Circulation. Arrhythmia and electrophysiology
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Circ Arrhythm Electrophysiol · Oct 2011
Randomized Controlled TrialCharacterization of fractionated atrial electrograms critical for maintenance of atrial fibrillation: a randomized, controlled trial of ablation strategies (the CFAE AF trial).
Whether ablation of complex fractionated atrial electrograms (CFAE) modifies atrial fibrillation (AF) by eliminating drivers or atrial debulking remains unknown. This randomized study aimed to determine the effect of ablating different CFAE morphologies compared with normal electrograms (ie, debulking normal tissue) on the cycle length of persistent AF (AFCL). ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00894400.
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Circ Arrhythm Electrophysiol · Oct 2011
Influence of race on atrial fibrillation after cardiac surgery.
Despite having fewer risk factors for atrial fibrillation (AF), white patients have a greater prevalence of AF in the community than black patients, and a genetic basis has been postulated. However, it is unknown whether occurrence of new-onset AF after cardiac surgery is different in white versus black patients, and secondarily, other non-Caucasian patients. ⋯ White patients had a markedly higher risk of postoperative AF than black and other non-Caucasian patients. The cause for racial differences of arrhythmic risk is unknown, but a genetic predisposition is plausible. Our results have implications for risk stratification and mechanistic understanding of postoperative AF.
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Circ Arrhythm Electrophysiol · Oct 2011
Outcomes of cardiac perforation complicating catheter ablation of ventricular arrhythmias.
Cardiac perforation is a recognized complication of catheter ablation procedures, most commonly encountered during ablation of atrial fibrillation. The study aims to investigate the incidence, management, and hospital outcomes of cardiac perforation complicating catheter ablation for ventricular arrhythmias. ⋯ Ventricular perforation and tamponade occurs in 1% of ventricular ablation procedures and in this series, occurred only in patients without a history of prior cardiac surgery. More than half the patients required surgical repair. Perforation is often associated with steam pops and emergent surgical repair is often required when perforation occurs after a steam pop.
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Circ Arrhythm Electrophysiol · Oct 2011
Iron overload decreases CaV1.3-dependent L-type Ca2+ currents leading to bradycardia, altered electrical conduction, and atrial fibrillation.
Chronic iron overload (CIO) is associated with blood disorders such as thalassemias and hemochromatosis. A major prognostic indicator of survival in patients with CIO is iron-mediated cardiomyopathy characterized by contractile dysfunction and electrical disturbances, including slow heart rate (bradycardia) and heart block. ⋯ Our results demonstrate that CIO selectively reduces Ca(V)1.3-mediated I(Ca,L), leading to bradycardia, slowing of electrical conduction, and atrial fibrillation as seen in patients with iron overload.
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Circ Arrhythm Electrophysiol · Aug 2011
Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death.
Early studies indicate that prolongation of the interval between the peak and the end of the T wave (Tpeak to Tend [TpTe]) on the 12-lead ECG is a marker of ventricular arrhythmogenesis. However, community-based studies have not been conducted. ⋯ Prolongation of the TpTe interval measured in lead V5 was independently associated with SCD, with particular utility when the QTc was normal or not measurable because of prolonged QRSD.