Related Experiment Video
Updated: Dec 6, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Atrial fibrillation is more frequently associated with nonobstructive coronary lesions: the Bialystok Coronary
Anna Tomaszuk-Kazberuk1, Marek Koziński2, Łukasz Kuźma3
1Department of Cardiology, Medical University of Bialystok, Białystok, Poland. a.tomaszuk@poczta.fm
Insights
Patients with atrial fibrillation (AF) often show no significant coronary lesions, suggesting diagnostic challenges. Further noninvasive methods are needed for suspected chronic coronary syndrome (CCS) in AF patients.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Atrial fibrillation (AF) and chronic coronary syndrome (CCS) share risk factors and can coexist.
- AF symptoms may mimic CCS, complicating diagnosis.
Purpose of the Study:
- To test the hypothesis that patients with AF have fewer significant coronary lesions compared to those in sinus rhythm.
- To evaluate the relationship between AF and the presence of coronary artery disease.
Main Methods:
- Retrospective single-center study of 8288 patients undergoing elective coronary angiography (2007-2016).
- Comparison of coronary lesion prevalence and subsequent procedures between patients with and without AF.
Main Results:
- 1674 patients had AF; they were older, more likely male, with diabetes, CKD, and heart failure, but less hyperlipidemia.
- CCS was less frequent in AF patients (37.5% vs 41.1%, P <0.001).
- AF was independently associated with the absence of significant coronary lesions (OR 1.57; P <0.001).
Conclusions:
- AF is linked to fewer significant coronary lesions on angiography, possibly due to diagnostic workup challenges.
- A more effective noninvasive diagnostic strategy is needed for AF patients with suspected CCS.
Introduction:
Atrial fibrillation (AF) and chronic coronary syndrome (CCS) share common risk factors and frequently coexist. Additionally, AF symptoms may mimic CCS.
Objectives:
The aim of the study was to investigate the hypothesis indicating absence of significant coronary lesions in patients with AF as compared with those with sinus rhythm.
Patients And Methods:
We conducted a single‑center retrospective study including consecutive patients referred for elective coronary angiography between 2007 and 2016.
Results:
The study population included 8288 patients out of whom 1674 had AF. There were substantial differences between groups with and without AF. Patients with AF were significantly older, more often were men and had diabetes, and more frequently were diagnosed with both chronic kidney disease and heart failure. On the other hand, they had history of hyperlipidemia less often. CCS was less frequently detected in patients with AF as compared with those with sinus rhythm (37.5% vs 41.1%; P <0.001). Additionally, the latter group more often underwent subsequent coronary angioplasty (19.2% vs 22.3%; P = 0.004). Multivariable analysis identified AF as an independent factor associated with absence of significant coronary lesions (odds ratio, 1.57; 95% CI, 1.32-1.87; P <0.001). Moreover, a comparison between patients with and without angiographically significant CCS revealed a higher prevalence of AF in the latter group (18.7% vs 21.2%; P = 0.006).
Conclusions:
In our study, AF was associated with the absence of significant coronary lesions on angiography, reflecting difficulties with qualifying patients with AF for invasive CCS diagnostic workup. Our findings suggest the need for more efficacious noninvasive diagnostic approach for patients with AF and suspected CCS.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures