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New-onset AF linked to SCD in patients with hypertension

Development of new-onset atrial fibrillation (AF) identifies hypertensive patients at increased risk of sudden cardiac death (SCD), according to a study1 published recently in Circulation: Arrhythmia and Electrophysiology.

Researchers investigated the relationship of SCD to new-onset AF in 8,831 hypertensive patients with electrocardiographic left ventricular hypertrophy with no history of AF, in sinus rhythm on their baseline electrocardiogram, randomly assigned to losartan- or atenolol-based treatment. During 4.7±1.1 years mean follow-up, new-onset AF occurred in 701 patients (7.9%) and SCD in 151 patients (1.7%). In univariate Cox analyses, new-onset AF was associated with a >4-fold higher risk of SCD (hazard ratio, 4.69; 95% CI interval, 2.96–7.45; p<0.001).

In multivariate Cox analyses adjusting for age, sex, race, diabetes mellitus, history of heart failure, myocardial infarction, ischaemic heart disease, stroke, smoking, serum high-density lipoprotein cholesterol, creatinine, glucose, and urine albumin/creatinine ratio as standard risk factors, and for incident myocardial infarction, in-treatment use of digoxin, systolic and diastolic pressure, heart rate, QRS duration, Cornell voltage-duration product, and Sokolow-Lyon voltage left ventricular hypertrophy treated as time-varying covariates, new-onset AF remained associated with a >3-fold increased risk of SCD (hazard ratio, 3.13; 95% confidence interval, 1.87–5.24; p<0.001).

References

1. Okin PM, Bang CN, Wachtell K, Hille DA, Kjeldsen SE, Dahlöf B, Devereux RB. Relationship of sudden cardiac death to new-onset atrial fibrillation in hypertensive patients with left ventricular hypertrophy. Circ Arrhythm Electrophysiol 2013;6:243–51. http://dx.doi.org/10.1161/​CIRCEP.112.977777

Published on: June 20, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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