In a big-data analysis of 74 patient-years of continuous electrocardiography (ECG) from over 8,000 admissions to the adult medical and surgical ICUs, Cardiovascular Medicine fellow Travis Moss and colleagues found that nearly half of all detected AF was new-onset and that 4 of 5 cases remained unrecognized or subclinical. Compared to admissions without any AF, those with new subclinical AF had median ICU lengths of stay that were nearly twice as long, and those with new clinical AF had nearly double the risk of hospital mortality. Surprisingly, there was no association of new AF with survival after hospital discharge.
Dr. Moss’s research received honorable mention in the American College of Cardiology‘s Young Investigators Awards competition, in the category of “Cardiovascular Health Outcomes and Population Genetics,” and their findings were published in the April 5 edition of the Journal of the American College of Cardiology (“The impact of incident atrial fibrillation in the intensive care unit“*).
Dr. Moss noted that “There is debate about whether silent or subclinical atrial fibrillation is simply a marker of illness severity or whether it independently contributes to morbidity and mortality.”
He added, “We think this study suggests that new atrial fibrillation in the critically ill exists as a spectrum, such that once the burden is sufficient to attain clinical recognition, the arrhythmia has even stronger association with poor hospital outcomes. It also reinforces the notion that new atrial fibrillation detected in the ICU should be evaluated differently from when it is discovered outside the ICU, since we found no evidence for poorer survival after hospital discharge.”
Dr. Moss’s faculty mentor is Randall Moorman, MD (Cardiovascular Medicine). Other Department of Medicine collaborators were Kyle Enfield and Diana Gomez-Manjarres (Pulmonary and Critical Care Medicine) and John DiMarco and Douglas Lake (Cardiovascular Medicine). James F. Calland (Department of Surgery) and Caroline Ruminski (UVA medical student) were additional co-authors.
The ACC announced the winners of the Young Investigator Awards competition on April 4 at its 65th Annual Scientific Session in Chicago. The competition in intended to recognize and encourage young scientific investigators of promise, upon whom “progress in the field of cardiology is dependent.”
For more information on these awards, visit www.acc.org/researchawards.