Tagayasu Anzai, Andrew Grandinetti, Alan R Katz, Eric L Hurwitz, Yan Yan Wu, Kamal Masaki
INTRODUCTION: Several studies have indicated high cholesterol is paradoxically associated with low prevalence of atrial fibrillation/flutter (AF). However, the etiology is uncertain. One potential explanation might be the confounding effect of age exemplifying prevalence-incidence (Neyman's) bias. However, this bias has not often been discussed in depth in the literature. Therefore, we conducted a cross-sectional analysis to test the hypothesis that there is a paradoxical association between lipid profile and AF prevalence...
December 23, 2020: Journal of Electrocardiology
Giovambattista Caruso, Chiara Toscano, Giuseppe Evola, Salvatore Antonio Maria Benfatto, Martina Reina, Giuseppe Angelo Reina
INTRODUCTION AND IMPORTANCE: Amyand hernia is a rare disease seen in approximatively 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0.1%. Its diagnosis is very difficult in the preoperative period: it is usually an incidental finding. CASE PRESENTATION: We report an unusual case of perforated gangrenous appendicitis with peri-appendicular abscess occurring in an irreducible Amyand's hernia. An 80-year-old male, with chronic obstructive disease and pulmonary emphysema, atrial fibrillation, acute myocardial infarction, underwent urgent surgery, under local anesthesia, for right incarcerated inguinoscrotal hernia...
January 16, 2021: International Journal of Surgery Case Reports
Adi Lador, Leif E Peterson, Vijay Swarup, Paul A Schurmann, Akash Makkar, Rahul N Doshi, David DeLurgio, Charles A Athill, Kenneth A Ellenbogen, Andrea Natale, Jayanthi Koneru, Amish S Dave, Irakli Giorgberidze, Hamid Afshar, Michelle L Guthrie, Raquel Bunge, Carlos A Morillo, Neal S Kleiman, Miguel Valderrábano
BACKGROUND: The VENUS trial demonstrated that adding vein of Marshall (VOM) ethanol infusion to catheter ablation (CA) improves ablation outcomes in persistent atrial fibrillation (AF). There was significant heterogeneity in the impact of VOM ethanol infusion on rhythm control. OBJECTIVE: To assess the association between outcomes and: 1) achievement of bidirectional perimitral conduction block, and 2) procedural volume. METHODS: VENUS randomized patients (n=343) with persistent AF to CA combined with VOM ethanol, or CA alone...
January 19, 2021: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Soonil Kwon, Tae Jung Kim, Eue-Keun Choi, Hyo-Jeong Ahn, Euijae Lee, So-Ryoung Lee, Sang-Bae Ko, Seil Oh, Gregory Y H Lip
BACKGROUND: The predictors of ischemic stroke in 'low-risk' patients with atrial fibrillation (AF) (CHA2 DS2 -VASc score 0 in men or 1 in women) are debated. OBJECTIVE: This study aimed to investigate the factors associated with ischemic stroke in 'low-risk' AF patients. Imaging characteristics of their ischemic strokes were also evaluated. METHODS: This was a matched case-control study conducted at a single tertiary institution. We identified 44 patients with de novo ischemic stroke, and incidentally found AF with low-risk CHA2 DS2 -VASc scores...
January 19, 2021: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Marco Proietti, Marco Vitolo, Gregory Y H Lip
BACKGROUND: Integrated care for management of atrial fibrillation (AF) patients has been associated with a reduction in adverse events. The 'Atrial fibrillation Better Care (ABC) pathway' has been proposed to streamline such integrated management. In this paper we analysed the impact of ABC pathway adherent clinical management on outcomes in AF patients with high-risk 'metabolic' comorbidities (i.e. diabetes mellitus [DM], chronic kidney disease [CKD], metabolic syndrome [MetS]. METHODS: Patients from the SPORTIF III and V trials and with available data to evaluate ABC criteria were analysed...
January 9, 2021: European Journal of Clinical Investigation
Burcu Candemir, Cem Haymana, Mustafa Candemir
No abstract text is available yet for this article.
January 22, 2021: Journal of Clinical Endocrinology and Metabolism
James Kelly
Cerebral amyloid angiopathy (CAA) most commonly presents with lobar intracerebral haemorrhage, though also with transient focal neurological episodes, cognitive impairment, as an incidental finding and rarely acutely or subacutely in patients developing an immune response to amyloid. Convexity subarachnoid haemorrhage, cortical superficial siderosis and lobar cerebral microbleeds are the other signature imaging features. The main implications of a diagnosis are the risk of intracerebral haemorrhage and frequent co-existence of antithrombotic indications...
January 22, 2021: Age and Ageing
Polly W C Li, Doris S F Yu, Bryan P Yan
BACKGROUND: The Atrial Fibrillation Effect on Quality-of-Life Questionnaire (AFEQT) is a psychometrically sound instrument for measuring disease-specific health-related quality of life in atrial fibrillation populations. OBJECTIVE: In this study we aimed to validate the Chinese version of AFEQT (AFEQT-C) among Chinese patients with atrial fibrillation. METHODS: The AFEQT was translated into Chinese according to Brislin's model. The psychometric properties of internal consistency, stability, and concurrent and factorial validity were examined in a convenience sample...
January 19, 2021: Journal of Cardiovascular Nursing
Roopinder K Sandhu, Sunjidatul Islam, Douglas Dover, Jason G Andrade, Justin Ezekowitz, Finlay A McAlister, Nathaniel M Hawkins, Padma Kaul
AIM: To determine the concurrent use of P-glycoprotein (P-gp) or Cytochrome (CYP) 3A4 drugs and non-vitamin K antagonist oral anticoagulants (NOACs) among non-valvular AF (NVAF) patients in clinical practice. METHODS AND RESULTS: Administrative databases identified all adults (≥ 18 years) with incident or prevalent NVAF who initiated a NOAC in an outpatient or inpatient setting, between July 2012-March 2019 in Alberta, Canada. Concurrent use was defined as a P-gp or CYP3A4 dispensation in the 100 days prior to and overlapping NOAC dispensation...
January 22, 2021: European Heart Journal. Quality of Care & Clinical Outcomes
Abdullah Saleh AlQattan, Weaam Zohier Ghulam, Najla Aldaoud, Lama Algheryafi, Nadia Aleisa, Fozan A Aldulaijan
Breast fat necrosis (BFN) is usually a benign inflammatory response to breast trauma. However, an extremely rare cause of fat necrosis is calciphylaxis, a calcification of small- and medium-sized arteries causing thrombosis and ischemia. It is classified into (A) uremic (B) nonuremic-induced calciphylaxis. Calciphylaxis has been reported to be encountered in different parts of the body. However, to the best of our knowledge there is only one case in the English literature of BFN 2ry to warfarin-induced calciphylaxis...
January 21, 2021: Breast Journal
Manel Ben Halima, Kais Sammoud, Jihene Ben Amar, Selim Boudiche, Bassem Rekik, Fethia Mghaieth, Sana Ouali, Mohamed Sami Mourali
BACKGROUND: Obstructive Sleep Apnea Syndrome (OSAS) is a common but often under diagnosed condition that constitutes a real public health problem. The prevalence of OSAS in atrial fibrillation (AF) patients ranges from 32 to 85% according to recent studies. AIM: To determine the prevalence and severity of OSAS in a population followed for non-valvular AF (NVAF), and to identify OSAS's predictive factors in this population. METHODS: A cross-sectional study was conducted, including successive patients followed for NVAF...
December 2020: La Tunisie Médicale
Taku Inohara, Thomas Gilhofer, Christina Luong, Michael Tsang, Jacqueline Saw
BACKGROUND: Despite maturing experience, transseptal puncture (TSP) remains a challenging part of percutaneous left atrial appendage closure (LAAC) and has inherent risks and safety concerns in accessing the left atrium (LA). The VersaCross radiofrequency (RF) system (Baylis Medical), a new RF-tipped pigtail wire-based TSP system, may facilitate LA access by serving as an exchange support wire once access is achieved. METHODS: We retrospectively compared TSP safety and procedural efficiency in 10 consecutive LAAC cases using the VersaCross RF system to 10 cases using the conventional BRK1-XS mechanical needle (Abbott Vascular)...
January 22, 2021: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Tom Hartley, Nicholas D Lane, John Steer, Mark W Elliott, Milind P Sovani, Helen Jane Curtis, Elizabeth R Fuller, Patrick B Murphy, Dinesh Shrikrishna, Keir E Lewis, Neil R Ward, Chris D Turnbull, Nicholas Hart, Stephen C Bourke
INTRODUCTION: Acute exacerbations of COPD (AECOPD) complicated by acute (acidaemic) hypercapnic respiratory failure (AHRF) requiring ventilation are common. When applied appropriately, ventilation substantially reduces mortality. Despite this, there is evidence of poor practice and prognostic pessimism. A clinical prediction tool could improve decision making regarding ventilation, but none is routinely used. METHODS: Consecutive patients admitted with AECOPD and AHRF treated with assisted ventilation (principally non-invasive ventilation) were identified in two hospitals serving differing populations...
January 21, 2021: European Respiratory Journal
Ashutosh P Jadhav, Shashvat M Desai, Ronald F Budzik, Rishi Gupta, Blaise Baxter, Joey D English, Bruno Mario Bartolini, Antonin Krajina, Diogo C Haussen, Raul G Nogueira, David Liebeskind, Erol Veznedaroglu
BACKGROUND: First pass effect (FPE), defined as near-total/total reperfusion of the territory (modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3) of the occluded artery after a single thrombectomy attempt (single pass), has been associated with superior safety and efficacy outcomes than in patients not experiencing FPE. OBJECTIVE: To characterize the clinical features, incidence, and predictors of FPE in the anterior and posterior circulation among patients enrolled in the Trevo Registry...
January 21, 2021: Journal of Neurointerventional Surgery
Mohit K Turagam, William Whang, Marc A Miller, Petr Neuzil, Arash Aryana, Alexander Romanov, Frank A Cuoco, Moussa Mansour, Dhanunjaya Lakkireddy, Gregory F Michaud, Srinivas R Dukkipati, Sam Cammack, Vivek Y Reddy
OBJECTIVES: This study sought to determine the impact of adjunctive renal sympathetic denervation to catheter ablation in patients with atrial fibrillation (AF) and history of hypertension. BACKGROUND: There are limited data regarding the impact of upstream adjunctive renal sympathetic denervation (RSDN) to pulmonary vein isolation (PVI) in patients with symptomatic atrial fibrillation (AF) and hypertension. METHODS: The data for this study were obtained from 2 prospective randomized pilot studies, the HFIB (Adjunctive Renal Denervation to Modify Hypertension and Sympathetic tone as Upstream Therapy in the Treatment of Atrial Fibrillation)-1 (n = 30) and HFIB (Adjunctive Renal Denervation to Modify Hypertension and Sympathetic tone as Upstream Therapy in the Treatment of Atrial Fibrillation)-2 (n = 50) studies, and we performed a meta-analysis including all published studies comparing RSDN+PVI versus PVI alone up to January 25, 2020, in patients with AF and hypertension...
January 2021: JACC. Clinical Electrophysiology
Erind Gjermeni, Michael Doering, Sergio Richter, Gerhard Hindricks, Kerstin Bode
Cardiovascular implantable electronic devices can initiate and sustain pacemaker-mediated arrhythmias. Endless loop tachycardia and repetitive non-re-entrant ventriculoatrial synchrony (RNRVAS) are well-described examples of pacemaker-mediated arrhythmias. However, such arrhythmias only occur in the presence of ventriculoatrial conduction. We identified a novel pacemaker-mediated arrhythmia that closely mimics RNRVAS but in the absence of ventriculoatrial conduction. We identified these arrhythmias in 9 patients, all with a St...
January 2021: JACC. Clinical Electrophysiology
Mohamed B Elshazly, Bruce L Wilkoff, Khaldoun Tarakji, Yuping Wu, Eoin Donnellan, Charbel Abi Khalil, Nidal Asaad, Wael Jaber, Oussama Wazni, Leslie Cho
BACKGROUND: In heart failure (HF) with sinus rhythm, resting and exercise heart rates correlate with exercise capacity and mortality. However, in HF with atrial fibrillation (AF), this correlation is unknown. Our aim is to investigate the association of resting and exercise ventricular rates (VRs) with exercise capacity and mortality in HF with AF. METHODS: We identified 903 patients with HF and AF referred for cardiopulmonary stress testing. AF was defined as history of AF and AF during cardiopulmonary stress testing...
January 22, 2021: Circulation. Heart Failure
Ningrong Lei, Murtadha Kareem, Seung Ki Moon, Edward J Ciaccio, U Rajendra Acharya, Oliver Faust
In this paper, we discuss hybrid decision support to monitor atrial fibrillation for stroke prevention. Hybrid decision support takes the form of human experts and machine algorithms working cooperatively on a diagnosis. The link to stroke prevention comes from the fact that patients with Atrial Fibrillation (AF) have a fivefold increased stroke risk. Early diagnosis, which leads to adequate AF treatment, can decrease the stroke risk by 66% and thereby prevent stroke. The monitoring service is based on Heart Rate (HR) measurements...
January 19, 2021: International Journal of Environmental Research and Public Health
Kaito Abe, Fumiya Hasegawa, Ryota Nakajima, Hidetoshi Fukui, Moto Shimada, Takahiro Miyazaki, Hiroshi Doi, Goro Endo, Kaori Kanbara, Yasuyuki Mochida, Jun Okuda, Nobuya Maeda, Akira Isoshima, Koichi Tamura, Tomoaki Ishigami
The comparative severity of patent foramen ovale (PFO)-related stroke in patients without atrial fibrillation (AF) and AF-related stroke in patients without PFO is unknown. Therefore, we compared the severity of PFO-related stroke and AF-related stroke. Twenty-six patients who underwent transesophageal echocardiography (TEE) were diagnosed with cardioembolic stroke from July 2018 to March 2020. Cases with AF detected by electrocardiograms or thrombus in the left atrium or left atrial appendage on TEE were included in the AF-related stroke group...
January 18, 2021: Journal of Clinical Medicine
Rafi Sakhi, Roy Huurman, Dominic A M J Theuns, Arend F L Schinkel, Amira Assaf, Tamas Szili-Torok, Jolien W Roos-Hesselink, Michelle Michels, Sing-Chien Yap
AIMS: The aim of the present study was to compare the rate of actionable arrhythmic events between patients with hypertrophic cardiomyopathy (HCM) who are monitored with an insertable cardiac monitor (ICM) or Holter monitoring. METHODS: We studied 50 patients (mean age 52 years, 72% men) with HCM at low or intermediate risk for sudden cardiac death (SCD), of whom 25 patients received an ICM between November 2014 and February 2019. We retrospectively identified a control group of 25 patients who were matched on age, sex, and HCM Risk-SCD score category...
January 21, 2021: Cardiology
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