J Korean Med Sci.  2018 May;33(22):e160. 10.3346/jkms.2018.33.e160.

Increased Risk of Atrial Fibrillation in the Early Period after Herpes Zoster Infection: a Nationwide Population-based Case-control Study

• Cha MJ
• Seo HM
• Choi EK
• Lee JH
• Han K
• Lee SR
• Lim WH
• Park YM
• Oh S

• KMID: 2411889
• DOI: http://doi.org/10.3346/jkms.2018.33.e160

Abstract

BACKGROUND
Herpes zoster (HZ) is a chronic inflammatory disease that could result in autonomic dysfunction, often leading to atrial fibrillation (AF).
METHODS
From the Korean National Health Insurance Service database of 738,559 subjects, patients newly diagnosed with HZ (n = 30,685) between 2004 and 2011, with no history of HZ or AF were identified. For the non-HZ control group, 122,740 age- and sex-matched subjects were selected. AF development in the first two-years following HZ diagnosis, and during the overall follow-up period were compared among severe (requiring hospitalization, n = 2,213), mild (n = 28,472), and non-HZ (n = 122,740) groups.
RESULTS
There were 2,204 (1.4%) patients diagnosed with AF during follow-up, and 825 (0.5%) were diagnosed within the first two years after HZ. The severe HZ group showed higher rates of AF development (6.4 per 1,000 patient-years [PTPY]) compared to mild-HZ group (2.9 PTPY) and non-HZ group (2.7 PTPY). The risk of developing AF was higher in the first two-years after HZ diagnosis in the severe HZ group (10.6 PTPY vs. 2.7 PTPY in mild-HZ group and 2.6 PTPY in non-HZ group).
CONCLUSION
Severe HZ that requires hospitalization shows an increased risk of incident AF, and the risk is higher in the first two-years following HZ diagnosis.

Keyword

Atrial Fibrillation; Herpes Zoster; Inflammation; Autonomic Dysfunction

MeSH Terms

Atrial Fibrillation*
Case-Control Studies*
Diagnosis
Follow-Up Studies
Herpes Zoster*
Hospitalization
Humans
Inflammation
National Health Programs