Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Choi, Yun Young; Han, Kyungdo; Min, Kyongjin; Choi, Ha Young; Shim, Jaemin; Choi, Jong‐il; Kim, Young-Hoon

doi:10.1038/s41598-021-97335-y

Cited by 16 publications

(15 citation statements)

References 36 publications

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“…Notably, in our analysis, dyslipidaemia was significantly associated with a reduced risk of VT/VF/CA. While this seems anomalous, a similar finding was observed by Kim et al where a significant interaction effect was noted between AF and dyslipidaemia as well as AF and age, suggesting that younger people without dyslipidaemia were at a greater risk of VAs due to AF [12]. Whether this is a true association or if there is a further interaction effect with statin use is unclear due to the lack of data on drugs in these database-based analyses.…”

Section: Discussionsupporting

confidence: 70%

“…In the largest study evaluating the association between Vas and AF, individuals with new onset AF in the Korean general population were found to have a 4.6-fold increased risk of Vas [12]. This figure is nearly 3.5 times higher than our reported aHR of 1.34, bearing in mind our primary outcome was a composite of Vas as well as cardiac arrests as opposed to Vas only.…”

Section: Discussioncontrasting

confidence: 42%

“…Patients with prevalent AF, heart failure, ischaemic stroke, Vas and premature ventricular contractions were excluded from this study, in contrast to our study which only excluded those with a history of Vas and cardiac arrests. While the former approach will have minimised confounding effects to a larger degree, the yield of outcome events was significantly smaller in both the AF and non-AF groups [12]. Large differences in the sample size and outcome events with significant differences in baseline characteristics between the two groups were also a feature of our study; hence, a PSM analysis was carried out to address this.…”

Section: Discussionmentioning

confidence: 98%

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Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

Fawzy

Bisson

Bodin

et al. 2023

JCM

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Background: Atrial fibrillation (AF) has been linked to an increased risk of ventricular arrhythmias (VAs) and sudden death. We investigated this association in hospitalised patients in France. Methods: All hospitalised patients from 2013 were identified from the French National database and included if they had at least 5 years of follow-up data. Results: Overall, 3,381,472 patients were identified. After excluding 35,834 with a history of VAs and cardiac arrest, 3,345,638 patients were categorised into two groups: no AF (n = 3,033,412; mean age 57.2 ± 21.4; 54.3% female) and AF (n = 312,226; 78.1 ± 10.6; 44.0% female). Over a median follow-up period of 5.4 years (interquartile range (IQR) 5.0–5.8 years), the incidence (2.23%/year vs. 0.56%/year) and risk (hazard ratio (HR) 3.657 (95% confidence interval (CI) 3.604–3.711)) of VAs and cardiac arrest were significantly higher in AF patients compared to non-AF patients. This was still significant after adjusting for confounders, with a HR of 1.167 (95% CI 1.111–1.226) and in the 1:1 propensity score-matched analysis (n = 289,332 per group), with a HR of 1.339 (95% CI 1.313–1.366). In the mediation analysis, the odds of cardiac arrest were significantly mediated by AF-associated VAs, with an OR of 1.041 (95% CI 1.040–1.042). Conclusion: In hospitalised French patients, AF was associated with an increased risk of VAs and sudden death.

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Section: Discussionsupporting

confidence: 70%

Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 98%

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Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

Fawzy

Bisson

Bodin

et al. 2023

JCM

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“…A recent study reported that PACs developed due to early ventricular contractions (PVCs); subclinical AF was observed, and ischemic stroke developed due to it 23 . Conversely, another study reported that frequent PACs trigger PVCs and cause cryptogenic stroke 24 . In contrast, Engström et al identified frequent PACs as independent risk factors for stroke 25 .…”

Section: Discussionmentioning

confidence: 98%

The association between frequent premature atrial contractions and recurrent stroke in a population of ischemic stroke

Günlü

Aktan

2022

Dicle Tıp Dergisi

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Objective: Premature atrial contractions (PACs) are a prevalent cardiac occurrence. Recent research indicates that PACs are linked to atrial fibrillation (AF), ischemic stroke, and mortality. We aimed to investigate the association of PACs and the risk of recurrent stroke in patients with ischemic stroke in sinus rhythm. Methods: The study was conducted as a cross-sectional study. 24-hour standard three-lead Holter ECG monitoring was performed for seven days and analyzed. Patients were separated into two groups based on the results of Holter ECG monitoring: those with subclinical AF and those with frequent PACs. Frequent PACs were characterized as more than fourteen PACs per hour and >3 PAC runs each 24 hours. Subclinical AF was defined as atrial fibrillation, atrial flutter, or atrial tachycardia events detected by implantable or wearable cardiac devices in people without AF symptoms and in whom clinical AF was not previously detected. Results: 150 patients, consisting of 82 men (54.7% of the total) and 68 women (45.3%), with an average age of 60.9±13.5 years, were enrolled in the research. Based on the Holter findings, patients were separated into subclinical AF (n=54) and frequent PACs (n=96).During hospitalization, recurrent ischemic stroke was detected in 6 patients (11%) in the subclinical AF arm and 26 patients (26%) in the frequent PACs arm (p=0.03). Six patients died of whom 4 died after a recurrent stroke event in the hospital. In univariate analysis age [OR: 1.03, 95%CI (1-1.07), p=0.02], dyslipidemia [OR: 2.68, 95%CI (1.16-6.18), p=0.021] and frequent PACs [OR: 2.97, 95%CI (1.13-7.76), p=0.026] were found significant predictors of recurrent stroke. Furthermore, in multivariate logistic regression analysis only frequent PACs [OR: 2.69, 95%CI (1-7.17), p=0.048] was found independent predictors of recurrent stroke. Conclusion: Frequent PACs on Holter analysis were significantly associated with recurrent ischemic stroke.

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“…Это может быть обусловлено как более высоким тонусом симпатической нервной системы, так и степенью прогрессирования кардиомиопатии с вовлечением в патологический процесс миокарда предсердий. В литературе имеются данные об ассоциации фибрилляции предсердий и повышенного риска развития ЖТ, как независимом предикторе смерти у пациентов с ЖТ [15,16].…”

Section: рис 3 кривая выживаемости Kaplan-meyer: а -риск рецидива тах...unclassified

Predictors of long-term ventricular tachyarrhythmia recurrence after combined endo-epicardial ablation in patients with structural heart disease

Simonova

Orshanskaya

Лебедева

et al. 2022

Vestnik aritmologii

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Purpose. To identify predictors of ventricular tachycardia (VT) recurrence after endo-epicardial ablation in patients with structural heart disease.Methods. A prospective observational study included 39 patients with structural heart disease and indications for catheter ablation of ventricular tachyarrhythmia. Endo- and epicardial electroanatomical mapping of the ventricular myocardium and ablation of abnormal electrical activity areas were performed. Clinical, ECG characteristics, and voltage maps of bipolar potentials (limits of scar detection <0.5 mV, normal activity >1.5 mV) and unipolar signals (limits <5.0 and >9.0 mV, respectively) on endo- and epicardial surfaces were evaluated. Intraprocedurally, the procedure was considered effective when no VT was inducible; partially effective - when only clinical VT(s) was/were non-inducible. Scheduled patient visits or remote monitoring were performed at 6, 12 and 24 months, and then annually.Results. The mean age of the patients was 49.5±15.7 years (34 men and 5 women). VT recurrences at 6 months were more often detected in non-ischemic cardiomyopathy patients, in subjects with non-paroxysmal atrial fibrillation (42.9% vs. 7.4%), with a lower VT-QRS amplitude in lead III (0.6 [0.4;1.07] versus 1.28 [0.99; 1.53] mV), and when epicardial “scar” area prevailed over endocardial, P<0.05 for all listed parameters. At 12-months, VT recurrence was more common in patients with partially effective ablation (33.3% vs. 5.0% in patients with effective ablation, P=0.02). The presence of electrical storm at the time of ablation was independently associated with recurrences (HR 4.32; 95% CI: 1.06-17.48; P=0.04).Conclusion. In a heterogeneous group of patients, clinical and electrophysiological factors associated with VT recurrence have been identified at various follow-up periods after endo-epicardial ablation. Electrical storm ablation is an independent predictor of VT recurrence in the long-term, up to 5 years of follow-up.

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Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Cited by 16 publications

References 36 publications

Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

The association between frequent premature atrial contractions and recurrent stroke in a population of ischemic stroke

Predictors of long-term ventricular tachyarrhythmia recurrence after combined endo-epicardial ablation in patients with structural heart disease

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