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https://www.readbyqxmd.com/read/28431066/limited-left-atrial-surgical-ablation-effectively-treats-atrial-fibrillation-but-decreases-left-atrial-function
#1
Marieke G Compier, Laurens F Tops, Jerry Braun, Katja Zeppenfeld, Robert J Klautz, Martin J Schalij, Serge A Trines
Aims: Limited left atrial (LA) surgical ablation with bipolar radiofrequency is considered to be an effective procedure for treatment of atrial fibrillation (AF). We studied whether limited LA surgical ablation concomitant to cardiac surgery is able to maintain LA function. Methods and Results: Thirty-six consecutive patients (age 66 ± 12 years, 53% male, 78% persistent AF) scheduled for valve surgery and/or coronary revascularization and concomitant LA surgical ablation were included...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430116/ghrelin-expression-and-significance-in-92-patients-with-atrial-fibrillation
#2
Tianyi Ma, Yujiang Su, Shijuan Lu, Moshui Chen, Jianghua Zhong, Zhihong Zhou, Dingjun Sun, Hui Yang, Xue Ao
OBJECTIVE: Ghrelin is a polypeptide that is closely associated with many cardiovascular diseases, such as hypertension, atherosclerosis, and heart failure. This article aims to understand the expression of ghrelin in patients with atrial fibrillation (AF). METHODS: A total of 182 patients with non-valvular heart diseases were recruited, among whom 92 had AF and 90 had sinus arrhythmia (SA). The serum ghrelin amount was tested by the ELASA method. Moreover, blood sugar, lipids, liver function, and renal function were tested...
April 10, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#3
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28429136/is-there-an-alternative-treatment-for-patients-intolerant-to-antiplatelet-therapy-if-percutaneous-left-atrial-appendage-closure-is-considered
#4
F Akca, N J Verberkmoes, S E Verstraeten, C van Laar, B P van Putte, A H M van Straten
INTRODUCTION: Left atrial appendage (LAA) closure has become of major interest for patients with atrial fibrillation intolerant to oral anticoagulation therapy (OAC). Patients with a contraindication to both OAC and antiplatelet therapy are not eligible for percutaneous LAA closure. We aimed to find an alternative treatment for these specific patients. METHODS: From March 2014 until December 2015 five patients were referred for percutaneous LAA closure. Alternative treatment was necessary due to an absolute contraindication to OAC and antiplatelet therapy (n = 4) or after previous failed percutaneous device implantation (n = 1)...
April 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#5
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28427903/atrial-fibrillation-is-associated-with-hypermethylation-in-human-left-atrium-and-treatment-with-decitabine-reduces-atrial-tachyarrhythmias-in-spontaneously-hypertensive-rats
#6
R Doñate Puertas, E Meugnier, C Romestaing, C Rey, E Morel, J Lachuer, N Gadot, A Scridon, C Julien, F Tronc, B Chapuis, C Valla, A Janin, L Pirola, A Méjat, S Rome, P Chevalier
Atrial fibrillation (AF) is the most common cardiac arrhythmia. As the molecular mechanisms underlying the pathology are largely unknown, this cardiac arrhythmia remains difficult to treat. To identify specific molecular actors involved in AF, we have performed a transcriptomic analysis on left atrium (LA) from patients with valvular heart disease with or without AF. We showed that 1627 genes had altered basal expression level in LA tissue of AF patients compared with the control group. The significantly enriched gene ontology biological process "anatomical structure morphogenesis" contained the highest number of genes in line with changes in structure that occur when the human heart remodels following AF development (ie, LA dilatation and interstitial fibrosis)...
March 30, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28427583/improving-atrial-fibrillation-therapy-is-there-a-gene-for-that
#7
REVIEW
William J Hucker, Alan Hanley, Patrick T Ellinor
Atrial fibrillation (AF) is an all-too-common and often challenging reality of clinical care. AF leads to significant morbidity and mortality; however, currently available treatments for AF have modest efficacy and high recurrence rates. In recent years, genetic therapy approaches have been explored in preclinical models of AF, and offer potential as a treatment modality with targeted delivery, tissue specificity, and therapy tailored to address mechanisms underlying the arrhythmia. However, many challenges remain before gene therapy can advance to a clinically relevant AF treatment...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427162/effect-of-age-on-long-term-outcomes-after-stroke-with-atrial-fibrillation-a-hospital-based-follow-up-study-in-china
#8
Tao Wang, Bin Li, Hongfei Gu, Yongzhong Lou, Xianjia Ning, Jinghua Wang, Zhongping An
Atrial fibrillation (AF) is an established predictor of poor outcomes after stroke. We aimed to assess the effect of age on outcomes at 1 year and 3 years in stroke patients with AF.We recruited acute ischemic stroke patients with AF between January 2006 and September 2014 in Tianjin, China. Clinical features and outcomes at 1 year and 3 years after stroke were compared between younger group and elderly group. Overall, 951 consecutive stroke patients with AF were included in this study. There was a higher mortality and dependency rate in the elderly group than in the young group at both 1 and 3 years after stroke...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#9
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
https://www.readbyqxmd.com/read/28424659/online-measurement-of-microembolic-signal-burden-by-transcranial-doppler-during-catheter-ablation-for-atrial-fibrillation-results-of-a-multicenter-trial
#10
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Sabine Fredersdorf, Dobri Baldaranov, Lars Maier, Felix Schlachetzki
INTRODUCTION: Left atrial pulmonary vein isolation (PVI) is an accepted treatment option for patients with symptomatic atrial fibrillation (AF). This procedure can be complicated by stroke or silent cerebral embolism. Online measurement of microembolic signals (MESs) by transcranial Doppler (TCD) may be useful for characterizing thromboembolic burden during PVI. In this prospective multicenter trial, we investigated the burden, characteristics, and composition of MES during left atrial catheter ablation using a variety of catheter technologies...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28423126/chronic-atrial-fibrillation-ablation-with-harmonic-scalpel-during-mitral-valve-surgery
#11
Alexandre Visconti Brick, Domingo M Braile
Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasound in patients with mitral valve disease, considering preoperative clinical characteristics of patients undergoing surgical procedure and follow-up in the immediate postoperative period, in hospital and up to 60 months after discharge. Methods: We studied 100 patients with chronic atrial fibrillation and mitral valve disease who underwent surgical treatment using ultrasound ablation...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28423125/coronary-arteriovenous-fistulas-in-adult-patients-surgical-management-and-outcomes
#12
Sebnem Albeyoglu, Mustafa Aldag, Ufuk Ciloglu, Murat Sargin, Tugba Kemaloglu Oz, Hakan Kutlu, Sabri Dagsali
Objective: The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes. Methods: Twenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28422654/novel-mri-technique-enables-non-invasive-measurement-of-atrial-wall-thickness
#13
Marta Varela, Ross Morgan, Adeline Theron, Desmond Dillon-Murphy, Henry Chubb, John Whitaker, Markus Henningsson, Paul Aljabar, Tobias Schaeffter, Christoph Kolbitsch, Oleg V Aslanidi
Knowledge of atrial wall thickness (AWT) has the potential to provide important information for patient stratification and the planning of interventions in atrial arrhythmias. To date, information about AWT has only been acquired in post-mortem or poor-contrast CT studies, providing limited coverage and highly variable estimates of AWT. We present a novel contrast agent-free MRI sequence for imaging AWT and use it to create personalized AWT maps and a biatrial atlas. A novel black-blood phase-sensitive inversion recovery protocol was used to image 10 volunteers and 2 atrial fibrillation patients, as proof of concept...
April 13, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28421621/presence-of-ganglia-and-telocytes-in-proximity-to-myocardial-sleeve-tissue-in-the-porcine-pulmonary-veins-wall
#14
T Vandecasteele, P Cornillie, K Vandevelde, A Logothetidou, L Couck, G van Loon, W Van den Broeck
Ganglia and telocytes were identified inside the porcine pulmonary veins wall near myocardial sleeve tissue at the atriopulmonary junction. These structures are reported to play a role in the initiation of pulses from outside the heart, which potentially can cause cardiac conduction disorders such as atrial fibrillation. In-depth knowledge on the fine structure of the pulmonary vein wall is a pre-requisite to better understand the underlying pathophysiology of atrial fibrillation and the origin and conduction of ectopic pulses...
April 19, 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28421551/macrolides-digoxin-toxicity-and-the-risk-of-sudden-death-a-population-based-study
#15
Kieran L Quinn, Erin M Macdonald, Tara Gomes, Muhammad M Mamdani, Anjie Huang, David N Juurlink
INTRODUCTION: Digoxin is commonly prescribed to elderly patients with heart failure and atrial fibrillation, and macrolide antibiotics markedly increase the risk of digoxin toxicity. OBJECTIVE: The aim was to determine whether, in older patients receiving digoxin, macrolide antibiotics are associated with sudden death. METHODS: We used a population-based, nested, case-control design from January 1, 1994 to December 31, 2012 in a cohort of Ontario residents aged 66 years or older prescribed digoxin...
April 18, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28421394/waveform-integrity-in-atrial-fibrillation-the-forgotten-issue-of-cardiac-electrophysiology
#16
Miguel Martínez-Iniesta, Juan Ródenas, Raúl Alcaraz, José J Rieta
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice with an increasing prevalence of about 15% in the elderly. Despite other alternatives, catheter ablation is currently considered as the first-line therapy for the treatment of AF. This strategy relies on cardiac electrophysiology systems, which use intracardiac electrograms (EGM) as the basis to determine the cardiac structures contributing to sustain the arrhythmia. However, the noise-free acquisition of these recordings is impossible and they are often contaminated by different perturbations...
April 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28419594/catheter-ablation-for-the-treatment-of-atrial-fibrillation-is-associated-with-a-reduction-in-health-care-resource-utilization
#17
Michelle Samuel, Meytal Avgil Tsadok, Jacqueline Joza, Hassan Behlouli, Atul Verma, Vidal Essebag, Louise Pilote
BACKGROUND: Catheter ablation (CA) is superior to antiarrhythmic therapy at reducing recurrence of atrial fibrillation (AF); however, there is limited data regarding whether this decrease translates into a reduction in health care resource utilization. OBJECTIVE: To evaluate the impact of AF ablation on long-term health care resource utilization. METHODS: A population-based cohort was constructed to include patients who underwent CA for AF in Quebec, Canada between April 2005 and March 2011...
April 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28418664/selective-ikur-inhibitors-for-the-potential-treatment-of-atrial-fibrillation-optimization-of-the-phenyl-quinazoline-series-leading-to-clinical-candidate-5-5-phenyl-4-pyridin-2-ylmethylamino-quinazolin-2-yl-pyridine-3-sulfonamide
#18
Prashantha Gunaga, John L Lloyd, Somanadham Mummadi, Abhisek Banerjee, Naveen Kumar Dhondi, James K Hennan, Veena Subray, Ramya Jayaram, Nagendra Rajugowda, Umamaheshwar Reddy, Duraimurugan Kumaraguru, Umasankar Mandal, Dasthagiri Beldona, Ashok Kumar Adisechan, Navnath Yadav, Jayakumar Warrier, James A Johnson, Harinath Sale, Siva Prasad Putlur, Ajay Saxena, Anjaneya Chimalakonda, Sandhya Mandlekar, Mary Lee Conder, Dezhi Xing, Arun Kumar Gupta, Anuradha Gupta, Richard A Rampulla, Arvind Mathur, Paul C Levesque, Ruth R Wexler, Heather J Finlay
We have recently disclosed 5-phenyl-N-(pyridin-2-ylmethyl)-2-(pyrimidin-5-yl)quinazolin-4-amine 1 as a potent IKur current blocker with selectivity versus hERG, Na and Ca channels and an acceptable preclinical PK profile. On further characterization in vivo, Compound 1 demonstrated an unacceptable level of brain penetration. In an effort to reduce the level of brain penetration while maintaining the overall profile, SAR was developed at the C2' position for a series of close analogs by employing hydrogen bond donors...
April 18, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28416978/atrial-electromechanical-delay-in-patients-undergoing-heart-transplantation
#19
Mustafa Bulut, Mert Evlice, Mehmet Celik, Hayati Eren, Ömer F Savluk, Rezzan D Acar, Mustafa Tabakci, Mehmet Y Emiroglu, Ozlem Otcu Nurse, Ramazan Kargin, Mehmet Balkanay, Mustafa Akcakoyun
BACKGROUND: We aimed to assess atrial electromechanical delay (AEMD) in patients who had undergone heart transplantation. METHODS: A total of 32 patients who underwent biatrial anastomosis heart transplantation (24 men, 8 women; mean age: 42±11 years) and 30 healthy volunteers (20 men, 10 women; mean age: 36±13 years) were included in the study. Atrial electromechanical coupling (PA), intra-AEMD, and inter-AEMD were measured. RESULTS: PA lateral (68±7 vs...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#20
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
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