title: Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction.
abstract: BACKGROUND
  During acute myocardial infarction (MI), the incidence of atrial fibrillation (AF) is 6% to 22%, and its occurrence in this setting is associated with increased short- and long-term morbidity and mortality.
  
  
  OBJECTIVE
  The purpose of this case control study was evaluate the characteristics associated with the development of new-onset AF.
  
  
  METHODS
  Of 2,460 consecutive patients with acute MI, 149 (6%) were identified as having AF within 7 days of MI. After excluding patients with prior AF, previously documented heart failure, reduced left ventricular (LV) ejection fraction, valvular heart disease, LV hypertrophy, AF after coronary artery bypass grafting, or pericarditis; we identified 42 AF patients in whom coronary anatomy was assessed by invasive angiography and cardiac structure and function was evaluated using transthoracic echocardiography. Another 42 patients from the same cohort with MI but no AF matched for age, gender, and LV ejection fraction were studied as controls.
  
  
  RESULTS
  AF patients were more likely to present with an inferior MI (P = .002) but less likely to present with ST-segment elevation MI (P = .02). Univariate associations with AF included indexed left atrial volume (P <.001), LV filling pressure (E/e'; P = .001), right atrial branch disease (P <.001), left atrial branch disease (P = .009), sinoatrial branch disease (P <.001), left main stem disease (P = .02), and time from onset of symptoms to coronary intervention (P = .002). In multivariable analysis, right and left coronary artery atrial branch disease (P = .02) were predictors of AF post-MI.
  
  
  CONCLUSIONS
  Coronary artery disease affecting the atrial branches is an independent predictor for the development of AF after MI.
authors.affiliation: Centre for Heart Rhythm Disorders, University of Adelaide and the Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Muayad
authors.initials: M
authors.lastname: Alasady
authors.forename: Walter P
authors.initials: WP
authors.lastname: Abhayaratna
authors.forename: Darryl P
authors.initials: DP
authors.lastname: Leong
authors.forename: Han S
authors.initials: HS
authors.lastname: Lim
authors.forename: Hany S
authors.initials: HS
authors.lastname: Abed
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Brooks
authors.forename: Sue
authors.initials: S
authors.lastname: Mattchoss
authors.forename: Kurt C
authors.initials: KC
authors.lastname: Roberts-Thomson
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Worthley
authors.forename: Derek P
authors.initials: DP
authors.lastname: Chew
authors.forename: Prashanthan
authors.initials: P
authors.lastname: Sanders
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013021:South Australia / Q000453:epidemiology; D015996:Survival Rate; D016277:Ventricular Function, Left