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Atrial fibrillation is associated with sudden cardiac death: a systematic review and meta-analysis

Pattara Rattanawong1,2, Sikarin Upala3,4, Tanawan Riangwiwat1

  • 1University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|January 15, 2018
PubMed

Insights

Atrial fibrillation (AF) significantly increases the risk of sudden cardiac death (SCD). This meta-analysis confirms a doubled risk of SCD in AF patients across various populations and conditions, highlighting the need for proactive cardiovascular risk management.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Atrial fibrillation (AF) is increasingly recognized as a significant risk factor for cardiovascular events, including sudden cardiac death (SCD).
  • Existing research indicates a higher incidence rate of SCD in individuals with AF compared to those without the condition.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis to quantitatively assess the association between atrial fibrillation (AF) and the risk of sudden cardiac death (SCD).
  • To explore this association across diverse patient populations and individuals with specific cardiovascular conditions.

Main Methods:

  • A comprehensive literature search was performed on MEDLINE and EMBASE databases up to January 2017.
  • Included studies were prospective or retrospective cohort studies comparing SCD risk in AF patients versus non-AF controls.
  • Data were synthesized using a random-effects model to calculate pooled risk ratios and 95% confidence intervals.

Main Results:

  • The meta-analysis included 27 studies (1991-2017) with 8,401 AF patients and 67,608 controls.
  • AF patients exhibited a significantly higher risk of SCD (pooled risk ratio = 2.04, 95% CI: 1.77-2.35, p < 0.01).
  • This increased risk was consistent across subgroups, including those with heart failure, coronary artery disease, hypertrophic cardiomyopathy, Brugada syndrome, and implanted rhythm devices.

Conclusions:

  • Atrial fibrillation is associated with a statistically significant increase in the risk of sudden cardiac death.
  • The elevated SCD risk in AF patients is evident in the general population and in individuals with specific cardiovascular comorbidities and interventions.
Abstract

Keywords:
Atrial fibrillationSudden cardiac death

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