Background Atrial fibrillation (AF) is one of the most frequent arrhythmias in critically ill patients. Sepsis is a major cause of inpatient mortality and it has been associated with cardiac arrhythmias. The objective of this study was to study the outcome of atrial fibrillation in patients who are admitted with sepsis. Methods This is a prospective, single-center cohort study of patients admitted to the Medicine Department between June 1, 2019, and November 30, 2019. The inclusion criteria were adult patients with sepsis and septic shock. In this study, 113 patients were enrolled and outcomes were compared between the group that developed atrial fibrillation during the hospital stay and the group without atrial fibrillation. Results There were 57 (50.4%) patients with AF including 23 (20.4%) who also had a prior history. Total inpatient mortality was 42 (37.2%), of which 17 patients (40.5%) had AF. AF was not found to be associated with higher mortality or increased length of hospital stay (p-value 0.103 and 0.858, respectively). Conclusion AF was not found to be a cause of higher mortality in patients with sepsis or septic shock. There is a need for larger-scale studies to find out the causes of high inpatient mortality in sepsis and the need for local guidelines regarding the management of AF in critically ill patients.

BackgroundGlycated hemoglobin (HbA1c) is a commonly used indicator of glycemic control in diabetes mellitus. Uncontrolled diabetes can lead to cardiovascular complications. Ischemic strokes are often complicated by hemorrhagic transformation, which is the conversion of an infarcted area into an area of hemorrhage. The purpose of this study is to determine the association of raised HbA1c levels with the occurrence of hemorrhagic transformation in ischemic stroke. MethodsThis is a prospective, single-center cohort study of patients admitted to the Neurology and Medicine wards between June 1 and November 30, 2019. Inclusion criteria included adult patients who were admitted with acute ischemic stroke and had been tested for HbA1c on presentation. There were 110 ischemic stroke patients enrolled in our database. An HbA1c level >53 mmol/mol was considered raised. A comparison was done between the group with raised HbA1c levels and the group with target levels of HbA1c for the occurrence of hemorrhagic transformation. Brain imaging was used to diagnose hemorrhagic transformation. ResultsOut of 110 study participants with ischemic stroke, 70 (63.6%) patients had a history of prior known diabetes. The mean HbA1c levels were 7.44 ± 1.79%. A total of 77% of diabetic patients had raised HbA1c levels (>7%). Hemorrhagic transformation was seen in 21 (19.1%) patients, of whom only 38% (n=8) had raised HbA1c levels. The association between raised HbA1c and hemorrhagic transformation was not found to be statistically significant (p = 0.225). ConclusionIn this study of patients with ischemic stroke, raised HbA1c levels were not found to be associated with hemorrhagic transformation. There is a need for larger scale studies to find out the cause and mechanism of hemorrhagic transformation in ischemic stroke.