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[PMID]:29304037
[Au] Autor:Brembilla-Perrot B; Sellal JM; Olivier A; Villemin T; Beurrier D; Vincent J; Manenti V; de Chillou C; Bozec E; Girerd N
[Ad] Endereço:Department of Cardiology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France.
[Ti] Título:Influence of advancing age on clinical presentation, treatment efficacy and safety, and long-term outcome of inducible paroxysmal supraventricular tachycardia without pre-excitation syndromes: A cohort study of 1960 patients included over 25 years.
[So] Source:PLoS One;13(1):e0187895, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate the influence of increasing age on clinical presentation, treatment and long-term outcome in patients with inducible paroxysmal supraventricular tachycardia (SVT) without pre-excitation syndromes. METHODS: Clinical and electrophysiological study (EPS) data, as well as long-term clinical outcome (mean follow-up 2.4±4.0 years) were collected in patients referred for regular tachycardia with inducible SVT during EPS without pre-excitation. RESULTS: Among 1960 referred patients, 301 patients (15.4%) were aged ≥70 (70-97). In this subset, anticoagulants were prescribed in 49 patients following an erroneous diagnosis of atrial tachycardia and 14 were previously erroneously diagnosed with ventricular tachycardia because of wide QRS. Ablation was performed more frequently in patients ≥70 despite more frequent failure and complications. During follow-up, higher risks of AF, stroke, pacemaker implantation and death were observed in patients ≥70 whereas SVT recurrences were similar in both age groups. In multivariable analysis, age ≥70 was independently associated with higher risks of SVT-related adverse events prior to ablation (OR = 1.93, 1.41-2.62, p<0.001), conduction disturbances (OR = 11.27, 5.89-21.50, p<0.001), history of AF (OR = 2.18, 1.22-3.90, p = 0.009) and erroneous diagnosis at baseline (OR = 9.14, 5.93-14.09, p<0.001) as well as high rates of procedural complications (OR = 2.13, 1.19-3.81, p = 0.01) and ablation failure (OR = 1.68, 1.08-2.62, p = 0.02). In contrast, age ≥70 was not significantly associated with a higher risk of AF in multivariable analysis. CONCLUSIONS: A sizeable proportion of patients with inducible SVT without pre-excitation syndromes are elderly. These patients exhibit higher risks of erroneous tachycardia diagnosis prior to EPS as well as failure and/or complication of ablation, but similar risk of SVT recurrence. These results support performing transesophageal EPS in most patients and intracardiac EPS in selected patients. EPS may furthermore prove useful in elderly patients with regular tachycardia, mainly by avoiding treatment based on an erroneous diagnosis.
[Mh] Termos MeSH primário: Taquicardia Paroxística/diagnóstico
Taquicardia Supraventricular/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Ablação por Cateter/efeitos adversos
Estudos de Coortes
Técnicas Eletrofisiológicas Cardíacas
Feminino
Seres Humanos
Masculino
Meia-Idade
Síndromes de Pré-Excitação/diagnóstico
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Taquicardia Paroxística/terapia
Taquicardia Supraventricular/terapia
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187895


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[PMID]:29223435
[Au] Autor:Eckman MH; Costea A; Attari M; Munjal J; Wise RE; Knochelmann C; Flaherty ML; Baker P; Ireton R; Harnett BM; Leonard AC; Steen D; Rose A; Kues J
[Ad] Endereço:Division of General Internal Medicine and Center for Clinical Effectiveness, University of Cincinnati, Cincinnati, OH; Center for Health Informatics, University of Cincinnati, Cincinnati, OH. Electronic address: mark.eckman@uc.edu.
[Ti] Título:Atrial fibrillation decision support tool: Population perspective.
[So] Source:Am Heart J;194:49-60, 2017 Dec.
[Is] ISSN:1097-6744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients. METHODS: This is a retrospective cohort study of patients with paroxysmal or persistent nonvalvular AF. We updated an Atrial Fibrillation Decision Support Tool (AFDST) to include DOACs as treatment options. The tool generates patient-specific recommendations based upon individual patient risk factor profiles for stroke and major bleeding using quality-adjusted life-years (QALYs) calculated for each treatment strategy by a decision analytic model. The setting included inpatient and ambulatory sites in an academic health center in the midwestern United States. The study involved 5,121 adults with nonvalvular AF seen for any ambulatory visit or inpatient hospitalization over the 1-year period (January through December 2016). Outcome measure was net clinical benefit in QALYs. RESULTS: When DOACs are a therapeutic option, the AFDST recommends OAT for 4,134 (81%) patients and no antithrombotic therapy or aspirin for 489 (9%). A strong recommendation for OAT could not be made in 498 (10%) patients. When warfarin is the only option, OAT is recommended for 3,228 (63%) patients and no antithrombotic therapy or aspirin for 973 (19%). A strong recommendation for OAT could not be made in 920 (18%) patients. In total, 1,508 QALYs could be gained if treatment were changed to that recommended by the AFDST. CONCLUSIONS: Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1,500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
[Mh] Termos MeSH primário: Anticoagulantes/administração & dosagem
Fibrilação Atrial/tratamento farmacológico
Técnicas de Apoio para a Decisão
Hemorragia/epidemiologia
Vigilância da População
Taquicardia Paroxística/tratamento farmacológico
Tromboembolia/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Idoso
Idoso de 80 Anos ou mais
Fibrilação Atrial/complicações
Fibrilação Atrial/mortalidade
Feminino
Seguimentos
Hemorragia/induzido quimicamente
Seres Humanos
Incidência
Masculino
Meia-Idade
Ohio/epidemiologia
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Taquicardia Paroxística/complicações
Taquicardia Paroxística/mortalidade
Tromboembolia/epidemiologia
Tromboembolia/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


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[PMID]:28572399
[Au] Autor:Isaew A; Adderley NJ; Ryan R; Fitzmaurice D; Marshall T
[Ad] Endereço:Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
[Ti] Título:The treatment of paroxysmal atrial fibrillation in UK primary care.
[So] Source:Heart;103(19):1502-1507, 2017 Oct.
[Is] ISSN:1468-201X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine whether patients with paroxysmal atrial fibrillation (AF) are less likely to be treated with anticoagulants than patients with persistent/permanent AF and to investigate trends in treatment between 2000 and 2015. UK and European guidelines recommend that anticoagulants are offered to all patients with AF at increased risk of stroke, irrespective of AF type. METHODS: Sixteen sequential cross-sectional analyses from 2000 to 2015 were carried out with index dates on 1st of May each year. The data source was primary care data from 648 practices across the UK contributing to The Health Improvement Network database. All patients with a diagnosis of AF aged ≥35 years and registered for at least 1 year were included. The main outcome measure was prescription of anticoagulant medication. RESULTS: The proportion of patients with AF with a diagnosis of paroxysmal AF increased from 7.4% (95% CI 7.0 to 7.8) in 2000 to 14.0% (95% CI 13.7 to 14.3) in 2015. Among patients with a CHADS score of ≥1, between 2000 and 2015 the proportion prescribed anticoagulants increased from 18.8% (95% CI 16.4 to 21.4) to 56.2% (95% CI 55.0 to 57.3) and from 34.2% (95% CI 33.3 to 35.0) to 69.4% (95% CI 68.9 to 69.8) in patients with paroxysmal and other (persistent/permanent) AF, respectively; RR for treatment of patients with paroxysmal AF compared with patients with other AF increased from 0.48 (95% CI 0.42 to 0.55) to 0.76 (95% CI 0.74 to 0.77). Adjusting for age, sex, Townsend score and presence or absence of contraindications had little effect on the results. CONCLUSIONS: In 2000, eligible patients with paroxysmal AF were half as likely to be treated with anticoagulants as patients with other AF; this has improved over time, but in 2015, eligible patients with paroxysmal AF were still around 20% less likely to be prescribed anticoagulant medication.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Fibrilação Atrial/terapia
Gerenciamento Clínico
Atenção Primária à Saúde/métodos
Medição de Risco/métodos
Acidente Vascular Cerebral/prevenção & controle
Taquicardia Paroxística/terapia
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/complicações
Estudos Transversais
Feminino
Seguimentos
Seres Humanos
Incidência
Masculino
Estudos Retrospectivos
Acidente Vascular Cerebral/epidemiologia
Acidente Vascular Cerebral/etiologia
Taxa de Sobrevida/tendências
Taquicardia Paroxística/complicações
Reino Unido/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1136/heartjnl-2016-310927


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[PMID]:28552271
[Au] Autor:Çorbacioglu SK; Akinci E; Çevik Y; Aytar H; Öncül MV; Akkan S; Uzunosmanoglu H
[Ad] Endereço:Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. Electronic address: keremserefcorbacioglu@gmail.com.
[Ti] Título:Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial.
[So] Source:Am J Emerg Med;35(11):1662-1665, 2017 Nov.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). METHODOLOGY: This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients. In both groups; the determined procedure for standard or modified VM was repeated up to three times in patients whose PSVT did not convert to sinus rhythm. In both groups; if the maneuver was unsuccessful after three attempts, anti-arrhythmic medication was administered. The primary outcome was defined to compare the success rate of achieving sinus rhythm after standard VM or modified VM. RESULTS: Fifty-six patients were randomized to modified or standard VM with 28 patients in each treatment arm. Three of 28 patients (10.7%) in VM group and 12 of 28 patients (42.9%) in modified VM group were returned to sinus rhythm after intervention (p=0.007). The number of patients who needed rescue treatment was lower in the modified VM group - 16 (57.1%) of 28 versus 25 (89.3%) of 28 in the standard VM group (p=0.007). CONCLUSION: This study suggests that modified VM therapy was more effective than standard VM for terminating PSVT. The modified VM therapy also indirectly reduced the need for anti-arrhythmic medication and indirectly caused fewer side effects.
[Mh] Termos MeSH primário: Taquicardia Paroxística/terapia
Taquicardia Supraventricular/terapia
Manobra de Valsalva
[Mh] Termos MeSH secundário: Adulto
Antiarrítmicos/uso terapêutico
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Arrhythmia Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170530
[St] Status:MEDLINE


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[PMID]:27256429
[Au] Autor:Izumi G; Yokoshiki H; Takeda A
[Ad] Endereço:Department of Pediatrics, Hokkaido University Graduate School of Medicine, North-15 West-7, Sapporo 060-8638, Japan gaku-izumi0920@med.hokudai.ac.jp.
[Ti] Título:Atypical lower loop reentrant tachycardia associated with multiple hepatic veins.
[So] Source:Europace;19(1):65, 2017 Jan.
[Is] ISSN:1532-2092
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Transposição das grandes artérias
Veias Hepáticas/anormalidades
Taquicardia Paroxística/etiologia
Taquicardia Supraventricular/etiologia
Tetralogia de Fallot/cirurgia
[Mh] Termos MeSH secundário: Potenciais de Ação
Adulto
Ablação por Cateter
Técnicas Eletrofisiológicas Cardíacas
Feminino
Frequência Cardíaca
Veias Hepáticas/fisiopatologia
Veias Hepáticas/cirurgia
Seres Humanos
Taquicardia Paroxística/diagnóstico
Taquicardia Paroxística/fisiopatologia
Taquicardia Paroxística/cirurgia
Taquicardia Supraventricular/diagnóstico
Taquicardia Supraventricular/fisiopatologia
Taquicardia Supraventricular/cirurgia
Tetralogia de Fallot/diagnóstico
Veia Cava Inferior/anormalidades
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1093/europace/euw138


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[PMID]:27021469
[Au] Autor:Wegner FK; Silvano M; Bögeholz N; Leitz PR; Frommeyer G; Dechering DG; Zellerhoff S; Kochhäuser S; Lange PS; Köbe J; Wasmer K; Mönnig G; Eckardt L; Pott C
[Ad] Endereço:Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
[Ti] Título:Slow pathway modification in patients presenting with only two consecutive AV nodal echo beats.
[So] Source:J Cardiol;69(2):471-475, 2017 02.
[Is] ISSN:1876-4738
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown. METHODS: Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs. RESULTS: pSVT documentation by electrocardiography (ECG) was present in 20 patients. The procedural endpoint was inducibility of less than two AVNEBs. This was reached in 31 (97%) patients. Long-term success was assessed by a telephone questionnaire (follow-up time 63±9 months). A total 94% of the patients benefited from the procedure (59% freedom from symptoms; 34% improvement in symptoms). Among those patients in whom ECG documentation was not present, 100% benefited (58% freedom from symptoms, 42% improvement). CONCLUSION: This is the first collective analysis of a group of patients presenting with symptoms of pSVT and inducibility of only two AVNEBs. Procedural success and clinical long-term follow-up were in the range of the reported success rates of slow pathway modification of inducible AVNRT, independent of whether ECG documentation was present. Thus, SPM is a safe and effective therapy in patients with two AVNEBs.
[Mh] Termos MeSH primário: Ablação por Cateter
Taquicardia por Reentrada no Nó Atrioventricular/cirurgia
Taquicardia Paroxística/cirurgia
Taquicardia Supraventricular/cirurgia
[Mh] Termos MeSH secundário: Eletrocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Avaliação de Resultados da Assistência ao Paciente
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160330
[St] Status:MEDLINE


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[PMID]:27809773
[Au] Autor:Baturova MA; Sheldon SH; Carlson J; Brady PA; Lin G; Rabinstein AA; Friedman PA; Platonov PG
[Ad] Endereço:Department of Cardiology, Clinical Science, Lund University, Lund, SE-221 85, Sweden. Maria.Baturova@med.lu.se.
[Ti] Título:Electrocardiographic and Echocardiographic predictors of paroxysmal atrial fibrillation detected after ischemic stroke.
[So] Source:BMC Cardiovasc Disord;16(1):209, 2016 Nov 03.
[Is] ISSN:1471-2261
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Detection of atrial fibrillation after ischemic stroke is challenging due to its paroxysmal nature. We aimed to assess predictors of paroxysmal atrial fibrillation using non-invasive surface ECG and transthoracic echocardiography to select candidates for atrial fibrillation screening. METHODS: Ischemic stroke patients without documented atrial fibrillation (n = 110, 67 ± 10 years, 40 female) and a control group of age- and gender-matched patients with history of paroxysmal atrial fibrillation prior to stroke (n = 55, 67 ± 10 years, 19 female) comprised the study sample. Using non-invasive ECG monitoring for three weeks, short episodes of paroxysmal atrial fibrillation were detected in 24 of 110 patients (22 %). The standard 12-lead ECG with sinus rhythm at stroke onset was digitally processed and analyzed. Transthoracic echocardiography data were reviewed for these patients. RESULTS: Atrial fibrillation history was independently associated with P terminal force in lead V 1 > 40 mm*ms (OR 4.04 95 % CI 1.34-12.14, p = 0.013) and left atrial volume index (OR 1.08 95 % CI 1.03-1.13, p = 0.002; for LAVI > 40 mL/m OR 6.40 95 % CL 1.47-27.91, p = 0.013). Among patients without atrial fibrillation history, no ECG characteristics were predictive of atrial fibrillation detected after stroke. Left atrial volume index remained an independent predictor of atrial fibrillation detected after stroke (OR 1.09 95 % CI 1.02-1.16, p = 0.017). A cutoff of <40 mL/m had an 84 % negative predictive value for ruling out atrial fibrillation on ambulatory monitoring with a sensitivity of 50 % and a specificity of 86 %. CONCLUSION: In a post hoc analysis, left atrial dilatation assessed by left atrial volume index independently predicted atrial fibrillation after stroke in patients without prior atrial fibrillation history, while the other clinical or ECG markers were not predictive of atrial fibrillation detected early after ischemic stroke. TRIAL REGISTRATION: This study is a post hoc analysis from the prospective case-control study registered in December 2011, ClinicalTrials.gov ID: NCT01325545 .
[Mh] Termos MeSH primário: Fibrilação Atrial/diagnóstico
Isquemia Encefálica/etiologia
Ecocardiografia/métodos
Eletrocardiografia/métodos
Taquicardia Paroxística/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/complicações
Isquemia Encefálica/diagnóstico
Feminino
Seres Humanos
Masculino
Valor Preditivo dos Testes
Estudos Prospectivos
Curva ROC
Fatores de Risco
Taquicardia Paroxística/complicações
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:27716961
[Au] Autor:Uetake S; Maruyama M; Yamamoto T; Kato K; Miyauchi Y; Seino Y; Shimizu W
[Ad] Endereço:Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
[Ti] Título:Left ventricular stiffness estimated by diastolic wall strain is associated with paroxysmal atrial fibrillation in structurally normal hearts.
[So] Source:Clin Cardiol;39(12):728-732, 2016 Dec.
[Is] ISSN:1932-8737
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Left ventricular (LV) diastolic dysfunction depends on an impaired relaxation and stiffness. Abnormal LV relaxation contributes to the development of atrial fibrillation (AF), but the role of LV stiffness in AF remains unclear. HYPOTHESIS: Diastolic wall strain (DWS), a load-independent, noninvasive direct measure of LV stiffness, correlates with prevalent AF. METHODS: This study included 328 consecutive subjects with structurally normal hearts: 164 paroxysmal AF patients and 164 age- and sex-matched (1:1) controls. We calculated the DWS from the M-mode echocardiographic measurements of the LV posterior wall thickness at end-systole and end-diastole during sinus rhythm. RESULTS: The DWS was lower in the AF patients (0.35 ± 0.07) than in the controls (0.41 ± 0.06; P < 0.001). After adjusting for the risk factors of AF using a conditional logistic regression analysis, a history of hypertension, plasma brain-type natriuretic peptide level, and DWS were independently associated with AF prevalence, whereas body mass index, LV mass index, left atrial volume, and any conventional indices of the diastolic function were not. A low DWS (<0.380) was the strongest indicator of AF (odds ratio: 6.22, 95% confidence interval: 3.08-14.2, P < 0.001). CONCLUSIONS: Increased LV stiffness estimated by DWS was a strong determinant of the prevalence of AF. LV stiffness may play a role in the pathogenesis of paroxysmal AF in structurally normal hearts.
[Mh] Termos MeSH primário: Fibrilação Atrial/complicações
Ventrículos do Coração/fisiopatologia
Taquicardia Paroxística/complicações
Disfunção Ventricular Esquerda/etiologia
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/diagnóstico
Fibrilação Atrial/fisiopatologia
Diástole
Ecocardiografia
Eletrocardiografia Ambulatorial
Feminino
Seguimentos
Ventrículos do Coração/diagnóstico por imagem
Seres Humanos
Masculino
Estudos Retrospectivos
Taquicardia Paroxística/diagnóstico
Taquicardia Paroxística/fisiopatologia
Disfunção Ventricular Esquerda/diagnóstico
Disfunção Ventricular Esquerda/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161008
[St] Status:MEDLINE
[do] DOI:10.1002/clc.22595


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[PMID]:27692658
[Au] Autor:Galand V; Pavin D; Behar N; Auffret V; Fénéon D; Behaghel A; Daubert JC; Mabo P; Martins RP
[Ad] Endereço:Service de Cardiologie et Maladies Vasculaires, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Université de Rennes 1, CIC-IT 1414, 35000 Rennes, France; Inserm, U1099, 35000 Rennes, France. Electronic address: vincent.galand35@gmail.com.
[Ti] Título:Localization of gaps during redo ablations of paroxysmal atrial fibrillation: Preferential patterns depending on the choice of cryoballoon ablation or radiofrequency ablation for the initial procedure.
[So] Source:Arch Cardiovasc Dis;109(11):591-598, 2016 Nov.
[Is] ISSN:1875-2128
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pulmonary vein (PV) isolation, using cryoballoon or radiofrequency ablation, is the cornerstone therapy for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drugs. One-third of the patients have recurrences, mainly due to PV reconnections. AIMS: To describe the different locations of reconnection sites in patients who had previously undergone radiofrequency or cryoballoon ablation, and to compare the characteristics of the redo procedures in both instances. METHODS: Demographic data and characteristics of the initial ablation (cryoballoon or radiofrequency) were collected. Number and localization of reconduction gaps, and redo characteristics were reviewed. RESULTS: Seventy-four patients scheduled for a redo ablation of paroxysmal AF were included; 38 had been treated by radiofrequency ablation and 36 by cryoballoon ablation during the first procedure. For the initial ablation, procedural and fluoroscopy times were significantly shorter for cryoballoon ablation (147.8±52.6min vs. 226.6±64.3min [P<0.001] and 37.0±17.7min vs. 50.8±22.7min [P=0.005], respectively). Overall, an identical number of gaps was found during redo procedures of cryoballoon and radiofrequency ablations. However, a significantly higher number of gaps were located in the right superior PV for patients first ablated with radiofrequency (0.9±1.0 vs. 0.5±0.9; P=0.009). Gap localization displayed different patterns. Although not significant, redo procedures of cryoballoon ablation were slightly shorter and needed shorter durations of radiofrequency to achieve PV isolation. CONCLUSIONS: During redo procedures, gap localization pattern is different for patients first ablated with cryoballoon or radiofrequency ablation, and right superior PV reconnections occur more frequently after radiofrequency ablation. Redo ablation of a previous cryoballoon ablation appears to be easier.
[Mh] Termos MeSH primário: Fibrilação Atrial/cirurgia
Ablação por Cateter/métodos
Criocirurgia/métodos
Sistema de Condução Cardíaco/cirurgia
Taquicardia Paroxística/cirurgia
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/diagnóstico
Fibrilação Atrial/fisiopatologia
Ecocardiografia Transesofagiana
Eletrocardiografia
Feminino
Seguimentos
Sistema de Condução Cardíaco/diagnóstico por imagem
Sistema de Condução Cardíaco/fisiopatologia
Seres Humanos
Masculino
Veias Pulmonares/cirurgia
Estudos Retrospectivos
Taquicardia Paroxística/diagnóstico
Taquicardia Paroxística/fisiopatologia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170131
[Lr] Data última revisão:
170131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE


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[PMID]:27653899
[Au] Autor:Di Giovanni M; Battisti C; Salvatore S; Tumminelli G; Vinciguerra C; Ruocco G; Federico A
[Ad] Endereço:Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100 Siena, Italy.
[Ti] Título:Paroxysmal supraventricular tachycardia in anti-musk Myasthenia gravis: A case report.
[So] Source:J Neurol Sci;369:250-251, 2016 Oct 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Autoanticorpos/sangue
Miastenia Gravis/sangue
Miastenia Gravis/complicações
Receptores Proteína Tirosina Quinases/imunologia
Receptores Colinérgicos/imunologia
Taquicardia Paroxística/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Miastenia Gravis/imunologia
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Receptors, Cholinergic); EC 2.7.10.1 (MUSK protein, human); EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160923
[St] Status:MEDLINE



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