Figure 1 –

Approach to the short-term and long-term management of new-onset AF during critical illness. The initial approach involves clinical assessment for hemodynamic and respiratory stability related to AF, with evaluation for reversible triggers and initiation of heart rate or rhythm control treatments to meet hemodynamic goals. After clinical improvement, patients should be systematically reevaluated for stroke risk (eg, CHA₂DS₂-VASc [congestive heart failure, hypertension, age ≥ 75 y, diabetes, previous stroke/transient ischemic attack, vascular disease, age 65-74 y, sex category] score) and evidence of AF recurrence to guide initiation of thromboembolism prophylaxis, rate control, or rhythm control. AF = atrial fibrillation; DCCV = direct current cardioversion.