Incidentally Induced Atrial Fibrillation During Programmed Electrical Stimulation in Patients With Depressed Left Ventricular Systolic Function After an Acute Myocardial Infarction.

Autor: Sakthivel T; Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark., Risum N; Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark., Bundgaard H; Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark., Joergensen RM; Department of Cardiology, North Zealand University Hospital, Hillerød, Denmark., Jacobsen UG; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark., Huikuri HV; Department of Cardiology, Oulu University Hospital, Oulu, Finland., Thomsen PEB; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Jons C; Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark., Thomsen AF; Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc [Ann Noninvasive Electrocardiol] 2024 Sep; Vol. 29 (5), pp. e70011.
DOI: 10.1111/anec.70011
Abstrakt: Background: The aim of this study was to investigate the clinical implication of incidentally induced atrial fibrillation (AF) during programmed electrical stimulation (PES) in patients with left ventricular systolic dysfunction (≤40%) after an acute myocardial infarction (MI).
Methods: In this study, we included 231 patients from the Cardiac Arrhythmias and RIsk Stratification after Myocardial InfArction (CARISMA) study with left ventricular ejection fraction ≤40% and no prior history of AF. These patients underwent PES 6 weeks post-MI as part of the study protocol. Patients all received an implantable cardiac monitor (ICM) 3-21 days post-MI and were continuously monitored for cardiac arrhythmias for 2 years. Induction of AF was unwanted but reported if this incidentally occurred.
Results: A total of 61 patients (26%) developed AF within 2 years of follow-up, in which n = 10 (29%) had incidental AF during PES at baseline. The overall risk of AF was not significantly increased in patients with incidental AF (n = 34) during PES compared to patients without incidental AF (n = 197) (HR 1.6 [0.9-3.0], p = 0.14). The risk of bradyarrhythmia (HR = 0.2 [0.0-1.2], p = 0.07), ventricular arrhythmias (HR = 0.7 [0.1-5.8], p = 0.77), and major cardiovascular events (MACE) (HR 0.5 [0.2-1.7], p = 0.28) was not significantly different in patients with versus without incidental AF.
Conclusions: Incidentally induced AF during PES in post-MI patients with reduced LVEF was not significantly associated with a higher risk of long-term atrial fibrillation, other cardiac arrhythmias, or major cardiac events.
Trial Registration: NCT00145119.
(© 2024 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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