Atrial Fibrillation Is Associated with Increased Mortality in Patients Presenting with Ventricular Tachyarrhythmias

Behnes, Michael; Rusnak, Jonas; Taton, Gabriel; Schupp, Tobias; Reiser, Linda; Bollow, Armin; Reichelt, Thomas; Engelke, Niko; Ellguth, Dominik; Kuche, Philipp; El‐Battrawy, Ibrahim; Lang, Siegfried; Nienaber, Christoph; Mashayekhi, Kambis; Akin, Muharrem; Bertsch, Thomas; Ferdinand, Dennis; Weiß, Christel; Borggrefe, Martin; Akın, İbrahim

doi:10.1038/s41598-019-49325-4

Cited by 8 publications

(6 citation statements)

References 39 publications

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“…Our study is in accordance with the study in a more general AF population. Presence of AF in patients presenting with lethal ventricular arrhythmia was associated with a significantly increased mortality probably due to progressive worsening of heart function, increased shocks from implantable cardioverter-defibrillators, systematic inflammation, and heterogeneous atrioventricular conduction 33 . Such interactions between atrial and ventricular arrhythmias will be a valuable area of future research.…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Choi

Han

Min

et al. 2021

Sci Rep

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Atrial fibrillation (AF) is associated with various major adverse cardiac events such as ischemic stroke, heart failure, and increased overall mortality. However, its association with lethal ventricular arrhythmias such as ventricular tachycardia (VT), ventricular flutter (VFL), and ventricular fibrillation (VF) is controversial. We conducted this study to determine whether AF can increase the risk of VT, VFL, and VF. We utilized the Korean National Health Insurance Service database for this nationwide population-based study. This study enrolled people who underwent a nationwide health screen in 2009 for whom clinical follow-up data were available until December 2018. Primary outcome endpoint was the occurrence of VT, VFL, or VF in people who were and were not diagnosed with new-onset AF in 2009. We analyzed a total of 9,751,705 people. In 2009, 12,689 people were diagnosed with new-onset AF (AF group). The incidence (events per 1000 person-years of follow-up) of VT, VFL, and VF was 2.472 and 0.282 in the AF and non-AF groups, respectively. After adjustment for covariates, new-onset AF was associated with 4.6-fold increased risk (p < 0.001) of VT, VFL, and VF over 10 years of follow-up. The risk of VT, VFL, and VF was even higher if identification of AF was based on intensified criteria (≥ 2 outpatient records or ≥ 1 inpatient record; hazard ratio = 5.221; p < 0.001). In conclusion, the incidence of VT, VFL, and VF was significantly increased in people with new-onset AF. The potential risk of suffering lethal ventricular arrhythmia in people with AF should be considered in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Choi

Han

Min

et al. 2021

Sci Rep

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“…One study identified the presence of atrial fibrillation to be a strong predictor of adverse outcomes in patients who presented with VT. The rate of VT was found to be higher in atrial fibrillation patients than those without (67% vs. 59%, p=0.001), and these patients were found to have higher mortality rates (36% vs. 18%, p=0.001) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Ventricular Tachycardia in Patients With Pre-eclampsia: Prevalence, Predictors, and Associated In-Hospital Adverse Events

Elkattawy,

Malke,

Mothy

et al. 2024

Cureus

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Introduction Pre-eclampsia is a pregnancy-associated multisystem disorder; in rare cases, it can be complicated by arrhythmias such as ventricular tachycardia (VT). The purpose of this study was to determine the prevalence and predictors of VT among patients admitted with pre-eclampsia as well as to analyze the independent association of VT with in-hospital outcomes in this population. Methods Data were obtained from the National Inpatient Sample from January 2016 to December 2019. Patients with a primary diagnosis of pre-eclampsia were selected using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Subsequently, the study population was divided into patients who developed VT versus patients who did not develop this complication. We then assessed the predictors of VT in women with pre-eclampsia as well as the independent association of VT with outcomes taking into account confounders such as age, race, and comorbidities. Results Of 255,946 patients with pre-eclampsia, 92 developed VT (0.04%) during their hospital stay. Multivariate logistic regression showed that patients with VT were far more likely to develop cardiac arrest (adjusted odds ratio, or aOR: 92.582, 95% CI: 30.958-276.871, p=0.001), require permanent pacemaker implantation (aOR: 41.866, 95% CI: 14.800-118.432, p=0.001), develop postpartum hemorrhage (aOR: 2.932, 95% CI: 1.655-5.196, p=0.001), and require left heart catheterization (aOR: 19.508, 95% CI: 3.261-116.708, p=0.001). Predictors of VT included being African American (aOR: 1.939, 95% CI: 1.183-3.177, p=0.009), cerebrovascular disease (aOR: 23.109, 95% CI: 6.953-76.802, p=0.001), congestive heart failure (aOR: 50.340, 95% CI: 28.829-87.901, p=0.001), atrial fibrillation (aOR: 20.148, 95% CI: 6.179-65.690, p=0.001), and obstructive sleep apnea, or OSA (aOR: 3.951, 95% CI: 1.486-10.505, p=0.006). Patients in the VT cohort were found to have an increased length of hospital stay compared to the non-VT cohort (7.16 vs. 4.13 days, p=0.001). Conclusion In a large cohort of women admitted with pre-eclampsia, we found the prevalence of VT to be <1%. Predictors of VT included conditions such as atrial fibrillation, congestive heart failure, and OSA and being African American. VT was found to be independently associated with several adverse outcomes as well as an increased length of hospital stay.

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“…Additionally, among sepsis patients who developed VAs, the impact of AF might be more pronounced in females compared to males. There is growing evidence suggesting a mechanistic connection between AF and ventricular tachyarrhythmias [ 7 , 32 ]. This connection may be attributed to reduced ventricular refractoriness and the occurrence of pro-arrhythmic short-long-short sequences preceding the onset of ventricular tachyarrhythmias in the presence of AF, compared to when the heart is in sinus rhythm [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in the Epidemiology, Risk Factors, and Prognosis of Malignant Ventricular Arrhythmias in Sepsis Patients

Li,

Peng,

Zhou

et al. 2024

Rev. Cardiovasc. Med.

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Background: Women are frequently underrepresented in clinical trials and databases focusing on ventricular arrhythmias (VAs). However, understanding sex-based differences in risk factors and the prognosis of VAs is essential for tailoring personalized prevention and treatment strategies. This study aimed to investigate sex differences in the epidemiology, risk factors, and prognosis of VAs in patients with sepsis. Methods: We conducted a comprehensive analysis of 27,139 sepsis patients (mean [SD] age, 66.6 [16.2] years; 15,626 [57.6%] male), among whom 1136 (4.2%) developed VAs during their hospitalization. We evaluated VAs incidence and potential risk elements in both male and female patients, along with in-hospital mortality. Results: Men had a significantly higher likelihood of developing VAs compared to women (odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.50–1.94, p 0.001). In the case of non-ischemic cardiomyopathy (NICM), the association with VAs was stronger in men than in women (relative risk ratio [RRR] = 1.63, 95% CI: 1.10–2.40, interaction p = 0.014). Furthermore, we observed significant sex-specific interactions in the relationship between incident VAs, congestive heart failure (CHF) (RRR = 1.35, 95% CI: 1.03–1.76, interaction p = 0.031), and pneumonia (RRR = 1.33, 95% CI: 1.02–1.74, interaction p = 0.036) when considering the adjusted model. The presence of VAs was associated with a nearly twofold increase in the risk of in-hospital mortality, a result that was observed in both sexes. Conclusions: In sepsis patients, the emergence of VAs independently escalates the risk of in-hospital mortality, with a notable correlation between male sex and an increased VAs risk. The impacts of CHF, NICM and pneumonia on incident VAs were significantly influenced by sex.

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Atrial Fibrillation Is Associated with Increased Mortality in Patients Presenting with Ventricular Tachyarrhythmias

Cited by 8 publications

References 39 publications

Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

Ventricular Tachycardia in Patients With Pre-eclampsia: Prevalence, Predictors, and Associated In-Hospital Adverse Events

Sex Differences in the Epidemiology, Risk Factors, and Prognosis of Malignant Ventricular Arrhythmias in Sepsis Patients

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