Sepsis-induced Atrial Fibrillation: Can We Predict and Prevent This High-Risk Complication?

Sepsis-induced new-onset atrial fibrillation (NOAF) is a frequent and serious complication in critically ill patients, linked to increased morbidity, mortality, stroke, and prolonged hospitalization. Though often transient during acute illness, NOAF is now recognized as a predictor of long-term cardiovascular vulnerability, with recurrence rates exceeding 50% over five years and a significantly heightened risk of thromboembolic events. Stroke risk is notably elevated in this population, yet the role of anticoagulation remains uncertain due to potential bleeding complications and lack of clear guidelines. This review consolidates current evidence on the pathophysiology, incidence, risk factors, and clinical impact of sepsis-induced NOAF, with a focus on stroke prevention, recurrence, anticoagulation challenges, and emerging predictive models. Additionally, it examines prevention strategies that target inflammatory and hemodynamic pathways.