0299: De novo atrial fibrillation in the acute coronary syndrome

Introduction De novo atrial fibrillation (AF) is common in the acute coronary syndrome (ACS), but most patients (P) are discharged in sinus rhythm (SR). The recurrence of arrhythmia in follow-up (FU) remains unknown and its undervaluation may have prognostic impact. Aim To characterize a population with ACS and de novo AF and determine its prognostic impact. To evaluate the recurrence of AF and the incidence of ischemic stroke/systemic embolism in FU. Methods We analyzed 2383 P consecutivelly admitted with ACS and with a minimum of 180 days FU. De novo AF has been defined as AF first detected on admission or during hospitalization. Results It has been observed de novo AF in 199 P (8.4%), the majority being male (70.4%). These patients were significantly older (p The echocardiographic evaluation showed a higher prevalence of mitral insufficiency (p The in-hospital mortality (9.5% vs 3.3%, p 95 patients with de novo AF were followed for a median period of 690 days and it was observed the occurrence of ischemic stroke/systemic embolism in 9 P (9.5%), but only one was under oral anticoagulation. AF occurred in 37.5% of P that were in SR on discharge. Conclusion The presence of de novo AF was associated with increased risk of adverse events, although it may constitute only a marker of severity. We observed recurrence of AF in a considerable sample, which denotes the need for appropriate evaluation of thromboembolic risk of these P.