decreased atrioventricular synchrony, elevated filling pressures with enhanced remodeling and worsening left ventricular systolic dysfunction, and increased rates of ventricular arrhythmias and sudden cardiac death.[20-22] Previous studies have shown an increased risk of major adverse cardiovascular events and all-cause mortality in AF patients with ACS.[23-29] However, controversy still exists as to whether AF plays a prognostic role in poor outcomes or is merely a marker of worsening risk due to an increased number of confounding comorbidities.