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Review
. 2012 Oct 6;5(3):611.
doi: 10.4022/jafib.611. eCollection 2012 Oct-Nov.

Atrial Fibrillation Complicating Acute Coronary Syndromes

Sean D Pokorney  1 , Meena Rao  1 , Kent R Nilsson  1   2 , Jonathan P Piccini  1   3
Affiliations
Review

Atrial Fibrillation Complicating Acute Coronary Syndromes

Sean D Pokorney et al. J Atr Fibrillation. .

Abstract

Atrial fibrillation frequently complicates myocardial infarction. Patients with atrial fibrillation complicating acute coronary syndrome have increased morbidity and mortality relative to patients that remain in normal sinus rhythm. No studies have identified a mortality benefit to rhythm control compared with rate control in the setting of acute coronary syndrome. Stroke prevention should be pursued with oral anticoagulation therapy, although the majority of patients with atrial fibrillation associated with acute coronary syndrome receive only antiplatelet therapy. There are several novel oral anticoagulant therapies now available, but these agents have not been well studied in combination with dual antiplatelet therapy. Therefore, warfarin as part of triple therapy is the most conservative approach until additional data becomes available.

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Figures

Figure 1.
Figure 1.. Schematic representation of mechanisms of AF in the setting of ACS
Abbreviations: RA, right atrium; LA, left atrium; TV, Tricuspid valve; MV, mitral valve; PV, pulmonary vein; SVC, superior vena cava; IVC inferior vena cava; LAA, left atrial appendage
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