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Journal of Interventional Cardiac Electrophysiology
Erschienen in: Journal of Interventional Cardiac Electrophysiology 2/2018

13.01.2018 | MULTIMEDIA REPORT

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

verfasst von: Pattara Rattanawong, Sikarin Upala, Tanawan Riangwiwat, Veeravich Jaruvongvanich, Anawin Sanguankeo, Wasawat Vutthikraivit, Eugene H. Chung

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2018

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Abstract

Purpose

Recent studies suggest that atrial fibrillation (AF) is associated with increased cardiovascular risk and mortality including sudden cardiac death (SCD). According to the Cardiovascular Heath Study cohort, the incident rate of SCD was higher in the AF population (2.9 per 1000 per year) compared with non-AF controls (1.3 per 1000 per year). In this study, we performed a systematic review and meta-analysis to explore the association between AF and SCD.

Methods

We comprehensively searched the databases of MEDLINE and EMBASE from inception to January 2017. Included studies were published prospective or retrospective cohort studies that compared the risk of developing SCD, defined by World Health Organization’s criteria, in AF patients versus non-AF patients. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the risk ratios and 95% confidence intervals.

Results

Twenty-seven studies from January 1991 to February 2017 involving 8401 AF patients and 67,608 non-AF controls were included in this meta-analysis. Compared with controls, AF patients had a significantly higher risk of SCD in overall analysis (pooled risk ratio = 2.04, 95% confidence interval: 1.77–2.35, p < 0.01, I2 = 42.66) as well as subgroups of general population studies, previous myocardial infarction or coronary artery disease, heart failure, hypertrophic cardiomyopathy (HCM), Brugada syndrome, and patients with either a pacemaker or implantable cardioverter defibrillator (ICD). In subgroup analysis of multivariate-adjusted studies, AF also had a significantly higher risk of SCD (pooled risk ratio = 2.22, 95% confidence interval = 1.59–3.09, p < 0.01, I2 = 73.95). Incident rate of SCD in AF was 2-fold higher than controls but not statistically significant (pooled rate ratio = 2.06, 95% confidence interval = 0.66–7.53, p = 0.292, I2 = 88.58).

Conclusions

Our meta-analysis demonstrates a statistically significant increased risk of SCD with AF in the general population and in those with previous myocardial infarction, coronary artery disease, heart failure, HCM, Brugada syndrome, and an implanted rhythm device.
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Metadaten
Titel
Atrial fibrillation is associated with sudden cardiac death: a systematic review and meta-analysis
verfasst von
Pattara Rattanawong
Sikarin Upala
Tanawan Riangwiwat
Veeravich Jaruvongvanich
Anawin Sanguankeo
Wasawat Vutthikraivit
Eugene H. Chung
Publikationsdatum
13.01.2018
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2018
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-017-0308-9

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