Johnston Brian W, Udy Andrew A, McAuley Daniel F, Mogk Martin, Welters Ingeborg D, Sibley Stephanie
Institute of Life Course and Medical Sciences, Faculty of Health, and Life Sciences, University of Liverpool, Liverpool, United Kingdom.
Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
Crit Care Explor. 2024 Mar 26;6(4):e1069. doi: 10.1097/CCE.0000000000001069. eCollection 2024 Apr.
To evaluate the current management of new-onset atrial fibrillation and compare differences in practice regionally.
Cross-sectional survey.
United States, Canada, United Kingdom, Europe, Australia, and New Zealand.
Critical care attending physicians/consultants and fellows.
None.
A total of 386 surveys were included in our analysis. Rate control was the preferred treatment approach for hemodynamically stable patients (69.1%), and amiodarone was the most used antiarrhythmic medication (70.9%). For hemodynamically unstable patients, a strategy of electrolyte supplementation and antiarrhythmic therapy was most common (54.7%). Physicians responding to the survey distributed by the Society of Critical Care Medicine were more likely to prescribe beta-blockers as a first-line antiarrhythmic medication (38.4%), use more transthoracic echocardiography than respondents from other regions (82.4%), and more likely to refer patients who survive their ICU stay for cardiology follow-up if they had new-onset atrial fibrillation (57.2%). The majority of survey respondents (83.0%) were interested in participating in future studies of atrial fibrillation in critically ill patients.
Significant variation exists in the management of new-onset atrial fibrillation in critically ill patients, as well as geographic variation. Further research is necessary to inform guidelines in this population and establish if differences in practice impact long-term outcomes.
评估新发房颤的当前管理情况，并比较地区实践差异。
横断面调查。
美国、加拿大、英国、欧洲、澳大利亚和新西兰。
重症监护主治医师/顾问及住院医师。
无。
我们的分析共纳入386份调查问卷。对于血流动力学稳定的患者，心率控制是首选治疗方法（69.1%），胺碘酮是最常用的抗心律失常药物（70.9%）。对于血流动力学不稳定的患者，补充电解质和抗心律失常治疗策略最为常见（54.7%）。回复由危重病医学会分发调查问卷的医生更有可能将β受体阻滞剂作为一线抗心律失常药物开具（38.4%），比其他地区的受访者更多地使用经胸超声心动图（82.4%），并且如果新发房颤患者在重症监护病房住院期间存活，更有可能将其转诊至心脏病科进行随访（57.2%）。大多数受访者（83.0%）有兴趣参与未来关于危重病患者房颤的研究。
危重病患者新发房颤的管理存在显著差异，以及地区差异。有必要进行进一步研究，为该人群的指南提供依据，并确定实践差异是否会影响长期预后。
