keyword
https://read.qxmd.com/read/38534473/a-comparison-of-the-impact-of-pharmacological-treatments-on-cardioversion-rate-control-and-mortality-in-data-driven-atrial-fibrillation-phenotypes-in-critical-care
#1
JOURNAL ARTICLE
Alexander Lacki, Antonio Martinez-Millana
Critical care physicians are commonly faced with patients exhibiting atrial fibrillation (AF), a cardiac arrhythmia with multifaceted origins. Recent investigations shed light on the heterogeneity among AF patients by uncovering unique AF phenotypes, characterized by differing treatment strategies and clinical outcomes. In this retrospective study encompassing 9401 AF patients in an intensive care cohort, we sought to identify differences in average treatment effects (ATEs) across different patient groups. We extract data from the MIMIC-III database, use hierarchical agglomerative clustering to identify patients' phenotypes, and assign them to treatment groups based on their initial drug administration during AF episodes...
February 20, 2024: Bioengineering
https://read.qxmd.com/read/38533962/lower-recurrence-rates-of-atrial-fibrillation-and-mace-events-after-early-compared-to-late-ablation-a-danish-nationwide-register-study
#2
JOURNAL ARTICLE
Jacob Tønnesen, Martin H Ruwald, Jannik Pallisgaard, Peter Vibe Rasmussen, Arne Johannessen, Jim Hansen, Rene H Worck, Christopher R Zörner, Lise Riis-Vestergaard, Charlotte Middelfart, Samuel K Sørensen, Stefan Sattler, Gunnar Gislason, Morten Lock Hansen
BACKGROUND: Guidelines recommend prioritizing treatment with antiarrhythmic drugs before referral of patients with atrial fibrillation to ablation, delaying a potential subsequent ablation. However, delaying ablation may affect ablation outcomes. We sought to investigate the impact of duration from diagnosis to ablation on the risk of atrial fibrillation recurrence and adverse events. METHODS AND RESULTS: Using Danish nationwide registries, all patients with first-time ablation for atrial fibrillation were identified and included from 2010 to 2018...
March 27, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38533836/validation-of-a-novel-smartphone-based-photoplethysmographic-method-for-ambulatory-heart-rhythm-diagnostics-the-smartbeats-study
#3
JOURNAL ARTICLE
Jonatan Fernstad, Emma Svennberg, Peter Åberg, Katrin Kemp Gudmundsdottir, Anders Jansson, Johan Engdahl
BACKGROUND AND AIMS: In the current guidelines, smartphone-photoplethysmography (PPG) is not recommended for diagnosis of atrial fibrillation (AF), without a confirmatory electrocardiogram (ECG) recording. Previous validation studies have been performed under supervision in healthcare settings, with limited generalizability of the results. We aim to investigate the diagnostic performance of a smartphone-PPG method in a real-world setting, with ambulatory unsupervised smartphone-PPG recordings, compared with simultaneous ECG recordings and including patients with atrial flutter (AFL)...
March 27, 2024: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://read.qxmd.com/read/38524974/pulmonary-artery-stump-thrombus-in-a-patient-with-remote-history-of-rastelli-procedure
#4
Weijia Li, Xuan Guan, James Nguyen, Kelvin Lee
• Atrial tachyarrhythmia may develop in Rastelli patients after decades. • Thrombus can form in the PA stump after the Rastelli procedure. • TEE remains crucial to rule out intracardiac thrombus before cardioversion.
March 2024: CASE: Cardiovascular Imaging Case Reports
https://read.qxmd.com/read/38519830/assessment-of-physician-compliance-to-the-caep-2021-atrial-fibrillation-best-practices-checklist-for-rate-and-rhythm-control-in-the-emergency-department
#5
JOURNAL ARTICLE
Amanda M S Mattice, Samara Adler, Debra Eagles, Krishan Yadav, Sean Hui, Althaf Azward, Nikesh Pandey, Ian G Stiell
OBJECTIVES: Acute atrial fibrillation and flutter (AF/AFL) are common arrhythmias treated in the emergency department (ED). The 2021 CAEP Best Practices Checklist provides clear recommendations for management of patients with acute AF/AFL. This study aimed to evaluate physician compliance to Checklist recommendations for risk assessment and ED management of AF/AFL. METHODS: This health records review assessed the management of adult patients presenting to two tertiary care EDs for management of acute AF/AFL from January to August, 2022...
March 23, 2024: CJEM
https://read.qxmd.com/read/38500756/role-of-low-density-lipoprotein-electronegativity-and-sexual-dimorphism-in-contributing-early-ventricular-tachyarrhythmias-following-st-elevation-myocardial-infarction
#6
JOURNAL ARTICLE
Mei-Yao Wu, An-Sheng Lee, Yen-Nien Lin, Wei-Hsin Chung, Ke-Wei Chen, Chiung-Ray Lu, Yun-Fang Chen, Chia-Ming Chang, Wei-Chung Tsai, Yi-Tzone Shiao, Chu-Huang Chen, Kuan-Cheng Chang
BACKGROUND: Early ventricular tachycardia/fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) has higher morbidity and mortality. This study examines gender-differentiated risk factors and underlying mechanisms for early onset VT/VF in STEMI. METHODS: We analyzed data from 2,964 consecutive STEMI patients between January 1, 2008 and December 31, 2021. Early VT/VF was defined as occurrence of spontaneous VT/VF of ≥30 s or requirement of immediate cardioversion/defibrillation within the first 48 h after symptoms...
2024: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/38497695/diagnosis-and-management-of-paroxysmal-supraventricular-tachycardia
#7
JOURNAL ARTICLE
Gary Peng, Paul C Zei
IMPORTANCE: Paroxysmal supraventricular tachycardia (PSVT), defined as tachyarrhythmias that originate from or conduct through the atria or atrioventricular node with abrupt onset, affects 168 to 332 per 100 000 individuals. Untreated PSVT is associated with adverse outcomes including high symptom burden and tachycardia-mediated cardiomyopathy. OBSERVATIONS: Approximately 50% of patients with PSVT are aged 45 to 64 years and 67.5% are female. Most common symptoms include palpitations (86%), chest discomfort (47%), and dyspnea (38%)...
February 20, 2024: JAMA
https://read.qxmd.com/read/38487587/surgical-ventricular-reconstruction-and-intraoperative-cryoablation-in-a-patient-with-drug-refractory-ventricular-tachycardia-and-left-ventricular-thrombus-a-case-report
#8
Maryuri Delgado Lopez, Julia Vogler, Anas Aboud, Christian-Hendrik Heeger, Roland Richard Tilz
BACKGROUND: Despite modern techniques for ablation of ventricular tachycardia (VT), the procedure faces challenges such as deep intramural substrates or inaccessibility of the pericardial space. We aim to present a case of successful surgical treatment of a patient with drug-refractory VT, an apical aneurysm, large left ventricular (LV) thrombus, and recurrent implantable cardioverter defibrillator (ICD) shocks following failed epicardial catheter ablation. CASE SUMMARY: A 67-year-old male with a history of ischaemic cardiomyopathy was brought to the emergency room after a syncope because of VT...
March 2024: European Heart Journal. Case Reports
https://read.qxmd.com/read/38484180/association-between-sodium-glucose-cotransporter-2-inhibitors-and-arrhythmic-outcomes-in-patients-with-diabetes-and-pre-existing-atrial-fibrillation
#9
JOURNAL ARTICLE
Akash Fichadiya, Amity Quinn, Flora Au, Dennis Campbell, Darren Lau, Paul Ronksley, Reed Beall, David J T Campbell, Stephen B Wilton, Derek S Chew
AIMS: Prior studies suggest that sodium-glucose cotransporter-2 inhibitors (SGLT2is) may decrease the incidence of atrial fibrillation (AF). However, it is unknown whether SGLT2i can attenuate the disease course of AF among patients with pre-existing AF and Type II diabetes mellitus (DM). In this study, our objective was to examine the association between SGLT2i prescription and arrhythmic outcomes among patients with DM and pre-existing AF. METHODS AND RESULTS: We conducted a population-based cohort study of adults with DM and AF between 2014 and 2019...
March 1, 2024: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://read.qxmd.com/read/38478907/central-retinal-artery-occlusion-after-cardioversion-of-atrial-fibrillation
#10
JOURNAL ARTICLE
Lilia Lagha, Dimitrios Kalogeropoulos, Srinivas Goverdhan, Andrew J Lotery
Central retinal artery occlusion (CRAO) is a vascular ophthalmic emergency. Often caused by a sudden interruption of blood flow to the eye, with profound and painless vision loss, resulting in irreversible cell damage. An impacted embolus at the narrowest part of the central retinal artery is the most common cause. Cardioversion is a medical procedure used to restore a normal heart rhythm in individuals with atrial fibrillation (AF). In some cases, cardioversion can lead to thromboembolic complications. If an embolus reaches the central retinal artery, it can block the blood flow to the retina, resulting in CRAO and subsequent vision loss...
March 12, 2024: Retinal Cases & Brief Reports
https://read.qxmd.com/read/38465040/high-risk-aortic-plaque-in-atrial-fibrillation-a-therapeutic-dilemma
#11
Shaniza Haniff, Ashwin Shive Gowda, Nawfal Al-Khafaji, Asher Gorantla
Atrial fibrillation (AF), a common cardiac arrhythmia, is often accompanied by aortic plaques that are associated with an increased risk of embolic events, including stroke. Evidence-based management in this population is lacking. We present a case of a 77-year-old female with new-onset AF who was found to have a high-risk aortic plaque at the level of the ascending aorta and ostium of the right coronary artery. Definitive treatment for AF, cardioversion, high-risk aortic plaque, and cardiothoracic surgery, could not be performed due to the elevated risk of ischemic stroke and embolic complications...
February 2024: Curēus
https://read.qxmd.com/read/38464985/impact-of-atrial-fibrillation-triggers-on-long-term-outcomes-of-a-second-catheter-ablation-of-nonparoxysmal-atrial-fibrillation
#12
JOURNAL ARTICLE
Masaya Shinohara, Tadashi Fujino, Ryo Wada, Shintaro Yao, Kensuke Yano, Katsuya Akitsu, Hideki Koike, Toshio Kinoshita, Hitomi Yuzawa, Takanori Ikeda
Background: Catheter ablation (CA) of atrial fibrillation (AF) triggers, including non-pulmonary vein (PV) foci, contributes to improved procedural outcomes. However, the clinical significance of an AF trigger ablation during second CA procedures for nonparoxysmal AF is unknown. Methods and Results: We enrolled 94 patients with nonparoxysmal AF undergoing a second CA. Intracardiac cardioversion during AF using high-dose isoproterenol was performed to determine the presence or absence of AF triggers...
March 8, 2024: Circulation reports
https://read.qxmd.com/read/38463090/synchronized-cardioversion-resolving-refractory-supraventricular-tachycardia-in-a-neonate-a-case-report-with-comprehensive-analysis
#13
Neelam Kumari, Tek Nath Yogi, Amrit Bhusal, Niraj Paudel
INTRODUCTION AND IMPORTANCE: Neonatal supraventricular tachycardia (SVT) poses unique challenges in diagnosis and management, with refractory cases requiring synchronized cardioversion being exceptionally rare. This case report explores the presentation and management of refractory SVT in a neonate, emphasizing the significance of sharing such clinical scenarios. CASE PRESENTATION: A 16-day-old neonate, born via emergency caesarean section, presented with respiratory distress, poor feeding, and vomiting...
March 2024: Annals of Medicine and Surgery
https://read.qxmd.com/read/38463065/a-case-report-of-postcardioversion-device-related-thrombus-in-a-patient-with-left-atrial-appendage-occlusion-device-on-apixaban
#14
Hasaan Ahmed, Mahmoud Ismayl, Anirudh Palicherla, Miranda Heppler, Terezia Petraskova, Omar Kousa, Jalal Vargha
BACKGROUND: Current guidelines recommend proceeding with cardioversion, without the explicit need for preprocedural transesophageal echocardiography (TEE), in patients compliant with oral anticoagulation for at least 3 weeks. The relevance of these guidelines remains unclear in those undergoing repeat cardioversion. CASE SUMMARY: A 66-year-old male with a history of atrial fibrillation (AF) and a left atrial appendage occlusion (LAAO) device, compliant with apixaban, presented with dyspnea and lightheadedness...
March 2024: Annals of Medicine and Surgery
https://read.qxmd.com/read/38458580/atrial-thrombosis-prevalence-before-cardioversion-or-catheter-ablation-of-atrial-fibrillation-an-updated-systematic-review-and-meta-analysis-of-direct-oral-anticoagulants-versus-vitamin-k-antagonists
#15
JOURNAL ARTICLE
Federica Troisi, Pietro Guida, Nicola Vitulano, Federico Quadrini, Antonio Di Monaco, Giuseppe Patti, Massimo Grimaldi
Left atrial or left atrial appendage thrombosis (LAT) is contraindicated for cardiac ablation (CA) or cardioversion (CV) of atrial fibrillation (AF). This study was aimed to compare the frequency of LAT detected by transesophageal echocardiography (TEE) before CA or CV in patients with AF treated with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). We searched PubMed, Scopus, Web of Science, and Cochran Library databases from inception through July 13, 2023 to select studies reporting data on LAT identification before CA or CV using TEE in patients with AF treated with DOACs or VKAs...
March 7, 2024: American Journal of Cardiology
https://read.qxmd.com/read/38453002/atrial-arrhythmias-in-patients-with-pulmonary-hypertension
#16
REVIEW
Kyle O'Meara, Gregory Stone, Eric Buch, Adam Brownstein, Rajan Saggar, Richard Channick, Alexander E Sherman, Aron Bender
TOPIC IMPORTANCE: Atrial arrhythmia (AA) are common in patients with pulmonary hypertension (PH) and contribute to morbidity and mortality. Given the growing PH population, it is important to understand the pathophysiology, clinical impact, and management of AA in PH. REVIEW FINDINGS: AA occurs in PH with a five-year incidence of 10-25%. AA confers a higher morbidity and mortality, and restoration of normal sinus rhythm improves survival and functionality. AA is thought to develop due to structural alterations of the right atrium caused by changes to the right ventricle (RV) due to elevated pulmonary artery pressures...
March 5, 2024: Chest
https://read.qxmd.com/read/38426114/left-atrial-volume-index-a-predictor-of-atrial-fibrillation-recurrence-following-direct-current-cardioversion-a-systematic-review-and-meta-analysis
#17
REVIEW
Dipesh Raniga, Mina Goda, Laetitia Hattingh, Sarah Thorning, Matthew Rowe, Laurie Howes
This systematic review and meta -analysis was conducted to determine the clinical relevance of echocardiographically measured left atrial (LA) size to predict the recurrence of atrial fibrillation (AF) after direct current cardioversion (DCCV). A search was performed on Medline (Ovid), Embase (Elsevier), Cochrane Central Register of Controlled Trials (CENTRAL) in Cochrane Library, Wiley and Web of Science (Clarivate) to identify relevant studies. Amongst the initial 4066 citations identified, 31 fulfilled the criteria for inclusion in the data analysis incorporating 2725 patients with a mean follow-up period of 6...
April 2024: IJC Heart & Vasculature
https://read.qxmd.com/read/38417598/expedited-loading-with-intravenous-sotalol-is-safe-and-feasible-primary-results-of-the-prospective-evaluation-analysis-and-kinetics-of-iv-sotalol-peaks-registry
#18
JOURNAL ARTICLE
Benjamin A Steinberg, Richard Holubkov, Thomas Deering, Christopher A Groh, Suneet Mittal, Robert Kennedy, Parash Pokharel, Marco Perez, Salvatore Savona, Nishant Verma, Kevin Watt, Jonathan P Piccini, T Jared Bunch
BACKGROUND: Loading oral sotalol for atrial fibrillation (AF) requires 3 days, frequently in-hospital, to achieve steady state. The FDA approved loading with intravenous (IV) sotalol through model-informed development, without patient data. OBJECTIVE: We present results of the first multicenter evaluation of this recent labeling for IV sotalol. METHODS: The Prospective Evaluation Analysis and Kinetics of IV Sotalol (PEAKS) Registry was a multicenter observational registry of patients undergoing elective IV sotalol load for atrial arrhythmias...
February 26, 2024: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://read.qxmd.com/read/38398407/pregnancy-arrhythmias-management-in-the-emergency-department-and-critical-care
#19
REVIEW
Elena Conti, Nunzio Dario Cascio, Patrizia Paluan, Giulia Racca, Yaroslava Longhitano, Gabriele Savioli, Manfredi Tesauro, Roberto Leo, Fabrizio Racca, Christian Zanza
Pregnancy is closely associated with an elevated risk of arrhythmias, constituting the predominant cardiovascular complication during this period. Pregnancy may induce the exacerbation of previously controlled arrhythmias and, in some instances, arrhythmias may present for the first time in pregnancy. The most important proarrhythmic mechanisms during pregnancy are the atrial and ventricular stretching, coupled with increased sympathetic activity. Notably, arrhythmias, particularly those originating in the ventricles, heighten the likelihood of syncope, increasing the potential for sudden cardiac death...
February 15, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38393730/physician-estimates-and-patient-reported-health-status-in-atrial-fibrillation
#20
JOURNAL ARTICLE
Nobuhiro Ikemura, Shun Kohsaka, Takehiro Kimura, Philip G Jones, Yoshinori Katsumata, Kojiro Tanimoto, Ikuko Ueda, Seiji Takatsuki, Masaki Ieda, Paul S Chan, John A Spertus
IMPORTANCE: A primary objective in managing atrial fibrillation (AF) is to optimize patients' health status, which can be done only if physicians accurately quantify the outcomes associated with AF in patients' lives. OBJECTIVE: To explore physicians' estimation of the health status of patients with AF and its association with subsequent care and outcomes. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, prospective cohort study was conducted in 2 outpatient practices in Tokyo, Japan...
February 5, 2024: JAMA Network Open
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