Evaluating the effect of coronary atherosclerosis on the occurrence of atrial fibrillation through coronary computed tomography angiography.

Background: The direct impact of atherosclerotic lesions in coronary vessels on the occurrence of atrial fibrillation (AF) in patients without a history of acute myocardial ischemia, previous myocardial infarction, or revascularization procedures remains largely unknown.

Aims: To assess the risk and predictors of new-onset AF in patients with coronary atherosclerosis confirmed by coronary computed tomography angiography (CCTA).

Methods: We included consecutive patients referred for CCTA who had been observed and diagnosed with new-onset AF over 10 years.

Results: Of the 549 patients enrolled in the study, 208 (37.9%) were diagnosed with atherosclerotic lesions in the coronary vessels and 63 (11.5%) developed AF during the 10 years of observation. Patients with AF were older (61.8 [10.4] years vs. 58.3 [9.2] years; P = 0.005), had an enlarged left atrium in the anteroposterior dimension (38.2 [7.2] mm vs. 34.4 [5.4] mm; P < 0.001), and had a widened interventricular septum (12.3 [2.0] mm vs. 11.0 [2.1] mm; P < 0.001). We also found a significant correlation between the occurrence of AF in patients with coronary atherosclerotic lesions and with increased thickness of the interventricular septum relative to the posterior wall of the left ventricle (P = 0.017).

Conclusions: Our data indicate an association between coronary atherosclerosis and the greater risk of AF in patients with increased thickness of the interventricular septum relative to the posterior wall of the left ventricle. This finding suggests that by using CCTA we can predict which patients are at higher risk of developing AF.