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Search Results: 1 - 10 of 1224 matches for " atrial fibrillation "
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Biomarkers and atrial fibrillation: A new paradigm for assessing the progression of left atrial endocardial remodelling  [PDF]
Philippe Chevalier, Alina Scridon
Open Journal of Clinical Diagnostics (OJCD) , 2012, DOI: 10.4236/ojcd.2012.22004
Abstract: Atrial fibrillation is a heterogeneous disorder that is usually characterized by paroxysmal onset, particularly in patients without structural heart disease. Defining biological markers of atrial remodelling would help identify patients at high risk who would benefit most from prophylactic treatment and careful monitoring. Biomarkers of atrial fibrillation progression would be helpful for following patients that present with asymptomatic atrial fibrillation. Notably, the roles of such markers in the pathophysiology of atrial fibrillation must be determined. Some markers may indicate the presence, complications or progression of the disease, while others may be involved in key pathological processes and thus represent novel therapeutic targets. Although a number of markers have been reported as potential predictors of paroxysmal atrial fibrillation progression towards persistent arrhythmia, their usefulness and clinical value need further validation. This report reviews several newly identified markers of atrial fibrillation progression.
Effect of Atrial Fibrillation on Acute Ischemic Stroke Severity  [PDF]
Taha Kamel Alloush, Mahmoud Haroun Ibrahim, Nahed Salah El Dein Ahmed Ibrahim, Ghada Samir El-Shahed, Lobna Mohamed Nabil El-Sayed, Mohamed Hamdy Ibrahim, Hosam Ahmed Azmy
Open Journal of Medical Imaging (OJMI) , 2014, DOI: 10.4236/ojmi.2014.42013
Abstract:
Objectives: To assess the impact of atrial fibrillation on stroke severity and short-term (1 month) mortality. Materials and Methods: Totally 200 patients admitted to Ain Shams University Specialized Hospital were recruited and diagnosed clinically to have acute ischemic stroke within 3 days. Patients with hemorrhagic infarctions were excluded. History taking about previous heart disease was taken, full general and neurological examinations were done. Full metabolic profile, full cardiac investigations, carotid duplex, MRI brain stroke protocol with initial clinical evaluation and after 1 month re-evaluation using (NIHSS ) scale. Results: All patients underwent transthoracic echocardiography which revealed absence of “A” wave corresponding to atrial fibrillation in 33 patients (16.5%). Those Patients with atrial fibrillation had a median NIHSS score of 11.00 with IQR of 6.00 - 18.50 at admission and 6.00 with IQR of 2.00 - 14.50 after one month. Patients with atrial fibrillation showed significantly higher NIHSS at admission than patients in sinus rhythm, P < 0.05. Magnetic resonance imaging findings showed that MRA showed significant intracranial vessel stenosis in 117 (79.1%) patients. 51 (34.4%) patients had lacunar infarction, 65 (43.9%) patients had partial anterior circulation infarction, 25 (16.2%) patients had posterior circulation infarction and 7 (4.7%) patients had total anterior circulation infarction. 111 (75%) patients showed leucoaraiosis. Conclusion: Atrial fibrillation was found not to have significantly statistical effect on stroke severity and short term mortality.
Case report on the treatment of atrial fibrillation in a pregnant woman of 33 weeks’ gestation  [PDF]
N. Murphy, D. Sugrue, P. McKenna
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.41002
Abstract:

This case report highlights a recent case in the Rotunda Hospital of a patient of 33 weeks’ gestation with fast atrial fibrillation. She had an unusual presentation given that she had no prior cardiac history or obvious aetiology. She underwent successful DC cardioversion and was well on discharge. Follow-up with cardiology has been arranged.

Higher expression of connexin 40 in human atrial tissue of patients with type 2 diabetes who have undergone a coronary artery bypass graft surgery  [PDF]
Pascal Daleau, Geneviève Comeau, Dominique Fournier, Dany Patoine, Patrick Mathieu, Paul Poirier
Health (Health) , 2010, DOI: 10.4236/health.2010.23039
Abstract: Background: Although cardiac-related mortality rates are declining for the general population in the United States, this is not the case for patients with diabetes. Diabetes is a significant independent predictor of atrial fibrillation (AF), the most common cardiac rhythm disturbance responsible for substantial morbidity and mortality. Objectives: This research was designed to evaluate properties of the atrial tissue between patients with and without type 2 diabetes. Heart rate variability (HRV) indices were calculated and expression of Kv1.5, connexin 43 (Cx43), and 40 (Cx40) were compared. Methods: Patients undergoing a CABG were enrolled: 10 with type 2 diabetes and 8 without diabetes, paired for age, gender and co-morbidities such as hypertension and dyslipidemia. All patients showed normal ejection fraction. A sample of right auricular appendix was taken during CABG and Kv1.5, Cx40 and Cx43 protein contents were determined by western blotting and normalized to α-tubulin level. Results: No HRV difference was found between patients with and without diabetes. Cx43 and Kv1.5 levels were unaffected by diabetes (p=0.20 and 0.07, respectively) whe- reas Cx40 content was significantly increased by 55% (p=0.02). Levels of Cx43 phosphorylated and non-phosphorylated forms were non-significantly decreased in patients with diabetes. Conclusion: Patients with type 2 diabetes had higher expression of Cx40 in the right auricular appendix tissue. In light of other studies having demonstrated a link between AF and Cx40 expression, it is possible that higher prevalence of AF in patients with diabetes is explained, at least partially, by differential expression of gap-junction proteins.
Novel therapies for treating atrial fibrillation  [PDF]
Raj Parikh, Philip J. Kadowitz
World Journal of Cardiovascular Diseases (WJCD) , 2012, DOI: 10.4236/wjcd.2012.24040
Abstract: Atrial fibrillation is the most common cardiac arrhythmia and is a major risk factor for stroke, heart failure, and death. Current treatments focus on anti-coagulation as well as rate-control and rhythm-control strategies. Frequent INR checks associated with warfarin along with several adverse side effects of anti-arrhythmics have propelled investigations into novel treatments for atrial fibrillation. Research is focused not only on pioneering new pharmacological antico- agulation and anti-arrhythmic agents but also on improving surgical techniques in hopes of treating the arrhythmia. Here, we first briefly discuss the current treatment options, both pharmacological and non-pharmacological, for atrial fibrillation. We then present a focused review of recent animal and human investigations that examine the use of novel an-ticoagulation agents, mechanisms of new anti-arrhythmics, analyze potential triggers of atrial fibrillation, and highlight the role of genetics in atrial fibrillation.
Successful radiofrequency ablation of long-standing persistent atrial fibrillation in a patient with esophageal achalasia  [PDF]
Andrea Avella, Piergiuseppe De Girolamo, Francesco Laurenzi, Augusto Pappalardo, Vitaliano Buffa
World Journal of Cardiovascular Diseases (WJCD) , 2012, DOI: 10.4236/wjcd.2012.24047
Abstract: A 54-year-old man was referred for ablation of symptomatic drug-refractory long-lasting persistent atrial fibrillation. His past medical history was negative for cardiac disease but included a diagnosis of esophageal achalasia. The patient underwent an ablation procedure, guided by barium esophagram, including isolation of the pulmonary veins, ablation of complex fractionated left atrial electrograms recorded on the sep-tal wall and, finally, linear ablation of the cavo-tricuspid isthmus. The ablation procedure was performed with multielectrode ablation catheters using duty-cycled bipolar/unipolar radiofrequency energy. During 6 months of follow-up no recurrences of atrial fibrillation were documented. The reported case demonstrates how an ablation procedure for long-standing persistent AF may be safely performed even in a patient presenting with a achalasia, outlining the mega-esophagus position with a simple barium paste.
Atrial fibrillation in diabetes: A cause for concern?  [PDF]
Benjamin R. Szwejkowski, Sushma Rekhraj, Andrew D. Morris, Allan D. Struthers
Journal of Diabetes Mellitus (JDM) , 2012, DOI: 10.4236/jdm.2012.24059
Abstract: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and is associated with significant morbidity and mortality. It is becoming increasingly evident diabetes is a significant risk factor for the development of AF. The reason for this link is not clearly understood, however it is clear that other co-morbid diseases associated with diabetes such as hypertension and obesity may be implicated or there may be direct arrthymogenic affects of glucose dysregulation on the myocardium. The development of AF in patients with diabetes may be an ominous sign given the increased risk of death from cardiovascular disease and we propose this is an under researched area where treatments may bring benefits over and above those patients without diabetes in terms of morbidity or death from cardiovascular disease.
Atrial fibrillation ablation in patients with heart failure review  [PDF]
Mohammad I. Amin, Laurence D. Sterns, Richard A. Leather, Anthony S. Tang
World Journal of Cardiovascular Diseases (WJCD) , 2013, DOI: 10.4236/wjcd.2013.31011
Abstract:

Atrial fibrillation and heart failure often coexist in patients with advanced heart failure symptoms. The result, in addition to a significant impact on quality of life, is an increase in the risk of a adverse clinical outcomes including stroke, hospitalization and overall mortality. Pharmacological therapy for atrial fibrillation in the heart failure population remains limited due to sub-optimal drug efficacy and a likely increased mortality due to pro-arrhythmia. Atrial fibrillation ablation, since it allows for therapy without the need for toxic medication, has the potential to become mainstream treatment in patients with drug refractory, symptomatic atrial fibrillation and heart failure. Randomized studies and observational data suggest that atrial fibrillation ablation provides superior rhythm control to anti-arrhythmic drugs. Atrial fibrilla- tion ablation is relatively safe and may result in improvement of left ventricular function and quality of life. Ongoing studies are attempting to assess a number of outcome measures to help define its role in the heart failure patient population. This review focuses on atrial fibrillation ablation in patients with congestive heart failure, and summarizes the results of available literature.

Diabetics Have the Same Risk and Benefits Regarding Postoperative Amiodarone Prophylaxis for Atrial Fibrillation When Undergoing Surgery for Lung Cancer  [PDF]
Lars P. Riber, Thomas D. Christensen, Hans K. Pilegaard
Open Journal of Thoracic Surgery (OJTS) , 2013, DOI: 10.4236/ojts.2013.32012
Abstract:

Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objective: To compare the outcome of amiodarone prophylaxis in diabetics and non-diabetics. Design: Subgroup analysis within a randomized, controlled, double-blinded trial. Results: Development of atrial fibrillation was equally frequent among diabetics (18.2%) and non-diabetics (20.5%) (p = 1.00). Atrial fibrillation occurred in 7.1% of prophylactic diabetics and in 9.3% of prophylactic non-diabetics, while 37.5% non-prophylactic diabetics and 31.3% non-prophylactic non-diabetics experienced atrial fibrillation (p = 0.31). Prophylactic amiodarone was equally effective in diabetics as in non-diabetics with a relative risk of 3.5 (1.8 - 67.0) and the number need to treat of 4.4 (3.3 - 8.3) (p = 0.31). The length of in-hospital stay for diabetics was equal to non-diabetics with an average stay of 7.1 versus 8 days at Aarhus University Hospital (p =

Clinical profile and angiographic findings among patients with atrial fibrillation presenting for selective coronary angiography  [PDF]
Wael Elabbassi, Mohammed Andaleeb Chowdhury, Brano Liska, Robert Hatala
Health (Health) , 2014, DOI: 10.4236/health.2014.61007
Abstract:

Background: Coronary artery disease is the most common form of cardiovascular disease while Atrial fibrillation is the most common sustained arrhythmia. We set out to investigate the prevalence and clinical profile of patients with atrial fibrillation who present for selective coronary angiography and whether this has an effect on the angiogram findings and the treatment options offered to them. Methods and Results: This was a retrospectively collected database of 494 patients presenting for SCAG from 01.11.2010 to 30.11.2010 and 01.04.2010 to 30.04.2010. We collected and analyzed clinical characteristics of patients, their SCAG finding and modes of treatment offered up to discharge. 24.6% of patients had AF. They tended to be older, more commonly women, current or ex-smokers; presented with symptoms of atypical chest pain and were more likely to have a history of congestive heart failure or valvular heart disease. They had a longer hospital stay. Using CHADS-Vasc score, 83.6% were moderate to high risk for CVA. At SCAG, they were more likely to have non-significant coronary artery disease, and hence were more likely to be treated conservatively. Conclusion: AF patients presenting for SCAG constitute a unique subset of patients who despite having a higher likelihood of non-significant coronary stenosis are still prone to suffering from poorly-understood and under-appreciated myocardial ischemia.

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