P1004Atrial fibrillation during acute myocardial infarction : a prospective multicenter study

Abstract

Abstract New-onset atrial fibrillation (AF) frequently complicates acute myocardial infarction (AMI) and is associated with higher in-hospital and 1-year mortality, particularly in patients with ST-segment elevation AMI. In this clinical setting the occurrence of AF is of particular importance since irregular ventricular rates during AF may cause further impairment of the coronary circulation and left ventricular function in addition to the adverse consequences of neuro-hormonal activation. However, incidence and risk factors contributing to the occurrence of AF in AMI are still not well-known. The purpose of this study is to evaluate prospectively some risk factors contributing the incidence of AF in the setting of AMI. Methods This was a three-center prospective study, conducted in the coronary care unit of our medical center during the period of January 2017 to June 2018. This study included 976 patients with acute MI of different localization. AF was found in 82 patients of whom 68 experienced this arrhythmia anew. Onset, duration and mode of termination of AF, clinical and risk factors associated with its presentation and its relation with patient outcome were evaluated. Anamnesis, clinical and functional state of the heart (according to the results of instrumental and laboratory data) was studied in all patients. The data was analyzed for statistical significance using multivariate analyses by SPSS 16. Results The obtained results showed that in acute MI AF was registered in 9.4% of patients, among which new episodes of AF have been identified in 82.9% of patients. All the patients who developed AF after AMI were more than 60 years of age. Moreover, 68% of patients with AF have arterial hypertension, 27% - diabetes mellitus and 67% patients have higher heart rate. There is a relationship between developed AF and other supraventricular arrhythmias in the past history. In 62% of patients with AF, anterior MI was detected and accompanied by more severe hemodynamic disorders. Multivariate analyses showed that AF correlated weakly with age (r = 0.249) and strongly with left atrial diameter (r = 0.478) and left ventricular dysfunction (r = 0.419) especially with higher Killip class. Conclusions The results of the present study revealed that in the presence of identified certain risk factors in patients with acute MI, AF may develop. There is the link between identified risk factors and the occurrence of AF