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("ECG" OR "EKG") AND ("Atrial Flutter")

Veronica Lee, Gang Xu, Vivian Liu, Peter Farrehi, Jimo Borjigin
BACKGROUND: Atrial fibrillation (AFIB) and atrial flutter (AFL) are two common cardiac arrhythmias that predispose patients to serious medical conditions. There is a need to accurately detect these arrhythmias to prevent diseases and reduce mortality. Apart from accurately detecting these arrhythmias, it is also important to distinguish between AFIB and AFL due to differing clinical treatments. METHODS: In this study, we applied a new technology, the electrocardiomatrix (ECM) invented in our lab, in detecting AFIB and AFL in human patients...
August 11, 2018: Journal of Electrocardiology
Daniel F Kupsky, Karthikeyan Ananthasubramaniam, James Lee
CLINICAL INTRODUCTION: An 82-year-old man with a history of coronary artery bypass surgery, hypertension and small bowel gastrointestinal stromal tumour underwent cardiac risk evaluation prior to surgical resection of his tumour. He was asymptomatic from a cardiovascular perspective, but his activity level was less than four metabolic equivalents. Physical examination was notable for a 2/6 systolic murmur at the apex. ECG showed sinus rhythm. A transthoracic echocardiogram was performed (figure 1 and online supplementary video 1)...
August 9, 2018: Heart: Official Journal of the British Cardiac Society
Samantha Low, Carmen Kiper, Aimee Armstrong, Clifford L Cua
A pregnant female presented at 37 weeks of gestation in labor. The fetus was noted to be tachycardic on fetal monitor. Postnatally, the male neonate was still noted to be tachycardic with heart rates in the low 200 bpm range. EKG was consistent with tachycardia, but rhythm diagnosis was not definitively made. Echocardiogram with M-mode analysis clearly demonstrated 2:1 atrial to ventricular contraction pattern consistent with atrial flutter. The neonate was subsequently transferred to a tertiary pediatric hospital where the diagnosis of atrial flutter was confirmed...
August 6, 2018: Echocardiography
Antonio De Sisti, Marius Andronache, Pamela Damiano, Roman Echalier, Manuel Font
AIM: It is commonly conceived that coronary sinus (CS) participates in atrial flutter (AFL) circuit but limited to fibers surrounding its Ostium. We evaluated proximal CS involvement in typical AFL. METHODS: Twenty AFL patients underwent entrainment mapping using post-pacing interval minus AFL cycle length (PPI-AFL CL) including CS where a decapolar catheter was positioned with proximal bipole 1 cm from Ostium. RESULTS: We compared patients with proximal CS within the circuit (GR1, PPI-AFL CL ≤20 ms + concealed entrainment) and those without (GR2, PPI-AFL CL >20 ms)...
August 6, 2018: Journal of Cardiovascular Electrophysiology
Elyar Ghafoori, Nathan Angel, Derek J Dosdall, Rob S MacLeod, Ravi Ranjan
BACKGROUND: Differentiating between atrial fibrillation (AF) and atrial tachycardia (AT) or atrial flutter (AFL) on surface ECG can be challenging. The same problem arises in animal models of AF, in which atrial arrhythmias are induced by pacing or pharmacological intervention with the goal of making mechanistic determinations. Some of these induced arrhythmias can be AFL or AT, even though it might appear as AF on the body-surface ECG based on irregular R-R intervals. We hypothesize that a dominant frequency (DF) analysis of the ECG can differentiate between the two distinct arrhythmias, even when it is not evident by the presence of flutter waves or beat-to-beat regularity when looking at brief recordings...
July 17, 2018: Journal of Electrocardiology
Alan S Go, Mark A Hlatky, Taylor I Liu, Dongjie Fan, Elisha A Garcia, Sue Hee Sung, Matthew D Solomon
BACKGROUND: Contemporary data about symptomatic paroxysmal supraventricular tachycardia (PSVT) epidemiology are limited. We characterized prevalence and correlates of symptomatic PSVT within a large healthcare delivery system and estimated national PSVT burden. METHODS AND RESULTS: We identified adults with an encounter for potential PSVT between 2010 and 2015 in Kaiser Permanente Northern California, excluding those with prior known atrial fibrillation or atrial flutter...
July 7, 2018: Journal of the American Heart Association
Anoop N Koshy, Jithin K Sajeev, Nitesh Nerlekar, Adam J Brown, Kevin Rajakariar, Mark Zureik, Michael C Wong, Louise Roberts, Maryann Street, Jennifer Cooke, Andrew W Teh
BACKGROUND: Despite studies demonstrating the accuracy of smart watches (SW) and wearable heart rate (HR) monitors in sinus rhythm, no data exists regarding their utility in arrhythmias. METHODS: 102 hospitalized patients were evaluated at rest using continuous electrocardiogram (ECG) monitoring with concomitant SW-HR (FitBit, FB, Apple Watch, AW) for 30 min. RESULTS: Across all devices, 38,616 HR values were recorded. Sinus rhythm cohort demonstrated strong agreement for both devices with a low bias (FB & AW Bias = 1 beat)...
September 1, 2018: International Journal of Cardiology
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Harald Greiss, Christian W Hamm, Johannes Sperzel, Malte Kuniss, Thomas Neumann
INTRODUCTION: Data on long-term outcomes of cryoballoon ablation for treatment of atrial fibrillation (AF) are sparse. Here, we report the first 5-year follow-up results and predictors of outcome for pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB-Adv) in patients with symptomatic AF. METHODS AND RESULTS: For this prospective observational study, we enrolled 178 patients with paroxysmal (132/178 [74.2%] patients) or persistent AF who underwent PVI with CB-Adv at our institution during 2012...
September 1, 2018: International Journal of Cardiology
Rahul G Muthalaly, Bruce A Koplan, Alfred Albano, Crystal North, Jeffrey I Campbell, Bernard Kakuhikire, Dagmar Vořechovská, John D Kraemer, Alexander C Tsai, Mark J Siedner
OBJECTIVES: Atrial fibrillation (AF) is a major risk factor for stroke, which is the leading cause of cardiovascular mortality in sub-Saharan Africa. However, there is limited population-based epidemiological data on AF in sub-Saharan Africa. We sought to estimate the prevalence and correlates of AF in rural Uganda. METHODS: We conducted a cross-sectional study using community health fairs in 2015 targeting eight villages in rural Uganda. Study participants completed a medical history, a clinical exam, blood collection, and 12‑lead electrocardiographic (ECG) screening...
May 24, 2018: International Journal of Cardiology
Ruben Casado Arroyo, Decebal Gabriel Laţcu, Shingo Maeda, Maciej Kubala, Pasquale Santangeli, Fermin Carlos Garcia, Bogdan Enache, Mohammed Eljamili, Tatsuya Hayashi, Erica S Zado, Nadir Saoudi, Francis E Marchlinski
BACKGROUND: The electrocardiographic and intracardiac activation features of left atrial roof-dependent macroreentrant flutter have been incompletely characterized. METHODS: Patients post-pulmonary vein (PV) isolation with roof-dependent atrial flutter based on activation and entrainment mapping were included. ECG and coronary sinus activation were compared with mitral annular (MA) flutter. RESULTS: The roof-dependent left atrial flutter circled the right PVs in 32 of 33 cases...
June 2018: Circulation. Arrhythmia and Electrophysiology
Robert J H Miller, Derek S Chew, Saman Rezazadeh, Sheila Klassen, Payam Pournazari, Eddy Lang, F Russell Quinn
Atrial fibrillation and atrial flutter (AF/AFL) are associated with an increased risk of stroke and systemic embolism. However, many patients are not started on guideline-recommended oral anticoagulation (OAC). We determined factors associated with initiation of OAC in eligible patients presenting to emergency departments. This retrospective cohort included patients with electrocardiogram (ECG)-documented AF/AFL presenting to 4 urban emergency departments in 2015. Presenting diagnoses, admission status, and comorbidities were determined by chart review...
June 2018: Canadian Journal of Cardiology
Dieudonné Gnonlonfoun, Constant Adjien, Ronald Gnimavo, Gérard Goudjinou, Corine Hotcho, Jennifer Nyangui Mapaga, Arlos Sowanou, Pupchen Gnigone, Rodrigue Domingo, Dismand Houinato
INTRODUCTION: Poor access to cardiovascular checkups is a major cause of ignorance of embolic heart diseases as the etiology for ischemic stroke. OBJECTIVE: Study ischemic strokes due to embolic heart diseases and their associated factors. METHOD: It was a cross-sectional, prospective, descriptive and analytical study conducted from November 1, 2014 to August 31, 2015 on 104 patients with ischemic stroke confirmed through brain imaging. Embolic heart diseases included arrhythmia due to atrial fibrillation (AF), atrial flutter, myocardial infarction (MI), heart valve diseases and atrial septal aneurysm (ASA)...
April 15, 2018: Journal of the Neurological Sciences
Elisabetta Bucci, Marco Testa, Loretta Licchelli, Alessandra Frattari, Nadia Attalla El Halabieh, Erica Gabriele, Giulia Pignatelli, Tiziana De Santis, Laura Fionda, Fiammetta Vanoli, Stefania Morino, Matteo Garibaldi, Antonella Di Pasquale, Nicola Vanacore, Annalisa Botta, Giovanni Antonini
Cardiac conduction and/or rhythm abnormalities (CCRA) are the most frequent and life-threatening complications in DM1. In order to determine prevalence, incidence, characteristics, age of onset and predictors of CCRA, CCRA progression and sudden cardiac death (SCD) in DM1, we collected ECG/24hECG-Holter data from a yearly updated 34-year database of a cohort of 103 DM1 patients without cardiac abnormalities at baseline, followed for at least 1 year. Fifty-five patients developed CCRA [39 developed conduction abnormalities (CCA) and 16 rhythm abnormalities (CRA)], which progressed in 22...
April 2018: Journal of Neurology
Srishti Sareen, Mannu Nayyar, Brian Wheeler, Michelle Skelton, Rami N Khouzam
Atrial flutter (AF) is the second most common supraventricular tachyarrhythmia following atrial fibrillation. We present an interesting case of a diagnostic challenge manifested as an electrocardiogram (ECG) recording mimicking AF in a patient with Parkinson's disease (PD). A 72-year-old African-American female with history of PD presented to our Emergency Department with a one day history of chest pain. Her vital signs were within normal limits. Physical exam was remarkable for bilateral resting hand tremors at a frequency of 6-8 hertz and mild cogwheel rigidity in both upper extremities...
January 2018: Annals of Translational Medicine
Raúl A Borracci, José D Montoya Pulvet, Carlos A Ingino, Mario Fitz Maurice, Alfredo Hirschon Prado, Enrique Dominé
OBJECTIVE: To date, no systematic work has been intended to describe spatio-temporal patterns of cardiac rhythms using only short series of RR intervals, to facilitate visual or computerized-aided identification of EKG motifs for use in clinical practice. The aim of this study was to detect and classify eye-catching geometric patterns of Poincaré time-delay plots from different types of cardiac rhythms and arrhythmias using short-term EKG signals. METHODS: Approximately 150-300 representative, consecutive beats were retrieved from 24-h Holter registers of 100 patients with different heart rhythms...
December 27, 2017: Clinical Physiology and Functional Imaging
Kathleen T Hickey, Angelo B Biviano, Hasan Garan, Robert R Sciacca, Teresa Riga, Kate Warren, Ashton P Frulla, Nicole R Hauser, Daniel Y Wang, William Whang
Background: Little attention has focused on the integration of mobile health (mHealth) technology with self-management approaches to improve the detection and management of atrial fibrillation (AF) in clinical practice. Objective: The objective of this study was to investigate the differences between mHealth and usual care over a 6-month follow-up period among patients with a known history of atrial fibrillation. Methods: A pilot cohort from within the larger ongoing randomized trial, iPhone® Helping Evaluate Atrial fibrillation Rhythm through Technology (iHEART), was evaluated to determine differences in detection of AF and atrial flutter (AFL) recurrence rates (following treatment to restore normal rhythm) between patients undergoing daily smartphone ECG monitoring and age and gender matched control patients...
February 2017: Journal of Atrial Fibrillation
Thomas A Dewland, Elsayed Z Soliman, Jose-Miguel Yamal, Barry R Davis, Alvaro Alonso, Christine M Albert, Lara M Simpson, L Julian Haywood, Gregory M Marcus
BACKGROUND: Although atrial fibrillation (AF) guidelines indicate that pharmacological blockade of the renin-angiotensin system may be considered for primary AF prevention in hypertensive patients, previous studies have yielded conflicting results. We sought to determine whether randomization to lisinopril reduces incident AF or atrial flutter (AFL) compared with chlorthalidone in a large clinical trial cohort with extended post-trial surveillance. METHODS AND RESULTS: We performed a secondary analysis of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), a randomized, double-blind, active-controlled clinical trial that enrolled hypertensive individuals ≥55 years of age with at least one other cardiovascular risk factor...
December 2017: Circulation. Arrhythmia and Electrophysiology
Thomas Beiert, Georg Nickenig, Jan Wilko Schrickel, Markus Linhart
A 71-year-old man with no history of coronary artery disease presented with palpitations to the emergency department. The 12-lead ECG showed a regular tachycardia with wide QRS complexes (220 bpm) suggestive of ventricular tachycardia. Instead invasive electrophysiological investigation revealed typical atrial flutter as underlying arrhythmia. The altered QRS morphology resulted from displacement of the heart into the right hemithorax due to right-sided pneumonectomy in combination with bundle branch block.
July 2017: Indian Pacing and Electrophysiology Journal
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Harald Greiss, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
INTRODUCTION: Data on long-term outcomes of cryoballoon (CB) ablation for treatment of persistent atrial fibrillation (AF) are sparse. Here, we report the first 3-year follow-up results and predictors of success for catheter ablation using the second-generation CB in patients with persistent AF. METHODS AND RESULTS: For this prospective observational study, we enrolled 101 patients ablated with the second-generation CB at our institution. The endpoint was the first documented recurrence (> 30 seconds) of AF, atrial flutter, or atrial tachycardia after a 3-month blanking period...
January 2018: Journal of Cardiovascular Electrophysiology
Sergei Roumiantsev, Margaret Doyle Settle
Atrial flutter (AF) is an uncommon neonatal tachyarrhythmia that can present during the first few days after birth. The infant with AF may demonstrate an abrupt increase in heart rate greater than 220 bpm that is sustained despite vagal maneuvers. The diagnosis is made by electrocardiogram (ECG), and the treatments may include medication management and cardioversion. We present a case review of an infant diagnosed with AF and describe the incidence, pathophysiology, diagnosis, and management.
September 1, 2017: Neonatal Network: NN
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