After a Heart Attack, Heartbeat Disturbance Can Be Deadly
March 6, 2000 (New York) -- Elderly people hospitalized for a major heart
attack have a greater risk of dying if they develop atrial fibrillation, a
disturbance of the heart's natural rhythm. In a study appearing in the March 7
issue of Circulation, researchers say more attention should be paid to
this common complication, which occurred in 22% of the elderly people
Atrial fibrillation (AF), which is the rapid, uncontrolled beating of the
two upper chambers of the heart, affects more than 2 million Americans. Though
AF is known to increase a person's future risk of death, the new study shows it
to be a significant risk factor for death following a heart attack.
"We know that atrial fibrillation is a problem following [heart
attack]," study co-author Allen J. Solomon, MD, tells WebMD. "Outside
of [heart attack] we know that it is common in the elderly, but what was not
clear was how common it was in elderly [heart attack] patients. In this study
we found it to be even more common than suspected." Solomon is with the
division of cardiology of Georgetown University Medical Center in
The authors evaluated more than 100,000 people 65 and older who were
hospitalized with heart attacks.
AF, which occurred in close to a quarter of the study participants, was more
likely in the older patients and those who had a history of heart disease. The
patients with AF were more likely to have died while in the hospital -- 25% of
them died, compared to 16% of those without the condition -- and up to 30 days
after discharge. One year after their heart attacks, close to a half of the AF
patients had died, compared to just under a third of the patients without
The likelihood that atrial fibrillation will hurt recovery appears to depend
on when it develops. Some studies have shown that only those who develop it
while hospitalized are at increased risk of dying. Adding to the controversy,
at least one large study found no connection between developing AF and dying
after a heart attack.
"Various studies have said that atrial fibrillation is either an
important risk factor for bad prognosis, or some have said it's not really a
risk factor at all," Solomon says. His study found that though patients
admitted to the hospital with AF had a small risk of death, those who developed
it during hospitalization had a markedly increased risk.
Solomon says the next logical step is to determine the best treatment
regimen for AF in these patients and to find ways to prevent it from occurring
in concert with a heart attack. AF can be treated in a variety of ways, ranging
from medications to surgery.
"We don't yet know for certain the best way to treat people once they
have atrial fibrillation," Solomon says. "What we're looking at now is
treating them more aggressively at the beginning, with the hope that less
atrial fibrillation will develop. But we don't know for sure that that will
- Elderly patients who are in the hospital after having a heart attack are at
higher risk of death if they develop atrial fibrillation, an abnormality in the
heart rhythm, according to a recent study.
- Researchers found the atrial fibrillation in these patients was common,
affecting one out of five elderly, hospitalized heart-attack patients.
- Some studies have shown no association between atrial fibrillation and
death, while other research shows that the risk depends on when the patient
develops the condition.