Tài liệu Báo cáo y học: "Clinical review: Treatment of new-onset atrial fibrillation in medical intensive car

Atrial fibrillation (AF) is frequently observed in the medical intensive care unit (MICU) [1], with up to about 15% of MICU patients showing periods of AF [2-4]. AF directly leads to loss of the atrial kick and, as a consequence, reduces ventricular loading. Especially if the ventricular compliance is decreased, as is the case in sepsis and many other medical conditions, this reduction results in decreased cardiac performance. By performance, we mean the capacity to meet pressure and volume requirements. The irregular and mostly rapid ventricular response also shortens the ventricular filling time, and thereby shortens the preload. AF therefore reduces cardiac performance. The reduction is more serious in patients with pre-existing cardiac dysfunction due to decreased ventricular compliance. A persistent high ventricular rate may lead to tachycardia mediated cardiomyopathy [5]. Conversion to sinus