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Atrial fibrillation with rapid ventricular rate

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https://www.readbyqxmd.com/read/27909497/persistent-atrial-fibrillation-and-atrial-flutter-complicated-by-tachycardiomyopathy-because-of-intermittent-conduction-through-accessory-pathway
#1
L Valeri, A Coppolino, G Rossetti, A Vado, G Amoroso, G Bricco, A Battisti, L Correndo, S Dogliani, A Magliarditi, D Pancaldo, M De Benedictis, A Bassignana, B Doronzo
The term tachycardiomyopathy refers to a specific form of tachycardia-related cardiomyopathy caused by supraventricular or ventricular tachyarrhytmias that are both associated with ventricular rates higher than 120 bpm. The arrhythmias which are most frequently associated with these forms of heart disease are atrial fibrillation and atrial flutter, particularly found in the elderly population. The most frequent clinical manifestation is heart failure. In this case we are reporting a clinical case of a patient that came to our attention because of an episode of heart failure associated with atrial fibrillation and atrial flutter...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27868213/characteristics-and-outcomes-of-concurrently-diagnosed-new-rapid-atrial-fibrillation-or-flutter-and-new-reduced-ejection-fraction
#2
Yasser Rodriguez, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, G Stuart Mendenhall, Samir Saba, Alaa A Shalaby, Andrew H Voigt, Norman C Wang
BACKGROUND: Characteristics and outcomes of concurrently diagnosed new rapid atrial fibrillation (AF) or flutter (AFL) and new heart failure with reduced left ventricular ejection fraction (LVEF) are not well described. METHODS: A retrospective cohort study of subjects referred for expedited transesophageal echocardiography (TEE)-guided rhythm-control strategies for concurrent new AF/AFL and new LVEF ≤40% diagnosed during the same admission was analyzed. RESULTS: Twenty-five subjects (median age 57 years; 96% male; 100% Caucasian; median CHA2 DS2 -VASc = 2) presented with new AF (n = 18) or AFL (n = 7) with rapid ventricular rate (median 135 beats per minute) and new reduced LVEF (median 27%; range, 10%-37...
November 21, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27651407/apixaban-induced-liver-injury
#3
Sherri-Anne Clarke, Ali A Alsaad, Anwar Mack, Michael B Phillips
An 81-year-old woman with well-controlled hypertension presented to the emergency department with new-onset atrial fibrillation with rapid ventricular response. Treatment for atrial fibrillation was initiated, including rate control and anticoagulation with 5 mg of apixaban two times per day for primary stroke prophylaxis. Three days after initiation of apixaban, the patient noted new-onset abdominal pain, worsening shortness of breath and weakness. Laboratory results showed elevated liver enzymes. Workup for elevated transaminase did not reveal any underlying infectious or autoimmune process...
September 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27619976/st-segment-elevation-following-cardioversion-of-atrial-fibrillation-in-the-emergency-department-unmasked-myocardial-infarction-due-to-left-main-coronary-artery-plaque-rupture-or-unspecific-finding
#4
Dirk Prochnau, Ralf Surber, Matthias Hoyme, Sylvia Otto, Anna Selle, Tudor C Poerner
Atrial fibrillation (AF) is a frequent reason for emergency department visits. According to current guidelines either rate- or rhythm-control are acceptable therapeutic options in such situations. In this report, we present the complicated clinical course of a patient with AF and a rapid ventricular response. Because of paroxysmal AF, the patient was on chronic oral anticoagulation therapy with warfarin. Pharmacological treatment was ineffective to control ventricular rate, and immediate synchronized electrical cardioversion was performed...
September 13, 2016: CJEM
https://www.readbyqxmd.com/read/27553695/a-warning-sign
#5
Sandeep Patri, Soji Joseph, Yashwant Agrawal
A 64year old man presented with atypical chest pain of 6h duration. Physical examination showed tachycardia and an irregularly irregular pulse. Initial EKG showed atrial fibrillation with rapid ventricular rate. Intravenous Diltiazem was administered following which there was resolution of atrial fibrillation as well as his chest pain. Troponin T and CPK-MB were minimally elevated at 0.05ng/ml (0.0-0.03ng/ml) and 8.6ng/ml (0.0-7.0ng/ml) respectively. A repeat EKG obtained after symptom resolution showed biphasic T wave inversions in V2 and V3 which prompted an emergent coronary angiogram that revealed 90% occlusion of the proximal LAD...
August 20, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27475259/pulmonary-hypertension-due-to-radiofrequency-catheter-ablation-rfca-for-atrial-fibrillation-the-lungs-the-atrium-or-the-ventricle
#6
Isha Verma, Hemantkumar Tripathi, Rutuja Rajanikant Sikachi, Abhinav Agrawal
Atrial fibrillation is the most common heart rhythm disorder in United States, characterised by rapid and irregular beating of both the atria resulting in the similar ventricular response. While rate and rhythm control using pharmacological regimens remain the primary management strategies in these patients, radiofrequency catheter ablation (RFCA) is rapidly rising as an alternative modality of treatment. Increase in the incidence of RFCA has shed light on complications associated with this procedure. Pulmonary hypertension (PH) is one of the long-term complications that has been observed postcatheter ablation...
July 18, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27452987/comparison-of-weight-based-dose-vs-standard-dose-diltiazem-in-patients-with-atrial-fibrillation-presenting-to-the-emergency-department
#7
Adam L Ross, David M O'Sullivan, Michael J Drescher, Michelle A Krawczynski
BACKGROUND: Despite evidence-based recommended weight-based (WB) dosing of diltiazem for the initial treatment of atrial fibrillation (AF) with rapid ventricular response (RVR), many providers utilize lower initial doses of diltiazem. OBJECTIVE: We sought to determine whether a low, standard dose of diltiazem is noninferior to WB diltiazem as an initial bolus dose in the treatment of AF with RVR. METHODS: This retrospective review included patients who presented to the emergency department (ED) of an urban, academic tertiary medical center experiencing AF with RVR from November 2010 to August 2014...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27446216/sanguineous-pericardial-effusion-and-cardiac-tamponade-in-the-setting-of-graves-disease-report-of-a-case-and-review-of-previously-reported-cases
#8
Peter V Bui, Sonia N Zaveri, J Rush Pierce
Introduction. Pericardial effusion in the setting of hyperthyroidism is rare. We present a patient with Graves' disease who developed a sanguineous pericardial effusion and cardiac tamponade. Case Description. A 76-year-old man presenting with fatigue was diagnosed with Graves' disease and treated with methimazole. Two months later, he was hospitalized for uncontrolled atrial fibrillation. Electrocardiography showed diffuse low voltage and atrial fibrillation with rapid ventricular rate. Chest radiograph revealed an enlarged cardiac silhouette and left-sided pleural effusion...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27401780/safety-and-feasibility-of-treatment-with-rivaroxaban-for-non-canonical-indications-a-case-series-analysis
#9
Domenico Acanfora, Chiara Acanfora, Pietro Scicchitano, Marialaura Longobardi, Giuseppe Furgi, Gerardo Casucci, Bernardo Lanzillo, Ilaria Dentamaro, Annapaola Zito, Raffaele Antonelli Incalzi, Marco Matteo Ciccone
BACKGROUND AND OBJECTIVES: The new oral anticoagulants (NOACs) are used for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF) and those at risk of deep venous thrombosis. Their rapid onset of action and predictable pharmacokinetic and pharmacodynamic profiles make them the optimal alternative to warfarin in the treatment of these two categories of patients. Unfortunately, however, NOACs cannot be used in patients with valvular AF or valvular cardiac prostheses...
October 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27138313/atrial-fibrillation-due-to-licorice-root-syrup
#10
Musluhittin Emre Erkuş, İbrahim Halil Altıparmak, Recep Demirbağ, Özgür Günebakmaz
While it is known that consumption of licorice may lead to cardiac arrhythmias, there have been no reports of atrial fibrillation resulting from the consumption of licorice root syrup. A 57-year-old male with no prior history of cardiovascular disease was admitted to the emergency department with palpitation. His electrocardiogram showed atrial fibrillation with a moderate to rapid ventricular rate. In laboratory assessment, potassium was 2.0 mmol/L and plasma renin activity and aldosterone level were suppressed (<300 ng/L/hour, 42 ng/L respectively)...
April 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27127736/initial-outcome-following-invasive-cardiac-electrophysiologic-studies-and-radiofrequency-ablation-of-atrial-fibrillation
#11
Kelechukwu Uwanuruochi, Sabari Saravanan, Anita Ganasekar, Benjamin S Solomon, Ravikumar Murugesan, Ruchit A Shah, Jaishankar Krishnamoorthy, Ulhas M Pandurangi
BACKGROUND: Cardiac electrophysiologic study and radiofrequency ablation (RFA) have become an established mode of treatment for patients with refractory arrhythmias. These procedures are carried out regularly at the cardiac catheterization laboratory of Madras Medical Mission India. OBJECTIVE: The purpose of this study was to evaluate our experience with cardiac electrophysiologic studies (EPS) and RFA catheter of atrial fibrillation (AF). MATERIALS AND METHODS: This was a retrospective study carried out in the Cardiac Electrophysiology Department of the Institute of Cardiovascular Diseases, Madras Medical Mission, India...
April 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27092187/practical-applicability-of-landiolol-an-ultra-short-acting-%C3%AE-1-selective-blocker-for-rapid-atrial-and-ventricular-tachyarrhythmias-with-left-ventricular-dysfunction
#12
Yuko Wada, Takeshi Aiba, Yasuyuki Tsujita, Hideki Itoh, Mitsuru Wada, Ikutaro Nakajima, Kohei Ishibashi, Hideo Okamura, Koji Miyamoto, Takashi Noda, Yasuo Sugano, Hideaki Kanzaki, Toshihisa Anzai, Kengo Kusano, Satoshi Yasuda, Minoru Horie, Hisao Ogawa
BACKGROUND: Landiolol effectively controls rapid heart rate in atrial fibrillation or flutter (AF/AFL) patients with left ventricular (LV) dysfunction. However, predicting landiolol Responders and Non-Responders and patients who will experience adverse effects remains a challenge. The aim of this study was to clarify the potential applicability of landiolol for rapid AF/AFL and refractory ventricular tachyarrhythmias (VTs) in patients with heart failure. METHODS: A total of 39 patients with AF/AFL with ventricular response ≥120 bpm and 12 VTs were retrospectively enrolled...
April 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/26927707/impact-of-thyroidectomy-on-cardiac-manifestations-of-graves-disease
#13
Jason M Gauthier, Hossam Eldin Mohamed, Salem I Noureldine, Timo Z Nazari-Shafti, Tina K Thethi, Emad Kandil
OBJECTIVES/HYPOTHESIS: Graves' disease (GD) has multiple adverse effects on the cardiovascular system. We aimed to examine the outcome of thyroidectomy in patients with cardiac manifestations of GD and evaluate their associated postoperative complications. STUDY DESIGN: Retrospective analysis using a prospectively collected database. METHODS: A retrospective analysis of our prospectively collected thyroid surgery database was performed. Forty patients with hyperthyroidism due to GD were identified, and each was appropriately age matched to a euthyroid patient with multinodular goiter (MNG)...
May 2016: Laryngoscope
https://www.readbyqxmd.com/read/26898970/day-by-day-telemetric-care-of-patients-treated-with-cardiac-resynchronization-therapy-first-polish-experience
#14
Agnieszka Liberska, Oskar Kowalski, Michał Mazurek, Radosław Lenarczyk, Ewa Jędrzejczyk-Patej, Katarzyna Przybylska-Siedlecka, Monika Kozieł, Stanisław Morawski, Tomasz Podolecki, Jacek Kowalczyk, Patrycja Pruszkowska, Sławomir Pluta, Adam Sokal, Zbigniew Kalarus
BACKGROUND: Due to the recent rapid increase in the number of patients implanted with pacemakers, cardioverter-defibrillators (ICD), and cardiac resynchronization therapy devices (CRT), conventional monitoring at specialist clinics is becoming increasingly more difficult. The development of technology enabled remote device monitoring with the use of teletransmission systems. AIM: The aim of our study was to assess the effectiveness of transmission and the possibility of using telemetric data for further clinical management of patients with heart failure treated with cardiac resynchronization therapy (CRT-D)...
February 22, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/26873425/utility-of-high-output-his-pacing-during-difficult-av-node-ablation-an-underutilized-strategy
#15
Khalil Kanjwal, Blair P Grubb
Atrioventricular (AV) node ablation is a commonly performed procedure for patients with chronic drug refractory atrial fibrillation (AF) with episodes of rapid ventricular response. We report on a 72-year-old man who had difficulty managing chronic drug refractory AFs with frequent hospitalizations for rapid ventricular rate. The patient was taken to the electrophysiology laboratory for AV node ablation. Extensive mapping and localization techniques of the compact AV node and ablation in the region were unsuccessful...
June 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/26830391/achieving-ventricular-rate-control-using-metoprolol-in-%C3%AE-blocker-naive-patients-vs-patients-on-chronic-%C3%AE-blocker-therapy
#16
COMPARATIVE STUDY
Patricia Kuang, Nathan D Mah, Cassie A Barton, Andrea J Miura, Laura R Tanas, Ran Ran
STUDY OBJECTIVE: The objective of the study is to evaluate the difference in ventricular rate control using an intravenous (IV) metoprolol regimen commonly used in clinical practice in patients receiving chronic β-blocker therapy compared to patients considered β-blocker naive admitted to the emergency department (ED) for atrial fibrillation (AF) with rapid ventricular rate. METHODS: A single-center retrospective cohort study of adult ED patients who were admitted with a rapid ventricular rate of 120 beats per minute (bpm) or greater and treated with IV metoprolol was performed...
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26820362/mechanisms-underlying-atrial-selective-block-of-sodium-channels-by-wenxin-keli-experimental-and-theoretical-analysis
#17
Dan Hu, Hector Barajas-Martínez, Alexander Burashnikov, Brian K Panama, Jonathan M Cordeiro, Charles Antzelevitch
INTRODUCTION: Atrial-selective inhibition of cardiac sodium channel current (INa) and INa-dependent parameters has been shown to contribute to the safe and effective management of atrial fibrillation. The present study was designed to examine the basis for the atrial-selective actions of Wenxin Keli. METHODS: Whole cell INa was recorded at room temperature in canine atrial and ventricular myocytes. Trains of 40 pulses were elicited over a range of pulse durations and interpulse intervals to determine tonic and use-dependent block...
March 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/26820304/association-of-the-ratio-of-early-mitral-inflow-velocity-to-the-global-diastolic-strain-rate-with-a-rapid-renal-function-decline-in-atrial-fibrillation
#18
Szu-Chia Chen, Wen-Hsien Lee, Po-Chao Hsu, Chee-Siong Lee, Meng-Kuang Lee, Hsueh-Wei Yen, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Ho-Ming Su
The ratio of early mitral inflow velocity (E) to the global diastolic strain rate (E'sr) has been correlated with left ventricular filling pressure and predicts adverse cardiac outcomes in atrial fibrillation (AF). The relationship between the E/E'sr ratio and renal outcomes in AF has not been evaluated. This study examined the ability of the E/E'sr ratio in predicting progression to the renal endpoint, which is defined as a ≥ 25% decline in the estimated glomerular filtration rate in patients with AF. Comprehensive echocardiography was performed on 149 patients with persistent AF, and E'sr was assessed from three standard apical views using the index beat method...
2016: PloS One
https://www.readbyqxmd.com/read/26691143/a-clinical-network-project-improves-care-of-patients-with-atrial-fibrillation-with-rapid-ventricular-response-in-victorian-emergency-departments
#19
MULTICENTER STUDY
Anne-Maree Kelly, Jan Pannifex
OBJECTIVES: Atrial fibrillation with rapid ventricular response is a common condition in emergency departments (ED) and despite published guidelines, variation in practice is common. The aim of this nine-month evidence-based care improvement project was improving the management of atrial fibrillation with rapid ventricular response (AFRVR). METHODS: This was a quality improvement project, evaluated using before and after chart review methodology. The outcomes of interest were the proportion of patients managed according to a local treatment pathway, the proportion with duration of symptoms documented, the proportion with rate control versus rhythm control strategy documented and the proportion with a CHADS2 score (or equivalent) documented...
March 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/26658575/comorbidity-of-atrial-fibrillation-and-heart-failure
#20
REVIEW
Liang-Han Ling, Peter M Kistler, Jonathan M Kalman, Richard J Schilling, Ross J Hunter
Atrial fibrillation (AF) and heart failure (HF) are evolving epidemics, together responsible for substantial human suffering and health-care expenditure. Ageing, improved cardiovascular survival, and epidemiological transition form the basis for their increasing global prevalence. Although we now have a clear picture of how HF promotes AF, gaps remain in our knowledge of how AF exacerbates or even causes HF, and how the development of HF affects the outcome of patients with AF. New data regarding HF with preserved ejection fraction and its unique relationship with AF suggest a possible role for AF in its aetiology, possibly as a trigger for ventricular fibrosis...
March 2016: Nature Reviews. Cardiology
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