New-onset atrial fibrillation and acute coronary syndrome

Abstract

Despite advances in the diagnosis and management of acute coronary syndrome (ACS), atrial fibrillation (AF) remains a commonly encountered complication leading to adverse short- and long-term outcomes across the whole spectrum of ACS. At present, the underlying mechanisms of AF in myocardial ischemia remain incompletely understood. This article evaluates the incidence and trends of new-onset AF in ACS, its impact on ACS management and the associated prognostic significance in patients with acute ischemic heart disease. The safety and use of oral anticoagulation treatment in ACS patients on multiple antiplatelet agents are also explored. Further experimental and clinical studies are needed to improve current understanding and management of new-onset AF in ACS patients.

Keywords::

• acute coronary syndrome
• antiarrhythmic drugs
• atrial fibrillation
• oral anticoagulation

Financial & competing interests disclosure

Dennis H Lau is supported by a Medical Postgraduate Scholarship from the National Health and Medical Research Council of Australia, the Earl Bakken Electrophysiology Scholarship from the University of Adelaide, and a Biomedical Research Scholarship from Kidney Health Australia. Muayad Alasady is supported by a Divisional Scholarship and the Earl Bakken Electrophysiology Scholarship from the University of Adelaide, and a Medical Postgraduate Scholarship from the National Health and Medical Research Council of Australia. Anthony G Brooks and Prashanthan Sanders are supported by the National Heart Foundation of Australia. Prashanthan Sanders reports having served on the advisory board of and having received lecture fees and research funding from Bard Electrophysiology, Biosense-Webster, Medtronic and St. Jude Medical. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.