Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction

Alasady, M.; Abhayaratna, Walter P.; Leong, Darryl P.; Lim, H.; Abed, H.; Brooks, A.; Mattchoss, Sue; Roberts‐Thomson, Kurt C.; Worthley, M.; Chew, Derek P.; Sanders, Prashanthan

doi:10.1016/j.hrthm.2011.02.016

Cited by 84 publications

(68 citation statements)

References 33 publications

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“…Additionally, the present study showed that the group with NOAF, especially transient NOAF, had a higher prevalence of both inferior AMI and coronary artery disease affecting the atrial branches, consistent with prior studies. 24, 25 These findings suggested that direct atrial and sinus node ischemia because of impaired blood flow in the sinus node artery or atrioventricular node artery, which is caused mainly by inferior AMI, might be also part of the mechanism of transient NOAF. Inflammation can be considered as associated with promotion of transient NOAF because the hs-CRP level, a typical inflammatory marker, was much higher in the transient NOAF group.…”

Section: Discussionmentioning

confidence: 99%

Transient New-Onset Atrial Fibrillation Is Associated With Poor Clinical Outcomes in Patients With Acute Myocardial Infarction

Shin

Kim

et al. 2016

Circ J

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Section: Discussionmentioning

confidence: 99%

Transient New-Onset Atrial Fibrillation Is Associated With Poor Clinical Outcomes in Patients With Acute Myocardial Infarction

Shin

Kim

et al. 2016

Circ J

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“…Figure 7A shows the number of AF events by group. The AF incidence rate ratio (IRR) was significantly higher in LCX compared with LAD (LCX versus LAD, IRR, 6 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]; P=0.001) or control group (LCX versus control, IRR, 12 [3.26-44.14]; P<0.001, negative binomial model). In contrast, there was no significant differences in IRR between the LAD and control groups (IRR, 2 [0.47-8.5]; P=0.4).…”

Section: Conduction Velocitymentioning

confidence: 99%

“…40 In addition, other studies have also shown the favorable effect of early coronary reperfusion on AF incidence post-MI which may, in part, be explained by reduced total ischemic burden at both the ventricular and atrial level. 14,41 Atrial ischemia or infarction is rarely considered as a direct contributor to the development of AF after AMI. This study showed the direct relation between AF and atrial infarction.…”

Section: Clinical Implicationmentioning

confidence: 99%

Myocardial Infarction and Atrial Fibrillation

Alasady

Shipp

Brooks

et al. 2013

Circ: Arrhythmia and Electrophysiology

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Background— Myocardial infarction (MI) is associated with the development of atrial fibrillation (AF). We aimed to characterize the atrial abnormalities because of MI and determine the role of ischemia to the AF substrate. Methods and Results— Forty-four sheep were studied. MI was induced by occlusion of the left circumflex artery (LCX) or left anterior descending artery (LAD). Excluding 11 with fatal arrhythmias, equal groups of animals (LCX; LAD; and sham-operated) underwent sequential electrophysiology study for 45 minutes to determine atrial effective refractory periods, conduction velocity, conduction heterogeneity index, and AF inducibility. Postmortem evaluation was performed with 2,3,5 triphenyl tetrazolium chloride staining. MI resulted in greater left ventricular dysfunction ( P <0.05), LA pressure ( P <0.0003), and reduction in atrial effective refractory periods ( P <0.0001) compared with control. 2,3,5 triphenyl tetrazolium chloride staining demonstrated that the left circumflex artery, and not the LAD, group had atrial infarction. The left circumflex artery group demonstrated the following compared with the LAD or control groups: greater slowing in atrial conduction velocity ( P <0.0001 and P <0.001); increased absolute range of conduction phase delay ( P <0.001 and P <0.001); increased conduction heterogeneity index ( P <0.0001 and P <0.001); greater AF vulnerability ( P <0.05 for both); and longer AF duration ( P <0.05 for both). LAD group had modest but significant slowing in conduction velocity ( P <0.01) but no change in conduction heterogeneity index or AF duration compared with control. Conclusions— Left ventricular infarction, which is known to result in atrial stretch, hemodynamic change, and neurohumoral activation, contributes partially to the atrial abnormalities in MI. Atrial ischemia/infarction results in greater atrial electrophysiological changes and propensity for AF forming the dominant substrate for AF in MI.

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“…Alasady и соавт. в многомерном анализе также показали, что поражение левой предсердной ветви огибающей артерии и пра-вых предсердных ветвей приводит к развитию ФП при ОКС [47]. Показано, что ишемия миокарда предсер-дий вызывает трехкратное увеличение уровня адено-зина в тканях [48], что, в свою очередь, приводит к снижению продолжительности потенциала действия, уменьшая рефрактерный период предсердий, и при этом облегчая индукцию ФП [49].…”

Section: New-onset Atrial Fibrillation In Acs впервые возникшая фибриunclassified

New-Onset Atrial Fibrillation in Settings of Acute Coronary Syndrome. Current Issues

Galjautdinov

Gorelkin

Ibragimova

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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451Настоящий обзор посвящен теме впервые возникшей фибрилляции предсердий (ФП) в условиях острого коронарного синдрома (ОКС). Использованы источники литературы баз PubMed, Scopus. ФП часто встречается в общей популяции и в популяции ОКС, при этом выделяют впервые возникшую ФП, и ФП, бывшую на момент развития ОКС. У пожилых пациентов с хронической сердечной недостаточностью, явле-ниями гемодинамической нестабильности и дилатацией левого предсердия возникновение ее более вероятно. Хорошо известно о предик-торах неблагоприятного исхода ОКС. Согласно некоторым данным, впервые возникшая ФП приводит к ухудшению прогноза, по другим данным причина ее сочетания с высоким уровнем летальности обусловлена тяжестью протекания ОКС, и возникновение ее не является не-зависимым предиктором смерти. Отсутствие субъективных симптомов во время пароксизма ФП не позволяет оценить его продолжительность, и тем самым дифференцировать впервые возникший пароксизм и постоянную или персистирующую форму ФП. Удается проследить связь между ишемией миокарда и возникновением ФП. Неэффективная реперфузия во время проведения чрескожного коронарного вмеша-тельства или тромболитической терапии сопровождается возникновением фибрилляции предсердий, напротив, при достижении эффек-тивной проходимости сосуда она возникает реже. Впервые возникшая при ОКС, и, в частности, сопровождающаяся кардиогенным шоком, ФП требует экстренной кардиоверсии: медикаментозной или электроимпульсной. В ряде случаев проведение активной кардиоверсии не требуется, поскольку восстановление синусового ритма происходит спонтанно. Неоднозначность и многофакторность данной проблемы указывает на необходимость более детального понимания механизмов аритмогенеза и разработки инструментов для стратификации рисков возникновения ФП при ОКС.Ключевые слова: фибрилляция предсердий, острый коронарный синдром, левое предсердие, асимптомная фибрилляция предсердий, чрескожное коронарное вмешательство, кардиоэмболический инсульт. The present review is focuses on new onset atrial fibrillation (AF) in conditions of acute coronary syndrome (ACS). Literature sources from PubMed and Scopus was used. AF is common in the general population and in the ACS population, at that new onset AF, and AF, which was by the time of ACS development are determined. Appearance of AF is more likely amongst the elderly patients with congestive heart failure, with signs of the hemodynamic instability and with the left atrium dilatation. It is well-known about the predictors of adverse outcome in ACS. According to some literature data new onset AF leads to worsening of prognosis, and in line with other sources a reason of its association with high level of mortality is due to the severity of ACS and appearance of AF is not independent predictor of death. The absence of subjective symptoms at the time of paroxysm of new onset AF does not allow estimating its duration and distinguishing between the new onset AF, persistent and constant AF. It is possible to trace the relationship between the myocardial ischemia and AF appeara...

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Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction

Cited by 84 publications

References 33 publications

Transient New-Onset Atrial Fibrillation Is Associated With Poor Clinical Outcomes in Patients With Acute Myocardial Infarction

Transient New-Onset Atrial Fibrillation Is Associated With Poor Clinical Outcomes in Patients With Acute Myocardial Infarction

Myocardial Infarction and Atrial Fibrillation

New-Onset Atrial Fibrillation in Settings of Acute Coronary Syndrome. Current Issues

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