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Annals of Noninvasive Electrocardiology logoLink to Annals of Noninvasive Electrocardiology
letter
. 2007 Jul 5;12(3):279. doi: 10.1111/j.1542-474X.2007.00172.x

Electrocardiographic Predictors of Arrhythmic Death –“What is the Role of Atrial Fibrillation?”

Hari Dandapantula 1, Laxman Chandu 1
PMCID: PMC6932649  PMID: 17617074

To the Editor:

We read the article “Electrocardiographic predictors of arrhythmic death” by McLaughlin et al. 1 with lot of enthusiasm. This review article is concise and well written but left us with few un‐answered questions.

What, in author's opinion, is the role of new onset/perimyocardial infarction related atrial fibrillation in development and occurrence of sudden cardiac death? Why atrial fibrillation was not mentioned in their article, even though there has been a recent interest in the topic of atrial fibrillation and arrhythmic death?

Atrial fibrillation is consistently shown to be associated with increased risk of sudden cardiac deaths in various studies. In a prospective study by Gronefeld et al. 2 presence of atrial fibrillation was found to be an independent predictor of recurrent ventricular arrhythmia and sudden cardiac death. In another study by Pedersen et al. 3 the adjusted risk ratio of atrial fibrillation/atrial flutter for sudden cardiac death was 1.31 with 95% CI 1.07–1.60; P < 0.009. In a study of survivors of primary ventricular fibrillation by Dekker et al. 4 atrial fibrillation was diagnosed in 21% of cases and 0% of control subjects. In the RACE study by Hagens et al. 5 44% of total cardiac mortality in patients with atrial fibrillation was found to be secondary to sudden cardiac death.

Aforementioned data is strongly suggestive of the role and association of atrial fibrillation in development of sudden death. We really appreciate if authors of the review article share their opinion on this subject.

REFERENCES

  • 1. McLaughlin MG, Zimetbaum PJ. Electrocardiographic predictors of arrhythmic death. Ann Noninvasive Electrocardiol 2006;11:327–337. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2. Gronefeld GC, Mauss O, Li YG, et al Association between atrial fibrillation and appropriate implantable cardioverter defibrillator therapy: results from a prospective study. J Cardiovasc Electrophysiol 2000;11:1208–1214. [DOI] [PubMed] [Google Scholar]
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  • 4. Dekker LR, Bezzina CR, Henriques JP, et al Familial sudden death is an important risk factor for primary ventricular fibrillation: a case‐control study in acute myocardial infarction patients. Circulation 2006;114:1140–1145. [DOI] [PubMed] [Google Scholar]
  • 5. Hagens VE, Rienstra M, Van Veldhuisen DJ, et al Determinants of sudden cardiac death in patients with persistent atrial fibrillation in the rate control versus electrical cardioversion (RACE) study. Am J Cardiol 2006;98:929–932. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Noninvasive Electrocardiology : The Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc are provided here courtesy of International Society for Holter and Noninvasive Electrocardiology, Inc. and Wiley Periodicals, Inc.

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