Página 1 dos resultados de 4778 itens digitais encontrados em 0.017 segundos

Cirurgia vídeo-assistida para a ablação da fibrilação atrial isolada por radiofrequência bipolar; Videothoracoscopy for isolated atrial fibrillation ablation through bipolar radiofrequency; Cirugía videoasistida para ablación de fibrilación atrial aislada por radiofrecuencia bipolar

COLAFRANCESCHI, Alexandre Siciliano; MONTEIRO, Andrey José de Oliveira; BOTELHO, Eduardo Souza Leal; CANALE, Leonardo Secchin; RABISCHOFFSKY, Arnaldo; COSTA, Ieda Prata; CRUZ FILHO, Fernando Eugênio dos Santos; SÁ, Roberto Luiz Menssing da Silva; BOECH
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
66.92%
FUNDAMENTO: A prevalência da fibrilação atrial, os gastos com o sistema de saúde e a elevada morbidade e mortalidade associadas a ela, têm justificado a procura por novas abordagens terapêuticas. OBJETIVO: Avaliar a reprodutibilidade da técnica cirúrgica, a segurança e os resultados inicias da cirurgia vídeo-assistida para a ablação da fibrilação atrial isolada com radiofrequência bipolar. MÉTODOS: Dez pacientes (90% homens) com fibrilação atrial (50% paroxística) sintomática e refratária à terapia medicamentosa, sem doença cardíaca que requeresse cirurgia concomitante, foram submetidos à ablação da arritmia guiada por toracoscopia, no período de maio de 2007 a maio de 2008. Variáveis clínicas, laboratoriais e de imagem foram prospectivamente coletadas antes, durante e no seguimento pós-operatório. RESULTADOS: A cirurgia foi realizada conforme o planejado em todos os pacientes. Não houve lesão iatrogênica de estruturas intratorácicas ou óbitos. No seguimento médio de seis meses, 80% dos pacientes estão livres de fibrilação atrial. Houve melhora significativa dos sintomas de insuficiência cardíaca classe funcional New York Heart Association (2,4 ± 0,5 para 1,6 ± 0,7; p = 0,011). Não houve evidência de estenose de veias pulmonares à angiotomografia...

Fibrilação atrial e demência: estudo de base populacional no distrito do Butantã, São Paulo; Atrial fibrillation and dementia: a population-based study in the Butantã district, São Paulo

Yoshihara, Liz Andrea Kawabata
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/10/2008 PT
Relevância na Pesquisa
66.95%
INTRODUÇÃO: O aumento da proporção de idosos implica estudar os determinantes dos principais agravos associados ao envelhecimento como a demência, principalmente a associada à doença cerebrovascular. Um fator de risco relevante para doença cerebrovascular é a freqüência de fibrilação atrial crônica. O São Paulo Health and Ageing Study com base populacional para estudo de distúrbio cognitivo e demência é uma oportunidade única para verificar a prevalência de fibrilação atrial e de sua associação com demência. MÉTODOS: Estudo transversal, por arrolamento de 1524 idosos com 65 anos ou mais estudo acima, no distrito do Butantã, cidade de São Paulo. O diagnóstico de fibrilação atrial foi feito com o eletrocardiograma de repouso de doze derivações e o de demência foi feito utilizando-se o protocolo do Research Group of Dementia 10/66. Estudaram-se variáveis sócio-econômicas e fatores de risco cardiovascular como hipertensão, diabetes, dislipidemia e obesidade. RESULTADOS: A amostra estudada tinha idade média de 72,2 anos, era predominantemente feminina, branca, casada, de baixa escolaridade e renda. A prevalência de fibrilação atrial associou-se ao aumento da idade e foi de 1,9% para o sexo feminino e 3...

Cirurgia torácica vídeo-assistida para a ablação da fibrilação atrial por radiofreqüência bipolar: exeqüibilidade, segurança e resultados iniciais; Video-assisted thoracic surgery for atrial fibrillation ablation using bipolar radiofrequency: Feasibility, Safety and initial results

Colafranceschi, Alexandre Siciliano
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/10/2008 PT
Relevância na Pesquisa
66.92%
INTRODUÇÃO: A prevalência da fibrilação atrial, os gastos com o sistema de saúde e a elevada morbidade e mortalidade associados a ela, têm justificado a procura por um melhor entendimento de suas bases fisiopatológicas e por novas abordagens terapêuticas. O objetivo deste manuscrito é avaliar a exeqüibilidade, a segurança e os resultados em três meses da cirurgia vídeo-assistida para a ablação da fibrilação atrial com radiofreqüência bipolar. MÉTODOS: Dez pacientes (90% homens) com fibrilação atrial sintomática e refratária à terapia medicamentosa foram submetidos ao procedimento cirúrgico proposto no Instituto Nacional de Cardiologia, Rio de Janeiro, no período de Maio 2007 a Maio de 2008. Foram analisadas variáveis de peri e pós-operatório. Além da avaliação clínica dos sintomas, todos os pacientes foram submetidos a um ecocardiograma e Holter de 24horas antes e três meses após a cirurgia. Realizou-se também uma angiotomografia de veias pulmonares no terceiro mês de seguimento pós-operatório. RESULTADOS: O procedimento foi realizado conforme planejado em todos os pacientes. Cem por cento das veias pulmonares direitas e 90% das esquerdas tiveram o isolamento elétrico confirmado. Não houve lesão iatrogênica de estruturas intra-torácicas ou óbitos. Dois pacientes apresentaram pneumonia pós-operatória e longo tempo de permanência hospitalar no início da experiência clínica. Nove dos dez pacientes saíram do centro cirúrgico em ritmo sinusal. Houve uma recorrência da fibrilação atrial em três meses (11...

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Dantas,Rogério Carregoza; Barbosa,Eduardo Corrêa; Benchimol-Barbosa,P. R.; Bomfim,Alfredo de Souza; Ginefra,Paulo
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2001 EN
Relevância na Pesquisa
66.96%
OBJECTIVE: Using P-wave signal-averaged electrocardiography, we assessed the patterns of atrial electrical activation in patients with idiopathic atrial fibrillation as compared with patterns in patients with atrial fibrillation associated with structural heart disease. METHODS: Eighty patients with recurrent paroxysmal atrial fibrillation were divided into 3 groups as follows: group I - 40 patients with atrial fibrillation associated with non-rheumatic heart disease; group II - 25 patients with rheumatic atrial fibrillation; and group III - 15 patients with idiopathic atrial fibrillation. All patients underwent P-wave signal-averaged electrocardiography for frequency-domain analysis using spectrotemporal mapping and statistical techniques for detecting and quantifying intraatrial conduction disturbances. RESULTS: We observed an important fragmentation in atrial electrical conduction in 27% of the patients in group I, 64% of the patients in group II, and 67% of the patients in group III (p=0.003). CONCLUSION: Idiopathic atrial fibrillation has important intraatrial conduction disturbances. These alterations are similar to those observed in individuals with rheumatic atrial fibrillation, suggesting the existence of some degree of structural involvement of the atrial myocardium that cannot be detected with conventional electrocardiography and echocardiography.

Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

Almeida,Eduardo Dytz; Guimarães,Raphael Boesche; Stephan,Laura Siga; Medeiros,Alexandre Kreling; Foltz,Katia; Santanna,Roberto Tofani; Pires,Leonardo Martins; Kruse,Marcelo Lapa; Lima,Gustavo Glotz de; Leiria,Tiago Luiz Luz
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
66.98%
Introduction: Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce. Objective: To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use. Methods: Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012. Results: We included 407 patients (356 had atrial fibrillation and 51 had flutter). Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01) and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01). The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01). The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%. Conclusions: The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk...

Abnormal heart rate variability and atrial fibrillation after aortic surgery

Compostella,Leonida; Russo,Nicola; D’Onofrio,Augusto; Setzu,Tiziana; Compostella,Caterina; Bottio,Tomaso; Gerosa,Gino; Bellotto,Fabio
Fonte: Sociedade Brasileira de Cirurgia Cardiovascular Publicador: Sociedade Brasileira de Cirurgia Cardiovascular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
Relevância na Pesquisa
66.92%
Introduction: Complete denervation of transplanted heart exerts protective effect against postoperative atrial fibrillation; various degrees of autonomic denervation appear also after transection of ascending aorta during surgery for aortic aneurysm. Objective: This study aimed to evaluate if the level of cardiac denervation obtained by resection of ascending aorta could exert any effect on postoperative atrial fibrillation incidence. Methods: We retrospectively analysed the clinical records of 67 patients submitted to graft replacement of ascending aorta (group A) and 132 with aortic valve replacement (group B); all episodes of postoperative atrial fibrillation occurred during the 1-month follow-up have been reported. Heart Rate Variability parameters were obtained from a 24-h Holter recording; clinical, echocardiographic and treatment data were also evaluated. Results: Overall, 45% of patients (group A 43%, group B 46%) presented at least one episode of postoperative atrial fibrillation. Older age (but not gender, abnormal glucose tolerance, ejection fraction, left atrial diameter) was correlated with incidence of postoperative atrial fibrillation. Only among a subgroup of patients with aortic transection and signs of greater autonomic derangement (heart rate variability parameters below the median and mean heart rate over the 75th percentile)...

Angiotensin-converting enzyme gene 2350 G/A polymorphism and susceptibility to atrial fibrillation in Han Chinese patients with essential hypertension

Jiang,Min-Hui; Su,Ya-Min; Tang,Jian-Zhong; Shen,Yan-Bo; Deng,Xin-Tao; Yuan,Ding-Shan; Wu,Jie; Pan,Min; Huang,Zhong-Wei
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2013 EN
Relevância na Pesquisa
66.97%
OBJECTIVE: The angiotensin-converting enzyme gene is one of the most studied candidate genes related to atrial fibrillation. Among the polymorphisms of the angiotensin-converting enzyme gene, the 2350 G/A polymorphism (rs4343) is known to have the most significant effects on the plasma angiotensin-converting enzyme concentration. The aim of the present study was to investigate the association of the angiotensin-converting enzyme 2350 G/A polymorphism with atrial fibrillation in Han Chinese patients with essential hypertension. METHODS: A total of 169 hypertensive patients were eligible for this study. Patients with atrial fibrillation (n = 75) were allocated to the atrial fibrillation group, and 94 subjects without atrial fibrillation were allocated to the control group. The PCR-based restriction fragment length polymorphism technique was used to assess the genotype frequencies. RESULTS: The distributions of the angiotensin-converting enzyme 2350 G/A genotypes (GG, GA, and AA, respectively) were 40.43%, 41.49%, and 18.08% in the controls and 18.67%, 46.67%, and 34.66% in the atrial fibrillation subjects (p = 0.037). The frequency of the A allele in the atrial fibrillation group was significantly greater than in the control group (58.00% vs. 38.83%...

Score for atrial fibrillation detection in acute stroke and transient ischemic attack patients in a Brazilian population: The acute stroke atrial fibrillation scoring system

de Figueiredo,Marcelo Marinho; Rodrigues,Ana Clara Tude; Alves,Monique Bueno; Neto,Miguel Cendoroglo; Silva,Gisele Sampaio
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
Relevância na Pesquisa
66.94%
OBJECTIVE: Atrial fibrillation is a common arrhythmia that increases the risk of stroke by four- to five-fold. We aimed to establish a profile of patients with atrial fibrillation from a population of patients admitted with acute ischemic stroke or transient ischemic attack using clinical and echocardiographic findings. METHODS: We evaluated patients consecutively admitted to a tertiary hospital with acute ischemic stroke or transient ischemic attack. Subjects were divided into an original set (admissions from May 2009 to October 2010) and a validation set (admissions from November 2010 to April 2013). The study was designed as a cohort, with clinical and echocardiographic findings compared between patients with and without atrial fibrillation. A multivariable model was built, and independent predictive factors were used to produce a predictive grading score for atrial fibrillation (Acute Stroke AF Score-ASAS). RESULTS: A total of 257 patients were evaluated from May 2009 to October 2010 and included in the original set. Atrial fibrillation was diagnosed in 17.5% of these patients. Significant predictors of atrial fibrillation in the multivariate analysis included age, National Institutes of Health Stroke Scores, and the presence of left atrial enlargement. These predictors were used in the final logistic model. For this model...

The role of stretch-activated channels in atrial fibrillation and the impact of intracellular acidosis

Ninio, D.; Saint, D.
Fonte: Pergamon-Elsevier Science Ltd Publicador: Pergamon-Elsevier Science Ltd
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
66.91%
The incidence of atrial fibrillation correlates with increasing atrial size. The electrical consequences of atrial stretch contribute to both the initiation and maintenance of atrial fibrillation. It is suggested that altered calcium handling and stretch-activated channel activity could explain the experimental findings of stretch-induced depolarisation, shortened refractoriness, slowed conduction and increased heterogeneity of refractoriness and conduction. Stretch-activated channel blocking agents protect against these pro-arrhythmic effects. Gadolinium, GsMTx-4 toxin and streptomycin prevent the stretch-related vulnerability to atrial fibrillation without altering the drop in refractory period associated with stretch. Changes the activity of two-pore K+ channels, which are sensitive to stretch and pH but not gadolinium, could underlie the drop in refractoriness. Intracellular acidosis induced with propionate amplified the change in refractoriness with stretch in the isolated rabbit heart model in keeping with the clinical observation of increased propensity to atrial fibrillation with acidosis. We propose that activation of non-specific cation stretch-activated channels provides the triggers for acute atrial fibrillation with high atrial pressure while activation of atrial two-pore K+ channels shortens atrial refractory period and increases heterogeneity of refractoriness...

Characterisation of the substrate of atrial fibrillation and flutter.

Stiles, Martin Kingsland
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2009
Relevância na Pesquisa
67.03%
Atrial fibrillation and atrial flutter are the most common sustained arrhythmias, however their underlying mechanisms are yet to be fully characterised. This thesis evaluates the electrophysiological and electroanatomical substrate of the atria in patients with these arrhythmias. Experimental studies of atrial fibrillation have demonstrated effective refractory period shortening and conduction slowing as a result of atrial fibrillation giving rise to the concept that "atrial fibrillation begets atrial fibrillation". However, cardioversion to prevent electrical remodelling does not prevent progression of disease, suggesting a "second factor" drives this process. Chapters 2 and 3 evaluate the atrial substrate in patients with "lone" atrial fibrillation. These studies demonstrate such patients, remote from an arrhythmic event, have prolongation of atrial refractoriness, conduction slowing, impairment of sinus node function, site-specific conduction delay, lower voltage and a greater proportion of complex electrograms compared to reference patients. These abnormalities constitute the "second factor" critical to the development and progression of atrial fibrillation. Atrial flutter has a close inter-relationship with atrial fibrillation and these rhythms frequently co-exist. Atrial fibrillation often occurs in patients with heart disease known to demonstrate abnormal atrial substrate; whether similar substrate exists in patients with atrial flutter to account for the co-existence of both arrhythmias is unknown. Chapters 4 and 5 evaluate the atrial substrate in patients with atrial flutter...

An examination of the role of atrial stretch in the genesis of atrial fibrillation and the antiarrhythmic effects of dietary fish oil.

Ninio, Daniel Marc
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2009
Relevância na Pesquisa
67.01%
This thesis is submitted as a PhD by portfolio of publications. It explores the role of atrial stretch in the pathogenesis of atrial fibrillation and the modulating effect of dietary fish oil. Atrial fibrillation is more common in conditions associated with atrial stretch. This relationship is thought to be due to changes in activity of stretch-sensitive ion channels and alterations in calcium handling. Increasing atrial pressure in isolated rabbit hearts shortens atrial refractoriness and enhances the inducibility and sustainability of atrial fibrillation. The first of the publications in this thesis¹ describes the effect of pericardial constraint on the isolated rabbit heart model which uses increasing atrial pressure as a surrogate for increasing stretch. Reproducing the original description of this model but with an intact pericardium, increasing atrial pressure did not result in the electrical changes seen with marked atrial dilatation. When the pericardium was removed, the relationship between increasing atrial pressure and susceptibility to atrial fibrillation was restored. The second publication² reports the effect of streptomycin and intracellular acidosis on the rabbit heart atrial fibrillation model. Stretch-activated channel blockers gadolinium and Grammostola toxin have been shown to limit atrial fibrillation with stretch in the rabbit model. We further explored the role of the non-specific cation stretch-activated channel using streptomycin. Streptomycin reduced the stretch-related vulnerability to atrial fibrillation without altering the drop in refractory period associated with stretch. We proposed that the drop in refractoriness might be related to activation of stretch-activated potassium channels. These channels have also been shown to be sensitive to intracellular pH. We therefore investigated the interaction between intracellular pH and stretch in the induction of atrial fibrillation. Intracellular acidosis...

Substrate for atrial fibrillation in cardiomyopathies.

Lau, Dennis Hui Sung
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2010
Relevância na Pesquisa
67%
Atrial Fibrillation is the most common heart rhythm disorder. However, our understanding of the underlying patho-physiological mechanisms of AF remains limited. Both hypertension and heart failure are known to play an important role as risk factors for AF. With the increase in the incidence and prevalence of both these conditions and the predicted atrial fibrillation epidemic, their underlying mechanistic associations require careful attention. This thesis focused on the evaluation of atrial remodeling in large animal models of these common substrates. Chapter 2 presents the detailed anatomical, histological and functional characterization of the cardiac changes in the ovine “one-kidney, one-clip” model of hypertension using state of the art cardiac magnetic resonance imaging. Chapter 3 presents the significant atrial electrical, structural and functional remodeling evident with short duration (mean of 7 weeks) of hypertension. Pivotal changes were seen in increased atrial interstitial fibrosis and the resultant conduction abnormalities. This highlighted the importance of early and aggressive therapy of hypertension which may prevent the development of an arrhythmogenic atrial substrate. Chapter 4 examines the time course of atrial remodeling during the development of hypertension over a period of 15 weeks. Anatomical and functional remodeling started early while structural changes in increased fibrosis occurred later in the remodeling process. The early changes were associated with increased atrial fibrillation inducibility while the late changes were associated with more prolonged induced atrial fibrillation episodes. This understanding of the time course of remodeling provided important insights...

Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation a randomized clinical trial

Abed, H.; Wittert, G.; Leong, D.; Shirazi, M.; Bahrami, B.; Middeldorp, M.; Lorimer, M.; Lau, D.; Antic, N.; Brooks, A.; Abhayaratna, W.; Kalman, J.; Sanders, P.
Fonte: Amer Medical Assoc Publicador: Amer Medical Assoc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.95%
IMPORTANCE: Obesity is a risk factor for atrial fibrillation. Whether weight reduction and cardiometabolic risk factor management can reduce the burden of atrial fibrillation is not known. OBJECTIVE: To determine the effect of weight reduction and management of cardiometabolic risk factors on atrial fibrillation burden and cardiac structure. DESIGN, SETTING, AND PATIENTS: Single-center, partially blinded, randomized controlled study conducted between June 2010 and December 2011 in Adelaide, Australia, among overweight and obese ambulatory patients (N = 150) with symptomatic atrial fibrillation. Patients underwent a median of 15 months of follow-up. INTERVENTIONS: Patients were randomized to weight management (intervention) or general lifestyle advice (control). Both groups underwent intensive management of cardiometabolic risk factors. MAIN OUTCOMES AND MEASURES: The primary outcomes were Atrial Fibrillation Severity Scale scores: symptom burden and symptom severity. Scores were measured every 3 months from baseline to 15 months. Secondary outcomes performed at baseline and 12 months were total atrial fibrillation episodes and cumulative duration measured by 7-day Holter, echocardiographic left atrial area, and interventricular septal thickness. RESULTS: Of 248 patients screened...

Aortic stiffness in lone atrial fibrillation: A novel risk factor for arrhythmia recurrence

Lau, D.; Middeldorp, M.; Brooks, A.; Ganesan, A.; Roberts-Thomson, K.; Stiles, M.; Leong, D.; Abed, H.; Lim, H.; Wong, C.; Willoughby, S.; Young, G.; Kalman, J.; Abhayaratna, W.; Sanders, P.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
67%
BACKGROUND Recent community-based research has linked aortic stiffness to the development of atrial fibrillation. We posit that aortic stiffness contributes to adverse atrial remodeling leading to the persistence of atrial fibrillation following catheter ablation in lone atrial fibrillation patients, despite the absence of apparent structural heart disease. Here, we aim to evaluate aortic stiffness in lone atrial fibrillation patients and determine its association with arrhythmia re currence following radio-frequency catheter ablation. METHODS We studied 68 consecutive lone atrial fibrillation patients who underwent catheter ablation procedure for atrial fibrillation and 50 healthy age- and sex-matched community controls. We performed radial artery applanation tonometry to obtain central measures of aortic stiffness: pulse pressure, augmentation pressure and augmentation index. Following ablation, arrhythmia recurrence was monitored at months 3, 6, 9, 12 and 6 monthly thereafter. RESULTS Compared to healthy controls, lone atrial fibrillation patients had significantly elevated peripheral pulse pressure, central pulse pressure, augmentation pressure and larger left atrial dimensions (all P<0.05). During a mean follow-up of 2.9±1.4 years...

Approaches to catheter ablation for persistent atrial fibrillation

Verma, A.; Jiang, C.Y.; Betts, T.R.; Chen, J.; Deisenhofer, I.; Mantovan, R.; Macle, L.; Morillo, C.A.; Haverkamp, W.; Weerasooriya, R.; Albenque, J.P.; Nardi, S.; Menardi, E.; Novak, P.; Sanders, P.
Fonte: Massachusetts Medical Society Publicador: Massachusetts Medical Society
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
66.95%
BACKGROUND: Catheter ablation is less successful for persistent atrial fibrillation than for paroxysmal atrial fibrillation. Guidelines suggest that adjuvant substrate modification in addition to pulmonary-vein isolation is required in persistent atrial fibrillation. METHODS: We randomly assigned 589 patients with persistent atrial fibrillation in a 1:4:4 ratio to ablation with pulmonary-vein isolation alone (67 patients), pulmonary-vein isolation plus ablation of electrograms showing complex fractionated activity (263 patients), or pulmonary-vein isolation plus additional linear ablation across the left atrial roof and mitral valve isthmus (259 patients). The duration of follow-up was 18 months. The primary end point was freedom from any documented recurrence of atrial fibrillation lasting longer than 30 seconds after a single ablation procedure. RESULTS: Procedure time was significantly shorter for pulmonary-vein isolation alone than for the other two procedures (P<0.001). After 18 months, 59% of patients assigned to pulmonary-vein isolation alone were free from recurrent atrial fibrillation, as compared with 49% of patients assigned to pulmonary-vein isolation plus complex electrogram ablation and 46% of patients assigned to pulmonary-vein isolation plus linear ablation (P=0.15). There were also no significant differences among the three groups for the secondary end points...

Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

Almeida,Eduardo Dytz; Guimarães,Raphael Boesche; Stephan,Laura Siga; Medeiros,Alexandre Kreling; Foltz,Katia; Santanna,Roberto Tofani; Pires,Leonardo Martins; Kruse,Marcelo Lapa; Lima,Gustavo Glotz de; Leiria,Tiago Luiz Luz
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2015 EN
Relevância na Pesquisa
66.98%
Introduction:Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce.Objective:To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use.Methods:Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012.Results:We included 407 patients (356 had atrial fibrillation and 51 had flutter). Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01) and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01). The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01). The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%.Conclusions:The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk...

Aortic Stiffness in Lone Atrial Fibrillation: A Novel Risk Factor for Arrhythmia Recurrence

Lau, Dennis H.; Middeldorp, Melissa E.; Brooks, Anthony G.; Ganesan, Anand N.; Roberts-Thomson, Kurt C.; Stiles, Martin K.; Leong, Darryl P.; Abed, Hany S.; Lim, Han S.; Wong, Christopher X.; Willoughby, Scott R.; Young, Glenn D.; Kalman, Jonathan M.; Abh
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
67%
BACKGROUND Recent community-based research has linked aortic stiffness to the development of atrial fibrillation. We posit that aortic stiffness contributes to adverse atrial remodeling leading to the persistence of atrial fibrillation following catheter ablation in lone atrial fibrillation patients, despite the absence of apparent structural heart disease. Here, we aim to evaluate aortic stiffness in lone atrial fibrillation patients and determine its association with arrhythmia recurrence following radio-frequency catheter ablation. METHODS We studied 68 consecutive lone atrial fibrillation patients who underwent catheter ablation procedure for atrial fibrillation and 50 healthy age- and sex-matched community controls. We performed radial artery applanation tonometry to obtain central measures of aortic stiffness: pulse pressure, augmentation pressure and augmentation index. Following ablation, arrhythmia recurrence was monitored at months 3, 6, 9, 12 and 6 monthly thereafter. RESULTS Compared to healthy controls, lone atrial fibrillation patients had significantly elevated peripheral pulse pressure, central pulse pressure, augmentation pressure and larger left atrial dimensions (all P<0.05). During a mean follow-up of 2.9±1.4 years...

Effect of β-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction

PESARO, Antonio Eduardo; SOEIRO, Alexandre de Matos; SERRANO, Carlos Vicente; GIRALDEZ, Roberto Rocha; LADEIRA, Renata Teixeira; NICOLAU, José Carlos
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
66.96%
INTRODUCTION: Oral β-blockers improve the prognosis of patients with acute myocardial infarction, while atrial fibrillation worsens the prognosis of this population. The reduction of atrial fibrillation incidence in patients treated with β-blockers could at least in part explain the benefits of this drug. OBJECTIVE: To investigate the effect of β-blockers on the incidence of atrial fibrillation in patients with acute myocardial infarction. METHODS: We analyzed 1401 patients with acute myocardial infarction and evaluated the occurrence or absence of atrial fibrillation, the use of oral β-blockers and mortality during the first 24 hours. RESULTS: a) The use of β-blockers was inversely correlated with the presence of atrial fibrillation (ρ = 0.004; OR = 0.54). b) Correlations with mortality were as follows: 31.5% in patients with atrial fibrillation, 9.2% in those without atrial fibrillation (ρ < 0.001; Odds Ratio = 4.52), and 17.5% in patients not treated with β-blockers and 6.7% in those who received the drug (ρ < 0.001; OR = 0.34). c) Adjusted Models: The presence of atrial fibrillation was independently correlated with mortality (OR = 2.48, ρ = 0.002). The use of β-blockers was inversely and independently correlated with mortality (OR = 0.53; ρ = 0.002). The patients who used β-blockers showed a lower risk of atrial fibrillation (OR = 0.59; ρ = 0.029) in the adjusted model. CONCLUSION: The presence of atrial fibrillation and the absence of oral β-blockers increased in-hospital mortality in patients with acute myocardial infarction. Oral β-blockers reduced the incidence of atrial fibrillation...

Effect of β-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction

Pesaro,Antonio Eduardo; Soeiro,Alexandre de Matos; Serrano,Carlos Vicente; Giraldez,Roberto Rocha; Ladeira,Renata Teixeira; Nicolau,José Carlos
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2010 EN
Relevância na Pesquisa
66.96%
INTRODUCTION: Oral β-blockers improve the prognosis of patients with acute myocardial infarction, while atrial fibrillation worsens the prognosis of this population. The reduction of atrial fibrillation incidence in patients treated with β-blockers could at least in part explain the benefits of this drug. OBJECTIVE: To investigate the effect of β-blockers on the incidence of atrial fibrillation in patients with acute myocardial infarction. METHODS: We analyzed 1401 patients with acute myocardial infarction and evaluated the occurrence or absence of atrial fibrillation, the use of oral β-blockers and mortality during the first 24 hours. RESULTS: a) The use of β-blockers was inversely correlated with the presence of atrial fibrillation (ρ = 0.004; OR = 0.54). b) Correlations with mortality were as follows: 31.5% in patients with atrial fibrillation, 9.2% in those without atrial fibrillation (ρ < 0.001; Odds Ratio = 4.52), and 17.5% in patients not treated with β-blockers and 6.7% in those who received the drug (ρ < 0.001; OR = 0.34). c) Adjusted Models: The presence of atrial fibrillation was independently correlated with mortality (OR = 2.48, ρ = 0.002). The use of β-blockers was inversely and independently correlated with mortality (OR = 0.53; ρ = 0.002). The patients who used β-blockers showed a lower risk of atrial fibrillation (OR = 0.59; ρ = 0.029) in the adjusted model. CONCLUSION: The presence of atrial fibrillation and the absence of oral β-blockers increased in-hospital mortality in patients with acute myocardial infarction. Oral β-blockers reduced the incidence of atrial fibrillation...

Effect of β-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction

Pesaro, Antonio Eduardo; Soeiro, Alexandre de Matos; Serrano, Carlos Vicente; Giraldez, Roberto Rocha; Ladeira, Renata Teixeira; Nicolau, José Carlos
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2010 ENG
Relevância na Pesquisa
66.96%
INTRODUCTION: Oral β-blockers improve the prognosis of patients with acute myocardial infarction, while atrial fibrillation worsens the prognosis of this population. The reduction of atrial fibrillation incidence in patients treated with β-blockers could at least in part explain the benefits of this drug. OBJECTIVE: To investigate the effect of β-blockers on the incidence of atrial fibrillation in patients with acute myocardial infarction. METHODS: We analyzed 1401 patients with acute myocardial infarction and evaluated the occurrence or absence of atrial fibrillation, the use of oral β-blockers and mortality during the first 24 hours. RESULTS: a) The use of β-blockers was inversely correlated with the presence of atrial fibrillation (ρ = 0.004; OR = 0.54). b) Correlations with mortality were as follows: 31.5% in patients with atrial fibrillation, 9.2% in those without atrial fibrillation (ρ < 0.001; Odds Ratio = 4.52), and 17.5% in patients not treated with β-blockers and 6.7% in those who received the drug (ρ < 0.001; OR = 0.34). c) Adjusted Models: The presence of atrial fibrillation was independently correlated with mortality (OR = 2.48, ρ = 0.002). The use of β-blockers was inversely and independently correlated with mortality (OR = 0.53; ρ = 0.002). The patients who used β-blockers showed a lower risk of atrial fibrillation (OR = 0.59; ρ = 0.029) in the adjusted model. CONCLUSION: The presence of atrial fibrillation and the absence of oral β-blockers increased in-hospital mortality in patients with acute myocardial infarction. Oral β-blockers reduced the incidence of atrial fibrillation...