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

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.