Key result
First-time AF during AMI carries a ~9% one-year recurrence rate linked to worse prognosis.
Why the study?
Data on new-onset AF in the early phase of acute myocardial infarction are limited, and the long-term prognosis remains unclear.
Cohort (n=209)
New-onset paroxysmal AF during AMI has a relatively low one-year recurrence rate of 9.1%, but recurrence identifies a high-risk group prone to subsequent heart failure hospitalizations.
Recurrence after new-onset paroxysmal AF in AMI identifies higher-risk patients; this cohort study leaves open whether targeted monitoring improves outcomes.
INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide, with a prevalence of up to 21% in the early phase of acute myocardial infarction (AMI). Data on new-onset AF in this context are limited, and long-term prognosis remains unclear. METHODS: We conducted a retrospective observational cohort study from December 2011 to May 2021, including patients who experienced a first episode of paroxysmal AF during hospitalization for AMI. The primary outcome was the recurrence of AF within the first year post-discharge. Secondary outcomes included all-cause mortality, cardiovascular mortality, and a composite of major adverse cardiovascular events. RESULTS: A total of 209 patients were included. There was AF recurrence in 19 patients, 9.1% (95% CI 5.2-13.0%) with a median time to recurrence of 84 days (interquartile range 27.5-157.5). While mortality in the AF recurrence group was numerically higher than in the non-AF recurrence group, this difference did not achieve statistical significance (15.8% vs. 7.4%, p=0.19). Patients with AF recurrence had significantly worse prognosis (47.4% vs. 23.7%, p=0.04), primarily due to increased heart failure (HF) hospitalizations. CONCLUSIONS: In patients with a first episode of paroxysmal AF during AMI, one-year recurrence is relatively low (9.1%); however, AF recurrence is associated with significantly worse prognosis, driven largely by HF hospitalizations.
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Prieto-Lobato et al. (2025) conducted a cohort in Acute myocardial infarction with new-onset atrial fibrillation (n=209). Atrial fibrillation recurrence vs. No atrial fibrillation recurrence was evaluated on Recurrence of AF within the first year post-discharge (95% CI 5.2-13.0). In patients with a first episode of paroxysmal AF during AMI, the one-year recurrence rate was 9.1%, and recurrence was associated with a worse prognosis (47.4% vs. 23.7%, p=0.04).
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