Acute atrial infarction: a relatively neglected and under-recognized entity in clinical practice.

Autor: Di C; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China.; Cardiovascular Institute, Tianjin University, Tianjin, China., Wang H; Cardiac Interventional Center, TEDA International Cardiovascular Hospital, Tianjin, China., Wang M; Cardiac Interventional Center, TEDA International Cardiovascular Hospital, Tianjin, China., Wang Q; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China.; Cardiovascular Institute, Tianjin University, Tianjin, China., Wu Y; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China.; Cardiovascular Institute, Tianjin University, Tianjin, China., Li L; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China.; Cardiovascular Institute, Tianjin University, Tianjin, China., Zhang Y; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China.; Cardiovascular Institute, Tianjin University, Tianjin, China., Lin W; Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, 300457, Tianjin, China. linwenhuatich@163.com.; College of Clinical Cardiology, Tianjin Medical University, Tianjin, China. linwenhuatich@163.com.; Cardiovascular Institute, Tianjin University, Tianjin, China. linwenhuatich@163.com.
Jazyk: angličtina
Zdroj: Herz [Herz] 2024 Sep 24. Date of Electronic Publication: 2024 Sep 24.
DOI: 10.1007/s00059-024-05272-z
Abstrakt: Background: Electrocardiograms (ECGs) and angiographic features indicative of acute atrial infarction (AAI) often go unnoticed and are under-recognized in clinical practice.
Methods: In this retrospective observational study, we analyzed the data of 3981 out of 9803 patients (40.61%) who were referred to our hospital for angiography and/or percutaneous coronary intervention due to acute coronary syndrome (ACS). These patients were diagnosed with acute ST segment elevation myocardial infarction (AMI) affecting the inferior, posterior, and/or right ventricular regions.
Results: Of the 3981 patients, 270 (6.78%) had involvement of the main coronary atrial branch meeting the angiographic criteria for AAI. Among the 270 patients identified, the right coronary artery was diagnosed as the infarct-related artery (IRA) in 187 patients (group R), while the left circumflex artery was the IRA in 83 patients (group L). The incidence of PR-segment deviation was similar between the two groups (65.2% in group R vs. 66.3% in group L, p = 0.870), as was occurrence of atrial tachyarrhythmia (67.4% vs. 55.4%, p = 0.059). The prevalence of P wave morphology abnormalities (29.9% vs. 49.4%, p = 0.005) and sinus bradycardia or arrest (25.1% vs. 66.3%, p < 0.001) was significantly lower in Group R than in Group L.
Conclusion: Acute atrial infarction represents a distinct yet frequently overlooked clinical entity. Clinicians should consider the potential for atrial arrhythmias, thromboembolism, hemodynamic instability, and atrial rupture when diagnosing AAI.
(© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE
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