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A Flutter

Tricia A Smith
No abstract text is available yet for this article.
June 2018: Annals of Emergency Medicine
Norman C Wang, Matthew D Sather, Aliza Hussain, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, William E Katz, Alaa A Shalaby, Andrew H Voigt, Samir Saba
BACKGROUND: Oral anticoagulation (OAC) is prescribed for left atrial thrombi (LAT) in non-rheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The study objective was to review the existing evidence regarding LAT resolution in non-rheumatic AF and/or AFL with OAC agents. METHODS: Data sources included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) between January 1, 1991 and February 1, 2017. English-language studies that assessed LAT resolution with OAC agents in subjects with non-rheumatic AF and/or AFL, by serial transesophageal echocardiography (TEE), and with follow-up times ≥3 weeks and < 1 year were selected...
May 14, 2018: Pacing and Clinical Electrophysiology: PACE
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
Seyed Mohammadreza Hosseini, Guy Rozen, Ahmed Saleh, Jeena Vaid, Yitschak Biton, Kasra Moazzami, E Kevin Heist, Moussa C Mansour, M Ihsan Kaadan, Mark Vangel, Jeremy N Ruskin
OBJECTIVES: This study sought to investigate the utilization of and in-hospital complications in patients undergoing catheter ablation in the United States from 2000 to 2013 by using the National Inpatient Sample and Nationwide Inpatient Sample. BACKGROUND: Catheter ablation has become a mainstay in the treatment of a wide range of cardiac arrhythmias. METHODS: This study identified patients 18 years of age and older who underwent inpatient catheter ablation from 2000 to 2013 and had 1 primary diagnosis of any of the following arrhythmias: atrial fibrillation, atrial flutter, supraventricular tachycardia, or ventricular tachycardia...
November 2017: JACC. Clinical Electrophysiology
Ayman A Hussein, Tanmay S Panchabhai, Marie M Budev, Khaldoun Tarakji, Amr F Barakat, Walid Saliba, Bruce Lindsay, Oussama M Wazni
OBJECTIVES: The authors report their experience with atrial fibrillation (AF) rates and ablation findings in lung transplant recipients. BACKGROUND: Pulmonary venous (PV) conduction recovery accounts for most failed atrial fibrillation (AF) catheter ablation procedures. Lung transplantation involves full surgical resection and replacement of the recipient's PVs with donor's PVs, which may represent the ultimate PV ablation. METHODS: They followed 755 consecutive lung transplant recipients categorized based on transplant status (unilateral vs...
June 2017: JACC. Clinical Electrophysiology
Dawn C Scantlebury, Andrea G Kattah, Tracey L Weissgerber, Sanket Agarwal, Michelle M Mielke, Amy L Weaver, Lisa E Vaughan, Stanislav Henkin, Katherine Zimmerman, Virginia M Miller, Wendy M White, Sharonne N Hayes, Vesna D Garovic
BACKGROUND: Atrial fibrillation/flutter (AF) produces significant morbidity in women and is typically attributed to cardiac remodeling from multiple causes, particularly hypertension. Hypertensive pregnancy disorders (HPDs) are associated with future hypertension and adverse cardiac remodeling. We evaluated whether women with AF were more likely to have experienced a HPD compared with those without. METHODS AND RESULTS: A nested case-control study was conducted within a cohort of 7566 women who had a live or stillbirth delivery in Olmsted County, Minnesota between 1976 and 1982...
May 13, 2018: Journal of the American Heart Association
A Zedira, J Greffier, X Brunet, F Pereira, P-F Winum, M Granier
PURPOSE: To evaluate operator and patient irradiation during radiofrequency ablation (RFA) of common atrial flutter (AF) using three different fluoroscopy settings. MATERIAL AND METHOD: A total of 38 patients who underwent RFA of AF with three different fluoroscopy settings (low dose, standard dose and collimated field) were included. Twelve patients (11 men, 1 woman; mean age, 67±12 [SD]years) were included in the low dose group (3.75 frames per second), 13 patients (13 men; mean age, 66±8 [SD]years) were included in the standard dose group (7...
May 10, 2018: Diagnostic and Interventional Imaging
Jonathan P Piccini, Stuart J Connolly, William T Abraham, Jeff S Healey, Benjamin A Steinberg, Hussein R Al-Khalidi, Patricia Dignacco, Dirk J van Veldhuisen, William H Sauer, Michel White, Stephen B Wilton, Inder S Anand, Christopher Dufton, Debra A Marshall, Ryan G Aleong, Gordon W Davis, Richard L Clark, Laura L Emery, Michael R Bristow
BACKGROUND: Few therapies are available for the safe and effective treatment of atrial fibrillation (AF) in patients with heart failure. Bucindolol is a non-selective beta-blocker with mild vasodilator activity previously found to have accentuated antiarrhythmic effects and increased efficacy for preventing heart failure events in patients homozygous for the major allele of the ADRB1 Arg389Gly polymorphism (ADRB1 Arg389Arg genotype). The safety and efficacy of bucindolol for the prevention of AF or atrial flutter (AFL) in these patients has not been proven in randomized trials...
May 2018: American Heart Journal
Mark H Eckman, Alexandru Costea, Mehran Attari, Jitender Munjal, Ruth E Wise, Carol Knochelmann, Matthew L Flaherty, Pete Baker, Robert Ireton, Brett M Harnett, Anthony C Leonard, Dylan Steen, Adam Rose, John Kues
BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. METHODS: We hypothesized that a shared decision-making interaction facilitated by an Atrial Fibrillation Shared Decision Making Tool (AFSDM) would improve patient knowledge about atrial fibrillation, and the risks and benefits of various treatment options for stroke prevention; increase satisfaction with the decision-making process; improve the therapeutic alliance between patient and the clinical care team; and increase medication adherence...
May 2018: American Heart Journal
Hoda Hatoum, Jennifer Dollery, Scott M Lilly, Juan A Crestanello, Lakshmi Prasad Dasi
While in vivo studies clearly demonstrate that supra-annular Valve-in-Valve (ViV) implantation provides the highest probability for optimal post-ViV pressure gradients (PG), there is still no physical insight into explaining anomalies where some supra-annular ViV implantations yield high pressure gradients while some sub-annular implantations yield low pressure gradients. The aim of this study is to explain how severe tissue ingrowth and calcification (TIC) in a surgical aortic valve (SAV) can be one physical mechanism leading to anomalous ViV performance characteristic...
May 4, 2018: Journal of Biomechanics
Miki Yokokawa, Mohamad C Sinno, Mohammed Saeed, Rakesh Latchamsetty, Hamid Ghanbari, Thomas Crawford, Krit Jongnarangsin, Ryan Cunnane, Frank Pelosi, Frank Bogun, Aman Chugh, Fred Morady, Hakan Oral
PURPOSE: The endpoint for radiofrequency catheter ablation (RFA) of cavo-tricuspid isthmus (CTI)-dependent atrial flutter (AFL) is complete conduction block along the CTI. The purpose of this study is to evaluate the utility of the temporal relationship between the P wave and the local atrial electrograms in determining complete CTI block. METHODS: RFA of CTI was performed in 125 patients (age 63 ± 11 years). During pacing from the coronary sinus (CS), the intervals from the peak of the P wave (Ppeak ) in lead V1 to the second component of the local atrial electrogram (A2 ) along the ablation line (Ppeak -A2 ) and from the end of the P wave (Pend ) to A2 (Pend -A2 ) were investigated before and after complete block in the first 100 patients (training set)...
May 11, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
David H Yoo, Brian Clark, Daniel Nguyen, Timm-Michael Dickfeld, Andrew S Zohlman, Libin Wang, Vincent Y See
A 72-year-old man who underwent a left atrial appendage (LAA) closure device two years ago, presented with atrial flutter with rapid ventricular rate and was referred for cardioversion. Pre-cardioversion transesophageal echocardiogram (TEE) showed left atrial thrombus and therefore the procedure was aborted. Currently, there is no guideline on imaging surveillance or anticoagulation in patients with LAA closure device who develop intracardiac thrombus after the initial six month surveillance period. This article is protected by copyright...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
Loïc Tadrist, Marc Saudreau, Pascal Hémon, Xavier Amandolese, André Marquier, Tristan Leclercq, Emmanuel de Langre
The wind-induced motion of the foliage in a tree is an important phenomenon both for biological issues (photosynthesis, pathogens development or herbivory) and for more subtle effects such as on wi-fi transmission or animal communication. Such foliage motion results from a combination of the motion of the branches that support the leaves, and of the motion of the leaves relative to the branches. Individual leaf dynamics relative to the branch, and branch dynamics have usually been studied separately. Here, in an experimental study on a whole tree in a large-scale wind tunnel, we present the first empirical evidence that foliage motion is actually dominated by individual leaf flutter at low wind velocities, and by branch turbulence buffeting responses at higher velocities...
May 2018: Journal of the Royal Society, Interface
David R Vinson, Nelya Lugovskaya, Manvi R Nagam
We commend Baugh et al for their treatment pathway for the emergency department (ED) management of atrial fibrillation (AF) and flutter (AFL) (combined AFF).1 This will help clinicians facing bedside management decisions. It will also provide a model for ED leaders and key stakeholders creating a multidisciplinary comprehensive emergency care pathway for their own medical centers. Three issues on pharmacologic cardioversion, however, warrant clarification. This article is protected by copyright. All rights reserved...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jorge A Wong, Jeff S Healey
No abstract text is available yet for this article.
February 20, 2018: Canadian Journal of Cardiology
Varghese Mathai, Xiaojue Zhu, Chao Sun, Detlef Lohse
Heavy particles sink straight in water, while buoyant bubbles and spheres may zigzag or spiral as they rise. The precise conditions that trigger such path-instabilities are still not completely understood. For a buoyant rising sphere, two parameters are believed to govern the development of unsteady dynamics: the particle's density relative to the fluid, and its Galileo number. Consequently, with these parameters specified, the opportunities for variation in particle dynamics appear limited. In contrast to this picture, here we demonstrate that vigorous path-oscillations can be triggered by modulating a spherical particle's moment of inertia (MoI)...
May 4, 2018: Nature Communications
Hesham K Abdelaziz, Marwan Saad, Hossamaldin Z Abuomara, Ramez Nairooz, Naga Venkata K Pothineni, Mohamed E Madmani, David H Roberts, Ehtisham Mahmud
OBJECTIVES: To examine long-term clinical outcomes with transcatheter patent foramen ovale (PFO) closure versus medical therapy alone in patients with cryptogenic stroke. BACKGROUND: A long-standing debate regarding the optimal approach for the management of patients with PFO after a cryptogenic stroke exists. METHODS: An electronic search was performed for randomized clinical trials (RCTs) reporting clinical outcomes with PFO closure vs. medical therapy alone after stroke...
May 4, 2018: Catheterization and Cardiovascular Interventions
Matevž Jan, David Žižek, Živa Miriam Geršak, Borut Geršak
INTRODUCTION: While catheter ablation (CA) is an established treatment for symptomatic paroxysmal atrial fibrillation (AF), convergent epicardial and endocardial ablation procedure (CVP) has been primarily used to treat persistent AF. The aim of this single-center, prospective, randomized study was to compare treatment efficacy of CA and CVP in paroxysmal AF patients by monitoring AF, atrial tachycardia (AT) and atrial flutter (AFL) recurrence with Implantable Loop Recorder (ILR). METHODS AND RESULTS: Fifty patients (74% male) with history of paroxysmal AF were randomized between CA and CVP...
May 3, 2018: Journal of Cardiovascular Electrophysiology
Anoop N Koshy, Jithin K Sajeev, Nitesh Nerlekar, Adam J Brown, Kevin Rajakariar, Mark Zureik, Michael C Wong, Louise Roberts, Maryann Street, Jennifer Cooke, Andrew W Teh
The accuracy of photoplethysmography (PPG) for heart rate (HR) estimation in cardiac arrhythmia is unknown. PPG-HR was evaluated in 112 hospitalised inpatients (cardiac arrhythmias (n = 60), sinus rhythm (n = 52)) using a continuous electrocardiogram monitoring as a reference standard. Strong agreement was observed in sinus rhythm HR < 100 and atrial flutter (bias 1 beat), modest agreement in sinus tachycardia (bias 24 beats) and complete heart block (bias -6 beats) and weak agreement with significant HR underestimation was seen in atrial fibrillation (bias 23 beats)...
May 2018: Internal Medicine Journal
Mathew R Levy, Faisal M Merchant, Jonathan J Langberg, David B Delurgio
Background: The utility of standard distal bipolar electrograms (sEGMs) for assessing catheter-tissue contact may be obscured by the presence of far-field signals. Microelectrode electrograms (mEGMs) may overcome this limitation. Methods: We compared 5 mEGM characteristics (amplitude, frequency content, temporal signal variability, presence of injury current, and amplitude differential between bipoles) with the sEGM for determining tissue contact in 20 patients undergoing ablation of typical atrial flutter...
February 2018: Journal of Arrhythmia
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