The significance of paroxysmal atrial fibrillation complicating acute myocardial infarction in the thrombolytic era

The Prognostic Value of Atrial Fibrillation on 30-Day Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

“…[6][7][8] Therefore, it is certain that AF is associated with an increased in-hospital mortality after AMI in both the prethrombolytic and thrombolytic eras. 1,[6][7][8][9][10] In the present study, we found that patients with AF have significantly higher incidences of stroke, advanced CHF, advanced Killip score upon presentation, more myocardial damage, notably lower LVEF, and more advanced age than those with sinus rhythm. An important fact is that AF patients had a remarkably lower incidence of successful reperfusion and markedly higher 30-day mortality than those with sinus rhythm undergoing primary PCI.…”

“…Accordingly, our findings corroborated those of previous studies. 1,[6][7][8][9][10] Interestingly, while the results of the previous studies consistently indicate that new-onset AF is associated with unfavorable clinical outcomes, 1,2,6,7,23,24) whether new-onset AF is an independent predictor of short-term and long-term outcome remains controversial. 1,2,6,7,23,24) Some studies in the pre-reperfusion era revealed that AF is no longer independently predictive of clinical outcome after adjusting for baseline enrollment variables.…”

“…5) As compared with AMI patients with normal sinus rhythm, AMI patients with new-onset AF have been shown to have worse baseline characteristics, more complicated hospital courses, and unfavorable clinical outcomes such as higher incidences of advanced congestive heart failure (CHF), cardiac embolic stroke, and mortality. 1,[6][7][8][9][10]) Surprisingly, all of these studies were conducted in the prethrombolytic or thrombolytic eras. 1,[6][7][8][9][10] Evidence-based medicine has demonstrated that primary percutaneous coronary intervention (PCI) is superior to thrombolytic therapy in terms of increasing the successful reperfusion rate, reducing the incidences of recurrent ischemia and reinfarction, and improving prognostic outcome in patients with acute ST-segment elevation myocardial infarction (STEMI).…”

“…1,[6][7][8][9][10]) Surprisingly, all of these studies were conducted in the prethrombolytic or thrombolytic eras. 1,[6][7][8][9][10] Evidence-based medicine has demonstrated that primary percutaneous coronary intervention (PCI) is superior to thrombolytic therapy in terms of increasing the successful reperfusion rate, reducing the incidences of recurrent ischemia and reinfarction, and improving prognostic outcome in patients with acute ST-segment elevation myocardial infarction (STEMI). [11][12][13][14] Additionally, one previous study has found that AF was not a significantly independent predictor for short-and long-term outcomes after PCI in the setting of chest pain syndrome.…”

Vorhofflimmern - Diagnostik

“…Bei etwa 25% der Patienten mit Vorhofflimmern besteht eine koronare Herzerkrankung (16). Patienten mit akutem Myokardinfarkt haben in 10-11% Vorhofflimmern (12,22). Eine rheumatische Klappenerkrankung erhöht das Risiko, Vorhofflimmern zu entwickeln, um das 1,8-Fache (5 …”