title: New-onset supraventricular arrhythmia during septic shock: prevalence, risk factors and prognosis.
abstract: BACKGROUND
  The aims of this study were to prospectively assess the prevalence of sustained (lasting more than 30 s) new-onset supraventricular arrhythmia (NOSVA) during septic shock, identify the associated factors (including septic myocardial dysfunction), and evaluate its impact on hemodynamics and prognosis.
  
  
  METHODS
  Patients with a diagnosis of septic shock were screened in a medical intensive care unit of a tertiary hospital center in France with a continuous 12-lead EKG for the occurrence of NOSVA. Biological and clinical data (including septic myocardial dysfunction characterized by echocardiography) were collected. We also assessed the hemodynamic tolerance and prognosis of NOSVA.
  
  
  RESULTS
  Among the 71 septic shock episodes assessed during the study, NOSVA occurred in 30 [prevalence of 42 %, 95 % confidence interval (CI) 30-53 %]. Among all recorded factors, only renal failure (as assessed by renal SOFA score at day 1) was associated with NOSVA and this difference persisted by multivariable analysis (odds ratio of 1.29, 95 % CI 1.03-1.62, p = 0.03). There was a significant increase in norepinephrine dosage during the first hour after SVA onset. NOSVA was associated with longer catecholamine use during septic shock as compared with patients in sinus rhythm, whereas ICU mortality was identical between groups.
  
  
  CONCLUSIONS
  We found a high prevalence of sustained NOSVA during septic shock. NOSVA was not related to septic myocardial dysfunction, but rather to acute renal failure, raising the hypothesis of an acute renocardiac syndrome.
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. aurelien.seemann@aphp.fr.|AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Cardiologie, 94010, Créteil, France. aurelien.seemann@aphp.fr.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Seemann
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. florence.boissier@aphp.fr.|AP-HP, Hôpital Européen Georges Pompidou, Service de Réanimation Médicale, 75015, Paris, France. florence.boissier@aphp.fr.
authors.forename: Florence
authors.initials: F
authors.lastname: Boissier
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. keyvan.razazi@aphp.fr.|Université Paris Est Créteil, Faculté de Médecine, Groupe de recherche clinique CARMAS, 94010, Créteil, France. keyvan.razazi@aphp.fr.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Razazi
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. guillaume.carteaux@aphp.fr.|Université Paris Est Créteil, Faculté de Médecine, Groupe de recherche clinique CARMAS, 94010, Créteil, France. guillaume.carteaux@aphp.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Carteaux
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. nicolas.de-prost@aphp.fr.|Université Paris Est Créteil, Faculté de Médecine, Groupe de recherche clinique CARMAS, 94010, Créteil, France. nicolas.de-prost@aphp.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: de Prost
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. christian.brun-buisson@aphp.fr.|Université Paris Est Créteil, Faculté de Médecine, Groupe de recherche clinique CARMAS, 94010, Créteil, France. christian.brun-buisson@aphp.fr.
authors.forename: Christian
authors.initials: C
authors.lastname: Brun-Buisson
authors.affiliation: AP-HP, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 51, avenue du Mal de Lattre de Tassigny, 94 010, Créteil Cedex, France. armand.dessap@aphp.fr.|Université Paris Est Créteil, Faculté de Médecine, Groupe de recherche clinique CARMAS, 94010, Créteil, France. armand.dessap@aphp.fr.|INSERM U955, IMRB, Faculté de Médecine de Créteil, 94010, Créteil, France. armand.dessap@aphp.fr.
authors.forename: Armand
authors.initials: A
authors.lastname: Mekontso Dessap
keywords: Arrhythmia; Myocardial dysfunction; Sepsis; Shock