Comparative effectiveness of common treatments for new-onset atrial fibrillation within the ICU: Accounting for physiological status.
Bedford JP., Johnson A., Redfern O., Gerry S., Doidge J., Harrison D., Rajappan K., Rowan K., Young JD., Mouncey P., Watkinson PJ.
BACKGROUND: New-onset atrial fibrillation (NOAF) is common in patients on an intensive care unit (ICU). Evidence guiding treatments is limited, though recent reports suggest beta blocker (BB) therapy is associated with reduced mortality. METHODS: We conducted a multicentre cohort study of adult patients admitted to 3 ICUs in the UK and 5 ICUs in the USA. We analysed the haemodynamic changes associated with NOAF. We analysed rate control, rhythm control, and hospital mortality associated with common NOAF treatments. We balanced admission and post-NOAF, pre-treatment covariates across treatment groups. RESULTS: NOAF was followed by a systolic blood pressure reduction of 5 mmHg (p