The Incidence and Predictors of Developing Atrial Fibrillation in Patients With Inferior ST-segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention
研究概览
详细说明
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
研究类型
注册 (预期的)
联系人和位置
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
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
学习计划
研究是如何设计的？
设计细节
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
incidence of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
大体时间：baseline
|
incidence of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
|
baseline
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
atrial branches occlusion and left atrial volume index as predictors of atrial fibrillation
大体时间：baseline
|
atrial branches occlusion and left atrial volume index as predictors of atrial fibrillation in inferior STEMI patients after primary Percutaneous Coronary Intervention
|
baseline
|
合作者和调查者
调查人员
- 学习椅：Yehia Taha Kishk kishk, MD、Professor of cardiology department Assiut University
- 研究主任：Mohamed Ali Mohamed Tohamy tohamy, MD、Lecturer of cardiology department Assiut University
出版物和有用的链接
有用的网址
- 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
研究记录日期
研究主要日期
学习开始 (预期的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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