IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305176
Open Access Review
Atrial Fibrillation in the Setting of Acute Pneumonia: Not a Secondary Arrhythmia
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1 Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
2 Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
*Correspondence: (Giuseppe Boriani)
Academic Editors: Giuseppe Nasso and Giuseppe Santarpino
Rev. Cardiovasc. Med. 2022, 23(5), 176;
Submitted: 22 February 2022 | Revised: 1 April 2022 | Accepted: 7 April 2022 | Published: 16 May 2022
(This article belongs to the Special Issue New Insights in Treatment of Atrial Fibrillation)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Atrial fibrillation (AF) is the most common arrhythmia in the setting of critically ill patients. Pneumonia, and in particular community-acquired pneumonia, is one of the most common causes of illness and hospital admission worldwide. This article aims to review the association between AF and acute diseases, with specific attention to pneumonia, from the pathophysiology to its clinical significance. Even though the relationship between pneumonia and AF has been known for years, it was once considered a transient bystander. In recent years there has been growing knowledge on the clinical significance of this arrhythmia in acute clinical settings, in which it holds a prognostic role which is not so different as compared to that of the so-called “primary” AF. AF is a distinct entity even in the setting of pneumonia, and acute critical illnesses in general, and it should therefore be managed with a guidelines-oriented approach, including prescription of anticoagulants in patients at thromboembolic risk, always considering patients’ individuality. More data on the significance of the arrhythmia in this setting will help clinicians to give patients the best possible care.

atrial fibrillation
critically ill
Fig. 1.
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