Patients who develop new-onset atrial fibrillation (NOAF) during an ICU admission are at a higher risk of in-hospital death and readmission to hospital with AF, heart failure, and stroke than those who do not.

Using the RISK-II database (Case Mix Programme national clinical audit of adult intensive care linked with Hospital Episode Statistics and mortality data), we conducted a retrospective cohort study of 4615 patients with NOAF and 27 690 matched controls admitted to 248 adult ICUs in England, from April 2009 to March 2016.

We examined in-hospital mortality; hospital readmission with atrial fibrillation (AF), heart failure, and stroke up to 6 years post discharge; and mortality up to 8 years post discharge.

Compared with controls, patients who developed NOAF in the ICU were at a higher risk of in-hospital mortality, only partially explained by patient demographics, comorbidities, and ICU admission factors (adjusted OR 1.50, 95% CI 1.38–1.63).

They were also at a higher risk of subsequent hospitalization with AF, stroke (aCHR 1.47, 95% CI 1.12–1.93), and heart failure (aCHR 1.28, 95% CI 1.14–1.44) independent of pre-existing comorbidities.

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