Article Data

  • Views 1670
  • Dowloads 172

Original Research

Open Access

Clinical characteristics and mortality of patients in the intensive care unit with and without new-onset arrhythmias


1First Affiliated Hospital of Dalian Medical University, Department of Intensive Care Medicine, Liaoning, China

2 Third People’s Hospital of Dalian, Department of Intensive Care Medicine, Liaoning, China

3 First Affiliated Hospital of Dalian Medical University, Department of Cardiology, Liaoning, China

DOI: 10.22514/SV132.112017.2 Vol.13,Issue 2,November 2017 pp.20-24

Published: 06 November 2017

*Corresponding Author(s): YANG YAN-ZONG E-mail:


Objective. The aims of this study were to analyze the risk factors for and types of new-onset arrhythmias in ICU (Intensive care unit), and to evaluate their impact on patient outcomes.

Methods. We studied 1051 patients who were admitted to the two general ICUs between December 2013 and February 2016. These patients were divided into two groups: patients with new-onset arrhyth-mias and patients without new-onset ar-rhythmias. We compared the risk factors, types and prognoses of new-onset arrhyth-mias between these two groups.

Results. New-onset arrhythmias were ob-served in 20.84% (n=219) of 1051 patients. The main risk factors leading to arrhythmi-as included age, emergency operation, past cardiovascular disease, patients with multi-ple systemic diseases, acute respiratory dis-tress syndrome, severe sepsis/septic shock, acute renal dysfunction, cardiovascular disease, electrolyte disturbance, patients on ventilators, patients on vasopressors and higher Acute Physiology and Chronic Health Evaluation II scores (APACHE II score) on ICU admission. Multivari-ate logistic regression revealed that age, emergency operation, severe sepsis/septic shock, cardiovascular disease, electrolyte disturbance, patients on ventilators and those with higher APACHE II scores on ICU admission, were all significantly asso-ciated with new-onset arrhythmias. Arial fibrillation was the most frequent arrhyth-mia. ICU mortality in patients with new-onset arrhythmias was 22.37% (49 out of 219) compared with 3.61% (30 out of 832) in patients without new-onset arrhythmias (p<0.001). Among surviving patients, ICU stay for those with new-onset arrhythmias was longer than those without new-onset arrhythmias (median stay of 10 days versus 5 days, p<0.001).

Conclusion. We found a high prevalence of new-onset arrhythmias in ICU patients. Arrhythmia, especially atrial fibrillation, was a common complication in ICU pa-tients and was associated with increasing length of ICU stay and higher mortality. 


arrhythmia, intensive care unit, critical illness, mortality

Cite and Share

ZHANG YONG-LI,HAI FENG,YANG YAN-ZONG. Clinical characteristics and mortality of patients in the intensive care unit with and without new-onset arrhythmias. Signa Vitae. 2017. 13(2);20-24.


1. Heinz G. Arrhythmias in the ICU-What do we know? Am J Respir Crit Care Med 2008;178(1):1-2.

2. Magder SA. The ups and downs of heart rate. Crit Care Med 2012;40(1): 239-45.

3. Melduni RM, Koshino Y, Shen WK. Management of arrhythmias in the perioperative setting. Clin Geriatr Med 2012;28(4):729-43.

4. Shaver CM, Chen W, Janz DR, May AK, Darbar D, Bernard GR, et al. Atrial Fibrillation Is an Independent Predictor of Mortality in Critically Ill Patients. Crit Care Med 2015;43(10):2104-11.

5. Crawford TC, Oral H. Cardiac arrhythmias: management of atrial fibrillation in the critically ill patient. Crit Care Clin 2007;23(4):855-72.

6. Guenancia C, Binquet C, Laurent G, Vinault S, Bruyère R, Prin S, et al. Incidence and predictors of new-onset atrial fibrillation in septic shock patients in a medical ICU: data from 7-day Holter ECG monitoring. PLoS One. 2015;10(5):e0127168. doi: 10.1371/journal.pone.0127168.

7. Kanji S, Williamson DR, Yaghchi BM, Albert M, McIntyre L. Epidemiology and management of atrial fibrillation in medical and noncardiac surgical adult intensive care unit patients. J Crit Care 2012;27(3): 326.e1-8.

8. Goss CH, Carson SS. Is severe sepsis associated with new-onset atrial fibrillation and stroke? JAMA 2011;306(20):2264-6.

9. Reinelt P, Karth GD, Geppert A, Heinz G. Incidence and type of cardiac arrhythmias in critically ill patients: A singal center experi-ence in medical-cardiological ICU. Intensive Care Med 2001; 27(9):1466-73.

10. Valderrábano RJ, Blanco A, Santiago-Rodriguez EJ, Miranda C, Rivera-Del Rio Del Rio J, Ruiz J, et al. Risk factors and clinical out-comes of arrhythmias in the medical intensive care unit. J Intensive Care 2016;4:9. doi: 10.1186/s40560-016-0131-x.

11. Walkey AJ, Hogarth DK, Lip GY. Optimizing atrial fibrillation management: from ICU and beyond. Chest 2015;148(4):859-64.

12. Iscimen R, Brown DR, Cassivi SD, Keegan MT. Intensive care unit utilization and outcome after esophagectomy. J Cardioth Vascul Anesth 2010;24(3):440-6.

13. Fuchs L, Chronaki CE, Park S, Novack V, Baumfeld Y, Scott D, et al. ICU admission characteristics and mortality rates among elderly and very elderly patients. Intensive Care Med 2012;38(10):1654-61.

14. Somme D, Maillet JM, Gisselbrecht M, Novara A, Ract C, Fagon JY. Critically ill old and the oldest-old patients in intensive care: short and long term outcomes. Intensive Care Med 2003;29(12): 2137-43.

15. Walkey AJ, Laqu T, Lindenauer PK. Trends in sepsis and infection sources in the United States: a population based study. Ann Am Thorac Soc 2015;12(2):216-20.

16. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock:2012. Intensive Care Med 2013;39(2):165-228.

17. Seemann A, Boissier F, Razazi K, Carteaux G, de Prost N, Brun-Buisson C, et al. New-onset supraventricular arrhythmia during septic shock: prevalence, risk factors and prognosis. Ann Intensive Care 2015;5(1):27.

18. Seguin P, Launey Y. Atrial fibrillation is not just an artifact in the ICU. Crit Care 2010;14(4):182.

19. Walkey AJ, Hammill BG, Curtis LH, Benjamin EJ. Long-term outcomes following development of new-onset atrial fibrillation during sepsis. Chest 2014;146(5):1187-95.

20. Schwartz A, Brotfain E, Koyfman L, Kutz R, Gruenbaum SE, Klein M, Zlotnik A. Association between hypophosphatemia and cardiac arrhythmias in the early stage of sepsis: could phosphorus replacement treatment reduce the incidence of arrhythmias?Electrolyte Blood Press 2014,12(1):19-25.

21. Doig JC. Drug-Induced Cardiac Arrhythmias. Drug Safety 1997;17(4):265-75.

22. Barnes BJ, Hollands, JM. Drug-induced arrhythmias. Crit Care Med 2010;38(6 Suppl):s188-97.

23. Walkey AJ, Greiner MA, Heckbert SR, Jensen PN, Piccini JP, Sinner MF, et al. Atrial fibrillation among medicare beneficiaries hospi-talized with sepsis: incidence and risk factors. Am Heart J 2013;165(6):949-55.

24. Brathwaite D, Weissman C. The new onset of atrial arrhythmias following major noncardio thoracic surgery is associated with in-creased mortality. Chest 1998;114(2): 462-8.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time