Interatrial block at 6 hours post-primary PCI and multivessel coronary disease are significant predictors of new-onset atrial fibrillation at 12 months in STEMI patients.
Introduction: Interatrial block (IAB), defined as P wave duration greater than 120 milliseconds (ms), is strongly associated with recurrence of atrial fibrillation (AF) in different clinical scenarios. Ischemia is considered as one of the mechanisms underlying the pathogenesis of IAB by contributing atrial fibrosis. Purpose: The aim of this study is to investigate the correlation between culprit coronary artery lesion with the presence of IAB and newly detected AF at 12 months. Methods: Patients that are presented to our hospital with ST-segment elevated myocardial infarction (STEMI) and received successful primary percutaneous coronary intervention (P-PCI) were prospectively enrolled to the study. Surface electrocardiography (ECG) of all patients were recorded on admission and at 6th hour post P-PCI. Patients were screened for the occurrence of AF at 12 months visit. Results: The present study included 198 patients. IAB was detected in 102 (51.5%) patients on admission. Patients with an obstruction in only right coronary vasculature [63 (61.8%) vs 40 (41.7%); P<0.01] and in more than one coronary artery [56 (54.9%) vs 34 (35.4%); P<0.01] had a greater prevalence of IAB. Presence of IAB was reduced to 47 (23.7%) patients at 6th hour. AF was detected in 17.7% of study patients at 12 months. Presence of both p-IAB [15 (42.9%) vs 23 (14.1%); P<0.01] and a-IAB [7 (20%) vs 2 (1.2%); P<0.01] at 6th hour P-PCI and obstruction in more than one coronary artery [25 (71.4) vs 65 (39.9); P<0.01]. predicted the new onset AF at 12 months.
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Çinier et al. (2018) studied this question.
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