Atrial Fibrillation and Its Association With Sudden Cardiac Death

Evidence is emerging to indicate that atrial fibrillation (AF) is independently associated with an increased risk of sudden cardiac death (SCD). This association has been consistently observed in specific patient subgroups such as patients with myocardial infarction (MI), heart failure, and hyperten...

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Bibliographic Details
Published in:Circulation Journal 2014/10/24, Vol.78(11), pp.2588-2593
Main Authors: Chen, Lin Y., Benditt, David G., Alonso, Alvaro
Format: Article
Language:English
Subjects:
Atrial fibrillation
Atrial Fibrillation - mortality
Atrial Fibrillation - pathology
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Death, Sudden, Cardiac - epidemiology
Defibrillators, Implantable
Humans
Hypertension - mortality
Hypertension - pathology
Hypertension - physiopathology
Hypertension - therapy
Myocardial Infarction - mortality
Myocardial Infarction - pathology
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Risk Factors
Sudden cardiac death
Tachycardia, Ventricular - mortality
Tachycardia, Ventricular - pathology
Tachycardia, Ventricular - physiopathology
Tachycardia, Ventricular - therapy
Ventricular fibrillation
Ventricular tachycardia
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Summary:Evidence is emerging to indicate that atrial fibrillation (AF) is independently associated with an increased risk of sudden cardiac death (SCD). This association has been consistently observed in specific patient subgroups such as patients with myocardial infarction (MI), heart failure, and hypertension, and importantly, in the general population. Data from studies of implantable cardioverter-defibrillator recipients suggest that the rapid and irregular rhythm of AF and the short-long-short cycles that are highly prevalent in AF increase susceptibility to ventricular tachycardia and ventricular fibrillation. An alternative explanation for the association between AF and SCD includes confounding or mediation by shared risk factors such as coronary artery disease and heart failure. Possible risk factors for SCD in patients with AF include black race, left ventricular hypertrophy, history of MI, and diabetes. Additional research is needed to confirm the inherent proarrhythmic nature of AF, identify patients’ characteristics or clinical conditions that potentiate SCD risk, and define effective SCD prevention strategies for patients with AF. (Circ J 2014; 78: 2588–2593)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-14-0814