Atrial Fibrillation Clinical Trial
Official title:
The Incidence and Predictors of Developing Atrial Fibrillation in Patients With Inferior ST-segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention
Is to analyze the incidence and predictors of developing AF in patients with inferior infarction who undergo PCI with and without atrial and SN branches occlusion
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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