Atrial fibrillation during acute myocardial infarction: association with all-cause mortality and sudden death after 7-year of follow-up

Abstract

Patients with AMI and AF/FL portend a poor prognosis in the long-term chiefly because of an excess of SD. Treatment with ACE-inhibitors and digitalis may have long-term beneficial effects on SD.

Relationship of Sudden Cardiac Death to New-Onset Atrial Fibrillation in Hypertensive Patients With Left Ventricular Hypertrophy

“…20 However, in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial, 30 the relative contribution of previous AF to the prediction of SCD waned with time, contributing 12.5% of the predictive power for SCD during the in-hospital period but only 2.9% of the model power during the period from 6 months to 3 years. 30 Because new-onset AF during follow-up was not ascertained in VALIANT, 30 whether consideration of new-onset AF would further improve risk stratification for SCD could not be determined.…”

“…The presence of AF or atrial flutter at the time of presentation with an acute myocardial infarction has been associated with an increased risk of SCD 20,29,30 during follow-up that extends out to 7 years. 20 However, in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial, 30 the relative contribution of previous AF to the prediction of SCD waned with time, contributing 12.5% of the predictive power for SCD during the in-hospital period but only 2.9% of the model power during the period from 6 months to 3 years.…”

“…[15][16][17][18] In addition, AF has also been related to increased mortality in patients after-myocardial infarction 19,20 and in most [21][22][23][24][25][26] but not all [26][27][28] studies of heart failure patients. However, the relationship of SCD to existing AF has been less well characterized, and there have been no studies to date examining the risk of SCD solely in relation to development of new AF.…”

“…However, less is known about the relationship of SCD to AF. Prevalent AF is associated with an increased risk of SCD in patients postmyocardial infarction 20,29,30 and in women with coronary artery disease, 31 but the relationship of SCD to AF in patients with heart failure has been inconsistent. 24,25,27 Moreover, in patients with implantable cardioverter-defibrillators (ICDs), a history of AF, 32 persistent AF at the time of ICD implantation, 33 and permanent but not persistent or paroxysmal AF, 34 have an increased risk of appropriate device therapies for ventricular arrhythmias.…”

“…8 The incidence of AF increases with age 7 and in patients with hypertension, left ventricular hypertrophy (LVH), coronary heart disease, and heart failure. [9][10][11][12][13][14] Prevalent and incident AF have been associated with an increased risk of all-cause mortality in population-based studies, [15][16][17][18] postmyocardial infarction, 19,20 and in most [21][22][23][24][25][26] but not all 27,28 analyses of patients with heart failure. However, less is known about the relationship of SCD to AF.…”