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CLINICAL STATEMENTS AND GUIDELINES

Circulation. 2024;149:e1–e156. DOI: 10.1161/CIR.0000000000001193 January 2, 2024 e105

Joglar et al 2023 Guideline for the Diagnosis and Management of Atrial Fibrillation

a prescription for OACs within 30 days of admission. Over 3-year follow-up, no significant association was noted between anticoagulation and a lower incidence of ischemic stroke (OR, 1.98 [95% CI, 0.29-13.47]) or bleeding (OR, 0.96 [95% CI, 0.29-3.21]).11 Gaps in knowledge exist, and further research is needed to better understand the benefits and risks of acute and longterm anticoagulation in critically ill patients with acute AF.

Figure 27. Unadjusted Cumulative Risk of AF Recurrence. Unadjusted curves displaying cumulative risk of recurrent AF, generated using Kaplan-Meier method. (A) Overall risk of recurrent AF among individuals with and without acute precipitants. (B) Overall risk of recurrent AF among individuals with infection, cardiac surgery, and noncardiothoracic surgery compared with no precipitant. These 3 precipitants were selected for display because the risk of recurrent AF was significantly lower compared with the referent group without precipitants in multivariable adjusted models. Individuals with other AF precipitants were excluded from this plot for clarity.  Reproduced with permission from Wang et al.3 Copyright 2020 American Heart Association, Inc. AF indicates atrial fibrillation; and CT, cardiothoracic.

Figure 28. Acute Medical or Surgical Illness. Adapted with permission from Chyou et al. 17 Copyright 2023 American Heart Association, Inc. AF indicates atrial fibrillation.

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