Atrial Fibrillation

Source: heartdisease.about.com --- 10 days ago
Atrial Fibrillation is one of the most common cardiac arrhythmias - and unfortunately, it is of the most difficult to treat. Here is a review of Atrial Fibrillation, its... ...

Source: www.ncbi.nlm.nih.gov --- 8 days ago
Related Articles Rhythm control versus rate control for Atrial Fibrillation. N Engl J Med. 2008 Oct 2;359(14):1522; author reply 1522 Authors: Knecht S, O'Neill MD, Verbeet T PMID: 18832253 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 11 days ago
Related Articles Milrinone Use Is Associated With Postoperative Atrial Fibrillation After Cardiac Surgery. Circulation. 2008 Sep 29; Authors: Fleming GA, Murray KT, Yu C, Byrne JG, Greelish JP, Petracek MR, Hoff SJ, Ball SK, Brown NJ, Pretorius M BACKGROUND: -Postoperative Atrial Fibrillation (AF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. Inotropic drugs are commonly used perioperatively to support ventricular function. This study tested the hypothesis that the use of inotropic drugs is associated with postoperative AF. Methods and Results-We evaluated perioperative risk factors in 232 patients who underwent elective cardiac surgery. All patients were in sinus rhythm at surgery. Sixty-seven patients (28.9%) developed AF a mean of 2.9+/-2.1 days after surgery. Patients who developed AF stayed in the hospital longer (P<0.001) and were more likely to die (P=0.02). Milrinone use was associated with an increased risk of postoperative AF (58.2% versus 26.1% in nonusers; P<0.001). Older age (63.4+/-10.7 versus 56.7+/-12.3 years; P<0.001), hypertension (P=0.04), lower preoperative ejection fraction (P=0.03), mitral valve surgery (P=0.02), right ventricular dysfunction (P=0.03), and higher mean pulmonary artery pressure (27.1+/-9.3 versus 21.8+/-7.5 mm Hg; P=0.001) also were associated with postoperative AF. In multivariable logistic regression, age (P<0.001), ejection fraction (P=0.02), and ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles The Association Among Blood Transfusions, White Blood Cell Count, and the Frequency of Post-Cardiothoracic Surgery Atrial Fibrillation: A Nested Cohort Study From the Atrial Fibrillation Suppression Trials I, II, and III. J Cardiothorac Vasc Anesth. 2008 Aug 28; Authors: Sood N, Coleman CI, Kluger J, White CM, Padala A, Baker WL OBJECTIVE: To evaluate the impact of postoperative red blood cell transfusions and white blood cell (WBC) counts on post-cardiothoracic surgery Atrial Fibrillation. DESIGN: A nested cohort study of 550 patients from the Atrial Fibrillation Suppression Trials I, II, and III. SETTING: A large urban teaching hospital. PARTICIPANTS: Patients undergoing cardiothoracic surgery. MEASUREMENTS AND RESULTS: Endpoints included postoperative Atrial Fibrillation occurrence and maximum white blood cell counts during the first 5 days postoperatively. Multivariate logistic regression was used to control for potential confounders and calculate adjusted odds ratios (AOR) with 95% confidence intervals (95% CIs). Of the 173 patients (31.5%) who developed postoperative Atrial Fibrillation, 110 patients (63.5%) received postoperative transfusions and 63 patients (36.5%) did not (crude odds ratio = 1.89; 95% CI, 1.31-2.74; p = 0.001). Postoperative white blood cell counts were significantly greater in patients who developed Atrial Fibrillation on postoperative days 3 to 5. There were no differences in WBC between pa ...

Source: www.ncbi.nlm.nih.gov --- 1 day ago
Related Articles Epicardial ultrasonic ablation of Atrial Fibrillation during concomitant cardiac surgery is a valid option in patients with ischemic heart disease. Circulation. 2008 Sep 30;118(14 Suppl):S78-82 Authors: Groh MA, Binns OA, Burton HG, Champsaur GL, Ely SW, Johnson AM BACKGROUND: Surgical therapy of Atrial Fibrillation concomitant to coronary bypass grafting using epicardial Ultrasound technology was assessed after a minimum 6-month follow-up. METHODS AND RESULTS: A cohort of 98 consecutive patients with a mean age of 72+/-7.58 years and a primary diagnosis of ischemic heart disease had surgery for structural disease. Coronary artery bypass grafting was isolated (n=51) or associated (n=47) with various combinations of aortic, mitral, tricuspid, and left ventricular restoration surgery. Atrial Fibrillation duration ranged from 6 to 360 months (mean 71 months) and was permanent in 47 patients, paroxysmal in 34, and persistent in 17. Left Atrial mean diameter was 48+/-6.71 mm. A circumferential ablation was performed off-pump, before the concomitant procedure, and was always associated with an epicardial mitral line lesion using the same technology. At 3-, 6-, and 12-month visits, patients were routinely evaluated by physical examination, ECG, chest X-ray, and 24-hour Holter. There were 1 early death (1%) and 4 extracardiac late deaths. A pacemaker was implanted in 4 patients. Mean follow-up time was 325 days, 2 patients b ...

Source: www.ncbi.nlm.nih.gov --- 27 days ago
Related Articles [Clinical characteristics of patients with persistent Atrial Fibrillation referred for cardioversion: Spanish Cardioversion Registry (REVERSE)] Rev Esp Cardiol. 2008 Jun;61(6):630-4 Authors: Alegret JM, Viñolas X, Sagristá J, Hernández-Madrid A, Berruezo A, Moya A, Martínez Sande JL, Pastor A, The objectives were to investigate the treatment and clinical characteristics of patients referred for cardioversion in Spain and to compare them with those reported in the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) and RACE (RAte Control versus Electrical cardioversion) studies. The prospective study involved 1515 consecutive patients with persistent Atrial Fibrillation who were referred for cardioversion at 96 Spanish hospitals. Half of the patients were being treated with Vaughan-Williams group-I or -III antiarrhythmic drugs. The most frequently used approach to anticoagulation was to administer dicoumarins 34 weeks before and after cardioversion. Our patients were younger than those in the AFFIRM and RACE studies. Compared with AFFIRM patients, our patients had a lower prevalence of previous embolism, ischemic heart disease, hypertension, diabetes, and systolic dysfunction. Compared with RACE patients, our patients had a lower prevalence of ischemic heart disease and previous embolism, but a slightly higher prevalence of hypertension and diabetes. We conclude that patients referred for cardiover ...

Source: www.ncbi.nlm.nih.gov --- 27 days ago
Related Articles Managing the anticoagulated patient with Atrial Fibrillation at high risk of stroke who needs coronary intervention. BMJ. 2008;337:a840 Authors: Lip GY PMID: 18790815 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 36 days ago
Related Articles Molecular genetics of Atrial Fibrillation. J Am Coll Cardiol. 2008 Jul 22;52(4):241-50 Authors: Tsai CT, Lai LP, Hwang JJ, Lin JL, Chiang FT Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia. There is genetic predisposition for the development of AF. Recently, by linkage analysis, several loci have been mapped for monogenetic AF, including 11p15.5, 21q22, 17q, 7q35-36, 5p13, 6q14-16, and 10q22. Some of these loci encode for subunits of potassium channels (KCNQ1, KCNE2, KCNJ2, and KCNH2 genes), and the remaining are yet unidentified. All of the known mutations are associated with a gain of function of repolarization potassium currents, resulting in a shortening of action potential duration and Atrial refractory period, which facilitate multiple re-entrant circuits in AF. In addition to familial AF, common AF often occurs in association with acquired diseases such as hypertension, valvular heart disease, and heart failure. By genetic association study, some genetic variants or polymorphisms related to the mechanism of AF have been found to be associated with common AF, including genes encoding for subunits of potassium or sodium channels, sarcolipin gene, renin-angiotensin system gene, connexin-40 gene, endothelial nitric oxide synthase gene, and interleukin-10 gene. These observations suggest that genes related to ionic channels, calcium handling protein, fibrosis, conduction and inflammation play ...

Source: www.ncbi.nlm.nih.gov --- 37 days ago
Related Articles Alternatives to warfarin in Atrial Fibrillation: drugs and devices. Heart. 2008 Sep;94(9):1113-6 Authors: Bayard YL, Ostermayer SH, Sievert H PMID: 18703688 [PubMed - indexed for MEDLINE] ...

Source: www.moreover.com --- 17 days ago
Tayal AH et al. - There is a high rate of Atrial Fibrillation (AF) detection by Mobile Cardiac Outpatient Telemetry (21 days) in patients with cryptogenic TIA/stroke that may be related to extended monitoring duration, patient selection, and inclusion ...

Source: www.ncbi.nlm.nih.gov --- 19 days ago
Related Articles Atrial conduction and Atrial Fibrillation: What can we learn from surface ECG? Cardiol J. 2008;15(5):402-7 Authors: Platonov PG Despite the advancements in pharmacological and non-pharmacological management of Atrial Fibrillation (AF) observed during last decades, available treatment modalities and predictors of their success are still far from optimal. Understanding of pathophysiological mechanisms underlying AF and assessment of Atrial electrophysiological properties using easily available non-invasive diagnostic tools such as surface ECG are essential for further improvement of patient-tailored treatment strategies. P-wave duration is generally accepted as the most reliable non-invasive marker of Atrial conduction and its prolongation has been associated with history of AF. However, patients with paroxysmal AF without structural heart disease may not have any impressive P-wave prolongation thus suggesting that the global conduction slowing is not an obligatory requirement for development of AF. In these settings, the morphology of P-wave becomes an important source of information concerning propagation of Atrial activation. One of the most common morphologies, i.e. biphasic configuration of P-waves in right precordial leads has been considered a marker of left Atrial enlargement but, seen in patients with structurally normal hearts, appears to be linked to an interatrial conduction defect. Recent advances in endoca ...

Source: www.ncbi.nlm.nih.gov --- 18 days ago
Related Articles Evaluation of catheter ablation of periatrial ganglionic plexi in patients with Atrial Fibrillation. Am J Cardiol. 2008 Sep 1;102(5):578-83 Authors: Danik S, Neuzil P, d'Avila A, Malchano ZJ, Kralovec S, Ruskin JN, Reddy VY Recent data suggests that the cardiac autonomic nervous system has an important role in the initiation and maintenance of Atrial Fibrillation (AF). This study investigated (1) the feasibility of identifying and targeting these autonomic ganglia using endocardial radiofrequency stimulation and ablation, respectively; (2) the efficacy of endocardial ablation to completely eliminate the vagal response elicited from epicardial stimulation; and (3) the effect of autonomic ablation on the acute inducibility of AF. The study included 18 patients referred for catheter ablation of suspected vagal-mediated AF. The endocardial left Atrial surface was stimulated at high frequency (20 to 50 Hz) to elicit a vagal response. In selected patients (n = 5), pericardial access was obtained using a subxyphoid puncture to permit epicardial stimulation. Catheter ablation of the putative autonomic ganglionic sites was performed from the left Atrial endocardium using irrigated radiofrequency energy. After ablation of all identifiable autonomic ganglia, high-frequency pacing was repeated to induce AF. In all patients, stimulation at certain endocardial sites elicited a vagal response. Endocardial ablation abrogated this vaga ...

Source: www.ncbi.nlm.nih.gov --- 18 days ago
Related Articles Computed tomography model-based treatment of Atrial Fibrillation and Atrial macro-re-entrant tachycardia. Europace. 2008 Aug;10(8):939-48 Authors: Piorkowski C, Kircher S, Arya A, Gaspar T, Esato M, Riahi S, Bollmann A, Husser D, Staab C, Sommer P, Hindricks G AIMS: Accurate orientation within true three-dimensional (3D) anatomies is essential for the successful radiofrequency (RF) catheter ablation of Atrial Fibrillation (AF) and Atrial macro-re-entrant tachycardia (MRT). In this prospective study, ablation of AF and MRT was performed exclusively using a pre-acquired and integrated computed tomography (CT) image for anatomical 3D orientation without electro-anatomic reconstruction of the left atrium (LA). METHODS AND RESULTS: Fifty-four consecutive patients suffering from AF (n = 36) and/or MRT (n = 18) underwent RF catheter ablation. A 3D CT image was registered into the NavX-Ensite system without reconstruction of the Atrial chamber anatomy. The quality of CT alignment was assessed and validated according to fluoroscopy information, electrogram characteristics, and tactile feedback at 31 pre-defined LA control points. The ablation of AF as well as mapping and ablation of MRT was performed within the 3D CT anatomy. In all patients, mapping and ablation could be performed without the reconstruction of the respective Atrial chamber anatomy. The overall CT alignment was highly accurate with true surface contact in 90% ( ...

Source: www.ncbi.nlm.nih.gov --- 33 days ago
Related Articles Esophageal cancer presenting with Atrial Fibrillation: a case report. J Med Case Reports. 2008 Sep 8;2(1):292 Authors: Bayraktar UD, Dufresne A, Bayraktar S, Purcell OI, Ajah OI ABSTRACT: INTRODUCTION: Atrial Fibrillation was previously reported in patients with esophageal cancer as a complication of total esophagectomy or photodynamic therapy. Here, we propose that Atrial Fibrillation may also be caused by external compression of the left atrium by esophageal cancer. CASE PRESENTATION: We present a 58-year-old man who developed Atrial Fibrillation with rapid ventricular rate in the emergency room while being evaluated for dysphagia and weight loss. Atrial Fibrillation lasted less than 12 hours and did not recur. Echocardiogram did not reveal any structural heart disease. A 10-cm, ulcerated mid-esophageal mass was seen during esophagogastroscopy. Microscopic examination showed squamous cell carcinoma. Computed tomography of the chest revealed esophageal thickening compressing the left atrium. CONCLUSION: External compression of the left atrium was previously reported to provoke Atrial Fibrillation. Similarly, esophageal cancer may precipitate Atrial Fibrillation by mechanical compression of the left atrium or pulmonary veins, triggering ectopic beats in susceptible patients. PMID: 18775083 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 38 days ago
Related Articles Psoriasis, inflammation, and Atrial Fibrillation. Am J Cardiol. 2008 Sep 1;102(5):647 Authors: Liu T, Li G PMID: 18721531 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 29 days ago
Related Articles Olanzapine-associated new-onset Atrial Fibrillation. J Clin Psychopharmacol. 2008 Jun;28(3):354-5 Authors: Waters BM, Joshi KG, Flynn J PMID: 18480700 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 33 days ago
Related Articles Membrane translocation of small GTPase Rac1 and activation of STAT1 and STAT3 in pacing-induced sustained Atrial Fibrillation. Heart Rhythm. 2008 Sep;5(9):1285-93 Authors: Tsai CT, Lin JL, Lai LP, Lin CS, Huang SK BACKGROUND: Angiotensin II and its downstream mitogen-activated protein kinase signaling pathways are involved in the pathogenesis of AF. Pro-inflammatory JAK/STAT is another downstream signaling pathway of Angiotensin II, and its status in AF remains unknown. OBJECTIVE: The aim of this study was to characterize the status of the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathways in pacing-induced sustained Atrial Fibrillation (AF). METHODS: AF was induced by Atrial pacing at 600/min in 10 adult pigs (AF group), while 10 sham-operated pigs served as the control group. RESULTS: Significant structural and inflammatory changes were noted in the AF group. Atrial tissue angiotensin II level was elevated and STAT1 and STAT3 were activated in the AF group. Nuclear translocation of activated STAT3 and binding to STAT3 consensus DNA sequence were also increased in the AF group. Rac1, the molecular target of statin, which mediates the activation of STAT3 by angiotensin II, was also activated in the AF group. The tissue levels of interleukin-6, leukemia inhibitory factor (LIF) and cardiotrophin-1 (CT-1), which are known to activate STATs through membrane gp130 and JAKs, were not increase ...

Source: www.moreover.com --- 14 days ago
JWR's Pundits Mallard Fillmore Michael Barone Mona Charen Linda Chavez Ann Coulter Greg Crosby Larry Elder Don Feder Suzanne Fields Paul Greenberg Bob Greene Betsy Hart Nat Hentoff David Horowitz Marianne Jennings Michael Kelly Mort Kondracke Ch. ...

Source: www.ncbi.nlm.nih.gov --- 26 days ago
Related Articles Prevention of Atrial Fibrillation with 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors. Circulation. 2008 Sep 16;118(12):1285-93 Authors: Adam O, Neuberger HR, Böhm M, Laufs U PMID: 18794401 [PubMed - in process] ...

Source: www.prnewswire.com --- 40 days ago
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