Treating Atrial Fibrillation in Sepsis

For patients presenting with rapid atrial fibrillation (AF), clinicians have several pharmacologic and other options for rate control. To compare outcomes for septic patients with AF treated with IV calcium channel blockers, beta-blockers, digoxin, or amiodarone, these authors analyzed a large administrative dataset covering approximately 20% of U.S. hospitals. Propensity score matching was used to account for dozens of relevant comorbidities and patient factors.

Among nearly 40,000 patients with AF and sepsis, there was wide variability in medication choice by hospital, region, provider specialty, and teaching hospital status. Calcium channel blockers were the most common medication choice (36% of patients). However, beta-blockers were asso…