ATS Breathe Easy

At The Bedside: Episode 2 – Atrial Fibrillation in the ICU

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May 9, 2023
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ANECDOTE

Inconsistent AFib Management Sparks Interest

  • Dr. Alan Wauke became interested in atrial fibrillation in sepsis during fellowship when he saw many ICU patients develop it.
  • He found inconsistent advice from attendings and cardiologists, prompting him to research this underexplored area.
ADVICE

Assess Stability and Confirm Arrhythmia

  • Assess how stable the patient is and if other vital signs or mental status have acutely changed.
  • Confirm arrhythmia type with EKG as sudden heart rate increases usually indicate an arrhythmia rather than sinus tachycardia.
INSIGHT

Sepsis Triggers Atrial Fibrillation Mechanisms

  • Sepsis increases the risk of new onset atrial fibrillation by about sevenfold due to factors like inflammation, electrolyte imbalances, and sympathetic stimulation.
  • Patients often have predisposing atrial remodeling, but sepsis triggers the arrhythmia.
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