Management of Atrial Fibrillation in Critically Ill Patients
Joint Authors
Rudiger, Alain
Arrigo, Mattia
Bettex, Dominique
Source
Critical Care Research and Practice
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-01-16
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Atrial fibrillation (AF) is common in ICU patients and is associated with a two- to fivefold increase in mortality.
This paper provides a reappraisal of the management of AF with a special focus on critically ill patients with haemodynamic instability.
AF can cause hypotension and heart failure with subsequent organ dysfunction.
The underlying mechanisms are the loss of atrial contraction and the high ventricular rate.
In unstable patients, sinus rhythm must be rapidly restored by synchronised electrical cardioversion (ECV).
If pharmacological treatment is indicated, clinicians can choose between the rate control and the rhythm control strategy.
The optimal substance should be selected depending on its potential adverse effects.
A beta-1 antagonist with a very short half-life (e.g., esmolol) is an advantage for ICU patients because the effect of beta-blockade on cardiovascular stability is unpredictable in those patients.
Amiodarone is commonly used in the ICU setting but has potentially severe cardiac and noncardiac side effects.
Digoxin controls the ventricular response at rest, but its benefit decreases in the presence of adrenergic stress.
Vernakalant converts new-onset AF to sinus rhythm in approximately 50% of patients, but data on its efficacy and safety in critically ill patients are lacking.
American Psychological Association (APA)
Arrigo, Mattia& Bettex, Dominique& Rudiger, Alain. 2014. Management of Atrial Fibrillation in Critically Ill Patients. Critical Care Research and Practice،Vol. 2014, no. 2014, pp.1-10.
https://search.emarefa.net/detail/BIM-502416
Modern Language Association (MLA)
Arrigo, Mattia…[et al.]. Management of Atrial Fibrillation in Critically Ill Patients. Critical Care Research and Practice No. 2014 (2014), pp.1-10.
https://search.emarefa.net/detail/BIM-502416
American Medical Association (AMA)
Arrigo, Mattia& Bettex, Dominique& Rudiger, Alain. Management of Atrial Fibrillation in Critically Ill Patients. Critical Care Research and Practice. 2014. Vol. 2014, no. 2014, pp.1-10.
https://search.emarefa.net/detail/BIM-502416
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-502416