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

Muayad Alasady, Walter P. Abhayaratna, Darryl P. Leong, Han S. Lim, Hany S. Abed, Anthony G. Brooks, Sue Mattchoss, Kurt C. Roberts-Thomson, Matthew I. Worthley, Derek P. Chew, Prashanthan Sanders

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background: During acute myocardial infarction (MI), the incidence of atrial fibrillation (AF) is 6% to 22%, and its occurrence in this setting is associated with increased short- and long-term morbidity and mortality. Objective: The purpose of this case control study was evaluate the characteristics associated with the development of new-onset AF. Methods: Of 2,460 consecutive patients with acute MI, 149 (6%) were identified as having AF within 7 days of MI. After excluding patients with prior AF, previously documented heart failure, reduced left ventricular (LV) ejection fraction, valvular heart disease, LV hypertrophy, AF after coronary artery bypass grafting, or pericarditis; we identified 42 AF patients in whom coronary anatomy was assessed by invasive angiography and cardiac structure and function was evaluated using transthoracic echocardiography. Another 42 patients from the same cohort with MI but no AF matched for age, gender, and LV ejection fraction were studied as controls. Results: AF patients were more likely to present with an inferior MI (P = .002) but less likely to present with ST-segment elevation MI (P = .02). Univariate associations with AF included indexed left atrial volume (P <.001), LV filling pressure (E/e′; P = .001), right atrial branch disease (P <.001), left atrial branch disease (P = .009), sinoatrial branch disease (P <.001), left main stem disease (P = .02), and time from onset of symptoms to coronary intervention (P = .002). In multivariable analysis, right and left coronary artery atrial branch disease (P = .02) were predictors of AF post-MI. Conclusion: Coronary artery disease affecting the atrial branches is an independent predictor for the development of AF after MI. Crown

Original languageEnglish
Pages (from-to)955-960
Number of pages6
JournalHeart Rhythm
Volume8
Issue number7
DOIs
Publication statusPublished - 1 Jul 2011

Keywords

  • Atrial fibrillation
  • Coronary angiography Electrophysiology
  • Myocardial infarction
  • Pathophysiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Alasady, M., Abhayaratna, W. P., Leong, D. P., Lim, H. S., Abed, H. S., Brooks, A. G., ... Sanders, P. (2011). Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction. Heart Rhythm, 8(7), 955-960. https://doi.org/10.1016/j.hrthm.2011.02.016