Assessment of Risk Factors for Atrial Fibrillation With a Particular Focus on Echocardiographic Parameters, in Patients With Acute Myocardial Infarction

Abstract

Background

Atrial fibrillation is the most common arrhythmia worldwide, affecting between 2% and 4% of population. The projected further progression is a reason to consider AF as a global epidemic problem. The efficiency in diagnosing new cases is still unsatisfactory.

Methods

The prospective study included 74 patients hospitalized for acute myocardial infarction. Echocardiography with advanced assessment of the left atrium was performed on all patients. R Statistical Software was used for statistical and graphical processing.

Results

Atrial fibrillation was first diagnosed in 13.5% of patients with acute myocardial infarction, and in 5.4% of the patients the diagnosis was made during the long-term follow-up period. Analysis of the data collected showed that patients with arrythmia were older (71.79 vs 63.5 years; p = 0.047), had a higher BMI (30.15 vs 26.76 kg/m²; p = 0.039) and had a higher CHA₂DS₂ VASc score (4.14 vs 3.02 points). Among the echocardiographic parameters, those that significantly differentiated patients with arrythmia included larger LA area (21.62 vs 18.84 cm²; p = 0.027), lower LAEF 4CH (43.46 vs 55.93%; p = 0.029), lower LAEF mean (44.08 vs 55.63%; p = 0.014), lower EI (1.03 vs 1.49; p = 0.032), lower LASr 4CH (19.08 vs 26.72%; p = 0.020), lower LASr mean (18.62 vs 26.73%; p = 0.009), higher E/e’ (12.62 vs 9.58; p = 0.01), higher LASI (0.95 vs 0.45; p = 0.016).

Conclusions

Among the echocardiographic parameters, those that may indicate an increased risk of atrial fibrillation and could be implemented in clinical practice are LASr and LASI. Determining them in risk profiling and the implementation of individualized arrhythmia detection methods could increase diagnostic efficiency.