Response by Deo et al to Letters Regarding Article, “Development and Validation of a Sudden Cardiac Death Prediction Model for the General Population”
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Dr Karam and colleagues question the absence of atrial fibrillation (AF) from our sudden cardiac death (SCD) prediction model.1 A prior analysis by Chen et al,2 also from the ARIC study (Atherosclerosis Risk in Communities) and the CHS study (Cardiovascular Health Study), demonstrated an independent association between AF and SCD. We agree that there are potential electrophysiological reasons for evaluating AF as a risk factor for SCD. Atrial remodeling processes, which are characterized by shorter action potential duration and refractoriness, underlie the mechanisms implicated in AF and may predispose to similar changes in ventricular myocytes. In addition, both AF and SCD can result from myocardial fibrosis or hypertrophy. However, the differences in the statistical methods for these analyses1,2 are important in understanding why AF was not selected as a predictor in our multivariable prediction model.
The SCD …