New onset atrial fibrillation following PCI for MI or ACS is associated with a worse prognosis, highlighting the need for adequate arrhythmia management in this population.
Supports heightened vigilance for new AF after PCI in MI/ACS; leaves open optimal rhythm strategies.
Atrial fibrillation (AF) is a major arrhythmia with a high prevalence among population. AF is not uncommon in the setting of coronary artery disease, including myocardial infarction (MI) and acute coronary syndromes (ACS). Percutaneous coronary interventions (PCI) have significantly improved outcomes of patients with acute MI and acute coronary syndromes. Nevertheless, the AF was reported to occur in patients with MI and ACS undergoing PCI. New onset AF after PCI for MI and ACS, though being infrequent, was associated with worse clinical course and prognosis. The predictive value of AF has tendency to change in parallel with improvements of reperfusion strategies and comprehensive treatment. Observational studies suggest better patency of culprit vessels achieved by PCI was accompanied by improvement in signal-averaged electrocardiography indices of atrial electrophysiological properties and higher rate of restoration of sinus rhythm during primary PCI as compared with thrombolysis. The adequate management of arrhythmia is required to reduce the risk of complications.
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Kudaiberdieva et al. (2007) studied this question.
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