Drikite L, Bedford JP, O’Bryan L, et al. - Since new-onset atrial fibrillation (NOAF) in patients managed in an intensive care unit (ICU) is common and linked with significant morbidity as well as mortality, researchers summarized comparative evidence to inform NOAF treatment for patients admitted to ICU, by conducting this systematic scoping review. Multiple databases were explored to find studies assessing treatment or prophylaxis strategies for NOAF or acute anticoagulation in general medical, surgical or mixed adult ICUs. Overall 42 eligible articles were analyzed. Small randomised controlled trials indicated slower rhythm control with calcium channel blockers (CCBs) vs beta blockers (1 study), and that CCBs result in more cardiovascular instability compared with amiodarone (1 study). According to 4 non-randomised studies, beta blocker therapy may be equivalent to amiodarone therapy in terms of rhythm control. On the basis of the limited evidence available, a likely superiority of beta blockers or amiodarone to CCBs was suggested as first line therapy in undifferentiated patients in ICU. Experts noted that the little evidence present did not support therapeutic anticoagulation for NOAF whilst patients are critically ill. There is a requirement for consensus definitions for NOAF, rate and rhythm control.