Bhatia Gurbir S, Lip Gregory Y H
University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Curr Heart Fail Rep. 2004 Dec;1(4):149-55. doi: 10.1007/s11897-004-0002-y.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a frequent complication of acute myocardial infarction (MI). AF occurs in 5% to 10% of patients who have received fibrinolysis. Post-MI AF is more common in older patients, in patients with heart failure, and after more extensive infarction. Postinfarction prognosis is worse among patients complicated by AF--indeed, mortality and morbid events including stroke, thromboembolism, and heart failure are increased in this group. It is unclear as to whether AF directly reduces survival or merely demarcates patients at higher overall risk. Despite its frequent occurrence and deleterious influence on outcomes, randomized data regarding management of AF after acute MI are scarce. This review summarizes recent data charting the incidence of AF after acute MI and describes features associated with its occurrence. Clinical sequelae and current principles in treatment are also discussed.
心房颤动（AF）是最常见的持续性心律失常，也是急性心肌梗死（MI）的常见并发症。接受纤维蛋白溶解治疗的患者中，5%至10%会发生AF。心肌梗死后的AF在老年患者、心力衰竭患者以及梗死范围更广的患者中更为常见。合并AF的患者心肌梗死后的预后更差——事实上，该组患者的死亡率以及包括中风、血栓栓塞和心力衰竭在内的不良事件均增加。AF是直接降低生存率还是仅仅区分出总体风险较高的患者尚不清楚。尽管AF频繁发生且对预后有有害影响，但关于急性心肌梗死后AF管理的随机数据却很少。本综述总结了近期有关急性心肌梗死后AF发生率的数据，并描述了与其发生相关的特征。还讨论了临床后遗症和当前的治疗原则。
