Atrial fibrillation (AF) is a common arrhythmia encountered in acute and critical illness and is associated with poor short and long-term outcomes. Given the consequences of developing AF, research into prevention, prediction and treatment of this arrhythmia in the critically ill are of great potential benefit, however, study of AF in critically ill patients faces unique challenges, leading to a sparse evidence base to guide management in this population. Major obstacles to the study of AF in acute and critical illness include absence of a common definition, challenges in designing studies that capture complex etiology and assess causality, lack of a clear outcome set, difficulites in recruitment in acute environments with respect to timing, consent, and workflow, and failure to embed studies into clinical care platforms and capitalize on emerging technologies. Collaborative effort by researchers, clinicians, and stakeholders should be undertaken to address these challenges, both through interdisciplinary cooperation for the optimization of research efficiency and advocacy to advance the understanding of this common and complex arrhythmia, resulting in improved patient care and outcomes. The Symposium on Atrial Fibrillation in Acute and Critical Care was convened to address some of these challenges and propose potential solutions.

Department of Anesthesiology and Intensive Care 1st Faculty of Medicine Charles University Prague Czechia

Department of Anesthesiology and Pain Medicine Temerty Faculty of Medicine University of Toronto Toronto Canada

Department of Critical Care Medicine Queen's University 76 Stuart Street Kingston ON K7L 2V7 Canada

Department of Emergency Medicine Queen's University Kingston Canada

Department of Emergency Medicine University of British Columbia Vancouver Canada

Department of Medicine McMaster University Hamilton Canada

Department of Medicine University of Toronto Toronto Canada

Division of Critical Care Medicine Temerty Faculty of Medicine University of Toronto Toronto Canada

Division of Health Systems Science Department of Medicine University of Massachusetts Chan Medical School Worcester MA USA

Institute of Life Course and Medical Sciences Faculty of Health and Life Sciences University of Liverpool Liverpool UK

King's College London Guy's and St Thomas' Hospital London London UK

Liverpool Centre for Cardiovascular Science University of Liverpool Liverpool John Moores University and Liverpool Heart and Chest Hospital Liverpool UK

Management and Evaluation Institute for Health Policy University of Toronto Toronto Canada

Niagara Health Knowledge Institute Niagara Health St Catharines Canada

Population Health Research Institute McMaster University Hamilton Canada

Sunnybrook Research Institute Toronto Canada

The George Institute for Global Health Sydney Australia

The Ottawa Hospital Research Institute Ottawa Canada

University of Oxford Nuffield Department of Clinical Neurosciences Oxford UK

University of Sydney Royal North Shore Hospital Sydney Australia

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