A meta-analysis published in the Journal of Interventional Cardiac Electrophysiology has found a significant association between Afib and risk for sudden cardiac death (SCD) in the general population as well as in patients with cardiovascular comorbidities.
Researchers conducted a meta-analysis of 27 studies (retrospective cohort studies, 9; prospective cohort studies, 18) comparing the risk for SCD in patients with Afib (n=8401) vs non-Afib control participants (n=67,608), identified through a literature search on MEDLINE and EMBASE databases.
The pooled results showed overall higher risk for SCD in patients with Afib compared with control participants (pooled risk ratio [RR], 2.04; P<.01). The association was also significant in the subgroups including previous myocardial infarction or coronary artery disease, heart failure, hypertrophic cardiomyopathy, Brugada syndrome, and patients with either a pacemaker or implantable cardioverter defibrillator. On subgroup analysis of multivariate-adjusted studies, risk for SCD remained significantly higher in patients with Afib vs control participants (pooled RR, 2.22; P<.01). Incident rate for SCD was 2-fold higher in patients with Afib compared with control participants, but was not statistically significant (pooled RR, 2.06; P=.292).
“Afib increases the risk for SCD at a higher proportion compared with the risk for overall mortality. Afib may be associated with SCD regardless of other cardiovascular comorbidities,” the authors said. They call for further research to identify independent predictors and the underlying pathophysiology of SCD in patients with Afib.