Atrial Fibrillation and Risk of Sudden Cardiac Arrest in Young Adults.

ABSTRACT

BACKGROUND AND AIMS: Evidence of an association between atrial fibrillation (AF) and sudden cardiac arrest (SCA) in young adults is limited. We aimed to evaluate this association in a general population aged between 20-39 years. METHODS: Young adults who underwent health check-ups between 2009 and 2012 were screened from a nationwide healthcare database in South Korea. A history of AF diagnosis before the health check-ups was identified based on the relevant International Classification of Diseases, 10th edition codes reported in the database. Associations between an established diagnosis of AF and the risk of SCA during follow-up were examined. RESULTS: A total of 6,345,162 young people were analyzed with a mean follow-up duration of 9.4 years. The mean age was 30.9 ± 5.0 years, and 5,875 (0.09%) individuals were diagnosed with AF. During follow-up, SCA occurred in 5,352 (0.08%) individuals, and the crude incidence was 0.56 and 0.09 events per 1,000 person-years for participants with and without AF, respectively. Individuals with AF had a 3.0-fold higher risk in a multivariate model adjusted for age, sex, lifestyle, anthropometric data, and medical comorbidities (adjusted hazard ratio 2.96, 95% confidence interval 1.99-4.41, p<0.001). Both incident and prevalent AF were associated with an increased risk of SCA, with no significant differences between the two groups. CONCLUSION: Atrial fibrillation was associated with a significantly higher risk of developing SCA in healthy young adults. Whether the rate or rhythm affects the risk of SCA in young patients with AF remains to be examined.