Mortality of patients with implanted cardioverter/defibrillators in relation to episodes of atrial fibrillation.
OBJECTIVE
This study was undertaken to evaluate if a history of episodes of atrial fibrillation (AF) has an effect on survival in patients (pts) with implanted cardioverter defibrillators (ICD).


RESULTS
Retrospective analysis of baseline characteristics, medication and endpoints in pts receiving a dual-chamber ICD comparing pts without (group 1: n = 291) and with a history of AF (group 2: n = 68). Pts in groups 1 and 2 did not differ with regard to baseline characteristics. Forty-one pts (8.7%) experienced a detected episode of AF. During the study period (mean follow-up 9.5 months) 25 pts died (5.8% of group 1 vs 11.8% of group 2). Patient survival was found to be 97.9% vs 91.2% ( n = 279 vs 63) at 3 months after implantation, 97.5% vs 89.7% ( n = 244 vs 54) at 6 months, and 93.7% vs 86.5% ( n = 96 vs 28) at 12 months in group 1 vs group 2 (p = 0.005). The risk of death increased after a first episode of AF was experienced during follow-up (RR = 5.0, p = 0.0007). Independent predictors of mortality are NYHA class (p = 0.002, history of AF (p = 0.009 for predicting early mortality), and detected episodes of AF during follow-up (p = 0.001).


CONCLUSIONS
ICD-patients with a history of AF had a higher than average risk of death early after implantation and after device-detected episodes of AF.
Deneke
Thomas
T
Berufsgenossenschaftliche Kliniken Bergmannsheil, Bochum, Germany. thomas.deneke@ruhr-uni-bochum.de
Lawo
Thomas
T
Gerritse
Bart
B
Lemke
Bernd
B
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000401:mortality*; D016022:Case-Control Studies; D017147:Defibrillators, Implantable; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013610:Tachycardia / Q000453:epidemiology; D013997:Time Factors
D000889:Anti-Arrhythmia Agents