engleski

Atrial fibrillation in acute inferior myocardial inarction: influence of right ventricular involvement

Aim: The analysis of the influence of right ventricular infarction on the incidence of atrial fibrillation (AF) in patients with inferior wall acute myocardial infarction (AMI). Methods: Data were obtained and analyzed in 225 patients with inferior wall AMI. The patients were divided into two groups: patients with isolated inferior AMI (group I) ; patiens with inferior AMI and right ventricular involvement (group II). Each gorup was further subdivided depending on the absence or presence of AF (groups Ia and IIa, and groups Ib and IIb, respectively). The diagnosis of right ventricular infarction was based on the presence of ST segment elevation of &#8805; 0.1 mV in the right precordial ECG leads V3R and V4R in patients with typical changes in inferior leads. Results: There were 167 (74%) patients in group I, and 58 (26%) patients in group II. AF was found in 27 (12%) of all patients. In group I AF was recorded in 13 (8%) patients (group Ib), while in group II it occured in 14 (24%) patients (group IIb) (p<0.01). Spontaneous conversion to sinus rhythm occured in 6 (43%) patients in group IIb and in none of the patients in group Ib (p<0.05). Conclusion: High incidence of AF and great propensity to spontaneous conversion to sinus rhythm in patients with inferior AMI and right ventricular involvement, in comparison with patients with isolated inferior wall AMI was established. The likely explanation for this finding is the increase in right atrial pressure as a consequence of right ventricular dysfunction.

Acute myocardial infarction; atrial fibrillation; right ventricular infarction

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