[Atrial fibrillation during myocardial infarction with and without ST segment elevation]
Insights
Atrial fibrillation (AF) occurs in 7.6% of acute myocardial infarction (MI) patients, irrespective of ST segment elevation. This condition is linked to increased mortality and ventricular arrhythmias in MI patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Internal Medicine
Context:
- Atrial fibrillation (AF) is a frequent complication during acute myocardial infarction (MI), contributing to increased hospital mortality.
- The prognostic impact and incidence of AF in MI patients, with or without ST segment elevation, require further definition.
Purpose:
- To determine the incidence, predictive factors, and prognostic impact of AF within the first 24 hours of MI.
- To compare AF occurrence and outcomes in ST-elevation MI (STEMI) versus non-ST-elevation MI (NSTEMI) patients.
Summary:
- This study analyzed 1701 MI patients, finding AF in 7.6% within 24 hours, with identical incidence in STEMI (7.6%) and NSTEMI (7.7%).
- Independent predictors of AF included Killip class >2 and chronic obstructive pulmonary disease.
- AF presence significantly correlated with ventricular arrhythmias and/or cardiovascular mortality in both STEMI and NSTEMI groups.
Impact:
- The study highlights that AF incidence and its associated poor prognosis are consistent across MI types, regardless of ST segment elevation.
- Findings emphasize the importance of monitoring for AF in all acute MI patients due to its significant adverse outcomes.
Introduction:
The occurrence of atrial fibrillation (AF) in the acute phase of myocardial infarction with ST segment elevation is common and responsible for an excess hospital mortality. The aim of this work was to define the incidence, predictive factors, and the prognostic impact of AF during MI with and without raised ST segment in the RICO study.
Patients And Methods:
Between January 2001 and July 2003, 1701 patients were included in this study: 130 (7.6%) had AF in the first 24 hours of management (AF+ group); 1571 (92.4%) remained in sinus rhythm (AF- group).
Results:
Among the 1701 patients included in this study, 1197 (70.4%) had MI with raised ST and 504 (29.6%) had MI without raised ST. The incidence of AF was identical whatever the type of MI (7.6% with raised ST versus 7.7% without, p=0.334). The presence of Killip class >2 on admission and chronic obstructive pulmonary disease were independent predictive factors for the occurrence of AF (OR=3.84, p=0.007, and OR=2.47, p=0.014 respectively). The presence of AF was significantly associated with the occurrence of ventricular arrhythmia and/or cardiovascular mortality during admission in the non-selected MI population whatever the type of MI (raised ST ; AF+; 34% and AF-; 18%, p<0.01 versus without raised ST; AF+; 36% and AF-; 16%, p = 0.01).
Conclusion:
This study provides evidence that the incidence of AF during the first 24 hours of MI, as well as its poor prognosis, are identical whether or not there is ST segment elevation.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests