilä⁶¹, Maria Iso-Ketola⁶¹, Minttu Saario⁶¹, Tarja Suhonen⁶², Eija Vaskelainen⁶³, Elina Halonen⁶³, Sari Rahikainen⁶³, Sonja Julkunen⁶³, Sinikka Salkio⁶⁴, Sanna Mäkinen⁶⁵, Sanna Ristimäki⁶⁵, Juho Hartikainen⁶⁶, Nina Inkinen⁶⁶, Sinikka Tolmunen⁶⁶, Jonatan Oras⁶⁷, Kirsha Delaney⁶⁸, Leanlove Navarra⁶⁸, Raulle Cruz⁶⁸, Shaanti Olatunji⁶⁸, Marta Bombinska⁶⁹, Jon Laake⁷⁰, Frederik Keus⁷¹, Ruben Eck⁷²

Affiliations

¹ Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
² Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
³ Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
⁴ Department of Anaesthesiology Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
⁵ Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Department of Intensive Care Medicine, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
⁷ Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China.
⁸ Department of Clinical Science and Education, Section of Anaesthesia and Intensive Care, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
⁹ Department of Intensive Care Medicine, Liverpool Hospital, Liverpool, NSW, Australia.
¹⁰ South Western Clinical School, University of New South Wales, Warwick Farm, NSW, Australia.
¹¹ Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
¹² Medical Research Institute of New Zealand, Wellington, New Zealand.
¹³ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
¹⁴ Intensive Care Medicine, Department of Acute Medicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
¹⁵ Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
¹⁶ Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
¹⁷ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - North Zealand, Copenhagen, Denmark.
¹⁸ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹⁹ Department of Anaesthesia and Intensive Care, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
²⁰ Department of Medicine and Critical Care, Breach Candy Hospital Trust, Mumbai, India.
²¹ Department of Pulmonary Medicine, SCB Medical College & Hospital, Cuttack, India.
²² Department of Anaesthesia and Critical Care, MOSC Medical College, Kolenchery, India.
²³ Department of Critical Care Medicine, Apollo Hospitals, Hyderabad, India.
²⁴ Department of Critical Care Medicine, Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, India.
²⁵ Department of Cardiac Anaesthesiology and Critical Care, Tagore Hospital, Jalandhar, India.
²⁶ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
²⁷ Department of Anaesthesia and Intensive Care, Oulu University Hospital, Oulu, Finland.
²⁸ Department of Intensive Care, Tampere University Hospital, Tampere, Finland.
²⁹ Department of Anesthesia and Intensive Care, Central Finland Central Hospital, Central Finland Health Care District, Jyväskylä, Finland.
³⁰ Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
³¹ Department of Intensive Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China.
³² Department of Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China.
³³ Department of Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
³⁴ Department of Critical Care Medicine, The Second Hospital, Hebei Medical University, Hebei, China.
³⁵ Department of Intensive Care Medicine, Tianjin First Center Hospital, Tianjin, China.
³⁶ Department of Critical Care Medicine, Peking University First Hospital, Beijing, China.
³⁷ Emergency Intensive Care Unit, Xinjiang Production and Construction Crops 13 div Red Star Hospital.
³⁸ Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
³⁹ Department of Anaesthesia and Intensive Care, Hudiksvall Hospital, Hudiksvall, Sweden.
⁴⁰ Second Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
⁴¹ Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Opole, Poland.
⁴² Department of Intensive Care Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
⁴³ Department of Intensive Care Medicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
⁴⁴ Department of Intensive Care Medicine and Department of Clinical Research, University Hospital Basel and University of Basel Basel, Switzerland.
⁴⁵ Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University Beijing, China.
⁴⁶ Department of Critical Care Medicine, Peking University Shenzhen Hospital Shenzhen, China.
⁴⁷ Department of Critical Care Medicine, Peking University First Hospital Beijing, China.
⁴⁸ Copenhagen Trial Unit Denmark.
⁴⁹ Department of Anaesthesiology and Intensive Care, Holbaek Hospital Holbaek, Denmark.
⁵⁰ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand Hilleroed.
⁵¹ Department of Anaesthesia and Intensive Care, Zealand University Hospital Køge.
⁵² Department of Anaesthesiology and Intensive Care Medicine, Zealand University Hospital Roskilde.
⁵³ Department of Intensive Care, Herlev Hospital Herlev, Denmark.
⁵⁴ Department of Intensive Care, Hvidovre Hospital Hvidovre, Denmark.
⁵⁵ Department of Intensive Care, Gentofte Hospital Gentofte, Denmark.
⁵⁶ Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.
⁵⁷ Department of Neuroanaesthesiology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.
⁵⁸ Department of Anaesthesiology Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute Mumbai, India.
⁵⁹ Department of Medicine and Critical Care, Breach Candy Hospital Trust Mumbai, India.
⁶⁰ Department of Critical Care Medicine. Sir H N Reliance foundation Hospital and research Centre Mumbai, India.
⁶¹ Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital Helsinki, Finland.
⁶² Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital Helsinki, Finland Kuopio, Finland.
⁶³ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital Kuopio, Finland.
⁶⁴ Department of Anaesthesia and Intensive Care, Oulu University Hospital Oulu, Finland.
⁶⁵ Department of Intensive Care, Tampere University Hospital Tampere, Finland.
⁶⁶ Department of Anesthesia and Intensive Care, Central Finland Central Hospital, Central Finland Health Care District Jyväskylä, Finland.
⁶⁷ Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital Gothenburg, Sweden.
⁶⁸ Intensive Care Unit, Wellington Hospital Wellington, New Zealand.
⁶⁹ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College Kraków, Poland.
⁷⁰ Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet, Oslo University Hospital Oslo, Norway.
⁷¹ Department of Critical Care, University of Groningen, University Medical Center Groningen Groningen, the Netherlands.
⁷² Department of Critical Care, University of Groningen, University Medical Center Groningen Groningen the Netherlands Groningen, the Netherlands.

PMID: 37078722
DOI: 10.1097/CCM.0000000000005883

Multicenter Study

Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study

Mik Wetterslev et al. Crit Care Med. 2023.

. 2023 Sep 1;51(9):1124-1137.

doi: 10.1097/CCM.0000000000005883. Epub 2023 Apr 20.

Authors

Collaborators

AFIB-ICU Collaborators:
Haifaa Ibrahim Al Humedi⁴², Nuria Zellweger⁴³, Chiara Nuciforo⁴⁴, Yanjun Deng⁴⁵, Hua Luo⁴⁶, Miao Yan⁴⁷, Janus Engstrøm⁴⁸, Mette Krag⁴⁹, Frederik H Bestle⁵⁰, Lone M Poulsen⁵¹, Thomas Hildebrandt⁵², Anne Sofie Andreasen⁵³, Klaus Tjelle Kristiansen⁵⁴, Thomas Mohr⁵⁵, Hasse Møller-Sørensen⁵⁶, Kirsten Møller⁵⁷, Manoj Gorade⁵⁸, Bhavesh Gandhi⁵⁹, Tanya Jha⁵⁹, Owais Tisekar⁶⁰, Aparjeet Kar⁶⁰, Balkrishan Nimavat⁶⁰, Elina Lappi⁶¹, Jonna Heinonen⁶¹, Leena Pettilä⁶¹, Maria Iso-Ketola⁶¹, Minttu Saario⁶¹, Tarja Suhonen⁶², Eija Vaskelainen⁶³, Elina Halonen⁶³, Sari Rahikainen⁶³, Sonja Julkunen⁶³, Sinikka Salkio⁶⁴, Sanna Mäkinen⁶⁵, Sanna Ristimäki⁶⁵, Juho Hartikainen⁶⁶, Nina Inkinen⁶⁶, Sinikka Tolmunen⁶⁶, Jonatan Oras⁶⁷, Kirsha Delaney⁶⁸, Leanlove Navarra⁶⁸, Raulle Cruz⁶⁸, Shaanti Olatunji⁶⁸, Marta Bombinska⁶⁹, Jon Laake⁷⁰, Frederik Keus⁷¹, Ruben Eck⁷²

Affiliations

¹ Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
² Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
³ Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
⁴ Department of Anaesthesiology Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
⁵ Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Department of Intensive Care Medicine, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
⁷ Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China.
⁸ Department of Clinical Science and Education, Section of Anaesthesia and Intensive Care, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
⁹ Department of Intensive Care Medicine, Liverpool Hospital, Liverpool, NSW, Australia.
¹⁰ South Western Clinical School, University of New South Wales, Warwick Farm, NSW, Australia.
¹¹ Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
¹² Medical Research Institute of New Zealand, Wellington, New Zealand.
¹³ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
¹⁴ Intensive Care Medicine, Department of Acute Medicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
¹⁵ Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
¹⁶ Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
¹⁷ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - North Zealand, Copenhagen, Denmark.
¹⁸ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹⁹ Department of Anaesthesia and Intensive Care, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
²⁰ Department of Medicine and Critical Care, Breach Candy Hospital Trust, Mumbai, India.
²¹ Department of Pulmonary Medicine, SCB Medical College & Hospital, Cuttack, India.
²² Department of Anaesthesia and Critical Care, MOSC Medical College, Kolenchery, India.
²³ Department of Critical Care Medicine, Apollo Hospitals, Hyderabad, India.
²⁴ Department of Critical Care Medicine, Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, India.
²⁵ Department of Cardiac Anaesthesiology and Critical Care, Tagore Hospital, Jalandhar, India.
²⁶ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
²⁷ Department of Anaesthesia and Intensive Care, Oulu University Hospital, Oulu, Finland.
²⁸ Department of Intensive Care, Tampere University Hospital, Tampere, Finland.
²⁹ Department of Anesthesia and Intensive Care, Central Finland Central Hospital, Central Finland Health Care District, Jyväskylä, Finland.
³⁰ Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
³¹ Department of Intensive Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China.
³² Department of Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China.
³³ Department of Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
³⁴ Department of Critical Care Medicine, The Second Hospital, Hebei Medical University, Hebei, China.
³⁵ Department of Intensive Care Medicine, Tianjin First Center Hospital, Tianjin, China.
³⁶ Department of Critical Care Medicine, Peking University First Hospital, Beijing, China.
³⁷ Emergency Intensive Care Unit, Xinjiang Production and Construction Crops 13 div Red Star Hospital.
³⁸ Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
³⁹ Department of Anaesthesia and Intensive Care, Hudiksvall Hospital, Hudiksvall, Sweden.
⁴⁰ Second Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
⁴¹ Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Opole, Poland.
⁴² Department of Intensive Care Medicine, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
⁴³ Department of Intensive Care Medicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
⁴⁴ Department of Intensive Care Medicine and Department of Clinical Research, University Hospital Basel and University of Basel Basel, Switzerland.
⁴⁵ Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University Beijing, China.
⁴⁶ Department of Critical Care Medicine, Peking University Shenzhen Hospital Shenzhen, China.
⁴⁷ Department of Critical Care Medicine, Peking University First Hospital Beijing, China.
⁴⁸ Copenhagen Trial Unit Denmark.
⁴⁹ Department of Anaesthesiology and Intensive Care, Holbaek Hospital Holbaek, Denmark.
⁵⁰ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand Hilleroed.
⁵¹ Department of Anaesthesia and Intensive Care, Zealand University Hospital Køge.
⁵² Department of Anaesthesiology and Intensive Care Medicine, Zealand University Hospital Roskilde.
⁵³ Department of Intensive Care, Herlev Hospital Herlev, Denmark.
⁵⁴ Department of Intensive Care, Hvidovre Hospital Hvidovre, Denmark.
⁵⁵ Department of Intensive Care, Gentofte Hospital Gentofte, Denmark.
⁵⁶ Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.
⁵⁷ Department of Neuroanaesthesiology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.
⁵⁸ Department of Anaesthesiology Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute Mumbai, India.
⁵⁹ Department of Medicine and Critical Care, Breach Candy Hospital Trust Mumbai, India.
⁶⁰ Department of Critical Care Medicine. Sir H N Reliance foundation Hospital and research Centre Mumbai, India.
⁶¹ Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital Helsinki, Finland.
⁶² Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital Helsinki, Finland Kuopio, Finland.
⁶³ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital Kuopio, Finland.
⁶⁴ Department of Anaesthesia and Intensive Care, Oulu University Hospital Oulu, Finland.
⁶⁵ Department of Intensive Care, Tampere University Hospital Tampere, Finland.
⁶⁶ Department of Anesthesia and Intensive Care, Central Finland Central Hospital, Central Finland Health Care District Jyväskylä, Finland.
⁶⁷ Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital Gothenburg, Sweden.
⁶⁸ Intensive Care Unit, Wellington Hospital Wellington, New Zealand.
⁶⁹ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College Kraków, Poland.
⁷⁰ Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet, Oslo University Hospital Oslo, Norway.
⁷¹ Department of Critical Care, University of Groningen, University Medical Center Groningen Groningen, the Netherlands.
⁷² Department of Critical Care, University of Groningen, University Medical Center Groningen Groningen the Netherlands Groningen, the Netherlands.

PMID: 37078722
DOI: 10.1097/CCM.0000000000005883

Abstract

Objectives: To assess the incidence, risk factors, and outcomes of atrial fibrillation (AF) in the ICU and to describe current practice in the management of AF.

Design: Multicenter, prospective, inception cohort study.

Setting: Forty-four ICUs in 12 countries in four geographical regions.

Subjects: Adult, acutely admitted ICU patients without a history of persistent/permanent AF or recent cardiac surgery were enrolled; inception periods were from October 2020 to June 2021.

Interventions: None.

Measurements and main results: We included 1,423 ICU patients and analyzed 1,415 (99.4%), among whom 221 patients had 539 episodes of AF. Most (59%) episodes were diagnosed with continuous electrocardiogram monitoring. The incidence of AF was 15.6% (95% CI, 13.8-17.6), of which newly developed AF was 13.3% (11.5-15.1). A history of arterial hypertension, paroxysmal AF, sepsis, or high disease severity at ICU admission was associated with AF. Used interventions to manage AF were fluid bolus 19% (95% CI 16-23), magnesium 16% (13-20), potassium 15% (12-19), amiodarone 51% (47-55), beta-1 selective blockers 34% (30-38), calcium channel blockers 4% (2-6), digoxin 16% (12-19), and direct current cardioversion in 4% (2-6). Patients with AF had more ischemic, thromboembolic (13.6% vs 7.9%), and severe bleeding events (5.9% vs 2.1%), and higher mortality (41.2% vs 25.2%) than those without AF. The adjusted cause-specific hazard ratio for 90-day mortality by AF was 1.38 (95% CI, 0.95-1.99).

Conclusions: In ICU patients, AF occurred in one of six and was associated with different conditions. AF was associated with worse outcomes while not statistically significantly associated with 90-day mortality in the adjusted analyses. We observed variations in the diagnostic and management strategies for AF.

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Conflict of interest statement

The Department of Intensive Care, Rigshospitalet, has received funds for other research projects from the Novo Nordisk Foundation, Sygeforsikringen “danmark,” Pfizer, and Fresenius Kabi, and does contract research for AM-Pharma. The Department of Intensive Care, Copenhagen University Hospital—North Zealand, has received funds for other research projects from the Novo Nordisk Foundation, Sygeforsikringen “danmark,” and other foundations and does contract research for AM-Pharma and Inotrem. Dr. Bestle has received consultancy fee from AM-Pharma. Dr. Wetterslev received funding from The Research Council of Rigshospitalet, The Ehrenreich’s Foundation, and The Danish Society of Anesthesiology and Intensive Care Medicine; he received support for article research from The Research Council of Rigshospitalet, Copenhagen, Denmark. Drs. Granholm’s and Bestle’s institutions received funding from Sygeforsikringen. Dr. Granholm’s institution received funding from The Ehrenreich’s Foundation, the Novo Nordisk Foundation, Pfizer, Fresenius Kabi, and AM-Pharma. Drs. Shen, Gao, and Yang disclosed work for hire. Dr. Bestle received funding from AM-Pharma. Dr. Haranath received funding from Medvarsity. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Comment in

"Irregularly Irregular" - The Patterns, Challenges, and Outcomes of Atrial Fibrillation in the ICU.
Jones-O'Connor M, Zakaria S. Jones-O'Connor M, et al. Crit Care Med. 2023 Sep 1;51(9):1255-1257. doi: 10.1097/CCM.0000000000005917. Epub 2023 Aug 17. Crit Care Med. 2023. PMID: 37589515 No abstract available.

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References

1. Chugh SS, Roth GA, Gillum RF, et al.: Global burden of atrial fibrillation in developed and developing nations. Glob Heart. 2014; 9:113–119
1. Hindricks G, Potpara T, Dagres N, et al.; ESC Scientific Document Group: 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42:373–498
1. Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke. 1991; 22:983–988
1. Odutayo A, Wong CX, Hsiao AJ, et al.: Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: Systematic review and meta-analysis. BMJ. 2016; 354:i4482
1. Clark DM, Plumb VJ, Epstein AE, et al.: Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol. 1997; 30:1039–1045

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[1] Chugh SS, Roth GA, Gillum RF, et al.: Global burden of atrial fibrillation in developed and developing nations. Glob Heart. 2014; 9:113–119

[2] Chugh SS, Roth GA, Gillum RF, et al.: Global burden of atrial fibrillation in developed and developing nations. Glob Heart. 2014; 9:113–119

[3] Hindricks G, Potpara T, Dagres N, et al.; ESC Scientific Document Group: 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42:373–498

[4] Hindricks G, Potpara T, Dagres N, et al.; ESC Scientific Document Group: 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42:373–498

[5] Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke. 1991; 22:983–988

[6] Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke. 1991; 22:983–988

[7] Odutayo A, Wong CX, Hsiao AJ, et al.: Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: Systematic review and meta-analysis. BMJ. 2016; 354:i4482

[8] Odutayo A, Wong CX, Hsiao AJ, et al.: Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: Systematic review and meta-analysis. BMJ. 2016; 354:i4482

[9] Clark DM, Plumb VJ, Epstein AE, et al.: Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol. 1997; 30:1039–1045

[10] Clark DM, Plumb VJ, Epstein AE, et al.: Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol. 1997; 30:1039–1045

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Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study

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Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study

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