Atrial fibrillation in acute myocardial infarction

الملخص EN

The aim of this study is to assess the incidence and prognosis of atrial fibrillation (AF) during the first 72 hours among six hundred patients admitted to coronary care unit with acute myocardial infarction (AMI) in Diwaniyah Teaching Hospital from April 2004 to May 2006 ; and to determine the characteristics of the myocardial infarction–induced AF .

Full history and physical examination was taken and patients were followed in the coronary care unit (CCU) by monitoring and ECG facilities during the first 72 hours of onset .

Atrial fibrillation was found in 96 patients (16%(, 32 females and 64 males.

AF occurred in the first 24 hours in 56 patients (58%), recurrent in 24 patients (25%) and was transient (lasted less than 24 hours) in 80 patients (83%).

Compared with patients without AF, those with this arrhythmia were older, had a higher frequency of heart failure (75% vs.

50%) particularly in anterior myocardial infarction (94% vs.

54%) and of pericarditis (25% vs.

7%) and had a higher CCU mortality (38% vs.

15%).

As opposed to death rates close to (44%) among patients with anterior infarction, the presence of AF did not affect the mortality among patients with inferior infarction (17%).

Absence of heart failure, persistent arrhythmia (longer than 24 hours ) , ventricular rate (higher than 120 beats per minute) and recurrence of arrhythmia were not associated with increased mortality , while late onset AF after 48 hours were associated with higher mortality.

It is concluded that AF is not an uncommon arrhythmia after myocardial infarction and that its occurrence should signify a more guarded prognosis.