Transient Atrial Fibrillation During Acute Myocardial Infarction Is a Predictor of Poor Outcomes

Fukunami, Masatake

doi:10.1253/circj.cj-16-0529

Cited by 6 publications

(9 citation statements)

References 15 publications

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“…The large epidemiological studies demonstrated that AF is correlated with high mortality and adverse events in patients with AMI [7–9]. However, the answer of this association is still unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Thromboembolic complications are one of the known mechanisms [10,11]. Patients with AF develop during the hospital period are older as well as with higher rate of hypertension (HTA) and heart failure (HF) which may contribute to the worse outcome [1,2,7–9,12–16] Atrial fibrillation may precipitate the occurrence of severe ventricular arrhythmias which may lead to sudden death in these patients [17]. The large numbers of research has been done in patients with ST-elevation myocardial infarction (STEMI), but some studies have also included patients [18–21] with non-ST-elevation myocardial infarction (NSTEMI) [12,17,22].…”

Section: Introductionmentioning

confidence: 99%

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Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction

et al. 2017

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AbstractThe large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months. Atrial fibrillation develops during the hospital period was registered in 48 patients (8%). After adjustment by logistic regression model the strongest predictor of atrial fibrillation develop during the hospital period was older age, particularly more than 70 years (odds ratio 2.37, CI 1.23-4.58, p=0.010), followed by increased of Body Mass Index (odds ratio 1.17, CI 1.04-1.33, p=0.012), enlarged diameter of left atrium (LA) (odds ratio 1,18, CI 1,03-1,33, p=0,015) presentation of mitral regurgitation (odds ratio 3.56, CI 1.25-10.32, p=0.018) and B-type natriuretic peptide (odds ratio 2.12, CI 1.24-3.33, p=0.048).Patients with atrial fibrillation develop during the hospital period had a higher mortality during the hospital course (10.4% vs. 5.6%) p=0.179. as well as follow-up period of 84 months than patients without it (64.6% vs. 39.1%) p=0.569, than patients without it, but without statistically significance. Patients with AF develop during the hospital period had higher mortality during the hospital course as well as follow up period of 84 months than patients without it, but without statistically significance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction

et al. 2017

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“… 9 17 18 Ventricular dysfunction caused by myocardial infarction can be aggravated with the development of AF by tachycardia without atrioventricular synchrony. 19 Further, ventricular dysfunction with an irregular ventricular cycle length can lead to fatal ventricular arrhythmia. 19 However, there is no strong evidence that supports the notion that early direct current cardioversion of AF affords survival benefits in patients with AMI.…”

Section: Discussionmentioning

confidence: 99%

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

et al. 2020

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ObjectiveTo investigate the long-term prognostic implications of transient new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).DesignRetrospective observational study.SettingSingle tertiary centre.ParticipantsThis study included 2523 patients who presented with AMI from 3 June 2003 to 24 February 2015, after the exclusion of those with prior AF or in-hospital death.Outcome measuresPatients were divided into three groups according to the occurrence and type of new-onset AF: (1) sinus rhythm (SR) group; (2) paroxysmal AF (PaAF: AF converted to SR prior to discharge) group and (3) persistent AF (PeAF: AF persisted during the hospitalisation) group. Post-discharge all-cause mortality and stroke incidences were compared between the groups.ResultsNew-onset AF was observed in 271 patients (10.7%; PaAF: 230, PeAF: 41). The median follow-up period was 7.2 years (IQR: 5.2–9.4). The incidence of all-cause death and stroke was highest in the PeAF group, followed by the PaAF and SR groups (all-cause mortality: 48.8% vs 26.5% vs 14.7%, p<0.001; stroke 22.0% vs 8.3% vs 4.4%, p<0.001). In the multivariable analysis, PaAF and PeAF were associated with an increased risk of stroke (PaAF, HR: 1.972, 95% CI: 1.162–3.346; PeAF, HR: 5.160, CI: 2.242–11.873) compared with SR. The PaAF group showed a higher incidence of post-discharge AF than the SR group (29.1% vs 4.2%, p<0.001).ConclusionsNew-onset AF following AMI is associated with poor long-term outcomes. Even when AF episodes are brief and are converted to SR, new-onset AF remains associated with an increased risk of recurrent AF and stroke.

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“…In a beat‐to‐beat analysis of the P wave, they showed that P wave variability can add information in the understanding of the association between the anatomical atrial substrate and atrial arrhythmias, using advanced ECG recording system for high‐resolution biopotential measurement (sample frequency 2 kHz, 24‐bit resolution). In the present study, we assessed P wave duration, the RMS voltage for the last 20 ms, and P wave dispersion on SAECG, because SAECG is a simple noninvasive tool, which has been used for years, and previous studies adopted it to show the preventive effect of RAAS blockade on AF and a relationship between the severity of atrial fibrosis and the P‐wave morphology . Ad and P‐disp reflect whole atrial abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that the electrophysiological abnormality of the atrial muscle in patients with AF could be detected by P wave signal‐averaged electrocardiography (P‐SAECG) . In relationship between the extent of atrial fibrosis in left atrial appendage samples taken during open cardiac surgery and the total duration and root mean square (RMS) voltage for the last 20 ms of the filtered P wave in signal‐averaged electrocardiogram (ECG), it was shown that the more atrial fibrosis there is, the longer the filtered P wave duration is and the lower the RMS voltage for the last section . Furthermore, P‐wave dispersion was also reported to be related to the severity of atrial fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Eplerenone might affect atrial fibrosis in patients with hypertension

Kawasaki

Yamada

Okuyama

et al. 2017

Pacing Clinical Electrophis

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Transient Atrial Fibrillation During Acute Myocardial Infarction Is a Predictor of Poor Outcomes

Cited by 6 publications

References 15 publications

Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction

Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

Eplerenone might affect atrial fibrosis in patients with hypertension

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