Determinants of sudden cardiac death in patients with persistent atrial fibrillation in the rate control versus electrical cardioversion (RACE) study.
This report evaluated the correlates of sudden cardiac and nonsudden cardiac death in patients with persistent atrial fibrillation randomized to rate or rhythm control in the RAte Control vs Electrical cardioversion (RACE) study. Sudden cardiac death was observed in 16 patients, 8 patients in each group. Previous myocardial infarction resulted in a 4.9-fold increased risk of sudden death (95% confidence interval 1.8 to 13.2). The use of beta blockers showed their protective nature (hazard ratio 0.2, 95% confidence interval 0.05 to 0.9). The randomized treatment strategy, heart rhythm during follow-up, use of antiarrhythmic drugs, and number of stroke risk factors were not associated with sudden cardiac death. In conclusion, the treatment of underlying disease, rather than the heart rhythm, seems essential to prevent mortality.
Hagens
Vincent E
VE
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Rienstra
Michiel
M
Van Veldhuisen
Dirk J
DJ
Crijns
Harry J G M
HJ
Van Gelder
Isabelle C
IC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000401:mortality / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac; D003920:Diabetes Mellitus / Q000453:epidemiology; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004554:Electric Countershock; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005424:Flecainide / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D055502:Secondary Prevention; D013015:Sotalol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D004071:Digitalis Glycosides; D013015:Sotalol; D005424:Flecainide; D000638:Amiodarone