Features of the myocardial infarction course in patients with a permanent atrial fibrillation.

Анотація

Atrial fibrillation (AF) is the most common cardiac arrhythmias in the population. Nowadays, AF is regarded as potentially lethal arrhythmia, considering the broad range of its negative consequences, not only due to significant deterioration in the quality of the patients’ life, but also due to related significant increase in the incidence of serious complications and death. The presence of permanent AF is associated with a twofold increase in the risk of myocardial infarction (MI) development. The purpose of the research is to study the features of the MI course, the condition of intracardiac hemodynamics, the volume of the cardiac muscle injury in patients with a permanent AF. It was done a retrospective study of 1145 patients’ case histories who were undergoing in-patient treatment for the acute MI on the basis of the CI "Dnipropetrovsk Clinical Association of Emergency Medical Aid". The first group included 134 patients with acute MI without concomitant heart rhythm disorders. The second group consisted of 102 patients with acute MI which arose on the background of a permanent form of AF. The groups were comparable in age and gender. The presence of permanent AF was associated with prognosis deterioration, early hospital mortality in patients with acute MI due to progression of heart failure, development of acute left ventricular insufficiency. A larger amount of myocardial necrosis was observed in patients with permanent AF compared to those with sinus rhythm. Conclusion: the presence of permanent AF impairs the course of acute MI, increases the risk of early hospital mortality, which requires a personalized approach to the management of patients with a permanent AF for preventing the risk of MI developing and thromboembolic complications.