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A Flutter

Anne-Laure Faucon, Jean-Luc Mainardi, Oana Zamfir, Hervé Gorka, Patrick Bruneval, André Pruna
Acute limb ischemia related to Coxiella burnetii endocarditis is rare. We report an original case of a 68-year-old man hospitalized for recurrent acute left limb ischemia in a context of atrial flutter, which revealed C. burnetii endocarditis. This case illustrates that even if embolic events are uncommon, septic embolisms must be systematically searched for in case of C. burnetii endocarditis. Conversely, extensive etiologic explorations must be performed in case of systemic embolism. New molecular techniques represent a major step forward in infective endocarditis diagnosis...
February 16, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Davide Bigoni, Diego Misseroni, Mirko Tommasini, Oleg N Kirillov, Giovanni Noselli
A "flutter machine" is introduced for the investigation of a singular interface between the classical and reversible Hopf bifurcations that is theoretically predicted to be generic in nonconservative reversible systems with vanishing dissipation. In particular, such a singular interface exists for the Pflüger viscoelastic column moving in a resistive medium, which is proven by means of the perturbation theory of multiple eigenvalues with the Jordan block. The laboratory setup, consisting of a cantilevered viscoelastic rod loaded by a positional force with nonzero curl produced by dry friction, demonstrates high sensitivity of the classical Hopf bifurcation onset to the ratio between the weak air drag and Kelvin-Voigt damping in the Pflüger column...
February 2018: Physical Review. E
Diana Schoeppler, Hans-Ulrich Schnitzler, Annette Denzinger
Bats of the Rhinolophidae and Hipposideridae families, and Pteronotus parnellii, compensate for Doppler shifts generated by their own flight movement. They adjust their call frequency such that the frequency of echoes coming from ahead fall in a specialized frequency range of the hearing system, the auditory fovea, to evaluate amplitude and frequency modulations in echoes from fluttering prey. Some studies in hipposiderids have suggested a less sophisticated or incomplete Doppler shift compensation. To investigate the precision of Doppler shift compensation in Hipposideros armiger, we recorded the echolocation and flight behaviour of bats flying to a grid, reconstructed the flight path, measured the flight speed, calculated the echo frequency, and compared it with the resting frequency prior to each flight...
March 15, 2018: Scientific Reports
Ella Z Lattenkamp, Samuel Kaiser, Rožle Kaučič, Martina Großmann, Klemen Koselj, Holger R Goerlitz
Sensory systems experience a trade-off between maximizing the detail and amount of sampled information. This trade-off is particularly pronounced in sensory systems that are highly specialized for a single task and thus experience limitations in other tasks. We hypothesised that combining sensory input from multiple streams of information may resolve this trade-off and improve detection and sensing reliability. Specifically, we predicted that perceptive limitations experienced by animals reliant on specialised active echolocation can be compensated for by the phylogenetically older and less specialised process of passive hearing...
March 14, 2018: Journal of Experimental Biology
Zdeňka Hajšmanová, Pavla Šigutová, Alena Lavičková
Idarucizumab is designed to reverse the anticoagulant effect of dabigatran. This case report describes the administration of three independent doses of idarucizumab to a 76-year-old man suffering from atrial flutter being treated with dabigatran to prevent ischaemic stroke. The last dose of dabigatran was administered in the morning of the same day the patient was transferred to hospital because of the need for urgent pericardium puncture. Baseline dTT (dilute thrombin time) reached 700 ng/mL as glomerular filtration (GF) dropped to 0...
February 2018: Hämostaseologie
Anne-Céline Martin, Sarah Lessire, Isabelle Leblanc, Anne-Sophie Dincq, Ivan Philip, Isabelle Gouin-Thibault, Anne Godier
BACKGROUND: Guidelines recommend to perform atrial fibrillation (AF) catheter ablation without interruption of direct oral anticoagulant (DOAC) and to administer unfractionated heparin (UFH) for an activated clotting time (ACT) ≥300 seconds, by analogy with vitamin K antagonist (VKA). Nevertheless, pharmacological differences between DOAC and VKA, especially regarding ACT sensitivity and UFH response, prevent extrapolation from VKA to DOAC. HYPOTHESIS: The level of anticoagulation at the time of the procedure in uninterrupted DOAC-treated patients is unpredictable, and would complicate intra-procedural UFH administration and monitoring...
March 13, 2018: Clinical Cardiology
Mouhannad M Sadek, Varsha Chaugai, Mark J Cleland, Timothy J Zakutney, David H Birnie, F Daniel Ramirez
BACKGROUND: The relevance of transthoracic impedance (TTI) to electrical cardioversion (ECV) success for atrial tachyarrhythmias when using biphasic waveform defibrillators is unknown. HYPOTHESIS: TTI is predictive of ECV success with contemporary defibrillators. METHODS: De-identified data stored in biphasic defibrillator memory cards from ECV attempts for atrial fibrillation (AF) or atrial flutter (AFL) over a two-year period at our center were evaluated...
March 13, 2018: Clinical Cardiology
Wonwhi Na, Jinsung Kim, Hoyoon Lee, Byeongmin Yoo, Sehyun Shin
Even though microfluidics has been successfully used in minimizing complicated and onerous processes, the pumping and tubing systems used with it are yet undeveloped and need immediate development. The present study developed a fluttering bar-driven micropump, mounted on a polydimethylsiloxane microfluidic system. The pump consists of a rectangular ferromagnetic bar and a fan-shaped chamber with an inlet and outlet. Through various experiments, the net flow was examined as a function of chamber shape, inlet and outlet channel location, rotating center of the magnet, and rotational speed...
January 2018: Biomicrofluidics
Christopher W Baugh, Carol L Clark, Jason W Wilson, Ian G Stiell, Abraham G Kocheril, Krista K Luck, Troy D Myers, Charles V Pollack, Steven K Roumpf, Gery F Tomassoni, James M Williams, Brian B Patel, Fred Wu, Jesse M Pines
Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States (US). Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways...
March 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Alyssa Kirby, Sisira Jayathissa
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia encountered perioperatively in patients undergoing non-cardiac surgery. There is emerging evidence suggesting high risk of ischaemic stroke. There are no clear guidelines surrounding initiation of anticoagulation in this setting. This study evaluates current practice in anticoagulant management of new perioperative AF at Hutt Hospital. METHODS: We have undertaken a retrospective study of 3,558 patients aged 60 years and over admitted for non-cardiac surgery at Hutt Hospital in 2014, to assess incidence of new AF/flutter and review how they were managed in regards to anticoagulation...
March 9, 2018: New Zealand Medical Journal
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
Deepa Prasad, Joni Steinberg, Christopher Snyder
Introduction Newborn atrial flutter can be treated by medications, pacing, or direct current cardioversion. The purpose is to compare the cost-effectiveness of digoxin, pacing, and direct current cardioversion for the treatment of atrial flutter in neonates. Materials and methods A decision tree model was developed comparing the efficacy and cost of digoxin, pacing, and direct current cardioversion based on a meta-analysis of published studies of success rates of cardioversion of neonatal atrial flutter (age<2 months)...
March 6, 2018: Cardiology in the Young
Peter Manu, Yevgeniya Lapitskaya, Atef Shaikh, Jimmi Nielsen
BACKGROUND: Clozapine is widely prescribed for treatment-refractory schizophrenia, but its use is limited by many potentially life-threatening adverse effects. The risk of rechallenge after these complications has never been comprehensively assessed in controlled studies. Thus, clinical guidelines must rely on the published case reports. The number of such reports is likely to increase over time, and updated analyses of larger samples are needed, as they may lead to changes in clinical guidelines...
March 2018: American Journal of Therapeutics
Brittany Ricci, Andrew D Chang, Morgan Hemendinger, Katarina Dakay, Shawna Cutting, Tina Burton, Brian MacGrory, Priya Narwal, Christopher Song, Antony Chu, Emile Mehanna, Ryan McTaggart, Mahesh Jayaraman, Karen Furie, Shadi Yaghi
BACKGROUND: Occult paroxysmal atrial fibrillation (AF) is detected in 16%-30% of patients with embolic stroke of unknown source (ESUS). The identification of AF predictors on outpatient cardiac monitoring can help guide clinicians decide on a duration or method of cardiac monitoring after ESUS. METHODS: We included all patients with ESUS who underwent an inpatient diagnostic evaluation and outpatient cardiac monitoring between January 1, 2013, and December 31, 2016...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Andrew J Foy, John Mandrola, Guodong Liu, Gerald V Naccarelli
Prospective cohort studies involving older adults report an association of obesity and new-onset atrial fibrillation and atrial flutter. To assess this relation, we performed a longitudinal cohort study from January 1, 2006 to December 31, 2013, using a national claims database that tracks all inpatient, outpatient, and pharmacy claims data. The primary end point of new-onset atrial fibrillation was compared between obese and nonobese cohorts. We used logistic regression to determine the strength of association between obesity and new-onset atrial fibrillation controlling for age, gender, hypertension, and diabetes...
February 6, 2018: American Journal of Cardiology
Volker Schulze, Yingfeng Lin, Athanasios Karathanos, Maximilian Brockmeyer, Tobias Zeus, Amin Polzin, Stefan Perings, Malte Kelm, Georg Wolff
BACKGROUND: Previous randomized controlled trials (RCT) failed to demonstrate benefits of patent foramen ovale (PFO) closure (PFO-C) over medical therapy (MT) for secondary prevention of cryptogenic ischemic stroke. Three recently published RCTs, however, turned out positive for PFO-C and warrant an updated meta-analysis. METHODS: Data from all available RCTs on PFO-C vs. MT for secondary prevention of cryptogenic ischemic stroke up until October 2017 were abstracted and analyzed in a comprehensive meta-analysis...
March 2, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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
Xin-Lin Zhang, Li-Na Kang, Lian Wang, Biao Xu
BACKGROUND: Patent foramen ovale (PFO) closure has emerged as a secondary prevention option in patients with PFO and cryptogenic stroke. However, the comparative efficacy and safety of percutaneous closure and medical therapy in patients with cryptogenic stroke and PFO remain unclear. METHODS: Randomized controlled trials (RCTs) and comparative observational studies that compared PFO closure against medical therapy, each with a minimal of 20 patients in the closure arm and 1-year follow-up were included...
March 2, 2018: BMC Cardiovascular Disorders
Anjum B Khan, Ben Carpenter, Pedro Santos E Sousa, Constandina Pospori, Reema Khorshed, James Griffin, Pedro Veliça, Mathias Zech, Sara Ghorashian, Calum Forrest, Sharyn Thomas, Sara Gonzalez Anton, Maryam Ahmadi, Angelika Holler, Barry Flutter, Zaida Ramirez-Ortiz, Terry K Means, Clare L Bennett, Hans Stauss, Emma Morris, Cristina Lo Celso, Ronjon Chakraverty
A key predictor for the success of gene-modified T cell therapies for cancer is the persistence of transferred cells in the patient. The propensity of less differentiated memory T cells to expand and survive efficiently has therefore made them attractive candidates for clinical application. We hypothesized that re-directing T cells to specialized niches in the bone marrow (BM) that support memory differentiation would confer increased therapeutic efficacy. We show that overexpression of chemokine receptor CXCR4 in CD8+ T cells (TCXCR4) enhanced their migration towards vascular-associated CXCL12+ cells in the BM and increased their local engraftment...
February 27, 2018: Journal of Clinical Investigation
Sanghun Lee, Nam Kyung Je
BACKGROUND: Patients with atrial fibrillation not being adequately treated with oral anticoagulant (OAC) therapy, with therapy underutilization or premature termination, have been commonly reported. However, studies on the utilization pattern of OAC therapy for patients with atrial flutter (AFL) are few. The aim of this study was to investigate the utilization of OAC therapy, and its influencing factors for patients with AFL in South Korea, as well as the types and percentages of anticoagulants used...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
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