Effect of High Interatrial Block on In-hospital New-onset Atrial Fibrillation in Patients with Acute Non-ST-segment Elevation Myocardial Infarction
GE Wenjun
ZHANG Qi
WEI Xiao
ZHOU Weidong
WANG Ruili
Abstract：Objective: To explore the relationship between high-grade atrioventricular block (aIAB) and new-onset atrial fibrillation (NOAF) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods: A total of 820 patients diagnosed with NSTEMI who underwent coronary revascularization within 24 hours were consecutively enrolled from September 2020 to November 2022 at Suining People's Hospital. Standard 12-lead electrocardiograms (ECGs) were recorded at the first medical contact. Images were magnified and analyzed using a semi-automatic caliper to obtain aIAB. After admission, suspicious atrial fibrillation rhythms were recorded by continuous ECG monitoring and immediately confirmed by 12-lead ECG. Results: A total of 820 NSTEMI patients were included, of whom 81 (9.9%) developed NOAF. Patients were divided into two groups: those without NOAF (w/o NOAF) and those with NOAF (NOAF group). Compared with the w/o NOAF group, the NOAF group had higher age, heart rate, Killip classification, C-reactive protein (CRP), high-sensitivity troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), length of hospital stay, aIAB, and right coronary artery (RCA) proportion, while left anterior descending artery (LAD) proportion and left ventricular ejection fraction (LVEF) were lower, with statistically significant differences (P < 0.05). After adjusting for these risk factors, age, heart rate, LAD, LVEF, and aIAB were identified as independent risk factors for NOAF. The receiver operating characteristic (ROC) curve showed that age and aIAB had good predictive value for NOAF in NSTEMI patients. Adding aIAB to the traditional model for NOAF resulted in significant improvement in the net reclassification index (NRI) and integrated discrimination improvement (IDI) (P < 0.001). Conclusion: aIAB is associated with a higher risk of NOAF in NSTEMI patients and has good specificity and sensitivity for predicting NOAF.
Keywords：acute non-ST elevation myocardial infarctionatrial fibrillationelectrocardiograminteratrial block
Publication Date：2025-01-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 264-269 )