Atrial fibrillation as a risk factor in patients after cardiac arrest for ventricular fibrillation

Atrial fibrillation is the most common arrhythmia in adults. Several studies were focused on the association between atrial fibrillation and other heart diseases, including sudden cardiac death. Aim: The aim of our study was to analyse the incidence of atrial fibrillation as a risk factor after sudden cardiac arrest for ventricular fibrillation. Methods: Retrospective, monocentric study included 514 people after out-of-hospital cardiac arrest (OHCA) hospitalized in the Cardiology Intensive Care Unit. Patients underwent standard post-resuscitation man-agement (including coronary angiography and echocardiography). The case history of patients was found (comorbidities, medication, and presence of atrial fibrillation before the actual OHCA). These data were further evaluated then. Results: A higher incidence of atrial fibrillation was clearly demonstrated in comparison of patients with cardiac arrest due to ventricular fibrillation without ACS (VF without ACS) compared to the patients with ACS (total incidence AF 106 pts., 45.96% x 24 pts., 13.95%, p <0.0001). There were statistically more patients with already known coronary artery disease and arterial hypertension in the group of VF without ACS and patients used statistically significantly more ACEi/sartans, beta-blockers, digoxin, diuretics, antiplatelet and anticoagulant therapy, and statins. A comparison of patients with cardiac arrest due to ventricular fibrilla-tion with acute coronary syndrome and coronary artery disease (VF with ACS with CAD) with patients with ventricular fibrillation without acute coronary syndrome and without coronary artery disease (VF without ACS without CAD) showed a statistically significantly higher incidence of total atrial fibrillation in the VF group without ACS and without CAD (45 pts., 39.13% x 4 pts., 16.67%, p = 0.0376). There was no significant difference in the monitored comorbidities. There was a significant difference in the use of beta-blockers, an-tiplatelet therapy and statins in the monitored medication, which is due to the presence of coronary artery disease before cardiac arrest. Conclusion: Our investigation confirmed atrial fibrillation as a significant risk factor for sudden cardiac death in patients with cardiac arrest without acute coronary syndrome compared to patients with acute coronary syndrome. Similarly, it confirms a higher incidence of atrial fibrillation in patients after cardiac arrest due to ventricular fibrillation without coronary artery disease and acute coronary syndrome compared to patients with these diseases. This confirms atrial fibrillation as an independent risk factor for sudden cardiac death.