Screen-detected atrial fibrillation and ‘micro-atrial fibrillation' and risk of cardiovascular events after myocardial infarction in elderly patients

Background: Incident atrial fibrillation (AF) occurs in 5-10% of patients after acute myocardial infarction (AMI) and is associated with adverse outcomes. Guidelines now recommend screening for AF in all elderly patients. However, the relevance of screen-detected AF and short episodes of irregular supraventricular ectopic beats ( ‘micro-AF’) after AMI is unknown. Objectives: To investigate the value of two-week intermittent ECG screening to detect incident AF and ‘micro-AF’ in elderly patients 12 months after an AMI, and its association with risk of cardiovascular events. Methods: This was an investigator-initiated, multicenter substudy of the OMega-3 fatty acids in Elderly patients with Myocardial Infarction (OMEMI) trial, in Norway. Women and men aged 70-82 years, with a recent AMI, were recruited during 2012-2018. All participants had a 12-lead ECG performed at 3, 12 and 24 months. Patients without AF one ye ar after the index AMI underwent 2 weeks of intermittent 30-second ‘thumb ECG’ screening. Incident AF and ‘micro-AF’ (episodes of ≥3 consecutive irregular supraventricular ectopic beats) were registered, and the association with risk of major cardiovascular events (MACE; non-fatal AMI, str oke, coronary revascularization, hospitalization for heart failure, or all-cause death) was analyzed with logistic regression. Results: Among 1014 patients (198 (28.7%) women), 255 (25.1%) had known AF or AF identified at baseline. New-onset AF was detected clinica...
Source: Cardiology - Category: Cardiology Source Type: research