Circadian variation in new-onset atrial fibrillation in patients in ICUs

Jonathan P Bedford; Oliver Redfern; Alistair Johnson; Kim Rajappan; Peter J Watkinson

doi:10.1016/j.jcrc.2021.09.008

Circadian variation in new-onset atrial fibrillation in patients in ICUs

J Crit Care. 2022 Feb:67:1-2. doi: 10.1016/j.jcrc.2021.09.008. Epub 2021 Sep 22.

Authors

Jonathan P Bedford¹, Oliver Redfern², Alistair Johnson³, Kim Rajappan⁴, Peter J Watkinson⁵

Affiliations

¹ Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address: [email protected].
² Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. Electronic address: [email protected].
³ Glowyr ltd., Hawkstone House, Valley Road, Hebden Bridge, West Yorkshire, UK. Electronic address: [email protected].
⁴ Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address: [email protected].
⁵ Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; National Institute for Health Research Biomedical Research Centre, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address: [email protected].

PMID: 34560357
DOI: 10.1016/j.jcrc.2021.09.008

Abstract

New-onset atrial fibrillation (NOAF) is common in patients treated on an intensive care unit (ICU). Onset of certain arrhythmias exhibit circadian variation. Whether NOAF follows a circadian rhythm in patients in ICU is unknown. We undertook a retrospective observational study of two ICU databases to explore the timing of NOAF onset. We identified 2017 patients who developed NOAF during their ICU stay. NOAF onset exhibited a bimodal distribution with peaks at 8 am and 8 pm, consistent with the onset of paroxysmal AF in patients in the community. Future studies in ICUs should record time of AF onset, as understanding high risk periods may inform timing of preventative interventions.

Keywords: Arrhythmia; Atrial fibrillation; Circadian rhythm; Critical illness; Intensive care.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Atrial Fibrillation* / epidemiology
Atrial Fibrillation* / therapy
Humans
Intensive Care Units
Retrospective Studies
Risk Factors

Grants and funding

NIHR300224/DH_/Department of Health/United Kingdom