1/348. Minimally invasive cardiac surgery with surgical ablation of atrial fibrillation.Surgical ablation for atrial fibrillation with mitral valve operations has been often performed in patients who have chronic atrial fibrillation associated with mitral valve disease. We describe a case of the combined operation through a small incision. A 49-year-old woman presented with a 1-month history of left hemiplegia. echocardiography confirmed mitral stenosis and electrocardiogram revealed atrial fibrillation. The duration of the atrial fibrillation before admission was 12 years. Mitral commissurotomy, removal of clots, and surgical ablation for atrial fibrillation was performed through an 8-cm right parasternal incision. The right femoral artery and vein were used for cannulation. Another cannula was inserted into the superior vena cava. The extended use of cryoablation was carried out instead of atriotomy or reanastomosis. The patient was extubated for 5 hours after the operation. atrial fibrillation was converted to a sinus rhythm. On the basis of our experience, this procedure seemed promising.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
2/348. Impaired cardiac performance relating to delayed left atrial activation after atrial compartment operation for chronic atrial fibrillation.In the presence of a normal atrial systole and optimal AV delay, atrial kick contributes to a significant fraction of the stroke volume. This atrial contribution may be lost during atrial asystole or mismatch in the timing of atrial and ventricular contraction. A patient received atrial compartment operation for his chronic AF. Although the AF was successfully converted to sinus rhythm, the conduction from the right to left atrium was markedly delayed so that the left atrial and ventricular activations occurred almost simultaneously. This delay in left atrial activation resulted in impaired cardiac performance.- - - - - - - - - - ranking = 1.25keywords = cardiac (Clic here for more details about this article) |
3/348. Congestive heart failure induced by recipient atrial tachycardia conducted to the donor atrium after orthotopic heart transplantation: complete regression after successful radiofrequency ablation.We describe the case of a 30-year-old female patient who developed an interatrial tachycardia from the recipient to the donor atrium associated with signs of congestive heart failure 5 years after orthotopic heart transplantation. The patient underwent catheter mapping followed by successful radiofrequency (RF) ablation at the site of the presumed electrical connection between the recipient and the donor atria, through the interatrial surgical suture line, with stable recovery of sinus rhythm and disappearance of signs of left ventricular dysfunction. RF catheter ablation is confirmed to be feasible and safe in the treatment of heart transplant patients even in the presence of rare forms of arrhythmias, thus offering a cure for tachycardia to these patients.- - - - - - - - - - ranking = 8.1818291858028keywords = heart failure, heart (Clic here for more details about this article) |
4/348. Clinical manifestation and survival of patients with idiopathic bilateral atrial dilatation.We studied the histories of eight patients who lacked clear evidence of cardiac abnormalities other than marked bilateral atrial dilatation and atrial fibrillation, which have rarely been discussed in the literature. From the time of their first visit to our hospital, the patients' chest radiographs and electrocardiograms showed markedly enlarged cardiac silhouettes and atrial fibrillation, respectively. Each patient's echocardiogram showed a marked bilateral atrial dilatation with almost normal wall motion of both ventricles. In one patient, inflammatory change was demonstrated by cardiac catheterization and endomyocardial biopsy from the right ventricle. Seven of our eight cases were elderly women. Over a long period after the diagnosis of cardiomegaly or arrhythmia, diuretics or digitalis offered good results in the treatment of edema and congestion in these patients. In view of the clinical courses included in the present study, we conclude that this disorder has a good prognosis.- - - - - - - - - - ranking = 0.75keywords = cardiac (Clic here for more details about this article) |
5/348. A practical approach to atrial fibrillation.Management of atrial fibrillation is still an individualized proposition, requiring considerable clinical judgment to select the most effective means of controlling cardiac rate and rhythm and preventing thromboembolism and stroke. The advantages and disadvantages of electric shock cardioversion, catheter ablation, and several medicinal and mechanical agents are discussed.- - - - - - - - - - ranking = 0.25keywords = cardiac (Clic here for more details about this article) |
6/348. Early proarrhythmia during intravenous amiodarone treatment.We present a case of early (within the first 24 hours) development of malignant torsades de pointes (TdP) associated with intravenous amiodarone therapy. After correction of predisposing factors (heart failure, hypokalemia, digoxin) amiodarone again resulted in torsades. This observation suggests that in patients who have experienced amiodarone-induced proarrhythmia, amiodarone administration under different, more stable clinical conditions may still be hazardous.- - - - - - - - - - ranking = 1.1118404999623keywords = heart failure, heart (Clic here for more details about this article) |
7/348. ehlers-danlos syndrome: surgical management of mitral regurgitation and atrial fibrillation.ehlers-danlos syndrome is associated with fatal cardiovascular complications and intraoperative death. The lack of literature on cardiac surgery in the syndrome makes it difficult for surgeons to assess the risk of an operation and to choose optimal treatment. We describe the case of a 63-year-old man with ehlers-danlos syndrome type I or II, mitral regurgitation and atrial fibrillation who was managed successfully with mitral valve repair and surgical cardioversion.- - - - - - - - - - ranking = 0.25keywords = cardiac (Clic here for more details about this article) |
8/348. Ibutilide for termination of atrial fibrillation in the wolff-parkinson-white syndrome.Ibutilide promptly restored sinus rhythm on two occasions in an elderly patient with AF and rapid ventricular response associated with the WPW syndrome. As a selective Class III antiarrhythmic agent that prolongs cardiac refractoriness, ibutilide offers an alternative effective therapy for rapid termination of AF in WPW.- - - - - - - - - - ranking = 0.25keywords = cardiac (Clic here for more details about this article) |
9/348. atrial fibrillation and anabolic steroids.A young male bodybuilder, consuming large doses of anabolic steroids (AS), presented to the Emergency Department (ED) with symptomatic rapid atrial fibrillation (AF). Echocardiogram revealed significant septal hypokinesis, and posterior and septal wall thickness at the upper limit of normal for highly trained athletes. The atrial fibrillation had not recurred at 10 weeks after discontinuation of AS use. Consumption of these agents in athletes has been associated with hypertension, ischemic heart disease, hypertrophic cardiomyopathy, and sudden death.- - - - - - - - - - ranking = 0.43710444766524keywords = heart (Clic here for more details about this article) |
10/348. Atrial infarction is a unique and often unrecognized clinical entity.A patient with heart failure and acute atrial fibrillation received the final diagnosis of atrial infarction associated with ventricular infarction based on clinical findings of ischemia in association with atrial fibrillation and heart failure (mechanisms probably involved: contractile dysfunction and loss of atrial contribution). Although a transesophageal echocardiography, which could refine the diagnosis of anatomic abnormalities, was not performed, all evidence led to the diagnosis of atrial involvement. Electrocardiographic findings were consistent with Liu's major criterion 3. Therapy with digitalis, quinidine and angiotensin-converting enzyme inhibitors was chosen, as the patient had acute pulmonary edema. The use of beta-blockers and verapamil was res-tricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.- - - - - - - - - - ranking = 2.2236809999245keywords = heart failure, heart (Clic here for more details about this article) |
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