Risk, rate or rhythm control for new onset supraventricular arrhythmia during septic shock: protocol for the CAFS...

Area of Science:

• Critical Care Medicine
• Cardiology
• Clinical Trials

Background:

• New-onset supraventricular arrhythmia (NOSVA) is the most frequent arrhythmia in septic shock patients.
• NOSVA is linked to hemodynamic instability and increased mortality.
• Current management strategies for NOSVA in septic shock lack randomized trial data.

Purpose of the Study:

• To compare the efficacy and safety of three management strategies for NOSVA in septic shock.
• To evaluate risk control, rate control, and rhythm control in limiting shock duration and preventing organ dysfunction.

Main Methods:

• The Control Atrial Fibrillation in Septic shock (CAFS) study is a multicenter, randomized controlled superiority trial.
• 240 patients will be randomized 1:1:1 to risk control, rate control (low-dose amiodarone), or rhythm control (high-dose amiodarone and cardioversion).
• The primary endpoint is a hierarchical composite of all-cause mortality and septic shock duration at day 28.

Main Results:

• Primary results are pending as the trial is ongoing.
• Secondary outcomes include lactate clearance, cardiac rhythm control, organ dysfunction, adverse events, and length of stay.

Conclusions:

• The CAFS trial will provide crucial data on optimal NOSVA management in septic shock.
• Findings are expected to guide clinical practice and improve outcomes for septic shock patients with arrhythmias.