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https://www.readbyqxmd.com/read/28453809/in-patients-undergoing-lung-resection-is-it-safe-to-administer-amiodarone-either-as-prophylaxis-or-treatment-of-atrial-fibrillation
#1
Styliani Maria Kolokotroni, Levon Toufektzian, Leanne Harling, Andrea Billè
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether the administration of amiodarone is safe in patients undergoing lung resection either for prophylaxis or treatment of de novo postoperative atrial fibrillation (POAF). A total of 30 papers were identified, of which 13 represented the best evidence to answer the clinical question. The authors, journal, date, study type, country of publication, patient demographics, relevant outcomes and results were tabulated...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28449532/the-future-of-hybrid-ablation-an-emerging-need-for-an-anticoagulation-protocol-for-thoracoscopic-ablation
#2
EDITORIAL
Pavel Osmancik, Petr Budera
The midterm efficacy of hybrid ablation of atrial fibrillation (AF) reported in recent papers is about 70% in terms of sinus rhythm maintenance without antiarrhythmic drugs. Bearing in mind that the majority of patients enrolled are patients with persistent and long-standing persistent AF, the reported efficacies seem to be very good. Despite the high efficacies, safety remains a critical issue in hybrid, and especially thoracoscopic ablations. The frequency of complications during thoracoscopic ablations is more than 10% in the majority of reports...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28447320/should-ablation-be-first-line-therapy-for-patients-with-paroxysmal-af
#3
REVIEW
Sergio Conti, Atul Verma
Atrial fibrillation is the most common cardiac arrhythmia and the number of patients is expected to continuously increase in the next years. Catheter ablation is an effective, safe, and well-established treatment for patient with symptomatic and drug-resistant paroxysmal atrial fibrillation (PAF). Over the last decade, there was an increasing body of evidence demonstrating superiority of catheter ablation over antiarrhythmic drugs (AADs) in maintaining sinus rhythm. However, randomized clinical trials have not been conclusive to consider catheter ablation as a first-line therapy for PAF...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28447159/catheter-ablation-of-persistent-atrial-fibrillation-beneficial-effect-of-a%C3%A2-short-term-adjunctive-amiodarone-therapy-on-the-long-term-outcome
#4
Klaus Kettering, Felix Gramley
BACKGROUND: Catheter ablation has become the first line therapy in patients with symptomatic, recurrent, drug-refractory atrial fibrillation. Circumferential pulmonary vein ablation is still the standard approach in these patients. However, the results are not very favorable (especially in patients with persistent atrial fibrillation). Therefore, more complex ablation strategies and the usefulness of (short-term) adjunctive antiarrhythmic drug therapy are a matter of discussion. The aim of this study was to analyze whether short-term amiodarone therapy after catheter ablation (3 months) has a positive effect on the success rates after circumferential pulmonary vein ablation in patients with persistent atrial fibrillation...
April 26, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28446489/revisiting-propafenone-toxicity
#5
Ali A Alsaad, Yahaira Ortiz Gonzalez, Christopher O Austin, Fred Kusumoto
Propafenone is a Vaughan Williams class 1c antiarrhythmic medication widely used for treatment of arrhythmias. Although the long-term safety of propafenone use has not been established, it is commonly used for treatment of atrial fibrillation in patients with no structural heart disease. Propafenone is well known as pill-in-the-pocket treatment for its effect in terminating paroxysmal episodes of atrial fibrillation. Herein, we discuss an unusual adverse reaction to propafenone in a patient who presented with symptomatic bradycardia and hypotension...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28444174/catheter-ablation-for-ventricular-tachycardia-in-patients-with-cardiac-sarcoidosis-a-systematic-review
#6
Nikolaos Papageorgiou, Rui Providência, Konstantinos Bronis, Dirk G Dechering, Neil Srinivasan, Lars Eckardt, Pier D Lambiase
Aims: Cardiac sarcoidosis (CS) is associated with a poor prognosis. Important features of CS include heart failure, conduction abnormalities, and ventricular arrhythmias. Ventricular tachycardia (VT) is often refractory to antiarrhythmic drugs (AAD) and immunosuppression. Catheter ablation has emerged as a treatment option for recurrent VT. However, data on the efficacy and outcomes of VT ablation in this context are sparse. Methods and results: A systematic search was performed on PubMed, EMBASE, and Cochrane database (from inception to September 2016) with included studies providing a minimum of information on CS patients undergoing VT ablation: age, gender, VT cycle length, CS diagnosis criteria, and baseline medications...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28442147/troubleshooter-in-electrical-storm-mechanical-unloading-leads-to-heart-rhythm-stabilization
#7
Johannes Mierke, Tobias Loehn, Christian Pfluecke, Karim Ibrahim
The electrical storm is a life-threatening situation which causes a complex antiarrhythmic treatment. We firstly report a rhythmological stabilization through mechanical unloading of the left ventricle in a health patient who developed electrical storm after endo- and epicardiac re-ablation and who previously underwent 27 unsuccessful defibrillations. No evidence for a specific etiology of the rhythm disturbances was found. After implantation of a percutaneous left ventricular assist device (pLVAD) a single additional defibrillation was needed to terminate ventricular fibrillation...
April 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28441232/atriobronchial-fistula-complicated-by-septic-cerebral-air-emboli-after-pulmonary-vein-ablation
#8
David Velghe, Thomas Apers, Stefanie Devriendt, Ivo Deblier, Bart Hendriks, Rogier Nieuwendijk, Peter Rogiers
OBJECTIVE: To describe a case of an infected atriobronchial fistula as a late complication after pulmonary vein ablation, leading to septic air emboli and requiring urgent cardiac surgery. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. PubMed was searched for relevant literature. DATA SYNTHESIS: Given its high success and low complication rate, pulmonary vein isolation is expected to be increasingly performed worldwide...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28438723/long-term-outcomes-of-minimally-invasive-surgical-ablation-for-atrial-fibrillation-a-single-center-experience
#9
Aditya Saini, Yuhning L Hu, Vigneshwar Kasirajan, Frederick T Han, Muhammad Z Khan, Luke Wolfe, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
BACKGROUND: Minimally invasive surgical AF ablation delivers RF energy via a thoracoscopic approach to perform pulmonary vein isolation and LA ganglionic plexi ablation. Data on long term outcomes of MISAA is lacking. OBJECTIVE: We report 5 year follow-up data from a prospective cohort of patients who underwent MISAA at a single center. METHODS: One hundred nine consecutive patients (60 paroxysmal, 49 persistent, mean age 62.7±9.3 years) underwent MISAA with left atrial appendage exclusion by a single surgeon between 2006 and 2012...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#10
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28433989/oral-contraceptives-after-bariatric-surgery
#11
Joël Schlatter
OBJECTIVE: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. METHODS: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. RESULTS: The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters...
April 22, 2017: Obesity Facts
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#12
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
https://www.readbyqxmd.com/read/28431060/catheter-ablation-vs-antiarrhythmic-drug-therapy-in-patients-with-symptomatic-atrioventricular-nodal-re-entrant-tachycardia-a-randomized-controlled-trial
#13
Demosthenes G Katritsis, Theodoros Zografos, George D Katritsis, Eleftherios Giazitzoglou, Vasilios Vachliotis, George Paxinos, A John Camm, Mark E Josephson
Aims: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT). Methods and Results: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#14
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429512/tailored-approach-for-management-of-ventricular-tachycardia-in-cardiac-sarcoidosis
#15
Sachin Yalagudri, Ngwe Zin Thu, Soumen Devidutta, Daljeet Saggu, Ajit Thachil, Sridevi Chennapragada, Calambur Narasimhan
INTRODUCTION: Treating ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) is challenging as patients present in different phase of the disease (inflammatory, scar or sometimes both). A customized approach to treatment is required for better outcomes. We describe our experience in the management of VT in CS based on the phase of the disease. METHODS AND RESULTS: Patients were considered to have myocardial inflammation if there was an increased myocardial (18) Fluoro Deoxy Glucose (FDG) uptake in PET-CT scan of the chest (n=14)...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28428622/inhibition-of-late-sodium-current-suppresses-calcium-related-ventricular-arrhythmias-by-reducing-the-phosphorylation-of-camk-ii-and-sodium-channel-expressions
#16
Xiao-Hong Wei, Shan-Dong Yu, Lu Ren, Si-Hui Huang, Qiao-Mei Yang, Ping Wang, Yan-Peng Chu, Wei Yang, Yan-Sheng Ding, Yong Huo, Lin Wu
Cardiac arrhythmias associated with intracellular calcium inhomeostasis are refractory to antiarrhythmic therapy. We hypothesized that late sodium current (I Na) contributed to the calcium-related arrhythmias. Monophasic action potential duration at 90% completion of repolarization (MAPD90) was significantly increased and ventricular arrhythmias were observed in hearts with increased intracellular calcium concentration ([Ca(2+)]i) by using Bay K 8644, and the increase became greater in hearts treated with a combination of ATX-II and Bay K 8644 compared to Bay K 8644 alone...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28425222/class-iii-antiarrhythmic-drugs-amiodarone-and-dronedarone-impair-kir-2-1-backward-trafficking
#17
Yuan Ji, Hiroki Takanari, Muge Qile, Lukas Nalos, Marien J C Houtman, Fee L Romunde, Raimond Heukers, Paul M P van Bergen En Henegouwen, Marc A Vos, Marcel A G van der Heyden
Drug-induced ion channel trafficking disturbance can cause cardiac arrhythmias. The subcellular level at which drugs interfere in trafficking pathways is largely unknown. KIR 2.1 inward rectifier channels, largely responsible for the cardiac inward rectifier current (IK1 ), are degraded in lysosomes. Amiodarone and dronedarone are class III antiarrhythmics. Chronic use of amiodarone, and to a lesser extent dronedarone, causes serious adverse effects to several organs and tissue types, including the heart. Both drugs have been described to interfere in the late-endosome/lysosome system...
April 19, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28424445/management-of-tachyarrhythmia-during-pregnancy
#18
Emily Ann Enderlin, Khaldia Taufiq Khaled, Luke Oke, Mohammed Madmani, Hakan Paydak
Maternal tachyarrhythmia is a common complication during pregnancy due to hormonal changes that enhance pre-existing arrhythmias or induce new arrhythmias in the presence of congenital heart defects in pregnant females. Presence of tachyarrhythmia during pregnancy poses risk to the mother and fetus, calling for proper treatment with medications. Use of antiarrhythmic drugs in cases of maternal tachyarrhythmia must give due consideration of potential teratogenic side effects. Utilization of antiarrhythmic drugs during pregnancy has been well studied; some result in minimal fetal harm or none at all...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28423234/pulmonary-vein-isolation-with%C3%A2-concomitant%C3%A2-renal-artery-denervation%C3%A2-is-associated-with-reduction-of-both-arterial-blood-pressure-and-atrial-fibrillation-burden-data-from-implantable-cardiac-monitor
#19
Alexander Romanov, Evgeny Pokushalov, Dmitry Ponomarev, Artem Strelnikov, Vitaliy Shabanov, Denis Losik, Alexander Karaskov, Jonathan S Steinberg
BACKGROUND: Renal artery denervation (RDN) has provided incremental atrial fibrillation (AF) suppression after pulmonary vein isolation (PVI) in patients with AF in the setting of drug-resistant hypertension. OBJECTIVE: To assess the relationship between changes of mean blood pressure (BP) and AF recurrences/AF burden after PVI combined with RDN. METHODS: All patients from two randomized studies with symptomatic paroxysmal AF and/or persistent AF and resistant hypertension who underwent PVI only (n=37) or PVI with RDN (n=39), and implantable cardiac monitor (ICM) implantation, were eligible for this study...
April 19, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28423144/efficacy-of-catheter-ablation-for-nonparoxysmal-atrial-fibrillation
#20
Guy Amit, Jonathan Nyong, Carlos A Morillo
Clinical Question: Is catheter ablation better than antiarrhythmic drugs for the prevention of nonparoxysmal atrial fibrillation? Bottom Line: Radiofrequency catheter ablation was found to be superior to antiarrhythmic drugs in preventing recurrences of nonparoxysmal atrial fibrillation and reducing hospital admissions.
April 19, 2017: JAMA Cardiology
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