1/269. 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) |
2/269. 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) |
3/269. 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) |
4/269. 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) |
5/269. 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 = 0.25356314883061keywords = cardiac, death (Clic here for more details about this article) |
6/269. 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) |
7/269. 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 = 0.030111503569384keywords = sudden death, sudden, death (Clic here for more details about this article) |
8/269. Papillary fibroelastoma of the mitral valve 12 years after mitral valve commissurotomy.A 63 year-old woman who had had mitral valve commissurotomy 12 years earlier was seen because of rheumatic mitral stenosis and left brachial paresis due to cerebral embolism. On clinical evaluation, a diastolic rumble was heard over the mitral area, and the echocardiogram revealed a mass attached to the mitral subvalvular apparatus. The patient was operated on, and both the surgical and histologic findings depicted papillary fibroelastoma. This tumor may occur as an isolated lesion or be associated with mitral valve stenosis or other cardiac abnormalities, and it is an important source of emboli. Early echocardiographic diagnosis, followed by surgical excision, may avoid serious complications such as stroke, myocardial infarction, and sudden death.- - - - - - - - - - ranking = 0.28011150356938keywords = cardiac, sudden death, sudden, death (Clic here for more details about this article) |
9/269. Familial skeletal myopathy with atrioventricular block.OBJECTIVE: We studied familial cases of skeletal myopathy with atrial fibrillation (Af) and atrioventricular (AV) block to compare the clinical features to other myopathies associated with cardiac abnormalities. methods: Neurologic, cardiologic, electrophysiologic, muscle pathology, and genetic studies were performed on the patients showing muscle weakness. patients: Four patients (a 63-year-old mother, 30 and 32-year-old sisters, and their maternal grandmother) and three healthy family members from three generations were studied. The mode of inheritance was suspected as autosomal dominant. RESULTS: Two sisters with congenital myopathy without rigid spine developed Af and AV block at the age of 28 and 18, respectively. The mother showed AV block, and underwent pacemaker implantation at the age of 63. The maternal grandmother had dilated cardiomyopathy, Af and severe lordosis. She died of stroke attacks and congestive heart failure at the age of 78. Muscle biopsy obtained from the mother and sisters showed myopathic changes without characteristic abnormalities. No mitochondrial dna mutations were found. Other inherited myopathies with cardiac complications were not suspected in this family. CONCLUSION: This Japanese family appears to belong to a new genetically heterogeneous group of autosomal dominant skeletal myopathy with severe AV block and Af.- - - - - - - - - - ranking = 0.5keywords = cardiac (Clic here for more details about this article) |
10/269. Continuous intravenous quinidine infusion for the treatment of atrial fibrillation or flutter: a case series.BACKGROUND: The purpose of the study was to evaluate a continuous intravenous quinidine infusion (CIQI) for the treatment of cardiac arrhythmias in critically ill patients. methods AND RESULTS: A 2-year retrospective review was conducted in adult patients receiving a CIQI for cardiac arrhythmias. Patient demographics, baseline laboratory values, indication for quinidine, dose, duration of therapy, efficacy, adverse events, and serum concentration were among the collected data. All patients were critically ill and receiving quinidine for the treatment of atrial arrhythmias. quinidine was effective in 14 (61%) of the 23 enrolled patients. Ninety-one percent of the patients received the CIQI after surgery. A total of 8 (35%) patients died. Four (17%) patients had hypotension possibly attributed to the quinidine. CONCLUSIONS: A continuous intravenous infusion of quinidine gluconate may be effective in patients in whom other agents are contraindicated or have failed. However, as with all antiarrhythmic agents, risks of therapy must be carefully considered.- - - - - - - - - - ranking = 0.5keywords = cardiac (Clic here for more details about this article) |
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