New-onset atrial fibrillation

The prognosis of new-onset AF depends on several factors, such as the precipitating event, underlying cardiac status, risk of thromboembolism, and whether the nature of the AF is paroxysmal, persistent, or permanent. In young patients with no structural cardiac abnormalities who have an episode of new-onset AF as a result of alcohol bingeing, prognosis is excellent with avoidance of alcohol. In contrast, short- and long-term prognosis for patients presenting with new onset of AF with heart failure following myocardial infarction (MI) is poor. Furthermore, a meta-analysis has shown that there is an increased risk of mortality with the presence of AF in the setting of MI, which persists regardless of the timing of AF.[80]Jabre P, Roger VL, Murad MH, et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation. 2011 Apr 19;123(15):1587-93. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082773 http://www.ncbi.nlm.nih.gov/pubmed/21464054?tool=bestpractice.com Patients with prior AF or new-onset AF following MI need close clinical follow-up.