Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .
Association between atrial fibrillation and appropriate implantable cardioverter defibrillator therapy: results from a prospective study.
INTRODUCTION  Atrial fibrillation ( AF ) is associated with significant morbidity and mortality that may be related to hemodynamic impairment , thromboembolic events , or enhanced electrical instability of the ventricular myocardium . There is , however , a lack of data concerning the association of AF and ventricular tachyarrhythmias . METHODS AND RESULTS Consecutive patients with indication for an implantable cardioverter defibrillator ( ICD ) were classified for the presence or absence of persistent AF at the time of device implantation .  Incidence of device therapy , stored electrograms , and clinical events during follow-up were evaluated prospect ively . Two hundred fifty patients were included . During follow-up ( 20+/-14 months ) , patients in AF experienced appropriate device therapy for recurrent ventricular arrhythmias more frequently compared with patients in sinus rhythm ( SR ) ( 63 % vs 38 % , P = 0.01 ) . On multivariate analysis , AF was an independent predictor of appropriate ICD therapy ( relative risk 1.8 ; 95 % confidence interval [ CI ] 1.2 to 2.9 ) and inappropriate device therapy ( relative risk 2.3 ; 95 % CI 1.2 to 4.5 ) . Predefined clinical events ( cluster endpoint : death , syncope , and hospitalizations ) were observed more frequently in AF than in SR patients ( 55 % vs 31 % , P = 0.01 ) . Analysis of device-stored electrograms revealed a higher incidence of short-long-short cycles preceding ventricular arrhythmias in AF compared with SR patients ( 50 % vs 16 % , P = 0.002 ) . Baseline heart rate preceding ventricular arrhythmias did not differ between the two groups . CONCLUSION AF is an independent predictor of recurrent ventricular arrhythmias in ICD recipients . The underlying electrophysiologic mechanism seems to be irregular rather than rapid ventricular activation , with a high incidence of short-long-short sequences preceding ventricular tachyarrhythmias in AF patients
Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .