Tharsika Sakthivel, Niels Risum, Henning Bundgaard, Rikke Moerch Joergensen, Uffe G. Jacobsen, Heikki V. Huikuri, Poul Erik Bloch Thomsen, Christian Jons, Anna F. Thomsen
{"title":"急性心肌梗死后左心室收缩功能减退的患者在接受程序性电刺激时意外诱发心房颤动","authors":"Tharsika Sakthivel, Niels Risum, Henning Bundgaard, Rikke Moerch Joergensen, Uffe G. Jacobsen, Heikki V. Huikuri, Poul Erik Bloch Thomsen, Christian Jons, Anna F. Thomsen","doi":"10.1111/anec.70011","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The aim of this study was to investigate the clinical implication of incidentally induced atrial fibrillation (AF) during programmed electrical stimulation (PES) in patients with left ventricular systolic dysfunction (≤40%) after an acute myocardial infarction (MI).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this study, we included 231 patients from the Cardiac Arrhythmias and RIsk Stratification after Myocardial InfArction (CARISMA) study with left ventricular ejection fraction ≤40% and no prior history of AF. These patients underwent PES 6 weeks post-MI as part of the study protocol. Patients all received an implantable cardiac monitor (ICM) 3–21 days post-MI and were continuously monitored for cardiac arrhythmias for 2 years. Induction of AF was unwanted but reported if this incidentally occurred.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 61 patients (26%) developed AF within 2 years of follow-up, in which <i>n</i> = 10 (29%) had incidental AF during PES at baseline. The overall risk of AF was not significantly increased in patients with incidental AF (<i>n</i> = 34) during PES compared to patients without incidental AF (<i>n</i> = 197) (HR 1.6 [0.9–3.0], <i>p</i> = 0.14). The risk of bradyarrhythmia (HR = 0.2 [0.0–1.2], <i>p</i> = 0.07), ventricular arrhythmias (HR = 0.7 [0.1–5.8], <i>p</i> = 0.77), and major cardiovascular events (MACE) (HR 0.5 [0.2–1.7], <i>p</i> = 0.28) was not significantly different in patients with versus without incidental AF.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Incidentally induced AF during PES in post-MI patients with reduced LVEF was not significantly associated with a higher risk of long-term atrial fibrillation, other cardiac arrhythmias, or major cardiac events.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>NCT00145119</p>\n </section>\n </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 5","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369908/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidentally Induced Atrial Fibrillation During Programmed Electrical Stimulation in Patients With Depressed Left Ventricular Systolic Function After an Acute Myocardial Infarction\",\"authors\":\"Tharsika Sakthivel, Niels Risum, Henning Bundgaard, Rikke Moerch Joergensen, Uffe G. Jacobsen, Heikki V. Huikuri, Poul Erik Bloch Thomsen, Christian Jons, Anna F. Thomsen\",\"doi\":\"10.1111/anec.70011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The aim of this study was to investigate the clinical implication of incidentally induced atrial fibrillation (AF) during programmed electrical stimulation (PES) in patients with left ventricular systolic dysfunction (≤40%) after an acute myocardial infarction (MI).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In this study, we included 231 patients from the Cardiac Arrhythmias and RIsk Stratification after Myocardial InfArction (CARISMA) study with left ventricular ejection fraction ≤40% and no prior history of AF. These patients underwent PES 6 weeks post-MI as part of the study protocol. Patients all received an implantable cardiac monitor (ICM) 3–21 days post-MI and were continuously monitored for cardiac arrhythmias for 2 years. Induction of AF was unwanted but reported if this incidentally occurred.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 61 patients (26%) developed AF within 2 years of follow-up, in which <i>n</i> = 10 (29%) had incidental AF during PES at baseline. The overall risk of AF was not significantly increased in patients with incidental AF (<i>n</i> = 34) during PES compared to patients without incidental AF (<i>n</i> = 197) (HR 1.6 [0.9–3.0], <i>p</i> = 0.14). The risk of bradyarrhythmia (HR = 0.2 [0.0–1.2], <i>p</i> = 0.07), ventricular arrhythmias (HR = 0.7 [0.1–5.8], <i>p</i> = 0.77), and major cardiovascular events (MACE) (HR 0.5 [0.2–1.7], <i>p</i> = 0.28) was not significantly different in patients with versus without incidental AF.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Incidentally induced AF during PES in post-MI patients with reduced LVEF was not significantly associated with a higher risk of long-term atrial fibrillation, other cardiac arrhythmias, or major cardiac events.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Trial Registration</h3>\\n \\n <p>NCT00145119</p>\\n </section>\\n </div>\",\"PeriodicalId\":8074,\"journal\":{\"name\":\"Annals of Noninvasive Electrocardiology\",\"volume\":\"29 5\",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369908/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Noninvasive Electrocardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/anec.70011\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Noninvasive Electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/anec.70011","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Incidentally Induced Atrial Fibrillation During Programmed Electrical Stimulation in Patients With Depressed Left Ventricular Systolic Function After an Acute Myocardial Infarction
Background
The aim of this study was to investigate the clinical implication of incidentally induced atrial fibrillation (AF) during programmed electrical stimulation (PES) in patients with left ventricular systolic dysfunction (≤40%) after an acute myocardial infarction (MI).
Methods
In this study, we included 231 patients from the Cardiac Arrhythmias and RIsk Stratification after Myocardial InfArction (CARISMA) study with left ventricular ejection fraction ≤40% and no prior history of AF. These patients underwent PES 6 weeks post-MI as part of the study protocol. Patients all received an implantable cardiac monitor (ICM) 3–21 days post-MI and were continuously monitored for cardiac arrhythmias for 2 years. Induction of AF was unwanted but reported if this incidentally occurred.
Results
A total of 61 patients (26%) developed AF within 2 years of follow-up, in which n = 10 (29%) had incidental AF during PES at baseline. The overall risk of AF was not significantly increased in patients with incidental AF (n = 34) during PES compared to patients without incidental AF (n = 197) (HR 1.6 [0.9–3.0], p = 0.14). The risk of bradyarrhythmia (HR = 0.2 [0.0–1.2], p = 0.07), ventricular arrhythmias (HR = 0.7 [0.1–5.8], p = 0.77), and major cardiovascular events (MACE) (HR 0.5 [0.2–1.7], p = 0.28) was not significantly different in patients with versus without incidental AF.
Conclusions
Incidentally induced AF during PES in post-MI patients with reduced LVEF was not significantly associated with a higher risk of long-term atrial fibrillation, other cardiac arrhythmias, or major cardiac events.
期刊介绍：
The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients.
ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation.
ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.
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