The Incidence and Predictors of Developing Atrial Fibrillation in Patients With Inferior ST-segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention
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Descrizione dettagliata
Atrial fibrillation (AF) occurs in 5% to 18% of patient with acute ST-segment elevation myocardial infarctions (STEMIs) and 4.5% in patients with STEMI treated with percutaneous coronary intervention (PCI).
Diagnosis of AF in acute myocardial infarction (AMI) patients is important because it increases the risk of cardiovascular event and associated with increased in-hospital and long term rates . Atrial ischemia/infarction translates into P Q segment depression or elevation on the electrocardiogram and often associates with atrial tachyarrhythmias .
Side-branch obstruction is one of the adverse effects of PCI the location of the culprit vessel also affects the occurrence of AF in AMI Atrial arteries arise from the right coronary artery (RCA) and circumflex coronary artery (CX) and extend through the atrial myocardium to supply both chambers It is therefore conceivable that PCI of lesions located at the RCA and CX could lead to an accidental atrial branch occlusion .
Atrial myocardial ischemia secondary to atrial branches occlusion (ABO) might lead to mechanical atrial dysfunction, increased electrical vulnerability to atrial arrhythmias, and late structural remodeling .
The sino nodal (SN) artery originates from the proximal portion of the RCA in about 60% of humans Side branch occlusion of the SN artery occurring accidentally during PCI for proximal RCA lesions would provide an opportunity to produces SN dysfunction in humans. Uptill now , there have been no systematic studies concerning SN dysfunction caused by side-branch occlusion of the SN artery during PCI .
Left atrial volume seems to be a strong predictor of incident of AF , with increase in left atrial filling pressures, atrial stretch and enlargement of the chamber occur, leading to remodeling of the structure, physiologic properties, and electrical milieu of the left atrium, culminating in the development of AF
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Descrizione
Inclusion Criteria:
- Patients with inferior STEMI who will undergo PPCI (primary percutaneous coronary intervention )
Exclusion Criteria:
- -A history of preexisting AF
- Prior documentation of heart failure or reduced left ventricular ejection fraction < 50%,
- Severe valvular disease ( rheumatic , sclerotic ) or secondary to AMI
- Left ventricular hypertrophy : enlargement and thickening of the walls of the ventricle
- Patients with inferior STEMI treated with intravenous thrombolysis or conservative strategy
- Patients with inferior STEMI who undergo primary PCI and associated with right ventricular or posterior infarction
- History of pulmonary embolism or COPD ( chronic obstructive pulmonary disease )
- Those with thyrotoxicosis
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Misure di risultato primarie
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Misura Descrizione |
Lasso di tempo |
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incidence of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
Lasso di tempo: baseline
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incidence of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
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baseline
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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atrial branches occlusion and left atrial volume index as predictors of atrial fibrillation
Lasso di tempo: baseline
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atrial branches occlusion and left atrial volume index as predictors of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
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baseline
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Collaboratori e investigatori
Sponsor
Investigatori
- Cattedra di studio: Yehia Taha Kishk kishk, MD, Professor of cardiology department Assiut University
- Direttore dello studio: Mohamed Ali Mohamed Tohamy tohamy, MD, Lecturer of cardiology department Assiut University
Pubblicazioni e link utili
Collegamenti utili
- Clinical factors associated with the development of atrial fibrillation in the year following STEMI treated by primary PCI
- Impact of atrial fibrillation in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention
- Acute regional left atrial ischemia causes acceleration of atrial drivers during atrial fibrillation
- Atrial coronary artery occlusion during elective percutaneous coronary angioplasty
- Sinus arrest caused by occlusion of the sinus node artery during percutaneous coronary intervention for lesions of the proximal right coronary artery
- Left Atrial Volume: Important Risk Marker of Incident Atrial Fibrillation
- Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction
- Electrophysiological Effects of Selective Atrial Coronary Artery Occlusion in Humans
- Long Term Prognosis of Atrial Fibrillation in ST-Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention
- Left Atrial Size : Physiologic Determinants and Clinical Applications
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- AF in inferior STEMI after PCI
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