Early atrial fibrillation during acute posterior myocardial infarction: an interplay of ischemia of sinus node artery and atrial arrhythmogenesis.

Abstract

Atrial arrhythmias and especially atrial fibrillation in the early phase (first 12 hours) of acute myocardial infarction (AMI) are rare. They are more common in the later stages of AMI and the most of the times as a sign of heart failure. The pathogenesis seems to be an underlined coronary ischemia. Among the causes an ischemia of sinus node artery (SNA) is previously described. SNA arise the most of the times from the initial part of right coronary artery while the remaining from the LCx or in a small proportion of them have double origin from RCA and LCx one. In this case we describe a case of atrial fibrillation in the early phase of AMI promptly resolved in the next one hour after successful percutaneous coronary angioplasty (PTCA) treatment of the culprit lesion in the LCx at site of the origin of SNA.

Keywords

• early atrial fibrillation
• myocardial infarction
• sinus node artery ischemia.