New Onset Atrial Fibrillation in Hospitalized Patients

Authors

Arafat Ali Farooqui, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.Follow
Syed Mohammad Mazhar Uddin, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Sanjay Kumar Maheshwari, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Kevin Clements, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Rabiah Ashraf, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Jay Keith, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Neha Sharma, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Haris Bilal, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219.
Naira Saleem, Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA 11219
Vijay S. Shetty, Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA 11219

Abstract

Objectives: To evaluate different factors precipitating new onset atrial fibrillation (AF) in hospitalized patients and their effect on in-patient mortality.

Design: Retrospective cross-sectional study

Setting: Urban tertiary care center in New York City

Measurements:

Primary outcomes:

• Determine different factors precipitating new onset atrial fibrillation in hospitalized patients and their effect on in-patient mortality

Secondary outcomes:

• Determine the duration of hospital stay after admission precipitating new onset atrial fibrillation and its effect on mortality
• Evaluate different factors in COVID-19 patients with new onset atrial fibrillation

Results: Out of 464 patients; 62.3% were males and 37.72% were females. Evaluation of patients before developing new onset AF showed that 75.86% had hypertension, 41.38% had heart failure and 42.67% had ischemic heart disease (IHD). Younger patients were noted to be treated with more rhythm control as compared to rate control (52.38% vs 38.1%) for their management while opposite was observed with patients >50 years of age (70.88% vs 52.6%; rate control vs rhythm control respectively). In terms of mortality, female gender (, 95% CI: 1.03-6.94, ), presence of infection (, 95% CI: 2.23-18.08, ), use of vasopressors (, 95% CI: 2.58-19.42, ), and a history of CVA (, 95% CI: 1.99-24.58, ) all significantly increased the odds for mortality. Majority of the patients; 54.31%, developed new onset AF after the third day of admission but it did not increase the mortality (OR 0.93, 95% CI 0.37-2.45, p=0.884). Majority of the patients (67%) had enlarged left atrium (>35 ml/m²). However, it was not associated with higher mortality (OR 0.53, 95% CI 0.19-1.48, p=0.223). Patients that were tested positive for COVID-19 were more likely to have sepsis (75% vs 31.46%, ).

Conclusion: This study finds that four factors i.e., female gender, presence of infection, use of vasopressors, and a history of CVA all precipitate new onset atrial fibrillation with resultant increase in mortality during the same admission. Study concludes that longer hospital stay of more than three days increases the likelihood of developing new onset atrial fibrillation without increasing the mortality. Study found that patients who were positive for COVID-19 were more likely to have sepsis.

Keywords: Atrial fibrillation, In-Hospital Mortality, COVID-19, Hospitalized Adolescents.

Recommended Citation

Farooqui, Arafat Ali; Uddin, Syed Mohammad Mazhar; Maheshwari, Sanjay Kumar; Clements, Kevin; Ashraf, Rabiah; Keith, Jay; Sharma, Neha; Bilal, Haris; Saleem, Naira; and Shetty, Vijay S. (2025) "New Onset Atrial Fibrillation in Hospitalized Patients," Journal of Community Hospital Internal Medicine Perspectives: Vol. 15: Iss. 2, Article 5.
DOI: 10.55729/2000-9666.1467
Available at: https://scholarlycommons.gbmc.org/jchimp/vol15/iss2/5