"New Onset of Atrial Fibrillation" As An Outcome Predictor in Critically Ill Patients with Sepsis: A Systemic Review

Abstract

Sepsis is common and often fatal, representing a major public health problem. Estimates of the incidence of sepsis vary widely due to differences in case ascertainment, ranging from 66 to 300 per 100000 population in the developed world. However, there is consensus that the incidence is increasing, driven by an ageing population with multiple co-morbidities, increased use of immunosuppressive therapy and high-risk interventions. Evidence of various cardiac arrhythmias in septic patients has been demonstrated by multiple clinical reports and observations .Most cardiac arrhythmias in sepsis are new-onset and may be related to sepsis-induced myocardial dysfunction, autonomic dysfunction and, most likely also, by impairment and involvement of the cardiac conduction system. AF is the most common type of cardiac arrhythmia with the ever-ageing population, the prevalence of AF is also increasing. In AF, the upper chambers of the heart do not function correctly as a result of abnormal electrical signaling. Epidemiologically, most septic patients who developed new atrial fibrillation were in septic shock. Pneumonia was shown to be the most likely source of infection in septic patients with new atrial fibrillation.

NOAF events in septic patients indicate a diversity of clinical strategies. It should be considered as a sign of the early SIRS. It follows that patient care may be enhanced by continuous cardiovascular monitoring and simple daily 12-lead ECG in addition to clinical exams and laboratory findings.