Mathematical model of the development of atrial fibrillation in patients with previous myocardial infarction

Abstract

Background: Atrial fibrillation is one of the most common and heavy disorders of heart rhythm, which affects 0,4% of the general population and more than 5% among people aged 65 and older. The prevalence has increased six times in the last 25 years. AF occurs more often in men (10 times), less-in women (4 times). Therefore atrial fibrillation has lately become an issue of intensive clinical research. The challenges deal with a recurrent character of episodes, their unpredictiveness as well as a question of feasibility of attesting AF as a permanent disease. The answers to these questions may determine a choice of conservative or surgical treatment, which contributes to quality of life and life expectancy in patients. Materials and methods: The study included 85 patients with atrial fibrillation and 30 somatically healthy individuals. All subjects underwent a comprehensive study of the protein, lipid oxidative stress and microcirculation indicators. Findings: It was established that the formation of the clinical course of is-chemic heart disease is interconnected with the intensification of the processes of peroxidation of proteins, lipids and a change in superoxide dismutase activity. It has been proven that in patients with AF (both paroxysmal and permanent forms) in combination with a previous infarction, there is a change in peripheral microhemodynamics: a decrease in tissue perfusion and inhibition of active modulating mechanisms of tissue microcirculation. Conclusion: According to the correlation and factor analysis, two factors have been identified that have a significant interrelation with the development of paroxysmal AF in patients with previous myocardial infarction: the level of advanced oxidation protein products and the microcirculation index. Our mathematical model for the risk of paroxysmal AF in patients with previous myocardial infarction has a level of statistical significance of 0,020, which indicates the reliability of the prediction results. K E Y w O R D S-atrial fibrillation, previous myocardial infarction, oxidative stress, microcirculation index, advanced oxidation protein products.