Europace Advance Access originally published online on May 20, 2008
Europace 2008 10(7):854-859; doi:10.1093/europace/eun128
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Atrial fibrillation
Association between statin therapy and reductions in atrial fibrillation or flutter and inappropriate shock therapy
1 Division of Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102-5037, USA; 2 University of Connecticut Schools of Pharmacy and Medicine, Storrs and Farmington, CT, USA
Aims: In patients without implantable cardioverter defibrillators (ICDs), statins have been shown to reduce the incidence of atrial fibrillation and atrial flutter (AF/AFL). We sought to determine if statin therapy could reduce the occurrence of AF/AFL with rapid ventricular rates with and without inappropriate shock therapy among a large heterogeneous ICD cohort.
Methods and results: We prospectively followed 1445 consecutive patients receiving an ICD for the primary (n = 833) or secondary (n = 612) prevention from December 1997 through January 2007. Outcome measures include incidence of AF/AFL that initiated ICD therapy or was detected during ICD interrogation. Cox hazard regression analyses were conducted to determine the predictors of AF/AFL with and without inappropriate shock delivery and did not include inappropriate shocks resulting from lead dysfunction or other exogenous factors. Patients in this study (n = 1445) were followed over a mean follow-up period of (mean ± SD) 874 ± 805 days. There were 563 episodes of AF/AFL detected, with 200 episodes resulting in inappropriate shock therapy. Overall, 745 patients received statin therapy and 700 did not. The use of statin therapy was associated with an adjusted hazard ratio of 0.472 [95% confidence interval (CI), 0.349–0.638, P < 0.001] for the development of AF/AFL with shock therapy and 0.613 (95% CI, 0.496–0.758, P < 0.001) without shock therapy when compared with the group without statin use.
Conclusion: Among a cohort with ICDs at high risk for cardiac arrhythmias, statin therapy was associated with a reduction in AF/AFL tachyarrhythmia detection and inappropriate shock therapy.
Key Words: Statins, Implantable cardioverter defibrillator, Atrial tachyarrhythmias, Inappropriate shock therapy
* Corresponding author. Tel: +1 860 545 2883; fax: +1 860 545 2756.E-mail address: jkluger{at}harthosp.org
Preliminary data in this paper were presented as an E-poster at the American Heart Association Scientific Sessions, Orlando, FL, USA, 4–7 November 2007.
Manuscript submitted 12 February 2008. Accepted after revision 24 April 2008.