الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Atrial fibrillation (AF) is the most common arrhythmia in patients with and without structural heart disease with an increasing incidence mainly due to the aging population (172). Data from large epidemiological studies have clearly demonstrated that AF is associated with an increase in mortality and morbidity (224). The combination of AF and congestive heart failure is particularly ominous in that it appears that the development of either condition has a marked detrimental impact upon the mortality of the other (225, 226). Atrial fibrillation can also complicate acute coronary syndromes particularly acute ST-segment elevation myocardial infarction (STEMI). In this clinical setting, the occurrence of AF is of particular importance since rapid and irregular ventricular rates during the arrhythmia may cause further impairment of the coronary circulation and left ventricular function in addition to the adverse consequences of neurohormonal activation. Atrial fibrillation is associated with a high mortality which may be due in part to the development of AF as a surrogate or marker of heart failure, elevated filling pressures and atrial volume overload.(165) The bulk of evidence demonstrates that AF in patients hospitalized for AMI carries adverse prognostic implications regarding in-hospital morbidity and mortality. Particularly in the setting of congestive heart failure and left ventricular dysfunction, mortality seems to be further elevated when AF is present.(172) It was conducted on 80 STEMI patients, and the study sample was divided into two groups according to rhythm; ➢ group 1: included 40 new onset AF-patients treated by primary PCI. ➢ group 2: with 40 sinus rhythm-patients treated by primary PCI. Patients in group 1 were matched to patients in group 2 regarding different demographic, clinical, laboratory, angiographic, and echocardiographic parameters. Patients in AF group showed significantly older age, higher CK-MB level, higher degree of mitral regurgitation and RCA as infarction related artery.