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https://www.readbyqxmd.com/read/28228428/the-effect-of-aggressive-blood-pressure-control-on-the-recurrence-of-atrial-fibrillation-after-catheter-ablation-a-randomized-open-label-clinical-trial-substrate-modification-with-aggressive-blood-pressure-control-smac-af
#1
Ratika Parkash, George A Wells, John L Sapp, Jeffrey S Healey, Jean-Claude Tardif, Isabelle Greiss, Léna Rivard, Jean-Francois Roux, Lorne Gula, Isabelle Nault, Paul G Novak, David H Birnie, Andrew C Ha, Stephen B Wilton, Iqwal Mangat, Christopher J Gray, Martin J Gardner, Anthony S L Tang
Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/28225684/assessing-the-risks-associated-with-mri-in-patients-with-a-pacemaker-or-defibrillator
#2
Robert J Russo, Heather S Costa, Patricia D Silva, Jeffrey L Anderson, Aysha Arshad, Robert W W Biederman, Noel G Boyle, Jennifer V Frabizzio, Ulrika Birgersdotter-Green, Steven L Higgins, Rachel Lampert, Christian E Machado, Edward T Martin, Andrew L Rivard, Jason C Rubenstein, Raymond H M Schaerf, Jennifer D Schwartz, Dipan J Shah, Gery F Tomassoni, Gail T Tominaga, Allison E Tonkin, Seth Uretsky, Steven D Wolff
Background The presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter-defibrillator (ICD) that was "non-MRI-conditional" (i.e., not approved by the Food and Drug Administration for MRI scanning). Methods Patients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1...
23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28217222/non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-for-cardioversion-of-atrial-fibrillation-in-clinical-practice-a-single-center-experience
#3
Naoki Shibata, Itsuro Morishima, Kenji Okumura, Yasuhiro Morita, Kensuke Takagi, Ruka Yoshida, Hiroaki Nagai, Toshiro Tomomatsu, Yoshihiro Ikai, Kazushi Terada, Kazuhito Tsuzuki, Hideyuki Tsuboi, Takahito Sone, Toyoaki Murohara
BACKGROUND: Anticoagulation therapy with the vitamin K antagonist (VKA) warfarin has been demonstrated to reduce thromboembolic risk after electrical cardioversion (ECV). However, data concerning ECV with non-VKA oral anticoagulants (NOACs) is limited. The objective of this study was to determine the efficacy and safety of NOACs in patients undergoing ECV in a real-world clinical practice at a single center in Japan. METHODS: We retrospectively analyzed the data of 406 consecutive patients who underwent ECV for atrial fibrillation (AF) or flutter under anticoagulation with one of the three NOACs (n=149) or with a VKA (n=257)...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28208773/wind-tunnel-measurements-for-flutter-of-a-long-afterbody-bridge-deck
#4
Zeng-Shun Chen, Cheng Zhang, Xu Wang, Cun-Ming Ma
Bridges are an important component of transportation. Flutter is a self-excited, large amplitude vibration, which may lead to collapse of bridges. It must be understood and avoided. This paper takes the Jianghai Channel Bridge, which is a significant part of the Hong Kong-Zhuhai-Macao Bridge, as an example to investigate the flutter of the bridge deck. Firstly, aerodynamic force models for flutter of bridges were introduced. Then, wind tunnel tests of the bridge deck during the construction and the operation stages, under different wind attack angles and wind velocities, were carried out using a high frequency base balance (HFBB) system and laser displacement sensors...
February 9, 2017: Sensors
https://www.readbyqxmd.com/read/28202855/early-and-late-atrial-arrhythmias-after-lung-transplantation%C3%A3-incidence-predictive-factors-and-impact-on-mortality
#5
Laurence Jesel, Jérémie Barraud, Han S Lim, Halim Marzak, Nathan Messas, Sandrine Hirschi, Nicola Santelmo, Anne Olland, Pierre Emmanuel Falcoz, Gilbert Massard, Michel Kindo, Patrick Ohlmann, Michel Chauvin, Olivier Morel, Romain Kessler
BACKGROUND: Atrial arrhythmias (AAs) are frequent after lung transplantation (LT) and late postoperatively. Several predictive factors of early postoperative AAs after LT have been identified but those of late AAs remain unknown. Whether AA after LT affects mortality is still being debated. This study assessed in a large cohort of LT patients the incidence of AAs early and late after surgery, their predictive factors and their effect on mortality.Methods and Results:We studied 271 consecutive LT patients over 9 years...
February 15, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28196179/concomitant-atrial-fibrillation-surgery-for-people-undergoing-cardiac-surgery
#6
Mark D Huffman, S Chris Malaisrie, Kunal N Karmali
Clinical Question: Should patients with preoperative atrial fibrillation who are undergoing cardiac surgery undergo concomitant atrial fibrillation surgery? Bottom Line: There is moderate-quality evidence that concomitant atrial fibrillation surgery approximately doubles the likelihood of freedom from atrial fibrillation, atrial flutter, or atrial tachycardia while not receiving antiarrhythmic medications at least 3 months after the procedure with a small absolute increase in needing a permanent pacemaker...
February 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28187920/holter-electrocardiogram-monitoring-in-patients-with-acute-ischaemic-stroke-find-afrandomised-an-open-label-randomised-controlled-trial
#7
Rolf Wachter, Klaus Gröschel, Götz Gelbrich, Gerhard F Hamann, Pawel Kermer, Jan Liman, Joachim Seegers, Katrin Wasser, Anna Schulte, Falko Jürries, Anna Messerschmid, Nico Behnke, Sonja Gröschel, Timo Uphaus, Anne Grings, Tugba Ibis, Sven Klimpe, Michaela Wagner-Heck, Magdalena Arnold, Evgeny Protsenko, Peter U Heuschmann, David Conen, Mark Weber-Krüger
BACKGROUND: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. METHODS: Find-AFRANDOMISED is an open-label randomised study done at four centres in Germany...
February 8, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28182159/incidence-type-of-atrial-fibrillation-and-risk-factors-for-stroke-a-population-based-cohort-study
#8
Cecilia Johansson, Erik Dahlqvist, Jonas Andersson, Jan-Håkan Jansson, Lars Johansson
PURPOSE: The aims of this study were to estimate the incidence of atrial fibrillation and atrial flutter (AF), to assess the presence of provoking factors and risk factors for stroke and systemic embolism, and to determine the type of AF in patients with first-diagnosed AF. PATIENTS AND METHODS: This cohort study was performed in northern Sweden between January 1, 2011 and December 31, 2012. Diagnosis registries were searched for the International Classification of Diseases-10 code for AF (I48) to identify cases of incident AF...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28146213/compound-heterozygous-scn5a-mutations-in-a-toddler-are-they-associated-with-a-more-severe-phenotype
#9
Luciana Sacilotto, Hindalis Ballesteros Epifanio, Francisco Carlos da Costa Darrieux, Fanny Wulkan, Theo Gremen Mimary Oliveira, Denise Tessariol Hachul, Alexandre da Costa Pereira, Mauricio Ibrahim Scanavacca
Compound heterozygosity has been described in inherited arrhythmias, and usually associated with a more severe phenotype. Reports of this occurrence in Brugada syndrome patients are still rare. We report a study of genotype-phenotype correlation after the identification of new variants by genetic testing. We describe the case of an affected child with a combination of two different likely pathogenic SCN5A variants, presenting sinus node dysfunction, flutter and atrial fibrillation, prolonged HV interval, spontaneous type 1 Brugada pattern in the prepubescent age and familiar history of sudden death...
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28144262/staged-hybrid-ablation-for-persistent-and-longstanding-persistent-atrial-fibrillation-effectively-restores-sinus-rhythm-in-long-term-observation
#10
Michal Zembala, Krzysztof Filipiak, Oskar Kowalski, Piotr Buchta, Tomasz Niklewski, Pawel Nadziakiewicz, Rafał Koba, Mariusz Gąsior, Zbigniew Kalarus, Marian Zembala
INTRODUCTION: Hybrid ablation (HABL) of atrial fibrillation combining endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome the limitations of current therapeutic options for patients with persistent (PSAF) and longstanding persistent atrial fibrillation (LSPAF). The purpose of this study was to evaluate the procedural safety and feasibility as well as effectiveness of HABL in patients with PSAF and LSPAF 1 year after the procedure...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#11
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28130373/catheter-ablation-for-atrial-flutter-a-survey-by-the-european-heart-rhythm-association-and-canadian-heart-rhythm-society
#12
Benedict M Glover, Jian Chen, Kathryn L Hong, Serge Boveda, Adrian Baranchuk, Kristina H Haugaa, Paul Dorian, Tatjana S Potpara, Eugene Crystal, Brent Mitchell, Roland Tilz, Peter Leong-Sit, Nikolaos Dagres
The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus (CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28127215/use-of-short-term-steroids-in-the-prophylaxis-of-atrial-fibrillation-after-cardiac-surgery
#13
Zeyad Al-Shawabkeh, Khalid Al-Nawaesah, Razi Abu Anzeh, Hael Al-Odwan, Wasfi Azyoud Bashar Al-Rawashdeh, Haetham Altaani
OBJECTIVES: To assess the effectiveness of corticosteroids in the prophylaxis of postoperative atrial fibrillation (AF) in patients undergoing elective coronary artery bypass grafting or valvular heart surgery in terms of reducing its incidence and decreasing the length of hospital stay. METHODS: This prospective double blinded randomized study was conducted at Queen Alia Heart Institute (Amman, Jordan) from June 2014 to June 2015 on 340 patients who underwent their first on-pump elective coronary artery bypass grafting (CABG) alone or combined with valvular surgery...
January 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28127119/repeat-ablation-and-hospitalization-following-cryoballoon-ablation-of-atrial-fibrillation-at-a-single-tertiary-medical-center
#14
Cara East, Teresa Phan, Giovanni Filardo, Jay Franklin, Alan Donsky, Kevin R Wheelan, Robert C Kowal
Cryoablation for atrial fibrillation (AF) has rapidly become a mainstream treatment for AF. In this report, 163 patients who had undergone a cryoablation procedure at one clinical center were contacted by telephone 33.1 ± 3.3 months after the procedure. All patients had received cryoablation of the pulmonary vein ostia, although concomitant procedures were performed at the same time in over 50% of the patients, including radiofrequency and/or cryoablation of other areas of the left atrium. Freedom from a repeat ablation procedure was 87%, while freedom from recurrent hospitalization for AF was 89%, as compared to previous reports of 65%...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28110987/outcomes-for-emergency-department-patients-with-recent-onset-atrial-fibrillation-and-flutter-treated-in-canadian-hospitals
#15
Ian G Stiell, Catherine M Clement, Brian H Rowe, Robert J Brison, D George Wyse, David Birnie, Paul Dorian, Eddy Lang, Jeffrey J Perry, Bjug Borgundvaag, Debra Eagles, Damian Redfearn, Jennifer Brinkhurst, George A Wells
STUDY OBJECTIVE: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. METHODS: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28099159/reducing-false-arrhythmia-alarm-rates-using-robust-heart-rate-estimation-and-cost-sensitive-support-vector-machines
#16
Qiang Zhang, Xianxiang Chen, Zhen Fang, Qingyuan Zhan, Ting Yang, Shanhong Xia
To lessen the rate of false critical arrhythmia alarms, we used robust heart rate estimation and cost-sensitive support vector machines. The PhysioNet MIMIC II database and the 2015 PhysioNet/CinC Challenge public database were used as the training dataset; the 2015 Challenge hidden dataset was for testing. Each record had an alarm labeled with asystole, extreme bradycardia, extreme tachycardia, ventricular tachycardia or ventricular flutter/fibrillation. Before alarm onsets, 300 s multimodal data was provided, including electrocardiogram, arterial blood pressure and/or photoplethysmogram...
January 18, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28090681/excess-of-exercise-increases-the-risk-of-atrial-fibrillation
#17
REVIEW
A Müssigbrodt, A Weber, J Mandrola, Y van Belle, S Richter, M Döring, A Arya, P Sommer, A Bollmann, G Hindricks
An interesting and still not well-understood example for old medical wisdom "Sola dosis facit venenum" is the increased prevalence of atrial fibrillation (AF) in athletes. Numerous studies have shown a fourfold to eightfold increased risk of AF in athletes compared to the normal population. Analysis of the existing data suggests a dose-dependent effect of exercise. Moderate exercise seems to have a protective effect and decreases the risk of AF, whereas excessive exercise seems to increase the risk of AF. The described cases illustrate clinical manifestations within the spectrum of AF in elderly athletes, that is, exercise-induced AF, vagal AF, chronic AF, and atrial flutter...
January 16, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28077104/effects-of-treadmill-exercise-versus-flutter%C3%A2-on-respiratory-flow-and-sputum-properties-in-adults-with-cystic-fibrosis-a-randomised-controlled-cross-over-trial
#18
Tiffany J Dwyer, Rahizan Zainuldin, Evangelia Daviskas, Peter T P Bye, Jennifer A Alison
BACKGROUND: Treadmill exercise and airway clearance with the Flutter® device have previously been shown to improve mucus clearance mechanisms in people with cystic fibrosis (CF) but have not been compared. It is therefore not known if treadmill exercise is an adequate form of airway clearance that could replace established airway clearance techniques, such as the Flutter®. The aim of this study was to evaluate respiratory flow, sputum properties and subjective responses of treadmill exercise and Flutter® therapy, compared to resting breathing (control)...
January 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28075344/pull-in-effect-of-suspended-microchannel-resonator-sensor-subjected-to-electrostatic-actuation
#19
Han Yan, Wen-Ming Zhang, Hui-Ming Jiang, Kai-Ming Hu
In this article, the pull-in instability and dynamic characteristics of electrostatically actuated suspended microchannel resonators are studied. A theoretical model is presented to describe the pull-in effect of suspended microchannel resonators by considering the electrostatic field and the internal fluid. The results indicate that the system is subjected to both the pull-in instability and the flutter. The former is induced by the applied voltage which exceeds the pull-in value while the latter occurs as the velocity of steady flow get closer to the critical velocity...
January 8, 2017: Sensors
https://www.readbyqxmd.com/read/28073682/study-design-for-control-of-heart-rate-in-infant-and-child-tachyarrhythmia-with-heart-failure-using-landiolol-heartful-a-prospective-multicenter-uncontrolled-clinical-trial
#20
Naokata Sumitomo, Hitoshi Horigome, Masaru Miura, Hiroshi Ono, Hideaki Ueda, Kiyohiro Takigiku, Jun Yoshimoto, Naoki Ohashi, Tsugutoshi Suzuki, Koichi Sagawa, Hiroya Ushinohama, Kazuhiro Takahashi, Aya Miyazaki, Heima Sakaguchi, Mari Iwamoto, Motoki Takamuro, Chiho Tokunaga, Tetsuji Nagano
BACKGROUND: Persistent tachycardia in pediatric patients after congenital heart surgery further deteriorates their hemodynamic condition, and may become fatal. Therefore, immediate control of the tachycardia is mandatory in these patients. For this purpose, quick-acting, short-acting, titratable intravenous agents are required. However, there are no agents with such characteristics among the drugs approved for control of pediatric arrhythmias in Japan, and thus novel and effective medications for these patients are awaited...
January 7, 2017: Journal of Cardiology
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