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Updated: Apr 23, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Atrial fibrillation is an independent risk factor for ventricular fibrillation: a large-scale population-based
Abdennasser Bardai1, Marieke T Blom1, Daniel A van Hoeijen1
1From the Heart Center, Department of Cardiology (A.B., M.T.B., D.A.v.H., H.W.M.v.D., H.L.T.), and Department of General Practice (H.J.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Insights
Atrial fibrillation (AF) significantly increases the risk of ventricular fibrillation (VF), a primary cause of sudden cardiac death. This association remains strong even after accounting for other health conditions and medications.
Area of Science:
- Cardiology
- Electrophysiology
- Public Health
Background:
- Atrial fibrillation (AF) is a known risk factor for sudden cardiac death.
- Ventricular fibrillation (VF) is the most common cause of sudden cardiac death.
- The independent association between AF and VF requires further investigation.
Purpose of the Study:
- To determine if atrial fibrillation (AF) is associated with ventricular fibrillation (VF).
- To assess if this association is independent of confounding factors such as comorbidities, medications, and acute myocardial infarction.
Main Methods:
- A community-based case-control study was conducted.
- 1397 VF cases and 3474 controls were analyzed.
- Logistic regression was used to adjust for confounders.
Main Results:
- Atrial fibrillation (AF) occurred in 15.4% of VF cases and 2.6% of controls.
- AF was associated with a 3-fold increased risk of VF (aOR, 3.1).
- This increased risk was consistent across subgroups and independent of comorbidities, antiarrhythmic drugs, QT-prolonging drugs, and acute myocardial infarction.
Conclusions:
- Atrial fibrillation (AF) is independently associated with a threefold increased risk of ventricular fibrillation (VF).
- Confounding factors do not fully explain the elevated VF risk in AF patients.
- These findings highlight the critical link between AF and VF, emphasizing the need for risk stratification and management.
Background:
Atrial fibrillation (AF) is associated with sudden cardiac death. We aimed to study whether AF is associated with ventricular fibrillation (VF), the most common cause of sudden cardiac death and whether this association is independent of confounders, ie, concomitant disease, use of antiarrhythmic or QT-prolonging drugs, and acute myocardial infarction.
Methods And Results:
We performed a community-based case-control study. Cases were patients with out-of-hospital cardiac arrest because of ECG-documented VF. Controls were age-/sex-matched non-VF subjects from the community. VF risk in AF patients was studied by means of (conditional) logistic regression, adjusting for all available confounders. We studied 1397 VF cases and 3474 controls. AF occurred in 215 cases (15.4%) and 90 controls (2.6%). AF was associated with a 3-fold increased risk of VF (adjusted odds ratio, 3.1 [2.1-4.5]). VF risk in AF cases was increased to the same extent across all age/sex groups and in AF cases who had no comorbidity (adjusted odds ratio 3.0 [1.6-5.5]) or used no confounding drugs (antiarrhythmics, 2.4 [1.4-4.3]; QT-prolonging drugs, 3.1 [1.8-5.4]). VF risk was similarly increased in AF cases with acute myocardial infarction-related VF (adjusted odds ratio 2.6 [1.4-4.8]), and those with non-acute myocardial infarction-related VF (adjusted odds ratio 4.3 [1.9-10.1]).
Conclusions:
AF is independently associated with a 3-fold increased risk of VF. Comorbidity, use of antiarrhythmic or QT-prolonging drugs, or acute myocardial infarction does not fully account for this increased risk.
