Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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
See this image and copyright information in PMC

References

    1. Fuster Valentin, Rydén Lars E, Cannom David S, Crijns Harry J, Curtis Anne B, Ellenbogen Kenneth A, Halperin Jonathan L, Le Heuzey Jean-Yves, Kay G Neal, Lowe James E, Olsson S Bertil, Prystowsky Eric N, Tamargo Juan Luis, Wann Samuel, Smith Sidney C, Jacobs Alice K, Adams Cynthia D, Anderson Jeffery L, Antman Elliott M, Halperin Jonathan L, Hunt Sharon Ann, Nishimura Rick, Ornato Joseph P, Page Richard L, Riegel Barbara, Priori Silvia G, Blanc Jean-Jacques, Budaj Andrzej, Camm A John, Dean Veronica, Deckers Jaap W, Despres Catherine, Dickstein Kenneth, Lekakis John, McGregor Keith, Metra Marco, Morais Joao, Osterspey Ady, Tamargo Juan Luis, Zamorano José Luis. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006 Aug 15;114 (7):e257–354. - PubMed
    1. Feinberg W M, Blackshear J L, Laupacis A, Kronmal R, Hart R G. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch. Intern. Med. 1995 Mar 13;155 (5):469–73. - PubMed
    1. Novaro Gian M, Asher Craig R, Bhatt Deepak L, Moliterno David J, Harrington Robert A, Lincoff A Michael, Newby L Kristin, Tcheng James E, Hsu Amy P, Pinski Sergio L. Meta-analysis comparing reported frequency of atrial fibrillation after acute coronary syndromes in Asians versus whites. Am. J. Cardiol. 2008 Feb 15;101 (4):506–9. - PubMed
    1. Go A S, Hylek E M, Phillips K A, Chang Y, Henault L E, Selby J V, Singer D E. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 09;285 (18):2370–5. - PubMed
    1. Furberg C D, Psaty B M, Manolio T A, Gardin J M, Smith V E, Rautaharju P M. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am. J. Cardiol. 1994 Aug 01;74 (3):236–41. - PubMed

LinkOut - more resources