This is the podcast surgery IC rounds. My name is Jeff Guy. I'm an associate professor of surgery at Vanderbilt University Medical Center. Today is February the 19th, 2008. The topic that I want to discuss today is atrial fibrillation.

Atrial fibrillation, as far as problems in intensive care unit, can almost be classified as a nuisance.

It is common. It has multiple potential etiologies, all of which could be serious,

and it is complicated by multiple potential therapies, all of which have varying success.

Atrial fibrillation is a common arrhythmia in intensive care unit second only to ventricular tachycardia.

A study by Ryan Elton Intensive Care Medicine in 2001 demonstrated that atrial fibrillation may occur up to 31% of patients in the medical, cardiac, or surgical intensive care unit.

Rathoran colleagues in circulation in the year 2000

demonstrated that atrial fibrillation is associated

the significant longer staying in intensive care unit in hospital mortality was associated

of acute myocardial infarction is higher in patients who have had atrial fibrillation 25%

versus 16% for those who don't have atrial fibrillation as I earlier, atrial fibrillation is associated with a variety of cardiac and extracardiac condition,

some of which are chronic and some of which are acute.

Some of these conditions which can lead to atrial fibrillation include surgery,

especially cardiac or thoracic surgery,

a pulmonary embolism or other pulmonary conditions, myocarditis,

electrocution, alcohol consumption, thyroid disorders, or other metabolic conditions. We can also

see atrial fibrillation associated to the history of hypertension or those patients who have

coronary artery disease. Goldberg, as a colleague, in American Heart

Journal in 2002, reported that 11% of patients presenting with acute MI develop atrial fibrillation

during their hospitalization. Also, a vavular heart disease, especially mitral stenosis or mitral

regurge, resulting in some left atrial dilatation are commonly associated with the development

of atrial arrhythmias. Among some non-cardiac conditions, which can lead to atrial fibrillation,

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