Francesco Santoro, Francesco Monitillo, Pasquale Raimondo, Agostino Lopizzo, Gaetano Brindicci, Michele Gilio, Francesco Musaico, Michele Mazzola, Domenico Vestito, Rossella Di Benedetto, Mohammad Abumayyaleh, Ibrahim El-Battrawy, Carmen Rita Santoro, Luigi Flavio Massimiliano Di Martino, Ibrahim Akin, Giulio De Stefano, Rosario Fiorilli, Michele Cannone, Annalisa Saracino, Salvatore Angarano, Sergio Carbonara, Salvatore Grasso, Luigi Di Biase, Natale Daniele Brunetti
BACKGROUND: Prolonged QTc interval and life-threatening arrhythmias (LTA) are potential drug induced complications previously reported with antimalarial, antivirals and antibiotics. OBJECTIVES: To evaluate prevalence and predictors of QTc interval prolongation and incidence of LTA during hospitalization for COVID-19 among patients with normal admission QTc. METHODS: 110 consecutive patients were enrolled in a multicenter international registry...
October 24, 2020: Clinical Infectious Diseases
Andreas Goette, Lars Eckardt, Marco Valgimigli, Thorsten Lewalter, Petra Laeis, Paul-Egbert Reimitz, Rüdiger Smolnik, Wolfgang Zierhut, Jan G Tijssen, Pascal Vranckx
AIMS: This subgroup analysis of the ENTRUST-AF PCI trial ( Identifier: NCT02866175; Date of registration: August 2016) evaluated type of AF, and CHA2 DS2 -VASc score parameters as predictors for clinical outcome. METHODS: Patients were randomly assigned after percutaneous coronary intervention (PCI) to either edoxaban (60 mg/30 mg once daily [OD]; n = 751) plus a P2Y12 inhibitor for 12 months or a vitamin K antagonist [VKA] (n = 755) plus a P2Y12 inhibitor and aspirin (100 mg OD, for 1-12 months)...
October 24, 2020: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Raja Jayaram, Michael Jones, Svetlana Reilly, Mark J Crabtree, Nikhil Pal, Nicola Goodfellow, Keshav Nahar, Jillian Simon, Ricardo Carnicer, Ravi DeSilva, Chandana Ratnatunga, Mario Petrou, Rana Sayeed, Andrea Roalfe, Keith M Channon, Yaver Bashir, Timothy Betts, Michael Hill, Barbara Casadei
AIMS: Systemic inflammation and increased activity of atrial NOX2-containing NADPH oxidases have been associated with the new onset of atrial fibrillation (AF) after cardiac surgery. In addition to lowering LDL-cholesterol, statins exert rapid anti-inflammatory and antioxidant effects, the clinical significance of which remains controversial. METHODS AND RESULTS: We first assessed the impact of cardiac surgery and cardiopulmonary bypass (CPB) on atrial nitroso-redox balance by measuring NO synthase (NOS) and GTP Cyclohydrolase -1 (GCH-1) activity, biopterin content, and superoxide production in paired samples of the right atrial appendage obtained before (PRE) and after CPB and reperfusion (POST) in 116 patients...
October 24, 2020: Cardiovascular Research
Alisha Gupta, Kelly J Shields, Susan Manzi, Mary Chester Wasko, Tarun S Sharma
OBJECTIVE: To study the relationship between hydroxychloroquine (HCQ) use and new onset atrial fibrillation in patients with systemic lupus erythematosus (SLE). METHODS: A retrospective cohort of adult SLE patients from Dec 1, 2014 to May 30, 2017 was constructed. Patients were categorized as either HCQ users or non-users. The primary outcome was incident atrial fibrillation; secondary outcomes included incident ventricular arrhythmias (composite of ventricular tachycardia (VT), ventricular fibrillation (VF), or torsades de pointes)...
October 23, 2020: Arthritis Care & Research
Gaetano Antonio Lanza, Antonio De Vita, Salvatore Emanuele Ravenna, Alessia D'Aiello, Marcello Covino, Francesco Franceschi, Filippo Crea
AIMS: The main severe complications of SARS-CoV-2 infection are pneumonia and respiratory distress syndrome. Recent studies, however, reported that cardiac injury, as assessed by troponin levels, is associated with a worse outcome in these patients. No study hitherto assessed whether the simple standard electrocardiogram (ECG) may be helpful for risk stratification in these patients. METHODS AND RESULTS: We studied 324 consecutive patients admitted to our Emergency Department with a confirmed diagnosis of SARS-CoV-2 infection...
October 23, 2020: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Samantha Haraszti, Selin Sendil, Nichole Jensen
BACKGROUND Acute generalized exanthematous pustulosis (AGEP) is a rare exanthem characterized by the abrupt onset of numerous small, non-follicular, sterile pustules arising on an erythematous base. AGEP is often associated with medications; however, it has also been connected to various viral infections including cytomegalovirus, parvovirus B19, and Epstein-Barr virus. Coronavirus disease 2019 (COVID-19) has been associated with a variety of skin findings, including erythematous or patchy rash, urticaria, hives, blisters, petechiae, livedo reticularis, and even AGEP in a patient undergoing treatment with hydroxychloroquine...
October 24, 2020: American Journal of Case Reports
Patrick M Boyle, Juan Carlos Del Álamo, Nazem Akoum
The current paradigm of stroke risk assessment and mitigation in patients with atrial fibrillation (AF) is centred around clinical risk factors which, in the presence of AF, lead to thrombus formation. The mechanisms by which these clinical risk factors lead to thromboembolism, including any role played by atrial fibrosis, are not understood. In patients who had embolic stroke of undetermined source (ESUS), the problem is compounded by the absence of AF in a majority of patients despite long-term monitoring...
October 23, 2020: Heart
Kolja Sievert, Jiangtao Yu, Stefan Bertog, Marius Hornung, Ralph Stephan von Bardeleben, Sameer Gafoor, Markus Reinartz, Predrag Matic, Ilona Hofmann, Iris Grunwald, Nalan Schnelle, Horst Sievert
BACKGROUND: A patent foramen ovale (PFO) has been associated with embolic strokes and transient ischemic attacks (TIAs). Catheter closure of PFO is effective in preventing recurrent events. Residual shunts and procedure or device related complications can occur, including atrial fibrillation and thrombus formation. This study examines the initial experience with a new PFO closure device, the IrisFIT PFO-Occluder (Lifetech Scientific, Shenzhen, China). METHODS: 95 patients with indications for PFO closure underwent percutaneous closure with the IrisFIT PFO-Occluder...
September 24, 2020: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Wengen Zhu, Weihao Liang, Zi Ye, Yuzhong Wu, Xin He, Ruicong Xue, Zexuan Wu, Yuanyuan Zhou, Jingjing Zhao, Yugang Dong, Chen Liu
BACKGROUND AND AIMS: Physical activity (PA) could modify the risk of atrial fibrillation (AF) in the general population and mortality in heart failure patients with preserved ejection fraction (HFpEF). HFpEF patients are frequently concomitant with AF, but whether PA could modify the risk of AF in HFpEF patients remains undiscovered. METHOD AND RESULTS: We performed a post hoc analysis of the TOPCAT trial. Patients without AF at baseline and with data on PA (n = 652) were included...
August 23, 2020: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Nathan R Hill, Chris Arden, Lee Beresford-Hulme, A John Camm, David Clifton, D Wyn Davies, Usman Farooqui, Jason Gordon, Lara Groves, Michael Hurst, Sarah Lawton, Steven Lister, Christian Mallen, Anne-Celine Martin, Phil McEwan, Kevin G Pollock, Jennifer Rogers, Belinda Sandler, Daniel M Sugrue, Alexander T Cohen
Atrial fibrillation (AF) is associated with an increased risk of stroke, enhanced stroke severity, and other comorbidities. However, AF is often asymptomatic, and frequently remains undiagnosed until complications occur. Current screening approaches for AF lack either cost-effectiveness or diagnostic sensitivity; thus, there is interest in tools that could be used for population screening. An AF risk prediction algorithm, developed using machine learning from a UK dataset of 2,994,837 patients, was found to be more effective than existing models at identifying patients at risk of AF...
October 19, 2020: Contemporary Clinical Trials
You-Jung Choi, Jang Jay Sohn, Soonil Kwon, So-Ryoung Lee, Myung-Jin Cha, Eue-Keun Choi, Hee Chan Kim, Seil Oh
INTRODUCTION: Frequency domain analysis is a methodology for quantifying the organization of atrial fibrillation (AF) pattern to understand the pathophysiology of the electrical mechanism. We aimed to investigate whether the dominant frequency (DF) and organization index (OI) can indicate left atrium (LA) dilatation in patients with AF. METHODS AND RESULTS: This observational, retrospective, single-center cohort study assessed 100 patients with persistent AF. The study population was divided into two groups based on an anterior-posterior left atrial dimension (LAD of 50 mm) measured by transthoracic echocardiography...
October 22, 2020: Journal of Cardiovascular Electrophysiology
Alessandra Serrao, Emilia Scalzulli, Luciano Fiori, Alessio Di Prima, Massimo Breccia, Antonio Chistolini
BACKGROUND AND OBJECTIVE: In the last decades, the chronic myeloid leukemia (CML) therapeutic landscape has changed dramatically with the introduction of tyrosine kinase inhibitors (TKIs), with 10-year survival rates improving to up to 80%. Long-lasting TKI treatment, in particular with second-generation TKIs, has enabled clinicians to manage the onset of several side effects and other co-morbidities, such as atrial fibrillation or venous thromboembolism (VTE). METHODS: We retrospectively evaluated nine CML patients treated with TKIs between 2017 and 2020 who experienced atrial fibrillation or VTE and received concomitant administration of TKIs and direct oral anticoagulants (DOACs) outside clinical trials, to evaluate the efficacy and safety of this combination...
October 22, 2020: Clinical Drug Investigation
Anett Behon, Walter Richard Schwertner, Eperke Dóra Merkel, Attila Kovács, Bálint Károly Lakatos, Endre Zima, László Gellér, Valentina Kutyifa, Annamária Kosztin, Béla Merkely
AIMS: Preferring side branch of coronary sinus during cardiac resynchronization therapy (CRT) implantation has been empirical due to the limited data on the association of left ventricular (LV) lead position and long-term clinical outcome. We evaluated the long-term all-cause mortality by LV lead non-apical positions and further characterized them by interlead electrical delay (IED). METHODS AND RESULTS: In our retrospective database, 2087 patients who underwent CRT implantation were registered between 2000 and 2018...
October 22, 2020: ESC Heart Failure
Thomas J Buist, Douglas P Zipes, Arif Elvan
Catheter ablation is an established treatment option for atrial fibrillation (AF), and pulmonary vein isolation (PVI) has become the gold standard in AF ablation. AF recurrence after PVI remains an important clinical problem. Recovery of conduction from the pulmonary veins (PVs) is considered the dominant mechanism for AF recurrence in paroxysmal AF. However, the underlying mechanism of AF recurrence after PVI is more complex in patients with persistent and longstanding persistent AF. Different ablation technologies and energy sources have been developed aimed at improving lesion quality and durability with an acceptable safety profile...
October 22, 2020: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ivan Cakulev, Jayakumar Sahadevan, Mohammed Najeeb Osman
Background: Experience has been emerging about cardiac manifestations of COVID-19-positive patients. The full cardiac spectrum is still unknown, and management of these patients is challenging. Case summary: We report a COVID-19 patient who developed unusually long asystolic pauses associated with atriventricular block (AV) block and atrial fibrillation who underwent leadless pacemaker implantation. Discussion: Asystole may be a manifestation of COVID-19 infection...
October 2020: European Heart Journal. Case Reports
Sebastian Schnaubelt, Marie-Kathrin Breyer, Jolanta Siller-Matula, Hans Domanovits
Background: Fulminant cardiac involvement in COVID-19 patients has been reported; the underlying suspected mechanisms include myocarditis, arrhythmia, and cardiac tamponade. In parallel, atrial fibrillation is common in the elderly population which is at particularly high risk for COVID-19 morbidity and mortality. Case summary: A 72-year-old male SARS-CoV2-positive patient was admitted to the intensive care unit due to delirium and acute respiratory failure. Atrial fibrillation known from history was exacerbated, and made complex rate and rhythm control necessary...
October 2020: European Heart Journal. Case Reports
Man Hung, Eric S Hon, Evelyn Lauren, Julie Xu, Gary Judd, Weicong Su
Background: Atrial fibrillation (AF) in the elderly population is projected to increase over the next several decades. Catheter ablation shows promise as a treatment option and is becoming increasingly available. We examined 90-day hospital readmission for AF patients undergoing catheter ablation and utilized machine learning methods to explore the risk factors associated with these readmission trends. Methods: Data from the 2013 Nationwide Readmissions Database on AF cases were used to predict 90-day readmissions for AF with catheter ablation...
January 2020: Health Services Research and Managerial Epidemiology
Rehan Karmali, Kyle Stawitzky, Isrin Srisethnil, Kaitlyn Simpson
Nitrofurantoin is a common treatment for urinary tract infections. Acute lung injury resulting from nitrofurantoin is a rare, life-threatening complication with women being at greater risk. Symptoms include respiratory distress with fevers, rash, eosinophilia, and new-onset atrial fibrillation. Treatment includes discontinuing the drug and possibly glucocorticoids for persistent oxygen demand.
October 2020: Clinical Case Reports
Simone Zanchi, Lorenzo Bianchini, Stefano Bordignon, Fabrizio Bologna, Shota Tohoku, Shaojie Chen, Julian K R Chun, Boris Schmidt
Maze-like linear substrate modification in atrial fibrillation patients nonresponders to pulmonary vein isolation represents a feasible technique to gain left atrial appendage electrical isolation even in the presence of a Watchman occluder device.
October 2020: Clinical Case Reports
Elaine M Hylek
Older adults with atrial fibrillation are at the highest risk of ischaemic stroke yet are the least likely to be prescribed anticoagulant therapy, adhere to this therapy, and maintain long-term persistence with this therapy. The reasons for this under treatment are multifactorial and include patient-driven factors, physician-driven factors, medical system complexities, and current unknowns regarding the biology and natural history of AF. Understanding these challenges to stroke prevention and addressing identified barriers to medication adherence and persistence in this vulnerable age group will improve outcomes related to AF...
September 2020: European Heart Journal Supplements: Journal of the European Society of Cardiology
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