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amiodarone, atrial fibrillation

Takeshi Omae, Eiichi Inada
New-onset atrial fibrillation (NOAF) is the most common perioperative complication of heart surgery, typically occurring in the perioperative period. NOAF commonly occurs in patients who are elderly, or have left atrial enlargement, or left ventricular hypertrophy. Various factors have been identified as being involved in the development of NOAF, and numerous approaches have been proposed for its prevention and treatment. Risk factors include diabetes, obesity, and metabolic syndrome. For prevention of NOAF, β-blockers and amiodarone are particularly effective and are recommended by guidelines...
March 9, 2018: Journal of Anesthesia
Naqash J Sethi, Emil E Nielsen, Sanam Safi, Joshua Feinberg, Christian Gluud, Janus C Jakobsen
BACKGROUND: During recent years, systematic reviews of observational studies have compared digoxin to no digoxin in patients with atrial fibrillation or atrial flutter, and the results of these reviews suggested that digoxin seems to increase the risk of all-cause mortality regardless of concomitant heart failure. Our objective was to assess the benefits and harms of digoxin for atrial fibrillation and atrial flutter based on randomized clinical trials. METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, SCI-Expanded, BIOSIS for eligible trials comparing digoxin versus placebo, no intervention, or other medical interventions in patients with atrial fibrillation or atrial flutter in October 2016...
2018: PloS One
João Mesquita, Diogo Cavaco, António Miguel Ferreira, Francisco Moscoso Costa, Pedro Carmo, Francisco Morgado, Miguel Mendes, Pedro Adragão
BACKGROUND: Pulmonary vein isolation (PVI) is the cornerstone of AF ablation, but its long-term clinical outcomes, predictors of relapse, and optimal pharmacological treatment remain controversial. OBJECTIVE: The objectives of this paper were to (1) assess very long-term AF recurrence, (2) identify predictors of relapse, and (3) evaluate the impact of continued antiarrhythmic drug (AAD) treatment after ablation. METHODS: Multicenter observational registry including all consecutive patients with drug-resistant AF who underwent a first PVI between 2006 and 2008 (n = 253 (age 55 years (IQR 48-63)), 80% males, 64% with paroxysmal AF...
March 6, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Alessandro Capucci, Laura Cipolletta, Federico Guerra, Irene Giannini
The main aim of current research on the field of atrial fibrillation (AF) treatment is to find new antiarrhythmic drugs with less side effects. Areas covered: Dronedarone and vernakalant showed promising result in term of efficacy and safety in selected patients. Ranolazine and colchicine are obtaining a role as a potential antiarrhythmic drug. Ivabradine is used in experimental studies for the rate control of AF. Moreover, new compounds (vanoxerine, moxonidine, budiodarone) are still under investigation. Monoclonal antibodies or selective antagonist of potassium channel are under investigation for long term maintenance of sinus rhythm...
March 6, 2018: Expert Opinion on Emerging Drugs
Komal M Joshi, Manjot K Gill
Purpose: To report the only known case, to our knowledge, of amiodarone induced retinal phototoxicity following vitrectomy surgery. Observations: A 66-year-old male presented with visual acuity of 20/150 OS secondary to an epiretinal membrane (ERM). Patient was on oral amiodarone for atrial fibrillation. Baseline spectral domain optical coherence tomography (SD-OCT) revealed an ERM with retinal thickening and schisis. The patient underwent an uncomplicated pars plana vitrectomy and membrane peel using standard vitrectomy settings and illumination...
April 2017: American Journal of Ophthalmology Case Reports
Jade A U Tamatea, Marianne S Elston, John V Conaglen
BACKGROUND: As thyrotoxicosis is a risk factor for atrial fibrillation, current guidelines recommend measuring a thyroid-stimulating hormone level in patients with this disorder. Hyperthyroidism may also be associated with other heart diseases including cardiac ischaemia and cardiac failure. Currently, the prevalence of thyrotoxicosis in cardiac admissions in the absence of a rhythm disorder is unknown. AIMS: The aims of this study were: 1) to calculate the prevalence of admissions for thyrotoxicosis-associated cardiac disease, 2) determine the type of cardiac disease i...
November 21, 2017: Heart, Lung & Circulation
Kaushik Mandal
No abstract text is available yet for this article.
February 28, 2018: Annals of Thoracic Surgery
Chuntao Wu, Stephanie Tcherny-Lessenot, Wanju Dai, Yunxun Wang, Hayet Kechemir, Sampada Gandhi, Stephen Lin, Juhaeri Juhaeri
PURPOSE: There are few data on the risk for peripheral neuropathy associated with dronedarone, a newer antiarrhythmic medicine. The objective of this study was to assess whether dronedarone is potentially associated with an increased risk for peripheral neuropathy compared with other antiarrhythmics, including amiodarone, sotalol, flecainide, and propafenone. METHODS: The MarketScan database was used for identifying patients who were at least 18 years of age, had atrial fibrillation or flutter, and had not been diagnosed with peripheral neuropathy in the 180-day period prior to or on the date of the first prescription of an antiarrhythmic between July 20, 2009, and December 31, 2011...
February 27, 2018: Clinical Therapeutics
Adam Oesterle, Benjamin Weber, Roderick Tung, Niteesh K Choudhry, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Although post-operative atrial fibrillation is common after non-cardiac surgery, there is a paucity of data regarding prophylaxis. We sought to determine if pharmacologic prophylaxis reduces the incidence of post-operative atrial fibrillation after non-cardiac surgery. METHODS: We performed an electronic search of Ovid MEDLINE, the Cochrane central register of controlled trials database, and SCOPUS from inception to 9/7/2016 and included prospective randomized studies in which patients in sinus rhythm underwent non-cardiac surgery and examined the incidence of post-operative atrial fibrillation as well as secondary safety outcomes...
February 21, 2018: American Journal of Medicine
Hee Kong Fong, Obai Abdullah, Sandeep Gautam
A 59-year-old woman with paroxysmal atrial fibrillation (AF) presented with severe non-productive cough, malaise, low-grade fever and AF flare-up 3 weeks following pulmonary vein isolation with radiofrequency catheter ablation. She denied chest pain or dyspnoea. Patient was haemodynamically stable. There was no pulsus paradoxus. Laboratories showed leucocytosis and elevated C-reactive protein. ECG showed sinus tachycardia. CT abdomen and pelvis showed a large pericardial effusion (PE). Shortly after admission, she developed AF with rapid ventricular response, responsive to intravenous amiodarone...
February 5, 2018: BMJ Case Reports
Hideyuki Hasebe
BACKGROUND Left bundle branch block (LBBB) is associated with atrial fibrillation (AF) and systolic heart failure, which can be treated with cardiac resynchronization therapy (CRT) that includes an implantable cardiac device (ICD). However, in some patients, LBBB may vary with heart rate, and during episodes of AF in LBBB, aberrant ventricular conduction, or wide QRS complex tachycardia (Ashman beats) can occur. This report is a case of LBBB treated with pharmacologic CRT, without the use of an ICD. CASE REPORT A 68-year-old man presented with persistent AF and systolic heart failure...
February 2, 2018: American Journal of Case Reports
Sahin Iscan, Bortecin Eygi, Yuksel Besir, Ismail Yurekli, Habib Cakir, Levent Yilik, Orhan Gokalp, Ali Gurbuz
Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response...
January 31, 2018: Current Pharmaceutical Design
J Hunter Mehaffey, Robert B Hawkins, Matthew Byler, Judy Smith, John A Kern, Irving Kron, Gorav Ailawadi, Tanya Wanchek, Leora T Yarboro
BACKGROUND: Postoperative Atrial Fibrillation (POAF) following cardiac surgery results in a significant increase in morbidity, mortality, and healthcare cost. Prophylactic amiodarone has been shown to reduce the incidence of POAF, however the cost-effectiveness of a protocol driven approach remains unknown. METHODS: All patients with a Society of Thoracic Surgeons (STS) risk score enrolled in a prophylactic amiodarone protocol (n=153) were propensity score matched 1:3 with patients prior to protocol implementation (n=3574)...
January 24, 2018: Annals of Thoracic Surgery
George Bazoukis, Konstantinos P Letsas, Gary Tse, Katerina K Naka, Panagiotis Korantzopoulos, Evangelia Ntzani, Konstantinos Vlachos, Athanasios Saplaouras, Eirini Pagkalidou, Lampros K Michalis, Antonios Sideris, Michael Efremidis
BACKGROUND: Atrial fibrillation (AF) ablation is increasingly used in patients with reduced left ventricular ejection fraction (LVEF). The aim of the present study was to evaluate the long-term results of a single radiofrequency catheter ablation procedure in heart failure (HF) patients with AF. HYPOTHESIS: We tested the hypothesis that left atrial ablation is an effective therapeutic modality in patients with heart failure. METHODS: Our study included HF patients with LVEF <50% who underwent catheter ablation for AF at our department between January 2010 and March 2017...
January 22, 2018: Clinical Cardiology
Marise Gauci, Francesca Wirth, Liberato Camilleri, Lilian M Azzopardi, Anthony Serracino-Inglott
Background: Atrial fibrillation (AF) is highly prevalent in older persons and is associated with considerable morbidity and mortality. Assessing appropriateness of drug therapy in AF may be facilitated by application of medication assessment tools (MATs). Objective: To develop, psychometrically evaluate and apply an innovative MAT for the long-term management of AF with particular relevance to older persons. Methods: Key recommendations from clinical practice guidelines for the long-term management of AF were selected and review criteria defining appropriate drug therapy were constructed as a 'qualifying statement' followed by a 'standard'...
October 2017: Pharmacy Practice
Mohammed Alawami, Andrew Chatfield, Rajaie Ghashi, Laurence Walker
Background: Atrial fibrillation (AF) after cardiac surgery is a major health problem that is associated with a significant financial burden. This paper aims to highlight this problem and review the current guidelines in the prevention and management of AF after cardiac surgery, providing our experience in the Australasian centers. Methods: We conducted a literature review using mainly PubMed to compare the current practice with the available evidence. EMBASE and Cochrane library were also searched...
January 2018: Journal of the Saudi Heart Association
Florentino Lupercio, Jorge Romero, Bradley Peltzer, Carola Maraboto, David Briceno, Pedro Villablanca, Kevin Ferrick, Jay N Gross, Soo Kim, John Fisher, Luigi Di Biase, Andrew Krumerman
BACKGROUND: Direct oral anticoagulants (DOACs) and amiodarone are widely used in the treatment of non-valvular atrial fibrillation. The DOACs are P-glycoprotein (P-gp) and cytochrome p-450 (CYP3A4) substrates. DOAC levels may be increased by the concomitant use of potent dual P-gp/CYP3A4 inhibitors such as amiodarone, which can potentially translate into adverse clinical outcomes. We aimed to assess the efficacy and safety of drug-drug interaction by the concomitant use of DOACs and amiodarone...
December 21, 2017: American Journal of Medicine
Tabitha G Moe, Victor A Abrich, Edward K Rhee
Advances in surgical techniques have led to the survival of most patients with congenital heart disease (CHD) up to their adulthood. During their lifetime, many of them develop atrial tachyarrhythmias due to atrial dilatation and scarring from surgical procedures. More complex defects and palliative repairs are linked to a higher incidence and earlier occurrence of arrhythmias. Atrial fibrillation (AF) is common in patients who have atrial septal defects repaired after age 55 and in patients with tetralogy of Fallot repaired after age 45...
June 2017: Journal of Atrial Fibrillation
Xingfu Huang, Yanjia Chen, Yuli Huang, Hongxin Zhao, Yanyu Chen, Liwei He, Shenrong Liu, Vikram Shee, Dingli Xu, Jian Peng
BACKGROUND: Pharmacological treatment during ablation of persistent atrial fibrillation (AF) is common, but utility of irrigated catheter application of amiodarone during ablation of persistent AF remains unclear. HYPOTHESIS: Irrigated catheter application of amiodarone improves quality of ablation and long-term outcomes. METHODS: We enrolled 90 persistent AF patients who underwent catheter ablation. Patients were randomized to the amiodarone group (n = 45) or control group (n = 45)...
December 16, 2017: Clinical Cardiology
Ahmed A Abouarab, Jeremy R Leonard, Lucas B Ohmes, Christopher Lau, Lisa Q Rong, Natalia S Ivascu, Kane O Pryor, Monica Munjal, Filippo Crea, Massimo Massetti, Tommaso Sanna, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. POAF is associated with increased morbidity and hospital costs. We herein describe the protocol for a randomized controlled trial to determine if performing a posterior left pericardiotomy prevents POAF after cardiac surgery. METHODS/DESIGN: All patients submitted to cardiac surgery at our institution will be screened for inclusion into the study. The study will consist of two parallel arms with random allocation between groups to either receive a posterior left pericardiotomy or serve as a control...
December 13, 2017: Trials
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