Key result
AF linked to ~34% higher risk of ventricular arrhythmias and cardiac arrest.
Why the study?
Atrial fibrillation has been linked to an increased risk of ventricular arrhythmias and sudden death, prompting investigation of this association in hospitalised patients.
Does atrial fibrillation increase the risk of ventricular arrhythmias and cardiac arrest in hospitalised patients?
Cohort (n=3,345,638)
Yes
Does atrial fibrillation increase the risk of ventricular arrhythmias and cardiac arrest in hospitalised patients?
Hazard Ratio: 1.339 (95% CI 1.313–1.366)
Absolute Event Rate: 2.23% vs 0.56%
In a large nationwide French cohort, atrial fibrillation was independently associated with a 34% increased risk of ventricular arrhythmias and cardiac arrest, highlighting the potential proarrhythmic nature of AF.
May warrant closer VA monitoring in hospitalized AF patients; extends prior associations but remains hypothesis-generating and should not yet change practice.
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.
No takes yet. Share an insight, caveat, or question.
Fawzy et al. (2023) conducted a cohort in Atrial fibrillation (n=3,345,638). Atrial fibrillation vs. No atrial fibrillation was evaluated on Combined endpoint of ventricular tachycardia, ventricular fibrillation, or cardiac arrest (HR 1.339, 95% CI 1.313-1.366). Atrial fibrillation was associated with a 34% higher risk of ventricular arrhythmias and cardiac arrest compared to patients without atrial fibrillation in a propensity score-matched analysis (HR 1.339).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: