B-P004-196 New Onset Atrial Fibrillation in Patient with Non Cardiac Critical Care Illness-A Systematic Review and Meta-Analysis

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Conference Proceeding - Restricted Access

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Publication Title

Heart Rhythm


Background: The incidence of new-onset secondary atrial fibrillation (NOSAF) is as high as 44% in non-cardiac critical illness. Little is known about the long-term outcomes in this patient population. Objective: We performed a systematic review and meta-analysis to evaluate the impact of NOSAF, compared with history of prior AF and no history of AF in this population. Methods: Statistical analysis was performed using meta-package for R version 4.0 and Rstudio version 1.2. Mantel-Haenszel risk ratio (RR) and standardized mean difference(SMD) with random-effects model was used to summarize data. In-hospital and long term mortality, ICU/hospital length of stay, and stroke outcomes were analyzed. Results: 19 studies met inclusion criteria (n=306,805). NOSAF compared to no history of AF was associated with increased in-hospital mortality (RR 2.06 95% CI 1.76 - 2.41, p < 0.001), longer intensive care unit (ICU) length of stay (LOS) (SMD 0.66 95% CI 0.41 - 0.91, p < 0.001), longer hospital LOS (SMD 0.31 95% CI 0.07 - 0.56, p = 0.001) and increased risk of long term (>1 year) mortality (RR 1.76 95% CI 1.29 - 2.40, p < 0.001). NOSAF compared to history of prior AF was also associated with higher in-hospital mortality (RR 1.29 95% CI 1.12 - 1.49, p < 0.001), longer ICU LOS (SMD 0.37 95% CI 0.03 - 0.70, p = 0.03) but no difference in hospital LOS (SMD -0.18 95% CI -0.66 - 0.31, p = 0.47). Conclusion: NOSAF in the setting of non-cardiac critical illness is associated with increased in-hospital mortality when compared to no history of AF and history of prior AF. NOSAF (vs. no history of AF) is also associated with increased long-term mortality. Early recognition and management of NOSAF may improve patient outcomes.




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Heart Rhythm 2021 Conference, July 28-31, 2021, Boston MA

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