Conversion of Infarction‐Associated Atrial Fibrillation by Restoration of Atrial Perfusion

Blanton, Robert M.; Nappi, Anthony; Kimmelstiel, Carey

doi:10.1002/clc.20573

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…Blanton Jr et al . 8 reported a case of inferior myocardial infarction complicated by atrial fibrillation that was converted to sinus rhythm after balloon dilatation and stenting of the large left atrial branch of the LCX. The role of anti-arrhythmic drugs in atrial infarction remains to be explored.…”

Section: Discussionmentioning

confidence: 99%

Atrial tachycardia related to atrial infarction treated with catheter ablation: a case report

Fujiwara

Yamashita

Takemoto

et al. 2022

European Heart Journal - Case Reports

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Background Atrial infarction, usually concurrent with ventricular infarction, is underrecognized. Although most patients with atrial infarction have complicated supraventricular tachyarrhythmias, its mechanism is still unknown. We report a case of atrial tachycardia related to atrial infarction treated with catheter ablation. Case summary A 51-year-old man was referred for acute chest pain. Electrocardiography showed a junctional rhythm with ST depression in the precordial leads. Emergency coronary angiography revealed an occluded dominant left circumflex coronary artery (LCX). A drug-eluting stent was deployed; however, the atrial branch from the distal side of the LCX was jailed by the stent and became occluded. On the 7th day, the premature atrial contractions (PAC) became frequent and changed to atrial tachycardia (AT). Due to its resistance to medication, we performed catheter ablation. The electro-anatomical map revealed counter-clockwise macro-reentrant tachycardia at the tricuspid valve annulus, with low-voltage and fragmented potential (FP) areas at the posterior wall of the right atrium (RA). After terminating the AT through linear ablation for the cavotricuspid isthmus, multiple-focus PACs originating from the FP area in the RA posterior wall were documented. Coronary angiography revealed that these damaged areas were perfused by the atrial branch of the LCX. Defragmentation in the FP area could eliminate PACs. The patient was discharged with sinus rhythm and without any complications. Discussion We can perform electro-anatomical mapping to identify tachycardia circuit and PACs arising from the FP area in the posterior RA, where the atrial branch was perfusing. Multiple PACs from infarcted myocardium result in tachycardia.

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Section: Discussionmentioning

confidence: 99%

Atrial tachycardia related to atrial infarction treated with catheter ablation: a case report

Fujiwara

Yamashita

Takemoto

et al. 2022

European Heart Journal - Case Reports

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“…The risk for subsequent hospitalization for bleeding was found to be 1.8 times higher in patients on vitamin K antagonists (VKAs) and aspirin, 3.5 times higher in patients on clopidogrel and VKAs and 4 times higher in patients on triple therapy [ 4 , 5 ]. Atrial ischemia induced by acute ST segment elevation myocardial infarction (MI) besides increased left atrial pressure due to left ventricular dysfunction, increased vagal stimulation and complication such as pericarditis have been postulated to be possible mechanism of infarct associated AF [ 6 , 7 ]. There has been correlation found between stenosis of the RCA and the occurrence of AF, particularly in acute phase of infarction.…”

Section: Discussionmentioning

confidence: 99%

Conversion of Atrial Fibrillation to Sinus Rhythm During Coronary Intervention: Complex Interplay of Arrhythmic and Ischemic Substrate

2018

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Atrial fibrillation (AF) can be a manifestation of acute coronary syndrome (ACS). Presence of AF during ACS further adds to complexities in the management issues and prognosis of ACS. We report a case of a 77-year-old male in whom we observed spontaneous conversion of AF to sinus rhythm during percutaneous coronary interventional procedure for critical ostial stenosis of the right coronary artery; and discuss potential electrophysiological mechanisms related to such phenomenon.

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“…54 Restoration of the sinus rhythm by reversal of left atrial ischemia has been reported in a patient with NOAF and proximal left circumflex occlusion. 55 However, the effect of early revascularization on NOAF in AMI patients requires further investigation. factor for NOAF, which was consistent with the results of previous studies.…”

mentioning

confidence: 99%

A Predictive Model of New-Onset Atrial Fibrillation After Percutaneous Coronary Intervention in Acute Myocardial Infarction Based on the Lymphocyte to C-Reactive Protein Ratio

Gao,

Bao,

et al. 2023

JIR

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Purpose Lymphocyte to C-reactive protein ratio (LCR) is a recognized systemic inflammatory marker and novel prognostic indicator for several cancers. This study investigated the relationship between preoperative LCR and new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Patients and Methods Patients with AMI (n=662) with no history of atrial fibrillation (AF) were enrolled and classified into NOAF and non-NOAF groups based on the occurrence of postoperative NOAF during hospitalization. Logistic regression models were used to analyze NOAF risk factors and to assess the association between preoperative LCR and NOAF incidence. We constructed a new nomogram from the selected NOAF risk factors, and tested its predictive performance, degree of calibration, and clinical utility using receiver operating characteristic and calibration curves, decision curve analysis, and clinical impact curves. Results Overall, 84 (12.7%) patients developed NOAF during hospitalization. The LCR was significantly lower in the NOAF group. Preoperative LCR accurately predicted NOAF after AMI and was correlated with increased NOAF risk. Age, body mass index, diabetes, serum albumin levels, uric acid levels, left atrium (LA) diameter, left ventricular ejection fraction, left circumflex artery stenosis > 50%, and Killip class II status were independent predictors of NOAF after AMI. In addition, a new nomogram combined with LCR was constructed to stratify the risk of NOAF in patients with AMI. The performance of the new nomogram was satisfactory, as shown by the receiver operating characteristic curve, calibration curve, decision curve analysis and clinical impact curve. Conclusion Preoperative LCR was an independent predictor of NOAF in patients with AMI after PCI. The novel nomogram combined with LCR could rapidly and individually identify and treat patients at a high risk of NOAF.

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Conversion of Infarction‐Associated Atrial Fibrillation by Restoration of Atrial Perfusion

Cited by 6 publications

References 6 publications

Atrial tachycardia related to atrial infarction treated with catheter ablation: a case report

Atrial tachycardia related to atrial infarction treated with catheter ablation: a case report

Conversion of Atrial Fibrillation to Sinus Rhythm During Coronary Intervention: Complex Interplay of Arrhythmic and Ischemic Substrate

A Predictive Model of New-Onset Atrial Fibrillation After Percutaneous Coronary Intervention in Acute Myocardial Infarction Based on the Lymphocyte to C-Reactive Protein Ratio

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