American Journal of Cardiology
Volume 98, Issue 7 , Pages 929-932, 1 October 2006

Determinants of Sudden Cardiac Death in Patients With Persistent Atrial Fibrillation in the RAte Control Versus Electrical Cardioversion (RACE) Study

  • Vincent E. Hagens, MD

      Affiliations

    • Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    • ,
  • Michiel Rienstra, MD

      Affiliations

    • Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    • ,
  • Dirk J. Van Veldhuisen, MD

      Affiliations

    • Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    • ,
  • Harry J.G.M. Crijns, MD

      Affiliations

    • Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands.
    • ,
  • Isabelle C. Van Gelder, MD

      Affiliations

    • Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    • Corresponding Author InformationCorresponding author: Tel: 0031-50-361-2355; fax 0031-50-361-4391.

Received 16 December 2005; received in revised form 19 April 2006; accepted 20 April 2006. published online 14 August 2006.

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 β 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.

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 The RACE Study was supported by grants from the Center for Health Care Insurance (Grant OG96-047), Diemen, The Netherlands; the Interuniversity Cardiology Institute, Utrecht, The Netherlands; and 3M Pharma, Leiden, The Netherlands.

PII: S0002-9149(06)01185-4

doi:10.1016/j.amjcard.2006.04.038

American Journal of Cardiology
Volume 98, Issue 7 , Pages 929-932, 1 October 2006

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