Association of comorbidities in atrial fibrillation in acute myocardial infarction

Authors

  • Irfan Ahamed H.B. Department of Internal Medicine, Al-Ameen Medical College, Bijapur, Karnataka, India
  • Bilal Bin Abdullah Department of Medicine, Al-Ameen Medical College, Bijapur, Karnataka, India
  • Mohammed Ismail Department of Medicine, Al-Ameen Medical College, Bijapur, Karnataka, India
  • Syed Aman Jagirdar Department of Medicine, Al-Ameen Medical College, Bijapur, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20170098

Keywords:

Atrial fibrillation, Blood Pressure, Heart rate, Stroke after acute myocardial infarction, Ventricular fibrillation

Abstract

Background: Atrial fibrillation is a most common arrhythmia in patients with and without structural heart disease with an increasing incidence mainly due to the aging population. As the population ages, one can expect that AF will remain a frequent and troublesome complication of AMI with comorbidities. Therefore, the present study was undertaken to investigate the association of co-morbidities in atrial fibrillation in acute myocardial infarction.

Methods: The study was performed after the institutional ethical clearance and consent from all the patients. Heart rate, atrial fibrillation, blood pressure, ventricular fibrillation and stroke after acute myocardial infarction were recorded. The blood sugar and serum lipid levels were also measured using commercially available kit as per the manufacturer’s guidelines. The data was analyzed for statistical significance using univariate analysis and comparison was performed by Fisher Exact test and by using SPSS Version 20.

Results: In our study, all the patients who developed AF after AMI were more than 60 years of age. Higher heart rate was more than or equal to 100 in 62.5% of the patients. 25% of patients had diabetes mellitus 75% of 8 patients had atrial fibrillation after acute myocardial infarction, 77% of patients without atrial fibrillation were known hypertensive’s. Out of the patients who had atrial fibrillation, 50% had hyperlipidemia and developed ventricular fibrillation.

Conclusions: Higher heart rate (>100 bpm) at time of presentation is a risk factor for AF following to AMI. Patients with new onset AF after AMI had more complication during hospital stay. 

References

Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101:969-74.

Roy D, Brugada P, Wellens HJ. Atrial tachycardia facilitating initiation of ventricular tachycardia. Pacing Clin Electrophysiol. 1983;6:47-52.

Gronefeld GC, Mauss O, Li YG, Klingenheben T, Hohnloser SH. Association between atrial fibrillationand appropriate implantable cardioverter defibrillator therapy: results from a prospective study. J Cardiovasc Electrophysiol. 2000;11:1208-14.

Schmitt J, Duray G, Gersh BJ, Hohnloser SH. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. European Heart J. 2009;30:1038-45.

Hod H, Lew AS, Keltai M. Early atrial fibrillation during myocardial infarction. a consequence of impaired left atrial perfusion. Circulation. 1987;75:146-50.

Goldberg RJ, Seeley D, Becker RC. Impact of atrial fibrillation on the in-hospital and long-term survival of patients with acute myocardial infarction: a communitywide perspective. Am Heart J. 1990;119:996-1001.

Kinjo K, Sato H, Sato H, Ohnishi Y, Hishida E, Nakatani D. Prognostic significance of atrial fibrillation/atrial flutter in patients with acute myocardial infarction treated with percutaneous coronary intervention. Am J Cardiol. 2003;92:1150-4.

Siu Z, Eldar M, Canetti M, Rotstein Z, Boyko V, Gottlieb S, Kaplinsky E. Significance of paroxysmal atrial fibrillation complicating acute myocardial infarction in the thrombolytic era. Circulation. 1998;97:965-70.

Kober L, Pedersen TC, Carlsen JE, Bagger H, Eliasen P, Lyngborg K. A clinical Atrial of the angiotensin- converting- enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. trandolapril cardiac evaluation (TRACE) study group. N Engl J Med. 1995;333:1670-6.

Laurent TL, Jessurun ER, Van Hemel NM, Defauw JJ. A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery. J Cardiovasc Surg. 2003;44:9.

McMurray J, Leizorovicz A, Maggioni AP, Rouleau JL, Van de WF. Valsartan in acute myocardial infarction trial (VALIANT): rationale and design. Am Heart J. 2000;140:727-50.

Lehto M, Snapinn S, Dickstein K, Swedberg K, Nieminen MS. Prognostic risk of atrial fibrillation in acute myocardial infarction complicated by left ventricular dysfunction: the OPTIMAAL experience. Eur Heart J. 2005;26:350-6.

Wong CK, White HD, Wilcox RG, Criger DA, Califf RM, Topol EJ. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. Am Heart J. 2000;140:878-85.

Crenshaw BS, Ward SR, Granger CB. Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. J Am Coll Cardiol. 1997;30:406-13.

Pedersen O, Bagger H, Køber L, et al. The occurrence and prognostic significance of atrial fibrillation/flutter following acute myocardial infarction. TRACE study group. Eur Heart J. 1999;20:748-54.

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Published

2017-01-23

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Original Research Articles