Management of Anticoagulant Therapy Monitored by an Implantable Device With Telecardiology in Patients With Acute Coronary Syndrome Associated With de Novo Atrial Fibrillation Arrhythmia

Inclusion Criteria:

• Atrial fibrillation diagnosed before hospitalization for acute coronary syndrome,whether treated or not.
• Atrial fibrillation still present at inclusion time.
• Transient atrial fibrillation due to a reversible disorder (thyrotoxycosis, pulmonaryembolism, recent surgery).
• Acute coronary syndrome that has not been revascularized.
• Acute coronary syndrome surgically treated (bypass).
• Patient already on anticoagulant therapy.
• Scheduled aortocoronary bypass.
• Creatinine clearance < 30 ml per minute.

Exclusion Criteria: Pathologic criteria :

• Atrial fibrillation diagnosed before hospitalization for acute coronary syndrome,whether treated or not.
• Atrial fibrillation still present at inclusion time.
• Transient atrial fibrillation due to a reversible disorder (thyrotoxycosis, pulmonaryembolism, recent surgery).
• Acute coronary syndrome that has not been revascularized.
• Acute coronary syndrome surgically treated (bypass).
• Patient already on anticoagulant therapy.
• Scheduled aortocoronary bypass.
• Creatinine clearance < 30 ml per minute. Bleeding risks :
• Contraindications to anticoagulant therapy.
• Active internal hemorrhage, clinically significant bleeding, bleeding non accessibleto compression or bleeding diathesis within 30 days prior to selection visit.
• Platelet count < 90000/µL at the selection visit.
• Bleeding event in the twelve months prior to inclusion.
• Bleeding events detected either clinically or biologically (hemoglobinemia < 10g/dl).
• Elective surgery. Comorbidities :
• Cardiogenic shock.
• Hyperthyroidism.
• Prior history of significant liver disease (acute hepatitis, active chronic hepatitis,cirrhosis) or liver function disorder detected at selection visit.
• Significant mitral valvular heart disease. General :
• Patient under 18.
• Non menopausal woman or without contraception.
• Patient whose physical and / or mental health may have an impact on the compliance tothe study.
• Participation in another biomedical research study (interventional ornoninterventional) or participation in a research study within the 30 days prior toinclusion.
• Protected adults (under judicial protection, guardianship, or supervision).