Atrial fibrillation (AF) is likely the most frequent supraventricular arrhythmia encountered in clinical practice—and in the ICU, it's also a leading cause of diastolic heart failure. I am Martin Balik from Czech republic and in my lecture, I focused on the potential role of short-acting beta-blockers, particularly landiolol and esmolol, in the management of atrial fibrillation in critically ill patients. These agents offer unique advantages due to their short half-lives and rapid titratability, making them ideal for the dynamic environment of the ICU. In this setting, it's crucial to optimize preload, taper catecholamines, and consider early rhythm control, especially for the prevention of heart failure. My approach is grounded in cardiovascular stabilization, rather than simply rate control. However, this kind of therapy requires a complex and individualized approach to monitoring. The decision to use short-acting beta-blockers should be based on advanced hemodynamic assessment, ideally supported by echocardiography. This allows us to identify a select group of patients who are likely to benefit from this therapy without compromising cardiac output or perfusion. What I appreciate most about this congress is that it's not just a platform to lecture— I also have the opportunity to organize echo workshops, contribute to the main program, and most importantly, learn from other prominent speakers from around the globe. The International Fluid Academy Days (IFAD) brings together world-class experts, offering cutting-edge education and discussion on topics that are highly relevant to real-life critical care. It's a privilege to be part of it.

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