A 3-year retrospective exploration of predictors for cardiac arrest in atrial fibrillation

Abstract Background An increasing correlation between atrial fibrillation (AF) and a heightened risk of cardiac arrest is emerging. Yet, the specific predictors of cardiac arrest in hospitalized patients with AF remain unclear. Purpose This study aims to identify these predictors, providing essential insights for refined risk assessment and targeted clinical interventions. Methods Adult patients hospitalized between 2018 and 2020 with a primary diagnosis of AF with or without cardiac arrest were identified using the International Classification of Diseases, Tenth Revision (ICD-10) code. Demographics and comorbidities were recorded. Logistic regression was employed to identify predictors of increased cardiac arrest. Results In a study of 272,028 hospitalizations with AF, 2,352 patients suffered cardiac arrest, and 523 died during hospitalization. Factors associated with increased odds of cardiac arrest include heart failure (OR = 1.79, 95% CI: 1.60–2.00), cardiogenic shock (OR = 2.95, 95% CI: 2.35–3.71), history of coronary angioplasty or bypass (OR = 1.79, 95% CI: 1.59–2.02), chronic kidney disease (OR = 1.26, 95% CI: 1.12–1.42), end-stage kidney disease (OR = 2.34, 95% CI: 1.98–2.77), and septic shock (OR = 6.50, 95% CI: 4.80–8.80). Chronic obstructive pulmonary disease (COPD) and infection were associated with a 13% (OR = 1.13, 95% CI: 1.02–1.26) and 45% (OR = 1.45, 95% CI: 1.25–1.68) increase in odds for cardiac arrest, respectively. Increased age (OR = 0.99, 95% CI: 0.98–0.99) and female sex (OR = 0.83, 95% CI: 0.76–0.91) showed an inverse relation with cardiac arrest. Hypertension and obesity exhibited protective effects against cardiac arrest, with odds ratios of 0.85 (95% CI: 0.74–0.97) and 0.83 (95% CI: 0.75–0.93), respectively. Conclusion Our study underscores the intricate web of factors influencing cardiac arrest risk in AF patients. A personalized approach to risk assessment in the context of AF might be needed.