Unit:
Κατεύθυνση Μονάδες Εντατικής Θεραπείας-Καρδιολογική ΝοσηλευτικήLibrary of the School of Health Sciences
Author:
Κατσαντώνη Αικατερίνη
Supervisors info:
Αν. Καθηγητής Γκατζούλης Κων/νος
Original Title:
Eπίπτωση κολπικής μαρμαρυγής σε οξύ στεφανιαίο σύνδρομο
Summary:
Introduction: Atrial fibrillation often complicates coronary artery disease,
with unpredictable hemodynamic consequences. Duration and maximum heart
frequency of atrial fibrillation determines the degree of clinical
deterioration. In this study we analyzed the characteristics of atrial
fibrillation complicating acute coronary syndrome, in order to find potentially
its predicting factors and hemodynamic sequelae to the patients.
Material and Methods: 106 successive patients (Men=72%, Age 74±11 y.o.)
admitted in coronary care unit between 2011-2012 were studied. Inclusion
criteria consisted of subjects, who developed atrial fibrillation during their
hospitalization. Atrial fibrillation was correlated with patients’
demographics, comorbidities, functional status, site and severity of lesions.
Atrial fibrillation's characteristics, its impact on clinical and
echocardiographic picture, and the influence it exerts on further therapeutic
management were documented.
Results: Women with hypertensive cardiomyopathy and men with chronic
obstructive pulmonary disease were the most vulnerable to develop atrial
fibrillation. Advanced age and coronary artery disease were of great prognostic
value. About half of patients suffered from anterior myocardial infarction with
high CPK and troponin levels. On admission functional status Killip>2 was
documented in 70% of patients. The majority of the atrial fibrillation episodes
had rapid ventricular response, appeared within the first two days of
hospitalisation and were medically cardioverted. Recurrence of arrhytmia was
documented in 9% of patients. The major echocardiographic findings documented
were left ventricular dilatation and indexes of reduced systolic and diastolic
ventricular function. Finally 26% of patients had to undergo percuataneous
coronary intervention for treatment of their coronary artery disease.
Conclusions: Atrial fibrillation during acute myocardial infarction occurs
mainly in elderly patients, with clinical and echocardiographic manifestations
of heart failure. Atrial fibrillation often appears early during the course of
myocardial infarction, responds well to antiarrhythmics, but recurrs in a
considerable amount of patients. Atrial fibrillation appearing characterizes
early in the course of myocardial infarction the more severe infarctions,
significant percentage of which is treated with percutaneous coronary
intervention.
File:
File access is restricted.
document.pdf
1 MB
File access is restricted.
