Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.
X, H., M, Z., Z, Z., Y, Z., & KY, C. (2026). Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.. Scientific reports. https://doi.org/10.1038/s41598-026-51249-9
X H, M Z, Z Z, Y Z, KY C. Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.. Scientific reports. 2026; doi: 10.1038/s41598-026-51249-9
X H, M Z, Z Z, et al. Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.[J]. Scientific reports. 2026. DOI: 10.1038/s41598-026-51249-9.
@article{x2026,
author = {Huang X and Zheng M and Zhu Z and Zhang Y and Chen KY},
title = {Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.},
journal = {Scientific reports},
year = {2026},
doi = {10.1038/s41598-026-51249-9},
note = {PMID: 42402640},
}
TY - JOUR AU - Huang X AU - Zheng M AU - Zhu Z AU - Zhang Y AU - Chen KY TI - Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation. T2 - Scientific reports PY - 2026 DO - 10.1038/s41598-026-51249-9 AN - PMID:42402640 ER -
Sepsis-induced new-onset atrial fibrillation (NOAF) is a potentially life-threatening arrhythmogenic complication, partially driven by catecholamine-mediated atrial remodeling. While β-adrenergic receptor blockers may mitigate this pathophysiology through sympatholytic and rate-controlling mechanisms, their association with patient survival remains incompletely characterized due to heterogeneous evidence. To elucidate the association between the administration of anti-catecholaminergic antiarrhythmic drugs and all-cause mortality in critically ill patients with sepsis-induced NOAF.This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care-IV database. We included adult patients admitted to a tertiary academic medical center between 2008 and 2019 who fulfilled the Sepsis-3 criteria and developed NOAF during their ICU stays.Based on the initial antiarrhythmic drug administration within 24 h following time-zero, patients were categorized into either β-blocker group or alternative antiarrhythmic drug group. The matched cohort comprised 560 patients (mean age 74.1 [SD 11.5] years; 64.6% male), among whom 280 were assigned to the β-blocker group and 280 to the alternative antiarrhythmic drug group. The β-blocker group demonstrated significantly lower 28-day mortality (36.1 vs. 51.1%; adjusted HR, 0.53; 95% CI, 0.41-0.67; P < .001) and 1-year mortality (50.7 vs. 63.6%; adjusted HR, 0.68; 95% CI, 0.55-0.85; P = .001). ICU mortality was also reduced in the β-blocker group (22.1 vs. 42.5%; P < .001). Furthermore, this group had more vasopressor-free days (median [IQR], 24.0 [18.0-26.0] vs. 16.0 [0.0-23.0]) and ventilator-free days (24.0 [18.0-26.0] vs. 17.0 [0.0-24.0]) (both P < .001). Safety outcomes included less bradycardia (12.5 vs. 20.0%; P = .016) but more hypotension (26.4 vs. 18.6%; P = .039). Subgroup and mediation analyses suggested greater benefit in high-risk patients, partially mediated (15.92%) by reduced vasopressor requirements. In critically ill patients with sepsis-induced NOAF, early β-blocker therapy was associated with markedly lower 28-day and 1-year mortality, along with decreased organ-support burden, warranting prospective trials are warranted to confirm these survival benefits.