Exploration of the association between inflammatory cytokines and development of new-onset atrial fibrillation in critically ill patients: a retrospective cohort study

Abstract Background New-onset atrial fibrillation (new AF) in critically ill patients is associated with increased morbidity and mortality. There has been evidence linking atrial fibrillation with inflammation in both the setting of chronic atrial fibrillation and critical illness. In this study we compare serum inflammatory marker levels in patients admitted to the intensive care unit (ICU) with no atrial fibrillation (AF), chronic AF, and new AF. Methods A retrospective chart review was performed on 129 mechanically ventilated, critically ill patients from the PREVAIL trial. History of cardiovascular disease, previous AF, and development of new AF were documented. Inflammatory cytokines TNFα, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, granulocyte-colony stimulating factor, granulocyte-macrophage colony-stimulating factor, interferon-γ, monocyte chemoattractant protein-1, and macrophage inflammatory protein-1b had been collected as part of the PREVAIL trial and were compared between three patient groups, those with no AF, chronic AF, and new AF. Results Higher APACHE II scores were found in patients with chronic AF (28.0±8.7) and new AF (27.1±6.2) compared to patients with no AF (23.0±7.2). No significant differences were found between groups in any inflammatory markers at baseline or on admission days 4 or 7. Conclusion We found no clear association between the studied inflammatory markers and the development of new AF, although this may be related to the timing of sampling. Further study is required to better elucidate the relationship between inflammatory cytokines and the development of new AF in critically ill patients.