Abstract
Objectives: Tachyarrhythmias are common in patients with sepsis, which is often associated with cardiac dysfunction, and severe sepsis is one risk factor of new-onset atrial fibrillation (Af). Therefore, management of new-onset Af in patients with sepsis is difficult. In this study, we retrospectively analyzed the incidence, treatment, and outcome of tachyarrhythmias in patients with sepsis. Methods: This study included patients with sepsis admitted to our ICU over a period of five years. We excluded patients who had an ICU stay within 24 hours, a history of Af, trauma, patients undergoing blood purification therapy and those with other confounding factors. We classified those with a heart rate over 130 /min as having tachyarrhythmia. Results: A total of 147 patients were included in this study. Tachyarrhythmias were detected in 63 patients (43%). The patients with tachyarrhythmias were significantly older, had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, greater use of noradrenaline, milrinone, and showed higher in-hospital mortality than those without tachyarrhythmias. Our management of Af is based on administration of digoxin and landiolol. Sinus rhythm was successfully restored in 90% of the patients. Patients in whom sinus rhythm was not achieved had higher ICU mortality than those in whom it was achieved. Conclusions: Tachyarrhythmias occurred in 43% of patients with sepsis, and patients with tachyarrhythmias had higher in-hospital mortality. Ninety percent of Af were returned to sinus rhythm by administration of digoxin and landiolol.
