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Revista Médica Electrónica
On-line version ISSN 1684-1824
Abstract
ROSABAL-GARCIA, Yoandro; ROSALES-GUIBERT, Eddy Alberto; TORRES-QUINONES, Lorchen and MOLINA-SARIOL, Magyoris Malo de. Clinical echo-cardiographic factors of failed therapy in acute coronary syndrome and paroxysmal atrial fibrillation. Rev.Med.Electrón. [online]. 2023, vol.45, n.3, pp. 395-407. Epub June 30, 2023. ISSN 1684-1824.
Introduction:
atrial fibrillation is the most frequent sustained tachyarrhythmia in humans. Its management requires a holistic approach for the results to be optimal; it is considered the cardiovascular epidemics of the 21st century.
Objective:
to establish echo-cardiographic variables associated with cardioversion failure in patients with clinical diagnosis of atrial fibrillation and acute coronary syndrome.
Materials and methods:
a retrospective, analytical, non-experimental study of cases and controls was carried out in patients with atrial fibrillation and acute coronary syndrome, during the period between 2017 and 2021.
Results:
electrical cardioversion was observed in 55 patients (68.8%) (OR = 0.24; CI 95%: 0.08-0.7; p = 0.008). Thrombolytic therapy was applied in 47 patients (58.8%) (OR = 5.03; CI 95%: 1.67-15.12; p = 0.0026). Regarding echocardiographic parameters, the variable left atrial volume ≥ 34 ml/sc predominated in 50 patients (62.5%) (OR = 3.5; CI 95%: 1.22-10.04; p = 0.016); left atrial pressure > 15 mmHg predominated in 23 patients (OR = 3.61; CI 95%: 1.23-10.54; p = 0.015), and left ventricular diameter > 57 mm in 20 patients (OR = 4.33; CI 95%: 1.35-13.87; p = 0.009).
Conclusions:
elevated left atrial volume, left atrial pressure, and left ventricular diameter, electric and thrombolytic therapy, are all associated to cardioversion failure in patients with atrial fibrillation and acute myocardial infarction.
Keywords : atrial fibrillation; non-ST-segment elevation acute myocardial infarction; atrial volume.