New-onset atrial fibrillation after cardiac arrest increased 1-year risk of adverse events by 25%, AMI by 59%, recurrent CA by 48%, with higher early stroke risk especially in females.
Does new-onset atrial fibrillation after cardiac arrest increase the risk of a composite of all-cause death, stroke, AMI, and recurrent CA in adult patients?
New-onset atrial fibrillation within 2 days after cardiac arrest is associated with a significantly increased 1-year risk of adverse events, including recurrent cardiac arrest and acute myocardial infarction.
ABSTRACT Background Data on adverse events in patients developing atrial fibrillation (AF) after cardiac arrest (CA) are limited. Methods Retrospective analysis using the TriNetX network. Adults (≥ 18 years) with CA (ICD‐10‐CM I46) from 2014 to 2024 were divided into two cohorts: those with new‐onset AF (I48) within 2 days after CA and those without. Primary outcome was the 1‐year risk of a composite of all‐cause death, stroke, acute myocardial infarction (AMI), and recurrent CA. Secondary outcomes were the individual components. Cox regression provided hazard ratios (HRs) and 95% confidence intervals (CIs) before and after 1:1 propensity score matching (PSM). Sensitivity analyses stratified follow‐up into early (3–33 days) and late (34–367 days) phases; subgroups included age, sex, hypertension, diabetes, heart failure, and shockable rhythms. Results We identified 1221 patients with post–CA AF (mean age 65 ± 14.9 years; 33.8% female) and 149 222 without AF (57.9 ± 17.6 years; 39.3% female). Before PSM, AF patients were older and had greater cardiovascular burden. After PSM post–CA AF was associated with higher risk of the composite outcome (HR 1.25, 95% CI 1.13–1.38), AMI (HR 1.59, 95% CI 1.30–1.95), recurrent CA (HR 1.48, 95% CI 1.30–1.70), and a non‐significant trend toward increased stroke risk, which was greater during the early phase post‐CA. Female patients showed stronger association between post–CA AF and stroke (p for interaction = 0.04). Conclusion Post–CA AF is associated with an increased risk of adverse events, including AMI and recurrent CA. Stroke risk was higher during the early post‐resuscitation phase and among female patients.
Tartaglia et al. (2026) studied this question. New-onset atrial fibrillation after cardiac arrest increased 1-year risk of adverse events by 25%, AMI by 59%, recurrent CA by 48%, with higher early stroke risk especially in females.