Search results for "Atrial flutter"
showing 10 items of 20 documents
Role of CRT upgrading in pacing induced heart failure: A case report
2014
Abstract We submit a case report of a 78-year-old male came to our department for systolic heart, failure (EF of 25%). He has clinical history of recurring atrial tachycardia and atrial flutter previously treated in our department unsuccessfully with antiarrhythmic drug therapy. The echocardiographic evidence of left atrial enlargement (left atrium area 40 cm 2 ) and the clinical history of permanent atrial tachycardia has discouraged any attempt of substrate ablation. As it is impossible get rhythm and rate control with drug therapy, the patient was subjected to an "ablate and pace" procedure with implantation of a VVIR mode pacemaker. Also, for the absence of indications (QRS width During…
Impact of atrial fibrillation/flutter on the in-hospital mortality of surgical patients – Results from the German nationwide cohort
2020
To investigate the impact of atrial fibrillation/flutter (AF) on adverse in-hospital outcomes in hospitalized surgical patients.The nationwide German inpatient sample of the years 2005-2018 was used for this analysis. Surgical patients were stratified by AF and compared. Logistic regression models were used to investigate the impact of AF on in-hospital outcomes.In total, 96,589,627 hospitalizations with surgery were included in the present analysis in Germany (2005-2018). Among these, 6,680,261 were additionally coded with AF (6.9%). In-hospital death rate was substantially higher in surgical patients with AF (6.3%) than without (1.1%). Proportion of surgical patients with AF increased fro…
Effect of intravenous flecainide on atrial vulnerability in man.
1983
Sixteen patients were investigated by means of programmed atrial stimulation at two different driving rates: 100 and 120/min. All patients had an increased atrial vulnerability at both driving rates. After intravenous flecainide application (1 mg/kg body weight as a bolus followed by the same amount given by infusion over a period of 20 min) the increased vulnerability was abolished in 11 and 9 patients respectively. In the remaining patients the rate of induced atrial tachyarrhythmia decreased. These findings correlate with a significant prolongation of the effective refractory period of the right atrium and a significant shortening of the relative refractory period of the right atrium. It…
Quantitative assessment of regularity and synchronization of intracardiac recordings during human atrial fibrillation
2003
This study proposes the morphology-based evaluation of the regularity (R) and the synchronization (S) of intra-atrial electrograms acquired during atrial fibrillation (AF). R is defined as the degree of repetitiveness over time of the shapes of the activation waves detected in single atrial recordings. S accounts for the simultaneous presence of morphologically similar activation waves in two atrial electrograms, and for the dispersion of the propagation delays between the two sites. Both R and S resulted unitary for normal sinus rhythm and decreased significantly moving from atrial flutter (R=0.93, S=0.88) to AF of increasing complexity class (type I AF: R=0.75, S=0.66; type II AF: R=0.32,…
Prospective appraisal of the prevalence of primary aldosteronism in hypertensive patients presenting with atrial flutter or fibrillation (PAPPHY Stud…
2013
Primary aldosteronism (PA) is the most common endocrine form of hypertension and may carry an increased risk of atrial flutter or fibrillation (AFF). The primary goal of this multicentre cohort study is thus to prospectively establish the prevalence of PA in consecutive hypertensive patients referred for lone (non-valvular), paroxysmal or permanent AFF. Secondary objectives are to determine: (1) the predictors of AFF in patients with PA; (2) the rate of AFF recurrence at follow-up after specific treatment in the patients with PA; (3) the effect of AFF that can increase atrial natriuretic peptide via the atrial stretch and thereby blunt aldosterone secretion, on the aldosterone-to-renin rati…
The supraventricular tachycardias: Proposal of a diagnostic algorithm for the narrow complex tachycardias
2013
AbstractThe narrow complex tachycardias (NCTs) are defined by the presence in a 12-lead electrocardiogram (ECG) of a QRS complex duration less than 120ms and a heart rate greater than 100 beats per minute; those are typically of supraventricular origin, although rarely narrow complex ventricular tachycardias have been reported in the literature.As some studies document, to diagnose correctly the NCTs is an arduous exercise because sometimes those have similar presentation on the ECG. In this paper, we have reviewed the physiopathological, clinical, and ECG findings of all known supraventricular tachycardias and, in order to reduce the possible diagnostic errors on the ECG, we have proposed …
Subclinical atrial fibrillation: how hard should we look?
2012
More than three decades ago, an analysis from the Framingham Heart Study revealed that atrial fibrillation (AF) increases the risk of stroke by a factor of five in non-rheumatic AF and by a factor of 17 in rheumatic AF.1 Since then, it has convincingly been shown that anticoagulation is one of the most effective secondary stroke prophylactic treatment options, which reduces the risk of stroke by 2/3,2 even in an older population.3 AF may occur in different types and in an individual patient often starts with paroxysmal AF, but later becomes persistent or permanent AF.4 Interestingly, the risk of stroke or systemic embolism is influenced by cardiovascular risk factors such as hypertension, d…
Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study
2010
Aims Gold electrodes have the theoretical advantage of creating bigger lesions than platinum–iridium (Pt–Ir) electrodes. We performed a prospective randomized study to compare the clinical efficacy of standard 8 mm Pt–Ir tip catheter (control) and 8 mm gold-tip catheters in the ablation of the cavotricuspid isthmus (CTI)-dependent atrial flutter. Methods and results A total of 463 patients undergoing CTI ablation in 19 clinical centres were randomized to receive the treatment by gold-tip or control catheter. The primary endpoint was cumulative radiofrequency (RF) application duration until achieving bidirectional CTI block. It did not differ significantly for the two catheters. The gold-tip…
Quantitative assessment of synchronization during atrial fibrillation by Shannon Entropy characterization of propagation delays
2005
This study introduced a new method for the quantification of the synchronization (S) and the causal verse of activation (S12) in couples of atrial electrograms recorded during atrial fibrillation (AF). The synchronization indexes S and S12 relied on the measure of the propagation delays between coupled activation times in two atrial signals and on the characterization of their dispersion by Shannon-Entropy (SE). S and S12 were validated both on simulated activation time series and endocavitary signals in patients. In simulation, S and S12 were equal to 1 for propagation of one single wavefront in a fully excitable tissue, while they decreased for reentries in partially excitable tissue (S =…
A Strange Case of Left Bowel Ischemia after Right Hernioplasty
2010
We report the first observed case of a young man who suffered of large and unsuspected left bowel ischemia following an elective right open hernioplasty. A 54-year-old man had a 2-year history of right inguinal reducible mass and was admitted to hospital for an elective day case open inguinal hernioplasty for a direct right inguinal hernia. Apart from mild hypertension controlled with ACE inhibitor, he was medically fit and well. The patient was submitted to open tension-free mesh repair with polypropylene preshaped mesh with local infiltration anesthesia and additive sedation with midazolam. The local anesthesia and surgery were uneventful and he was discharged home on the same day as per …