title: Prognosis of silent atrial fibrillation after acute myocardial infarction at 1-year follow-up.
abstract: BACKGROUND
  Silent atrial fibrillation (AF), assessed by continuous ECG monitoring (CEM), has recently been shown to be common in acute myocardial infarction (AMI), and associated with higher hospital mortality. However, the long-term prognosis is still unknown. We aimed to assess 1-year prognosis in patients experiencing silent AF in AMI.
  
  
  METHODS
  All consecutive patients with AMI who were prospectively analysed by CEM during the first 48 h after admission and who survived at hospital discharge were included. Silent AF was defined as asymptomatic episodes lasting at least 30 s. Patients were followed up at 1 year for cardiovascular (CV) outcomes.
  
  
  RESULTS
  Among the 737 patients analysed, 106 (14%) developed silent AF and 32 (4%) symptomatic AF. Compared with the no-AF group, patients with silent AF were markedly older (79 vs 62 years, p<0.001), more frequently hypertensive (71% vs 49%, p<0.001) and less likely to be smokers (23% vs 37%, p<0.001). Also, they were more likely to have impaired LVEF (50% vs 55%, p<0.001). Risk factors in patients with silent AF were similar to those in patients with symptomatic AF. However, a history of stroke or AF was less frequent in silent AF than in symptomatic-AF patients (10% vs 25% and 10% vs 38%, respectively). At 1 year, CV events including hospitalisation for heart failure (HF) and CV mortality were markedly higher in silent-AF patients than in no-AF patients (6.6% vs 1.3% and 5.7% vs 2.0%, p<0.001, respectively).
  
  
  CONCLUSIONS
  Our large prospective study showed for the first time that silent AF is associated with worse 1-year prognosis after AMI. Systematic screening and specific management should be investigated in order to improve outcomes of patients after AMI.
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Stamboul
authors.affiliation: Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Zeller
authors.affiliation: Cardiology Department, Trousseau University Hospital and François Rabelais University, Tours, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Fauchier
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Gudjoncik
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Buffet
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Garnier
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Guenancia
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Lorgis
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Beer
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Touzery
authors.affiliation: Cardiology Department, University Hospital, Dijon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D004562:Electrocardiography; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D020521:Stroke / Q000401:mortality