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https://www.readbyqxmd.com/read/29151002/management-of-arrhythmia-in-sepsis-and-septic-shock
#1
Martin Balik, Vojtech Matousek, Michal Maly, Tomas Brozek
The occurrence of supraventricular arrhythmias is associated with an unfavourable prognosis in septic shock. Available trials are difficult to apply in sepsis and septic shock patients due to included cohorts, control groups and because "one size does not fit all". The priorities in the critically ill are maintenance of a sinus rhythm and diastolic ventricular filling. The rate control modality should be reserved for chronic AF and in situations when a sinus rhythm is difficult to maintain due to extreme stress conditions resulting from a high dosage of vasoactive agents...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#2
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29141843/stable-sr-electrophysiological-substrate-ablation-in-the-left-atrium-during-sinus-rhythm-for-the-treatment-of-nonparoxysmal-atrial-fibrillation-a-prospective-multicenter-randomized-clinical-trial
#3
Bing Yang, Chenyang Jiang, Yazhou Lin, Gang Yang, Huimin Chu, Heng Cai, Fengmin Lu, Xianzhang Zhan, Jian Xu, Xinhua Wang, Chi-Keong Ching, Balbir Singh, Young-Hoon Kim, Minglong Chen
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) alone or combined with adjuvant substrate modifications is unsatisfactory for atrial fibrillation (AF) control in nonparoxysmal AF patients. Ablation targeting the fibrotic areas after CPVI (STABLE-SR [Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm]) is a newly evolved substrate modification strategy. METHODS AND RESULTS: In this multicenter, randomized clinical trial, 229 symptomatic nonparoxysmal AF patients were 1:1 randomized to STABLE-SR group (n=114) or conventional STEPWISE group (n=115)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29141592/case-report-electrical-storm-during-induced-hypothermia-in-a-patient-with-early-repolarization
#4
Patrick Badertscher, Michael Kuehne, Beat Schaer, Christian Sticherling, Stefan Osswald, Tobias Reichlin
BACKGROUND: Population based studies showed an association of early repolarization in the electrocardiogram (ECG) and a higher rate of sudden cardiac death presumably due to ventricular fibrillation. The triggers for ventricular fibrillation in patients with early repolarization are not fully understood. CASE PRESENTATION: We describe the case of a young patient with a survived ventricular fibrillation arrest while asleep followed by multiple episodes of recurrent ventricular fibrillation...
November 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#5
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#6
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#7
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29129251/the-relationship-of-renal-function-to-outcome-a-post-hoc-analysis-from-the-edoxaban-versus-warfarin-in-subjects-undergoing-cardioversion-of-atrial-fibrillation-ensure-af-study
#8
Gregory Y H Lip, Naab Al-Saady, Michael D Ezekowitz, Maciej Banach, Andreas Goette
The ENSURE-AF study (NCT 02072434) of anticoagulation for electrical cardioversion in nonvalvular atrial fibrillation (NVAF) showed comparable low rates of bleeding and thromboembolism between the edoxaban and the enoxaparin-warfarin treatment arms. This post hoc analysis investigated the relationship between renal function and clinical outcomes. METHODS: ENSURE-AF was a multicenter, PROBE evaluation trial of edoxaban 60 mg, or dose reduced to 30 mg/d for weight≤60 kg, creatinine clearance (CrCl; Cockcroft-Gault) ≤50 mL/min, or concomitant P-glycoprotein inhibitors compared with therapeutically monitored enoxaparin-warfarin in 2,199 NVAF patients undergoing electrical cardioversion...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29121724/noacs-and-atrial-fibrillation-incidence-and-predictors-of-left-atrial-thrombus-in-the-real-world
#9
Emanuele Bertaglia, Matteo Anselmino, Alessandro Zorzi, Vincenzo Russo, Elisabetta Toso, Francesco Peruzza, Antonio Rapacciuolo, Federico Migliore, Fiorenzo Gaita, Umberto Cucchini, Marcello De Divitiis, Sabino Iliceto, Giuseppe Stabile
AIMS: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2DS2-VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29115093/a-case-of-multiple-cardiovascular-and-tracheal-anomalies-presented-with-wolff-parkinson-white-syndrome-in-a-middle-aged-adult
#10
Hyejin Shi, Sungmin Sohn, SungHo Wang, Sungrock Park, SangKi Lee, Song Yi Kim, Sun Young Jeong, Changhwan Kim
Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29105209/efficacy-and-safety-of-intravenous-vernakalant-for-the-rapid-conversion-of-recent-onset-atrial-fibrillation-a-meta-analysis
#11
REVIEW
Tamer Akel, James Lafferty
BACKGROUND: Atrial fibrillation is a common cardiac arrhythmia with increasing prevalence in the aging population. It is a major cause of emergency department visits worldwide. Vernakalant, a relatively new antiarrhythmic drug with selectively preferential effects on the atrial tissue is currently used in many European countries for the termination of recent-onset atrial fibrillation. Presently, the drug is still not approved by the United States Food and Drug Administration due to safety concerns...
November 4, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29103620/an-unusual-cause-of-heart-failure-in-a-young-man
#12
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Arun Gopalakrishnan, Sreevilasam Pushpangadhan Abhilash, Ajitkumar Valaparambil
A 21year old gentleman was admitted with shortness of breath and heart failure. He was noted to have incessant supraventricular tachycardia which was refractory to pharmacological and electrical cardioversion. Electrophysiology study revealed focal atrial tachycardia from an unusual location which was successfully ablated.
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29101955/cardioversions-and-transthoracic-echocardiography
#13
REVIEW
Ronak Shah, Elizabeth Zhou
Patients with atrial fibrillation and flutter routinely require transesophageal echocardiography with cardioversion. It is not uncommon to encounter patients with reduced ejection fractions, coronary artery disease, prior cardiac surgery, or obstructive sleep apnea. The anesthesiologist must carefully evaluate the patient and any available laboratory and study findings to assess for potential complications after anesthesia. Appropriate anesthetics must be chosen based on the preoperative evaluation. Additionally, because most of these cases are done without a secured airway, emergency medications and airway equipment must be readily available...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29093567/atrial-fibrillation-does-not-affect-ankle-brachial-index-measured-using-the-doppler-method
#14
Michał Dąbrowski, Jacek Lewandowski, Piotr Abramczyk, Izabela Łoń, Zbigniew Gaciong, Maciej Siński
Atrial fibrillation may affect blood pressure measurements. The ankle-brachial index (ABI) is a ratio of systolic blood pressure measured on the lower and upper limbs that may also be affected by arrhythmia. The purpose of the study was to investigate whether atrial fibrillation influenced ABI results. Ninety-nine patients (age 66.6±11 years, 63 males and 36 females) who underwent electrical cardioversion of atrial fibrillation were investigated. ABI measurements using the Doppler method were performed on both lower extremities before and after electrical cardioversion...
November 2, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/29076947/left-versus-biventricular-assist-devices-in-cardiac-arrest
#15
Erik J S Packer, Grete Slettom, Atle Solholm, Arve Mongstad, Rune Haaverstad, Vegard Tuseth, Ketil Grong, Jan Erik Nordrehaug
Maintaining adequate organ perfusion during cardiac arrest remains a challenge, and various assist techniques have been evaluated. We assessed whether a right ventricular impeller assist device (RVAD) in adjunct to a left ventricular impeller assist device (LVAD) is beneficial. Twenty anesthetized pigs were randomized to maximized circulatory support by percutaneously implanted left- or biventricular assist device(s) during 30 minutes of electrically induced ventricular fibrillation followed by three attempts of cardioversion...
October 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29072992/low-energy-cardioversion-of-ventricular-tachycardia-when-less-is-more
#16
Haran Burri, Francesco Moretti, Philippe Meyer
Herein we report the case of a patient who was admitted in ventricular tachycardia after having received multiple ineffective (and sometimes pro-arrhythmic) high-energy internal shocks from his ICD and who was finally successfully treated by a commanded low-energy internal cardioversion of 0.6 J. This article revisits the use of low-energy shocks and discusses their electrophysiogical mechanisms and clinical implications.
March 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29068807/antiarrhythmic-effects-of-combining-dofetilide-and-ranolazine-in-a-model-of-acutely-induced-atrial-fibrillation-in-horses
#17
Helena Carstensen, Line Kjær, Maria Mathilde Haugaard, Mette Flethøj, Eva Zander Hesselkilde, Jørgen K Kanters, Steen Pehrson, Rikke Buhl, Thomas Jespersen
BACKGROUND: Antiarrhythmic compounds against atrial fibrillation (AF) often have reduced efficacy and may display cardiac and/or non-cardiac toxicity. Efficacy can be improved by combining two compounds with distinct mechanisms, and it may be possible to use lower doses of each compound, thereby reducing the likelihood of adverse side-effects. The purpose of this study was to investigate whether the effective doses of dofetilide and ranolazine can be reduced if the drugs are combined...
October 25, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29068108/evaluation-of-sustained-tachyarrhythmia-in-children-younger-than-one-year-of-age
#18
Gulhan Tunca Sahin, Erkut Ozturk, Taner Kasar, Alper Guzeltas, Yakup Ergul
BACKGROUND: In this study, we aim to evaluate the results of non-operational sustained tachyarrhythmias in patients younger than 1 year of age in our center. METHODS: Between November 2010 and November 2016, the demographic characteristics, type and localization of the tachyarrhythmia, echocardiographic findings, and medical and/or ablation therapies applied for patients under 1 year of age who had sustained tachyarrhythmias were evaluated. RESULTS: Among 99 patients, 91 had sustained supraventricular tachycardia, and eight had sustained ventricular tachycardia...
October 25, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29064176/calciphylaxis-after-parathyroidectomy
#19
Sathish Karmegam, Anupkumar Shetty
A 60-year-old African American man with end stage renal disease on hemodialysis (HD) for the past 2.5 years developed severe hyperparathyroidism. Other past medical history included atrial fibrillation, type II diabetes mellitus, hypertension, gout, pericardial effusion needing pericardial window, deep vein thrombosis, mitral insufficiency, and cardiomyopathy with implantable cardioversion device placement. His parathyroid hormone (PTH) level peaked at 4,191 pg/mL despite being on cinacalcet, sevelamer, and paricalcitol...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29050922/the-impact-of-supraventricular-ectopic-complexes-in-different-age-groups-and-risk-of-recurrent-atrial-fibrillation-after-antiarrhythmic-medication-or-catheter-ablation
#20
Christina Alhede, Trine K Lauridsen, Arne Johannessen, Ulrik Dixen, Jan S Jensen, Pekka Raatikainen, Gerhard Hindricks, Haakan Walfridsson, Ole Kongstad, Steen Pehrson, Anders Englund, Juha Hartikainen, Peter S Hansen, Jens C Nielsen, Christian Jons
INTRODUCTION: Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients ±57years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). METHODS: In total, 260 patients with LVEF >40% and age ≤70 years were randomized to AAD (N=132) or CA (N=128) as first-line treatment for paroxysmal AF...
October 9, 2017: International Journal of Cardiology
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