Intravenous Hydrocortisone Reduces the Incidence of Atrial
Fibrillation (AF) after Cardiac Surgery
The
incidence of AF has been reported to be 20-40% after
coronary bypass graft (CABG) surgery, and is even higher
after valve and combined valve and bypass surgery. A
potential mechanism for the AF is an exaggerated
inflammatory response, demonstrated by increased levels of
complement, C-reactive protein complex, and number of white
blood cells in patients who develop AF. Jari Halonen, MD et
al from Kuopio University Hospital in Kuopio, Finland
investigated whether intravenous corticosteroids
administered after cardiac surgery prevents AF after cardiac
surgery. Their results, published in the April 11, 2007
issue of the Journal of the American Medical Association
concluded that intravenous hydrocortisone reduced the
incidence of AF after cardiac surgery.
MORE»
Pulse Pressure
is a Risk Factor for New-Onset Atrial Fibrillation (AF)
Atrial
fibrillation is associated with an increased risk of
mortality and stroke, and every one in four people will
develop AF at some point in their lifetime. Already
recognized clinical risk factors for AF include advancing
age, increased systolic blood pressure, diabetes,
hypertension, heart failure, valvular disease, myocardial
infarction, and obesity. Echocardiographic risk factors for
AF include left atrial enlargement, increased left
ventricular wall thickness, and impaired left ventricular
systolic function. Gary F. Mitchell, MD et al from the
Cardiovascular Engineering Inc. in Waltham, MA investigated
whether pulse pressure, a reflection of aortic stiffness,
could be a potentially easily modifiable risk factor for AF.
Their study, published in the February 21, 2007 issue of
The Journal of the American Medical Association, found
that pulse pressure is in fact an important risk factor for
incident AF in a community-based sample.
MORE»
Radiofrequency Catheter Ablation Should Be Considered a
First-Line Therapy After the First Episode of Symptomatic
Atrial Flutter
Until
now, there have been no studies comparing amiodarone therapy
and radiofrequency catheter ablation (RFA) for patients who
have had one episode of atrial flutter (AFL). Antoine Da
Costa, MD, PhD et al from the University Jean Monnet in
Saint-Etienne, France did a study comparing the efficacy and
safety of first-line RFA versus AFL therapy. The study found
that RFA should be considered a first-line therapy even
after the first episode of symptomatic AFL due to better
long-term success rate, the same risk of subsequent AF and
fewer secondary effects. The study was published in the
October 17, 2006 issue of Circulation. MORE»
Mutations in the Connexin 40 Gene, GJA5,
Predisposes Patients to Idiopathic Atrial
Fibrillation
Atrial Fibrillation is the most common type
of cardiac arrhythmia characterized by erratic
electrical activation of the atrial myocardium,
resulting in loss of effective contractility and
an increase in clot formation. Michael H. Gollob
et al from the University of Ottawa Heart
Institute studied the genetic basis of atrial
fibrillation as it relates to mutations in the
connexin 40 gene, GJA5. Their results, published
in the June 22, 2006 issue of The New England
Journal of Medicine, found that mutations in
GJA5 may predispose patients to idiopathic
atrial fibrillation by impairing gap-junction
assembly or electrical coupling.
MORE»
In
Pediatric Patients With Cardiac Arrest, Survival
Outcomes Were Higher Among Patients in Whom Ventricular
Fibrillation or Tachycardia was Present Initially Than
Among Those in Whom it Developed Subsequently
In
children, cardiac
arrests are typically presented secondary to a progressive
respiratory failure or shock, rather than as a primary
arrhythmogenic event as seen in adults.
Ventricular fibrillation or tachycardia can also occur
during cardiopulmonary resuscitation (CPR) for asystole
or pulseless electrical activity as a reperfusion
arrhythmia. A study by Robert A. Berg M.D et al, from
the Steele Children’s Research Center in Arizona, showed that a
presentation of ventricular fibrillation or
tachycardia at the beginning of cardiac arrest results
in a better survival outcome than if the ventricular
fibrillation presented subsequently during CPR. The
study was published in the June 1, 2006 issue of The New England
Journal of Medicine.
MORE»
No
Significant Difference in the Single-Chamber Versus
Dual-Chamber Pacing for High Grade Atrioventricular Block
- Cardiac pacing is a treatment for high-grade atrioventricular
heart block. There is a debate about whether Single-Chamber or
Dual-Chamber pacing is the most appropriate form of treatment.
While dual-chamber is associated with lower incidence of atrial
fibrillation, stroke and heart failure in non-randomized
studies, Dr. William Toff et al from the University of
Leicester, UK conducted a randomized, parallel-group trial
comparing patients who received single-chamber versus
double-chamber pacers. The study, published in the July 14,
2005 issue of The New England Journal of Medicine, indicates no significant difference between the group with
dingle-chamber pacing and that with dual-chamber pacing in the
rates of atrial fibrillation, heart failure or a composite of
stroke, transient ischemic attack or other thromboembolism.
MORE…
Amiodarone is Superior to Sotalol for Maintaining Sinus Rhythm
in Patients with Atrial Fibrillation
Transcatheter Ablation Is Feasible in Atrial Fibrillation
Patients with Prosthetic Mitral Valves
Prophylactic
Use of an Implantable Cardioverter-Defibrillator after Acute
Myocardial Infarction Does Not Reduce Overall Mortality
Outpatient Treatment of
Recent-Onset Atrial fibrillation with Flecainide and
Propafenone Has Been Shown to be Safe and Feasible in
Terminating Atrial Fibrillation
Catheter
Ablation for Atrial Fibrillation Improves Cardiac Function
in Patients with Congestive Heart Failure
Heart gone haywire blamed in some sudden
infant deaths
Terrorist attacks increased dangerous irregular heartbeats
Studies
Suggest Rate Control Equal to Rhythm Control in Some AF
Patients
Prophylactic
Catheter Ablation Found to Reduce Risk of Arrhythmia in
Asymptomatic Children with Wolff-Parkinson-White Syndrome
Addition of
Antiplatelet to Anticoagulant Therapy Increases Effectiveness
in Patients with Valvular and Non-valvular Atrial Fibrillation