Abstract

Introduction: Silent atrial fibrillation (AF) has been suggested to be frequent after acute coronary syndrome. Continuous ECG monitoring (CEM) has been shown to improve AF screening in patients at risk of stroke.

Objectives: We aimed to assess the incidence and prognosis of silent AF in patients with acute coronary syndrome.

Methods: All the consecutive patients with acute coronary syndrome were prospectively analyzed by CEM ≥ 24h after admission at intensive care of cardiology department CHU IBN ROCHD Casablanca. Silent AF was defined as asymptomatic episodes lasting at least 30s. The population was divided into three groups: no-AF, silent AF and symptomatic AF.

Results: Among the 84 patients, 13 (16%) developed silent AF and 5 (5%) symptomatic AF. Compared with the no-AF group, patients with silent AF were markedly older (70 vs. 55 years, p < 0.001), more frequently women (45% vs. 25%, p = 0.006) and less likely to be smokers (25% vs. 30%, p < 0.001). They had impaired left ventricular ejection fraction (LVEF) and left atrial (LA) enlargement. By multivariate analysis, age, history of AF, indexed LA area and LVEF were identified as independent predictors of silent AF. In-hospital heart failure and death rates were markedly higher in silent AF group when compared with no-AF patients (40% vs. 20.0% and 10% vs. 2%, respectively).

Conclusion: Our large prospective study showed for the first time that silent AF is more frequent than symptomatic AF after acute coronary syndrome. Our work suggests that indexed LA area could help to predict the risk of developing silent AF. Moreover, the onset of silent AF is associated with worse hospital prognosis.

Keywords: Silent Atrial Fibrillation; Acute Coronary Syndrome; Echocardiography, Prognosis

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Citation

Citation: Amal Moukhliss., et al. “Silent Atrial Fibrillation Complicating Acute Coronary Syndrome: Determinants and Prognosis". Acta Scientific Medical Sciences 4.6 (2020): 66-69.

Copyright

Copyright: © 2020 Amal Moukhliss., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.