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Sample records for premature atrial stimuli

  1. The circadian variation of premature atrial contractions

    DEFF Research Database (Denmark)

    Larsen, Bjørn Strøier; Kumarathurai, Preman; Nielsen, Olav W

    2016-01-01

    AIMS: The aim of the study was to assess a possible circadian variation of premature atrial contractions (PACs) in a community-based population and to determine if the daily variation could be used to assess a more vulnerable period of PACs in predicting later incidence of atrial fibrillation (AF...... variation in heart rate. After adjusting for relevant risk factors, the risk of AF was equal in all time intervals throughout the day. CONCLUSION: Premature atrial contractions showed a circadian variation in subjects with frequent PACs. No specific time interval of the day was more predictive of AF than...

  2. Prevalence and Prognostic Significance of Runs of Premature Atrial Complexes in Ischemic Stroke Patients

    DEFF Research Database (Denmark)

    Høeg Vinther, Kristina; Tveskov, Claus; Möller, Sören

    2016-01-01

    BACKGROUND AND PURPOSE: Runs of premature atrial complexes (PACs) are common in stroke patients and perceived to be clinically insignificant, but their prognostic significance is unclear. This study investigated the association between runs of PACs in ischemic stroke patients and the risk...

  3. Auditory stimuli mimicking ambient sounds drive temporal "delta-brushes" in premature infants.

    Directory of Open Access Journals (Sweden)

    Mathilde Chipaux

    Full Text Available In the premature infant, somatosensory and visual stimuli trigger an immature electroencephalographic (EEG pattern, "delta-brushes," in the corresponding sensory cortical areas. Whether auditory stimuli evoke delta-brushes in the premature auditory cortex has not been reported. Here, responses to auditory stimuli were studied in 46 premature infants without neurologic risk aged 31 to 38 postmenstrual weeks (PMW during routine EEG recording. Stimuli consisted of either low-volume technogenic "clicks" near the background noise level of the neonatal care unit, or a human voice at conversational sound level. Stimuli were administrated pseudo-randomly during quiet and active sleep. In another protocol, the cortical response to a composite stimulus ("click" and voice was manually triggered during EEG hypoactive periods of quiet sleep. Cortical responses were analyzed by event detection, power frequency analysis and stimulus locked averaging. Before 34 PMW, both voice and "click" stimuli evoked cortical responses with similar frequency-power topographic characteristics, namely a temporal negative slow-wave and rapid oscillations similar to spontaneous delta-brushes. Responses to composite stimuli also showed a maximal frequency-power increase in temporal areas before 35 PMW. From 34 PMW the topography of responses in quiet sleep was different for "click" and voice stimuli: responses to "clicks" became diffuse but responses to voice remained limited to temporal areas. After the age of 35 PMW auditory evoked delta-brushes progressively disappeared and were replaced by a low amplitude response in the same location. Our data show that auditory stimuli mimicking ambient sounds efficiently evoke delta-brushes in temporal areas in the premature infant before 35 PMW. Along with findings in other sensory modalities (visual and somatosensory, these findings suggest that sensory driven delta-brushes represent a ubiquitous feature of the human sensory cortex

  4. Presentation of Aural Stimuli to Newborns and Premature Infants: An Audiological Perspective.

    Science.gov (United States)

    Cassidy

    1999-01-01

    The purpose of this study was twofold: (a) to examine extant research in the field of music with premature and full term infants in order to identify protocols being used in the presentation of musical stimuli to neonates and (b) to use knowledge gleaned from audiology as a basis for suggesting a standardized protocol for use of musical stimuli with infants. Articles considered appropriate for inclusion in the analysis met the following criteria: (a) presented data for the effects of music on a dependent measure, (b) had subjects who were identified as either premature or term newborns receiving treatment after birth and prior to discharge from the hospital, and (c) used music for some or all of the aural stimuli. Articles (N = 20) were categorized by demographic information, types of aural stimuli, independent variables, dependent measures, and protocol used to present the musical stimuli. Of primary importance to this study was the protocol used in each study to present musical stimuli. Data regarding total duration of stimuli per day, longest duration of stimuli per day, method of stimuli presentation, placement of speakers, decibel level of stimuli, and where;he decibel level was measured reveal that there is no standard protocol being followed with regard to the presentation of aural stimuli. Recommendations include future research on (a) determining a minimum gestational age where music therapy may be appropriate, (b) determining the frequency spectrum perceived by a premature infant, (c) determining the decibel levels reaching the ear drum and assessing appropriate levels for minimum stimulation with maximum results, and (d) carefully considering the method of stimulus presentation as it will have an impact on the decibel level reaching the ear drum of these infants.

  5. Auditory brain stem responses of premature infants to bone-conducted stimuli: a feasibility study.

    Science.gov (United States)

    Hooks, R G; Weber, B A

    1984-01-01

    The feasibility of bone conduction auditory brain stem response (ABR) audiometry in intensive care nursery neonates was investigated. Forty premature infants were tested with both air- and bone-conducted stimuli. Bone-conducted stimuli resulted in more identifiable ABRs and a greater number of subjects passing the hearing screening. The findings of this study suggest that bone conduction ABR audiometry is a feasible technique with premature infants. Due to the lower frequency composition of the bone-conducted click, it may be more effective than an air-conducted click when the immature cochlea is being evaluated.

  6. Giant aneurysm of the atrial septum associated with premature closure of foramen ovale

    Directory of Open Access Journals (Sweden)

    Romaguera Rita L

    2005-08-01

    Full Text Available Abstract Premature closure or restriction of foramen ovale (PCFO is a rare congenital anomaly that can lead to a wide spectrum of cardiac malformations. This spectrum of secondary malformations appears to depend on the gestational timing of closure of the foramen ovale and to the degree of restriction. Earlier in the gestation, closure of the foramen has been associated with severe hypoplasia of the left ventricle whereas later closure has been associated with right heart failure and rarely with the formation of an aneurysm of the atrial septum. We describe the case of a 1 day old infant in whom PCFO resulted in severe right heart failure in addition to the formation of a giant atrial septal aneurysm.

  7. Premature Contractions

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Premature Contractions - PACs and PVCs Updated:Dec 15,2016 ... You felt this more-forceful beat. Types of premature contractions Premature atrial contractions (PACs) start in the ...

  8. Influence of varied stimuli on development of motor patterns in the premature infant.

    Science.gov (United States)

    Chapman, J S

    1979-01-01

    The premature infant is at risk for both mortality and morbidity. His writhing contributes to weight loss, and his extrauterine environment does not contain the multi-modality patterned afferent stimuli that impinge upon the developing brain in utero. Sound is the most effective modality to achieve concurrent decrement in motility along with enhancement of cortical activity. It was anticipated that subjects exposed to 5 minutes of patterned sound 6 times a day would, by 36 weeks gestation, evidence: (a) less gross motor activity, (b) the normal predominance of upper over lower limb activity, and (c) beginning laterality. The sample consisted of 80 males and 73 females whose gestational age at birth was 26--33 weeks. By random assignment 52 subjects were exposed to the routine ambient noise of the isolette and nursery, 50 to a tape recording of their mother's voice, and 51 to an orchestral arrangement of Brahm's Lullaby. Limb activity was measured just prior to discharge by accelerometers worn unilaterally for a 24-hour period on the ankle and wrist prior to transfer to the alternate side for an additional 24 hours. No statistically significant differences were demonstrated among the limb patterns of the 3 groups. Large intragroup variation in gross activity precluded demonstration of between-group differences. The majority of subjects evidenced predominance of upper limb activity and laterality.

  9. Changes of cerebral current source by audiovisual erotic stimuli in premature ejaculation patients.

    Science.gov (United States)

    Hyun, Jae-Seog; Kam, Sung-Chul; Kwon, Oh-Young

    2008-06-01

    Premature ejaculation (PE) is one of the most common forms of male sexual dysfunction. The mechanisms of PE remain poorly understood, despite its high prevalence. To investigate the pathophysiology and causes of PE in the central nervous system, we tried to observe the changes in brain current source distribution by audiovisual induction of sexual arousal. Electroencephalograpies were recorded in patients with PE (45.0 +/- 10.3 years old, N = 18) and in controls (45.6 +/- 9.8 years old, N = 18) during four 10-minute segments of resting, watching a music video excerpt, resting, and watching an erotic video excerpt. Five artifact-free 5-second segments were used to obtain cross-spectral low-resolution brain electromagnetic tomography (LORETA) images. Statistical nonparametric maps (SnPM) were obtained to detect the current density changes of six frequency bands between the erotic video session and the music video session in each group. Comparisons were also made between the two groups in the erotic video session. In the SnPM of each spectrum in patients with PE, the current source density of the alpha band was significantly reduced in the right precentral gyrus, the right insula, and both superior parietal lobules (P erotic video session, the current densities of the beta-2 and -3 bands in the PE group were significantly decreased in the right parahippocampal gyrus and left middle temporal gyrus (P < 0.01). Neuronal activity in the right precental gyrus, the right insula, both the superior parietal lobule, the right parahippocampal gyrus, and the left middle temporal gyrus may be decreased in PE patients upon sexual arousal. Further studies are needed to evaluate the meaning of decreased neuronal activities in PE patients.

  10. Use of self-gated radial cardiovascular magnetic resonance to detect and classify arrhythmias (atrial fibrillation and premature ventricular contraction).

    Science.gov (United States)

    Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Feng, Li; Axel, Leon

    2016-11-25

    Arrhythmia can significantly alter the image quality of cardiovascular magnetic resonance (CMR); automatic detection and sorting of the most frequent types of arrhythmias during the CMR acquisition could potentially improve image quality. New CMR techniques, such as non-Cartesian CMR, can allow self-gating: from cardiac motion-related signal changes, we can detect cardiac cycles without an electrocardiogram. We can further use this data to obtain a surrogate for RR intervals (valley intervals: VV). Our purpose was to evaluate the feasibility of an automated method for classification of non-arrhythmic (NA) (regular cycles) and arrhythmic patients (A) (irregular cycles), and for sorting of common arrhythmia patterns between atrial fibrillation (AF) and premature ventricular contraction (PVC), using the cardiac motion-related signal obtained during self-gated free-breathing radial cardiac cine CMR with compressed sensing reconstruction (XD-GRASP). One hundred eleven patients underwent cardiac XD-GRASP CMR between October 2015 and February 2016; 33 were included for retrospective analysis with the proposed method (6 AF, 8 PVC, 19 NA; by recent ECG). We analyzed the VV, using pooled statistics (histograms) and sequential analysis (Poincaré plots), including the median (medVV), the weighted mean (meanVV), the total number of VV values (VVval), and the total range (VVTR) and half range (VVHR) of the cumulative frequency distribution of VV, including the median to half range (medVV/VVHR) and the half range to total range (VVHR/VVTR) ratios. We designed a simple algorithm for using the VV results to differentiate A from NA, and AF from PVC. Between NA and A, meanVV, VVval, VVTR, VVHR, medVV/VVHR and VVHR/VVTR ratios were significantly different (p values = 0.00014, 0.0027, 0.000028, 5×10(-9), 0.002, respectively). Between AF and PVC, meanVV, VVval and medVV/VVHR ratio were significantly different (p values = 0.018, 0.007, 0.044, respectively). Using our algorithm

  11. Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry.

    Science.gov (United States)

    Cosio, F G; Palacios, J; Vidal, J M; Cocina, E G; Gómez-Sánchez, M A; Tamargo, L

    1983-01-01

    Extrastimulus-induced intraatrial conduction delays were measured in 12 patients with documented episodes of atrial fibrillation (AF) by recording atrial electrograms at the high right atrium, His bundle region, and coronary sinus. Seventeen patients with and without heart disease, but without atrial arrhythmias served as the control group. During baseline-paced atrial rhythms, a conduction delay zone could be delineated, near the atrial effective refractory period, during which all extrastimuli produced conduction delays. When compared at the same paced cycle lengths (500 to 650 ms), the patients with AF had shorter atrial effective refractory periods (mean +/- standard deviation 206 +/- 24.1 versus 233 +/- 28.2 in control patients, p less than 0.02), wider conduction delay zones (79 +/- 21.7 ms versus 52 +/- 21 in control patients, p less than 0.01), and longer conduction delays both to the His bundle region (64 +/- 18.3 ms versus 35 +/- 21.7 in control patients, p less than 0.005) and the coronary sinus (76 +/- 18.9 ms versus 35 +/- 16.1 in control patients, p less than 0.001). Repetitive atrial responses were recorded in 6 patients with AF and in 9 control subjects. Sinus nodal function abnormalities were detected in 6 of the patients with fibrillation. Patients with AF had a higher tendency than control subjects to develop slow intraatrial conduction, as well as shorter effective refractory periods. Since both features would favor reentry, they may be the electrophysiologic manifestations of the abnormalities making these patients prone to atrial reentrant arrhythmias. Repetitive atrial responses were of no predictive value. Sinus nodal dysfunction was frequently found, but was not essential for the occurrence of AF.

  12. The effect of decibel level of music stimuli and gender on head circumference and physiological responses of premature infants in the NICU.

    Science.gov (United States)

    Cassidy, Jane W

    2009-01-01

    The purpose of this study was to examine different protocols with regard to the presentation of music stimuli and compare gender differential reactions to those stimuli. Subjects for this study (N = 63) were premature infants in the Neonatal Intensive Care Unit (NICU) between the gestational ages of 28 and 33 weeks. Half of the experimental infants listened to 20 mins of lullaby music (female voice with orchestral background) on 2 days followed by 20 mins of classical music (Mozart string music) on 2 days. The other half listened to the same music in the reverse order. One quarter of the males and one quarter of the females listened to music presented at an average of 65 dB, one quarter at an average of 70 dB, one quarter at an average of 75 dB, and one quarter did not listen to any music and served as control subjects. Head circumference data were collected four times by the researcher: (a) upon receipt of parental consent, (b) on the first day of music presentation (1 week after consent), (c) on the last day of music presentation, and (d) 1 week after music presentation. Physiological data (heart rate, respiratory rate, oxygen saturation) were recorded by the researcher at 2-minute intervals starting 4 minutes prior to and ending 4 minutes after music presentation. There was a significant difference (p < .0001) in average daily head growth across time, but this seems unrelated to the music condition as the same curvilinear trend (larger gain during days of treatment, smaller gain during baseline before and after treatment) was noted for control infants who did not listen to music. Results indicate a significant (p = .002), but biologically unimportant, decrease in heart rate over the course of data collection. No differences due to gender were noted.

  13. Atrial Ectopics Precipitating Atrial Fibrillation

    OpenAIRE

    Johnson Francis

    2015-01-01

    Holter monitor tracing showing blocked atrial ectopics and atrial ectopic precipitating atrial fibrillation is being demonstrated. Initially it was coarse atrial fibrillation, which rapidly degenerated into fine atrial fibrillation.

  14. Premature infant

    Science.gov (United States)

    There are many support groups for parents of premature babies. Ask the social worker in the neonatal intensive care unit. ... Prematurity used to be a major cause of infant deaths. Improved ... Prematurity can have long-term effects. Many premature infants ...

  15. Premature ejaculation

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001524.htm Premature ejaculation To use the sharing features on this page, please enable JavaScript. Premature ejaculation is when a man has an orgasm ...

  16. Atrial fibrillation

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    patients with atrial fibrillation managed in a referral hospital in Port Harcourt, southern Nigeria. ... treatment despite all the patients having moderate to high risk of stroke ... Keywords: Atrial fibrillation, thrombosis, CHADS2 Score, stroke risk, ...

  17. Left atrial electrophysiologic feature specific for the genesis of complex fractionated atrial electrogram during atrial fibrillation.

    Science.gov (United States)

    Hoshiyama, Tadashi; Yamabe, Hiroshige; Koyama, Junjiroh; Kanazawa, Hisanori; Ogawa, Hisao

    2016-05-01

    Complex fractionated atrial electrogram (CFAE) has been suggested to contribute to the maintenance of atrial fibrillation (AF). However, electrophysiologic characteristics of the left atrial myocardium responsible for genesis of CFAE have not been clarified. Non-contact mapping of the left atrium was performed at 37 AF onset episodes in 24 AF patients. Electrogram amplitude, width, and conduction velocity were measured during sinus rhythm, premature atrial contraction (PAC) with long- (L-PAC), short- (S-PAC) and very short-coupling intervals (VS-PAC). These parameters were compared between CFAE and non-CFAE regions. Unipolar electrogram amplitude was higher in CFAE than non-CFAE during sinus rhythm, L-, S- and VS-PAC (1.82 ± 0.73 vs. 1.13 ± 0.38, p genesis of CFAE.

  18. Your Premature Baby

    Science.gov (United States)

    ... birth defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since ... Complications & Loss > Preterm labor & premature birth > Premature babies Premature babies E-mail to a friend Please fill ...

  19. Osteopenia - premature infants

    Science.gov (United States)

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... the baby. This helps the baby grow. A premature infant may not receive the proper amount of ...

  20. Comparison of sinoatrial conduction time measured by Holter method and premature stimulation method.

    Science.gov (United States)

    Kramarz, Elżbieta; Piotrowicz, Ryszard; Krzyzanowski, Krystian; Kramarz, Paulina

    2015-05-01

    The reliability of noninvasive Holter method for the calculation of sinoatrial conduction time (SACT) has not been confirmed by results of invasive electrophysiological studies of sinus nodal function. The aim of this study was to compare the values of SACT obtained by Holter method with values estimated by premature atrial stimulation method. The study population consisted of 61 patients, in whom the 24-hour ambulatory ECG monitoring had shown the occurrence of atrial premature beats. All these subjects were undergoing electrophysiological study including programmed atrial and ventricular stimulation. The measurements of SACT were obtained using spontaneous atrial premature beats (Holter method) and high right atrial stimulation (Strauss method). There was a good correlation between measurements of SACT by Holter method and Strauss method (r = 0.79; P Holter method and Strauss method were significantly (P Holter method may be adequate for reliable calculation of SACT. © 2014 Wiley Periodicals, Inc.

  1. Premature delivery

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-09-01

    Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

  2. Atrial fibrillation

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Fauchier, Laurent; Freedman, Saul B;

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, and increases in prevalence with increasing age and the number of cardiovascular comorbidities. AF is characterized by a rapid and irregular heartbeat that can be asymptomatic or lead to symptoms such as palpitations...

  3. Atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Morten S; Nielsen, Morten W; Haunsø, Stig;

    2014-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1-2% of the general population. A number of studies have demonstrated that AF, and in particular lone AF, has a substantial genetic component. Monogenic mutations in lone and familial AF, although rare, have been recognized...

  4. Premature Ventricular Contractions (PVCs)

    Science.gov (United States)

    Diseases and Conditions Premature ventricular contractions (PVCs) By Mayo Clinic Staff Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two ...

  5. Premature ejaculation

    Directory of Open Access Journals (Sweden)

    Chris G McMahon

    2007-01-01

    Full Text Available Premature ejaculation (PE is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

  6. Premature ejaculation.

    Science.gov (United States)

    McMahon, Chris G

    2007-04-01

    Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

  7. Atrial Fibrillation.

    Science.gov (United States)

    Zimetbaum, Peter

    2017-03-07

    This issue provides a clinical overview of atrial fibrillation, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  8. Symbolic transfer entropy-based premature signal analysis

    Institute of Scientific and Technical Information of China (English)

    Wang Jun; Yu Zheng-Feng

    2012-01-01

    In this paper,we use symbolic transfer entropy to study the coupling strength between premature signals.Numerical experiments show that three types of signal couplings are in the same direction.Among them,normal signal coupling is the strongest,followed by that of premature ventricular contractions,and that of atrial premature beats is the weakest.The T test shows that the entropies of the three signals are distinct.Symbolic transfer entropy requires less data,can distinguish the three types of signals and has very good computational efficiency.

  9. Retinopathy of Prematurity (ROP)

    Science.gov (United States)

    ... of Prematurity (ROP) Facts About Retinopathy of Prematurity (ROP) This information was developed by the National Eye ... blind from ROP. Are there different stages of ROP? Yes. ROP is classified in five stages, ranging ...

  10. Pharmacotherapy for premature ejaculation

    NARCIS (Netherlands)

    Waldinger, Marcel D

    PURPOSE OF REVIEW: As there are various drugs and different treatment strategies to delay ejaculation, a review of the current drug treatments for premature ejaculation is relevant for daily clinical practice. RECENT FINDINGS: There are four premature ejaculation subtypes: lifelong premature

  11. Pharmacotherapy for premature ejaculation

    NARCIS (Netherlands)

    Waldinger, Marcel D

    2014-01-01

    PURPOSE OF REVIEW: As there are various drugs and different treatment strategies to delay ejaculation, a review of the current drug treatments for premature ejaculation is relevant for daily clinical practice. RECENT FINDINGS: There are four premature ejaculation subtypes: lifelong premature ejacula

  12. Health Issues of Premature Babies

    Science.gov (United States)

    ... Text Size Email Print Share Health Issues of Premature Babies Page Content Because premature babies are born before they are physically ready ... associated with prematurity. Because of these health concerns, premature babies are given extra medical attention and assistance ...

  13. The effect of atrial preference pacing on atrial fibrillation electrophysiological substrate in Myotonic Dystrophy type 1 population.

    Science.gov (United States)

    Russo, Vincenzo; Nigro, Gerardo; DI Meo, Federica; Papa, Andrea Antonio; Cioppa, Nadia Della; Proietti, Riccardo; Russo, Maria Giovanna; Calabrò, Raffaele; Politano, Luisa

    2014-12-01

    P-wave dispersion is a non invasive indicator of intra-atrial conduction heterogeneity producing substrate for reentry, which is a pathophysiological mechanism of atrial fibrillation. The relationship between P-wave dispersion (PD) and atrial fibrillation (AF) in Myotonic dystrophy type 1 (DM1) patients is still unclear. Atrial Preference Pacing (APP) is an efficient algorithm to prevent paroxysmal AF in patients implanted with dual-chamber pacemaker. Aim of our study was to evaluate the possible correlation between atrial preference pacing algorithm, P-wave dispersion and AF burden in DM1 patients with normal cardiac function underwent permanent dual-chamber pacemaker implantation. We enrolled 50 patients with DM1 (age 50.3 ± 7.3; 11 F) underwent dual-chamber pacemaker implantation for various degree of atrioventricula block. The study population was randomized following 1 months stabilization period to APP algorithm features programmed OFF or ON. Patients were assessed every 3 months for the first year, and every 6 months thereafter up to 3 years. At each follow-up visit, we counted: the number of premature atrial beats, the number and the mean duration of AF episodes, AF burden and the percentage of atrial and ventricular pacing. APP ON Group showed lower number of AF episodes (117 ± 25 vs. 143 ± 37; p = 0.03) and AF burden (3059 ± 275 vs. 9010 ± 630 min; p < 0.04) than APP OFF Group. Atrial premature beats count (44903 ± 30689 vs. 13720 ± 7717 beats; p = 0.005) and Pwave dispersion values (42,1 ± 11 ms vs. 29,1 ± 4,2 ms, p = 0,003) were decreased in APP ON Group. We found a significant positive correlation between PD and AF burden (R = 0,8, p = 0.007). Atrial preference pacing algorithm, decreasing the number of atrial premature beats and the P-wave dispersion, reduces the onset and perpetuator factors of AF episodes and decreases the AF burden in DM1 patients underwent dual chamber pacemaker implantation for various degree of atrioventricular blocks

  14. Disturbances in atrial rhythm and conduction following the surgical creation of an atrial septal defect by the Blalock-Hanlon technique.

    Science.gov (United States)

    Hamilton, S D; Bartley, T D; Miller, R H; Schiebler, G L; Marriott, H J

    1968-07-01

    Disturbances in atrial conduction or rhythm, or both, were found in 16 of 27 patients undergoing the surgical creation of an atrial septal defect by the Blalock-Hanlon technique. These included P-wave aberrations of intra-atrial block and ectopic atrial rhythm, A-V rhythm, A-V dissociation, sinus bradycardia, atrial flutter, escape-capture bigeminy, and atrial premature beats. Some of these were transient and occurred within 2 weeks after surgery. It seems likely that tissue trauma engendered by the clamp and resection of the atrial septum with possible injury to the internodal conducting pathways may be the genesis of these early postoperative disturbances. Of the eight cases with transient disturbances, six occurred in this period. Later changes, such as intra-atrial block, sinus bradycardia, and atrial flutter, may be attributed to changes in atrial size secondary to the postoperative pathophysiology. Digitalis intoxication and congestive heart failure cannot be excluded as contributory factors in either the early or the late disturbances. It was not possible to correlate the incidence and nature of these disturbances with morbidity and mortality. In such severely ill, cyanotic infants, irregularities, however slight, may have altered cardiac function significantly and contributed to their deaths.

  15. Atrial fibrillation.

    Science.gov (United States)

    Bang, Casper N

    2013-10-01

    Atrial fibrillation (AF) is a common complication after myocardial infarction (MI) and new-onset AF has been demonstrated to be associated with adverse outcome and a large excess risk of death in both MI and aortic stenosis (AS) patients. Prevention of new-onset AF is therefore a potential therapeutic target in AS and MI patients. Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent AF. Accordingly, statins are recommended as a class IIa recommendation for prevention of new-onset AF after coronary artery bypass grafting (CABG). However, this preventive effect has not been investigated on new-onset AF in asymptomatic patients with AS or a large scale first-time MI patient sample and data in patients not undergoing invasive cardiac interventions are limited. This PhD thesis was conducted at the Heart Centre, Rigshospitalet, Denmark, with the aim to investigate the three aforementioned questions and to add to the existing evidence of AF prevention with statins. This was done using three different settings: 1) a randomized patients sample of 1,873 from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, 2) a register patient sample of 97,499 with first-time MI, and 3) all published studies until beginning of June 2011 examining statin treatment on new-onset and recurrent AF in patients not undergoing cardiac surgery. This thesis revealed that statins did not lower the incidence or the time to new-onset AF in patients with asymptomatic AS. However, statin treatment showed an independently preventive effect on new-onset AF, including type-dependent effect and a trend to dosage-dependent effect. In addition, this thesis showed that good compliance to statin treatment was important to prevent new-onset AF. Finally, the meta-analysis in this PhD thesis showed a preventive effect in the observational studies although this effect was absent in the randomized controlled trials. Based on this PhD thesis

  16. Spontaneous Transition of Double Tachycardias with Atrial Fusion in a Patient with Wolff-Parkinson-White Syndrome

    Science.gov (United States)

    Kim, Dongmin

    2016-01-01

    Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare. This article describes a case of uncommon atrial activation by an AP during AVNRT and gradual transition of the two supraventricular tachycardias without any preceding atrial or ventricular activity in a patient with preexcitation syndrome. PMID:27482269

  17. Sex-specific increase in the prevalence of atrial fibrillation (The Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Friberg, Jens; Scharling, Henrik; Gadsbøll, Niels

    2003-01-01

    Atrial fibrillation (AF) is the most frequently encountered cardiac arrhythmia. It is a risk factor for stroke and premature death. We studied the temporal changes in the prevalence of AF from 1976 to 1994 in a random population aged 50 to 89 years. The prevalence of AF, diagnosed from electrocar......Atrial fibrillation (AF) is the most frequently encountered cardiac arrhythmia. It is a risk factor for stroke and premature death. We studied the temporal changes in the prevalence of AF from 1976 to 1994 in a random population aged 50 to 89 years. The prevalence of AF, diagnosed from...

  18. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik;

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  19. Atrial fibrillation: effects beyond the atrium?

    Science.gov (United States)

    Wijesurendra, Rohan S; Casadei, Barbara

    2015-03-01

    Atrial fibrillation (AF) is the most common sustained clinical arrhythmia and is associated with significant morbidity, mostly secondary to heart failure and stroke, and an estimated two-fold increase in premature death. Efforts to increase our understanding of AF and its complications have focused on unravelling the mechanisms of electrical and structural remodelling of the atrial myocardium. Yet, it is increasingly recognized that AF is more than an atrial disease, being associated with systemic inflammation, endothelial dysfunction, and adverse effects on the structure and function of the left ventricular myocardium that may be prognostically important. Here, we review the molecular and in vivo evidence that underpins current knowledge regarding the effects of human or experimental AF on the ventricular myocardium. Potential mechanisms are explored including diffuse ventricular fibrosis, focal myocardial scarring, and impaired myocardial perfusion and perfusion reserve. The complex relationship between AF, systemic inflammation, as well as endothelial/microvascular dysfunction and the effects of AF on ventricular calcium handling and oxidative stress are also addressed. Finally, consideration is given to the clinical implications of these observations and concepts, with particular reference to rate vs. rhythm control.

  20. Micafungin in Premature and Non-premature Infants

    Science.gov (United States)

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants premature [birth weight (BW) premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  1. Effects of beta-blockade on atrial and atrioventricular nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation in pigs

    NARCIS (Netherlands)

    van den Berg, MP; van de Ven, LLM; Witting, W; Crijns, JGM; Haaksma, J; Bel, KJ; de Langen, CDJ; Lie, KI

    1997-01-01

    Despite their widespread use in atrial fibrillation, the effects of beta-adrenoceptor blockers on atrial and atrioventricular (AV) nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation have been incompletely characterised. In particular, it is unknown whether additional sodiu

  2. Surgery for atrial fibrillation.

    Science.gov (United States)

    Lawrance, Christopher P; Henn, Matthew C; Damiano, Ralph J

    2014-11-01

    Atrial fibrillation is the most common cardiac arrhythmia, and its treatment options include drug therapy or catheter-based or surgical interventions. The surgical treatment of atrial fibrillation has undergone multiple evolutions over the last several decades. The Cox-Maze procedure went on to become the gold standard for the surgical treatment of atrial fibrillation and is currently in its fourth iteration (Cox-Maze IV). This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure. This article also reviews the literature describing the surgical results for both approaches including comparisons of the Cox-Maze IV to the previous cut-and-sew method.

  3. Left Atrial Ablation for Atrial Fibrillation

    Science.gov (United States)

    Sternik, Leonid; Schaff, Hartzel V.; Luria, David; Glikson, Michael; Kogan, Alexander; Malachy, Ateret; First, Maya; Raanani, Ehud

    2011-01-01

    The maze procedure is the gold standard for the ablation of atrial fibrillation, and the “box lesion” around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins). From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients. Of this number, 205 underwent operation by a hybrid maze technique and the remaining 35 (our study cohort) underwent the creation of a box lesion around the pulmonary veins by means of a bipolar radiofrequency device. Ablation lines were created by connecting the left atriotomy to the amputated left atrial appendage, with 2 ablation lines made with a bipolar radiofrequency device above and below the pulmonary veins. Lesions were made along the transverse and oblique sinuses by epicardial and endocardial application of a bipolar device. The left atrial isthmus was ablated by bipolar radiofrequency and cryoprobe. No complications were associated with the box lesion: 90% and 89% of patients were in sinus rhythm at 3 and 6 months of follow-up, respectively. By creating a box lesion around the pulmonary veins, we expect to improve transmurality by means of epicardial and endocardial ablation of 1 rather than 2 layers of atrial wall, as in epicardial pulmonary vein isolation. Isolation of the entire posterior wall of the left atrium is better electrophysiologically and renders dissection around the pulmonary veins unnecessary. PMID:21494518

  4. What Is Atrial Fibrillation?

    Science.gov (United States)

    ... regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump ... read your ECG to find out if the electric signals are normal. In atrial fibrillation (AFib), the heart’s ...

  5. Sex-specific increase in the prevalence of atrial fibrillation (The Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Friberg, Jens; Scharling, Henrik; Gadsbøll, Niels;

    2003-01-01

    Atrial fibrillation (AF) is the most frequently encountered cardiac arrhythmia. It is a risk factor for stroke and premature death. We studied the temporal changes in the prevalence of AF from 1976 to 1994 in a random population aged 50 to 89 years. The prevalence of AF, diagnosed from...

  6. Atrial arrhythmia after newborn eye exam, to caffeine or not to caffeine?

    Science.gov (United States)

    Ahmad, A; Mondal, T; Klein, B

    2016-01-01

    Mydriatic drops are routinely administered to premature neonates to screen for retinopathy of prematurity. Adverse anticholinergic side effects, particularly convulsions and tachycardia have been reported in the pediatric age group following instillation of mydriatics for diagnostic fundus examination [1, 2]. Caffeine is frequently used for apnea of prematurity. In the neonatal intensive care unit, the combined use of caffeine and mydriatic drops is a common practice. Here we report two cases of atrial arrhythmias after neonatal eye exam that improved with conservative management. Both patients were receiving caffeine at the time of events.

  7. Long-term Prognosis of Paroxysmal Atrial Fibrillation and Predictors for Progression to Persistnt or Chronic Atrial Fibrillation in the Korean Population.

    Science.gov (United States)

    Im, Sung Ii; Chun, Kwang Jin; Park, Seung-Jung; Park, Kyoung-Min; Kim, June Soo; On, Young Keun

    2015-07-01

    Little is known about the long-term prognosis of or predictors for the different clinical types of atrial fibrillation (AF) in Korean populations. The aim of this study was to validate a risk stratification to assess the probability of AF progression from paroxysmal AF (PAF) to persistent AF (PeAF) or permanent AF. A total of 434 patients with PAF were consecutively enrolled (mean age; 71.7 ± 10.7 yr, 60.6% male). PeAF was defined as episodes that are sustained > 7 days and not self-terminating, while permanent AF was defined as an ongoing long-term episode. Atrial arrhythmia during follow-up was defined as atrial premature complex, atrial tachycardia, and atrial flutter. During a mean follow-up of 72.7 ± 58.3 months, 168 patients (38.7%) with PAF progressed to PeAF or permanent AF. The mean annual AF progression was 10.7% per year. In univariate analysis, age at diagnosis, body mass index, atrial arrhythmia during follow-up, left ventricular ejection fraction, concentric left ventricular hypertrophy, left atrial diameter (LAD), and severe mitral regurgitation (MR) were significantly associated with AF progression. In multivariate analysis, age at diagnosis (P = 0.009), atrial arrhythmia during follow-up (P = 0.015), LAD (P = 0.002) and MR grade (P = 0.026) were independent risk factors for AF progression. Patients with younger age at diagnosis, atrial arrhythmia during follow-up, larger left atrial chamber size, and severe MR grade are more likely to progress to PeAF or permanent AF, suggesting more intensive medical therapy with close clinical follow-up would be required in those patients.

  8. Spontaneous Transition of Double Tachycardias with Atrial Fusion in a Patient with Wolff-Parkinson-White Syndrome

    OpenAIRE

    Kim, Dongmin; Lee, Myung-Yong

    2016-01-01

    Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also...

  9. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  10. Lifestyle influences on prematurity.

    Science.gov (United States)

    Creasy, R K

    1991-01-01

    It is apparent from this review that the lifestyle of an individual gravida can potentially lead to a premature delivery. Some of these adverse behavioral characteristics may be dealt with by education and motivation, and some with actual medical treatment. However, there also appears to be significant need for public policy reorientation if we are to make a significant impact on the problem of preterm delivery.

  11. Integrin β1 Participates in Atrial Remodeling in Rapid Atrial Pacing Induced Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Zhang wei; Yang guirong; Zheng zhaotong; Wang sujia; Zhang yun

    2004-01-01

    @@ Objective Integrin β1 regulates cell to cell and cell to extracellualr matrix interaction in heart. however, its pathop hysiological role in atrial fibrillation is unclear. The purpose of t his study was to determine whether atrial structural remodeling during atrial fibrillation is associated with altered integrinβ1.

  12. Stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-01-01

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal...... or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K...

  13. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation : Role of duration of at atrial fibrillation

    NARCIS (Netherlands)

    Van Den Berg, MP; Crijns, HJGM; Van Veldhuisen, DJ; Van Gelder, IC; De Kam, PJ; Lie, KI

    1998-01-01

    The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial n

  14. Origin and pharmacological response of atrial tachyarrhythmias induced by activation of mediastinal nerves in canines.

    Science.gov (United States)

    Armour, J Andrew; Richer, Louis-Philippe; Pagé, Pierre; Vinet, Alain; Kus, Teresa; Vermeulen, Michel; Nadeau, Réginald; Cardinal, René

    2005-03-31

    We sought to determine the sites of origin of atrial tachyarrhythmias induced by activating mediastinal nerves, as well as the response of such arrhythmias to autonomic modulation. Under general anaesthesia, atrioventricular block was induced after thoracotomy in 19 canines. Brief trains of 5 electrical stimuli were delivered to right-sided mediastinal nerves during the atrial refractory period. Unipolar electrograms were recorded from 191 right and left atrial epicardial sites under several conditions, i.e. (i) with intact nervous systems and following (ii) acute decentralization of the intrathoracic nervous system or administration of (iii) atropine, (iv) timolol, (v) hexamethonium. Concomitant right atrial endocardial mapping was performed in 7 of these dogs. Mediastinal nerve stimulation consistently initiated bradycardia followed by atrial tachyarrhythmias. In the initial tachyarrhythmia beats, early epicardial breakthroughs were identified in the right atrial free wall (28/50 episodes) or Bachmann bundle region (22/50), which corresponded to endocardial sites of origin associated with the right atrial subsidiary pacemaker complex, i.e. the crista terminalis and dorsal locations including the right atrial aspect of the interatrial septum. Neuronally induced responses were eliminated by atropine, modified by timolol and unaffected by acute neuronal decentralization. After hexamethonium, responses to extra-pericardial but not intra-pericardial nerve stimulation were eliminated. It is concluded that concomitant activation of cholinergic and adrenergic efferent intrinsic cardiac neurons induced by right-sided efferent neuronal stimulation initiates atrial tachyarrhythmias that originate from foci anatomically related to the right atrial pacemaker complex and tissues underlying major atrial ganglionated plexuses.

  15. Social representations of mothers about gestational hypertension and premature birth

    OpenAIRE

    2013-01-01

    OBJECTIVE: To identify the meanings attributed by mothers to hypertensive disorders of pregnancy (HDPs) and their consequences, such as premature birth and hospitalization of the infant in the neonatal intensive care unit (NICU). METHOD: A qualitative study, based on the Central Nucleus Theory, with 70 women who had hypertensive disorders of pregnancy and preterm delivery. We used the technique of free word association (FWAT) with three stimuli: high blood pressur...

  16. Fibrilação atrial em cão associada ao quimiodectoma infiltrativo atrial: relato de caso Atrial fibrillation in dog associated with an infiltrative chemodectoma in the atrial myocardium: a case report

    Directory of Open Access Journals (Sweden)

    G.A.O. Cavalcanti

    2006-12-01

    Full Text Available Relata-se o caso de um cão, sem raça definida, levado ao veterinário por apresentar cansaço fácil e episódios de síncope. Foram identificadas fibrilação atrial e extra-sístoles ventriculares isoladas ao exame eletrocardiográfico. O tratamento antiarrítmico não foi eficaz, e o animal morreu devido a um episódio de síncope. À necropsia, observou-se massa em região de base cardíaca, invadindo a luz do átrio esquerdo. Histologicamente, constatou-se a presença de quimiodectoma. A infiltração miocárdica atrial causou lesões nos miócitos, produzindo circuitos reentrantes e/ou focos ectópicos de despolarização atrial.This case reports a mongrel dog referred to a veterinarian due to tiredness and syncope episodes. Atrial fibrillation and ventricular premature complex were observed during electrocardiographic exam. The anti-arrhythmic treatment was not effective and the dog died from syncope. At necropsy, a mass invading the internal area of the left atrium was evidenced in the base of the heart. The occurrence of chemodectoma was histologically exhibited. Infiltrations in the atrial myocardium caused alterations in the miocites and produced reentrant circuits and/or atrial depolarization ectopic points.

  17. Functional and topographic concordance of right atrial neural structures inducing sinus tachycardia.

    Science.gov (United States)

    Eickholt, Christian; Mischke, Karl; Schimpf, Thomas; Knackstedt, Christian; Scherer, Kira; Pauza, Danius; Marx, Nikolaus; Shin, Dong-In; Kelm, Malte; Meyer, Christian

    2013-01-01

    Cardiorespiratory autonomic control is in tight interaction with an intracardiac neural network modulating sinus node function. To gain novel mechanistical insights and to investigate possible novel targets concerning the treatment of inadequate sinus tachycardia, we aimed to characterize functionally and topographically the right atrial neural network modulating sinus node function. In 16 sheep 3-dimensional electro-anatomical mapping of the right atrium was performed. In five animals additionally magnetically steered remote navigation was used. Selective stimulation of nerve fibers was conducted by applying high frequency (200 Hz) electrical impulses within the atrial refractory period. Histological analysis of whole heart preparations by acetylcholinesterase staining was performed and compared to the acquired neuroanatomical mapping.We found that neural stimulation in the cranial part of the right atrium, within a perimeter around the sinus node area, elicited predominantly shortening of the sinus cycle length of -20.3 ± 10.1 % (n = 80, P < 0.05). Along the course of the crista terminalis atrial premature beats (n = 117) and atrial fibrillation (n = 123) could be induced. Catheter stability was excellent during remote catheter navigation. Histological work-up (n = 4) was in accord with the distribution of neurostimulation sites. Ganglions were mainly innervated by the dorsal right-atrial subplexus, with substantial additional input from the ventral right atrial subplexus. In conclusion, our findings suggest a functional and topographic concordance of right atrial neural structures inducing sinus tachycardia. This might open up new avenues in the treatment of heart rate related disorders.

  18. Aneurysm of the Right Atrial Appendage

    Directory of Open Access Journals (Sweden)

    Silvio Henrique Barberato

    2002-02-01

    Full Text Available Atrial aneurysms involving the free wall or atrial appendage are rare entities in cardiology practice and may be associated with atrial arrhythmias or embolic phenomena. We review the literature and report a case of aneurysm of the right atrial appendage in a young adult, whose diagnosis was established with echocardiography after an episode of paroxysmal atrial flutter.

  19. Premature aging syndrome.

    Science.gov (United States)

    Coppedè, Fabio

    2012-01-01

    Hutchinson-Gilford progeria syndrome and Werner syndrome are two of the best characterized human progeroid diseases with clinical features mimicking physiological aging at an early age. Both disorders have been the focus of intense research in recent years since they might provide insights into the pathology of normal human aging. The chapter contains a detailed description of the clinical features of both disorders and then it focuses on the genetics, the resulting biochemical alterations at the protein level and the most recent findings and hypotheses concerning the molecular basis of the premature aging phenotypes. A description of available diagnostic and therapeutic approaches is included.

  20. Modulation of atrial fibrillation

    NARCIS (Netherlands)

    Geuzebroek, G.S.C.

    2013-01-01

    In this thesis we investigate the results of various surgical procedures for atrial fibrillation which have been performed in the last 2 decades in the Sint Antonius Hospital, Nieuwegein, The Netherlands. In the 1990s the classical Maze III procedure was the main surgical technique for drug-refracto

  1. Lesson Five Atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2003-01-01

    @@ Atrial fibrillation(AF) may occur in paroxysmaland persistent forms. It may be seen in normal subjects,particularly during emotional stress or follow-ing surgery,exercise, or acute alcoholic intoxication.It also may occur in patients with heart or lungdisease who develop acute hypoxia, hypercapnia,ormetabolic or hemodynamic derangements.

  2. Social representations of mothers about gestational hypertension and premature birth.

    Science.gov (United States)

    de Souza, Nilba Lima; de Araújo, Ana Cristina Pinheiro Fernandes; Costa, Iris do Ceu Clara

    2013-01-01

    To identify the meanings attributed by mothers to hypertensive disorders of pregnancy (HDPs) and their consequences, such as premature birth and hospitalization of the infant in the neonatal intensive care unit (NICU). A qualitative study, based on the Central Nucleus Theory, with 70 women who had hypertensive disorders of pregnancy and preterm delivery. We used the technique of free word association (FWAT) with three stimuli: high blood pressure during pregnancy, prematurity and NICU. We obtained 1007 evocations, distributed as follows: high blood pressure during pregnancy (335) prematurity (333) and NICU (339). These constituted three thematic units: representation of HDPs, prematurity and the NICU. The categories death and negative aspects were inherent to the three units analyzed, followed by coping strategies and needs for care present in HDPs and prematurity. The study had death as its central nucleus, and highlighted the subjective aspects present in the high risk pregnancy and postpartum cycle. It is hoped that this research will contribute to qualifying nursing care for women confronting the problem of HDPs, so that they can cope with less impacts from the adverse effects of high risk pregnancy and birth.

  3. HYPERTHYROIDISM AND ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    I. M. Marusenko

    2017-01-01

    Full Text Available Review on a problem of the development of atrial fibrillation in patients with thyrotoxicosis is presented. Thyrotoxicosis is one of the most frequent endocrine diseases, conceding only to a diabetes mellitus. The most frequent reasons of hyperthyroidism are Graves’ disease and functional thyroid autonomy. The authors give an analysis of data on the cardiac effects of thyrotoxicosis, features of heart remodeling under the influence of thyroid hyperfunction, prevalence of atrial fibrillation in thyrotoxicosis, depending on age, as well as the possibility of restoring sinus rhythm in the combination of these diseases. Particular attention is paid to the effect on the heart of subclinical thyrotoxicosis, which is defined as a dysfunction of the thyroid gland, characterized by low serum concentration of thyrotropin, normal values of free thyroxine and free triiodothyronine. Subclinical hyperthyroidism is also capable of causing heart remodeling and diastolic dysfunction.Prevalence of thyrotoxicosis in elderly people is higher in areas of iodine deficiency; it is relevant for our country due to the large territory of iodine deficiency. In elderly patients, the cardiac effects of thyrotoxicosis prevail in the clinical picture, that makes it difficult to diagnose endocrine disorders, and correction of thyrotoxicosis is critically important for the successful control of the heart rhythm. The article also discusses the problem of thyrotoxic cardiomyopathy, caused by the toxic effect of excess thyroid hormones: features of this heart disorder, factors affecting its formation, clinical significance and contribution to the development of rhythm disturbances. The greatest significance is the development of atrial fibrillation as a result of thyrotox-icosis in older patients who already have various cardiovascular diseases.Atrial fibrillation is the most frequent heart rhythm disorder in thyrotoxicosis. The main cause of arrhythmia in hyperthyroidism is the

  4. Premature ovarian failure.

    Science.gov (United States)

    Shelling, Andrew N

    2010-11-01

    Premature ovarian failure (POF) is a common cause of infertility in women, and is characterised by amenorrhoea, hypo-oestrogenism and elevated gonadotrophin levels in women under the age of 40. Known causes include iatrogenic agents that cause permanent damage to the ovaries, such as chemotherapy, radiation therapy and surgery, autoimmune conditions, X-chromosome abnormalities and autosomal genetic conditions. However, few genes have been identified that can explain a substantial proportion of cases of POF. Most women with POF are deeply upset by the diagnosis, partly due to the unexpected menopausal symptoms, but also due to infertility. Therefore, early detection would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help to direct potential targets for future treatment.

  5. Apnea of prematurity

    Directory of Open Access Journals (Sweden)

    Piermichele Paolillo

    2013-06-01

    Full Text Available Apnea of prematurity (AOP is one of the most frequent pathologies in the Neonatal Intensive Care Unit, with an incidence inversely related to gestational age. Its etiology is often multi factorial and diagnosis of idiopathic forms requires exclusion of other underlying diseases. Despite being a self-limiting condition which regresses with the maturation of the newborn, possible long-term effects of recurring apneas and the degree of desaturation and bradycardia who may lead to abnormal neurological outcome are not yet clarified. Therefore AOP needs careful evaluation of its etiology and adequate therapy that can be both pharmacological and non-pharmacological. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  6. Premature ejaculation: A review

    Directory of Open Access Journals (Sweden)

    Sukumar Reddy Gajjala

    2014-01-01

    Full Text Available Premature ejaculation (PE is a common male sexual disorder. It is defined by the Diagnostic and statistical manual of mental disorders as "ejaculation occurring, without control, on or shortly after penetration and before the person wishes it, causing marked distress or interpersonal difficulty. [1] Although the timing of intravaginal ejaculatory latency time (IELT (i.e., time from penetration to ejaculation is not included in this definition, an IELT of <2 min, or ejaculation occurring before penetration, has been considered consistent with PE. [2] Management involves both the patient and his partner. Therapeutic options should suit both partners and be appropriate to their habit in planning and frequency of intercourse. Follow-up at appropriate intervals to judge efficacy, titrate dosage of pharmacological treatments and ascertain side effects is mandatory.

  7. Intrauterine infection and prematurity.

    Science.gov (United States)

    Gonçalves, Luís F; Chaiworapongsa, Tinnakorn; Romero, Roberto

    2002-01-01

    Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation. Copyright 2002 Wiley-Liss, Inc.

  8. Apnea of Prematurity (For Parents)

    Science.gov (United States)

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  9. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roberto A.Franken; Ronaldo F.Rosa; Silvio CM Santos

    2012-01-01

    This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted.

  10. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  11. Occlusion of left atrial appendage in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    О. Н. Ганеева

    2015-10-01

    Full Text Available The article reviews a new method of prophylaxis of thromboembolitic complications, specifically occlusion of left atrial appendage, in patients with atrial fibrillation. Indications and contraindications for the procedure, as well as a step-by-step process of the intervention itself are described. Special emphasis is placed on the up-to-date evidence and the review of clinical trials.

  12. Left atrial appendage occlusion for stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer;

    2015-01-01

    Aims: To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). Methods and results: Data from consecutive patients treated in 22 centres were collected...

  13. Abnormal atrial activation in young patients with lone atrial fibrillation

    DEFF Research Database (Denmark)

    Holmqvist, Fredrik; Olesen, Morten S; Tveit, Arnljot

    2011-01-01

    Aims Patients with a history of atrial fibrillation (AF) have previously been shown to have altered atrial conduction, as seen non-invasively using signal-averaged P-wave analysis. However, little is known about the P-wave morphology in patients in the early phases of AF with structurally normal ...

  14. Impedance to transesophageal atrial pacing: significance regarding power sources.

    Science.gov (United States)

    Kerr, C R; Chung, D C; Wickham, G; Jameson, M; Vorderbrugge, S

    1989-06-01

    Transesophageal stimulation is an expeditious method of atrial pacing. Using pulse widths of 10 msec results in reduction of current requirement to values that are usually less than 15 mA. An unknown variable in transesophageal atrial pacing has been impedance. In this study, we investigated the impedance to transesophageal atrial pacing in ten patients using a stimulator with a 63 V power source capable of delivering constant current to 20 mA against an impedance of 2,000 ohms. A bipolar electrode was used to deliver stimuli with a current of 15 mA. Voltage across a known resistance and current were measured on an oscilloscope and the impedance was calculated. Pacing thresholds were also performed and ranged from 6.2 to 16.5 mA (mean 9.4 +/- 2.9 mA, SD). Impedance varied between 720 and 2,670 ohms (mean 1,750 +/- 540 ohms). The stimulator used to measure impedance in man and two other commercially available stimulators were bench tested against known resistances of 500 to 2,000 ohms. The other stimulators with power sources of 12.5 and 15 V had attenuation of the delivered current at resistances of between 1,000 and 2,000 ohms. Thus, this study has demonstrated that transesophageal atrial pacing incurs impedances two to five times greater than incurred with intracardiac pacing leads. Therefore stimulators with high power sources are required to deliver the programmed current against these impedances.

  15. Association between Familial Atrial Fibrillation and Risk of New-onset Atrial Fibrillation

    Science.gov (United States)

    Lubitz, Steven A.; Yin, Xiaoyan; Fontes, João D.; Magnani, Jared W.; Rienstra, Michiel; Pai, Manju; Villalon, Mark L.; Vasan, Ramachandran S.; Pencina, Michael J.; Levy, Daniel; Larson, Martin G.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2011-01-01

    Context Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. Objective To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. Design, Setting, and Participants The Framingham Heart Study, a prospective population-based cohort study started in 1948. Original and Offspring Cohort participants were age at least 30 years, free of AF at the baseline examination, and had at least one parent or sibling enrolled in the study. Main outcome measures The incremental predictive value of incorporating different features of familial AF (any familial AF, premature familial AF [onset ≤65 years], number of affected relatives, and youngest age of onset in a relative) into a risk model for new-onset AF. Results Of 4421 participants (11971 person-examinations, mean age 54±13 years, 54% women), 440 developed AF during follow-up. Familial AF occurred in 1185 participants (26.8%) and premature familial AF occurred in 351 (7.9%) participants. AF occurred more frequently among participants with familial AF than without familial AF (unadjusted absolute event rates of 5.8% and 3.1%, respectively). The association was not attenuated by adjustment for AF risk factors (multivariable-adjusted HR 1.40, 95% CI 1.13–1.74) or reported AF-related genetic variants. Among the different features of familial AF examined, premature familial AF was associated with improved discrimination beyond traditional risk factors to the greatest extent (c-statistic 0.842; 95% CI, 0.826–0.858 to 0.846; 95%CI, 0.831–0.862; P=.004). Modest changes in integrated discrimination improvement were observed with premature familial AF (2.1%). Net reclassification improvement (assessed using eight-year risk thresholds of 10%) did not change significantly with premature familial AF (0.011; 95% CI, −0.021–0.042; P=.51), although category-less net reclassification was

  16. Prenatal Stress, Prematurity, and Asthma.

    Science.gov (United States)

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced "premature asthma." Prenatal stress may cause not only abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring TH2 (allergic) immune responses characteristic of atopic asthma: interleukin 6 (IL-6), which has been associated with premature labor, can promote TH2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing "premature asthma." If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health.

  17. The role of atrial electrical remodeling in the progression of focal atrial ectopy to persistent atrial fibrillation

    NARCIS (Netherlands)

    Hobbs, WJC; Van Gelder, IC; Fitzpatrick, AP; Crijns, HJGM; Garratt, CJ

    1999-01-01

    Focal Atrial Fibrillation and Electrical Remodeling. Although atrial fibrillation- (AF) induced changes in atrial refractoriness (atrial electrical remodeling) have been demonstrated in a number of different animal models, the clinical significance of this process is unknown. We describe a patient i

  18. Effects of trimetazidine on atrial structural remodeling and platelet activation in dogs with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    HAN Wei; LI Wei-min; ZHOU Hong-yan; HUO Hong; WEI Na; DONG Guo; CAO Yong; ZHOU Guo; YANG Shu-sen

    2009-01-01

    @@ Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. AF results in electrophysiological alterations which involve increased atrial effective refractory period and atrial effective refractory period dispersion, reduced rate adaptation of atrial effective refractory period, and slowed atrial conduction.

  19. Development of ST Elevation Myocardial Infarction and Atrial Fibrillation after an Electrical Injury

    Directory of Open Access Journals (Sweden)

    Erdal Gursul

    2015-01-01

    Full Text Available Electrical energy is a type of energy that is commonly used in daily life. Ventricular premature beats, ventricular tachycardia, ventricular fibrillation, atrial tachycardia, atrial fibrillation, bundle branch blocks, and AV block are arrhythmic complications that are encountered in case of electric shocks. Myocardial infarction is one of the rarely seen complications of electric shocks yet it has fatal outcomes. Coronary arteries were detected to be normal in most of the patients who had myocardial infarction following an electric shock. So, etiology of myocardial infarction is thought to be unrelated to coronary atherosclerosis in these cases. Coronary artery vasospasm is thought to be the primary etiological cause. In our case report, we presented a patient who developed ST elevation MI with atrial fibrillation after an electric shock.

  20. Premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2012-01-01

    Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

  1. Preterm labor and premature birth: Are you at risk?

    Science.gov (United States)

    ... labor and premature birth: Are you at risk? Preterm labor and premature birth: Are you at risk? ... for preterm labor and premature birth. What are preterm labor and premature birth? Preterm and premature mean ...

  2. Long Latency Auditory Evoked Potential in Term and Premature Infants

    Directory of Open Access Journals (Sweden)

    Didoné, Dayane Domeneghini

    2014-01-01

    Full Text Available Introduction The research in long latency auditory evokes potentials (LLAEP in newborns is recent because of the cortical structure maturation, but studies note that these potentials may be evidenced at this age and could be considered as indicators of cognitive development. Purpose To research the exogenous potentials in term and premature infants during their first month of life. Materials and Methods The sample consisted of 25 newborns, 15 term and 10 premature infants. The infants with gestational age under 37 weeks were considered premature. To evaluate the cortical potentials, the infants remained in natural sleep. The LLAEPs were researched binaurally, through insertion earphones, with frequent /ba/ and rare /ga/ speech stimuli in the intensity of 80 dB HL (decibel hearing level. The frequent stimuli presented a total of 80% of the presentations, and the rare, 20%. The data were statistically analyzed. Results The average gestational age of the term infants was 38.9 weeks (± 1.3 and for the premature group, 33.9 weeks (± 1.6. It was possible to observe only the potentials P1 and N1 in both groups, but there was no statistically significant difference for the latencies of the components P1 and N1 (p > 0.05 between the groups. Conclusion It was possible to observe the exogenous components P1 and N1 of the cortical potentials in both term and preterm newborns of no more than 1 month of age. However, there was no difference between the groups.

  3. Atrial fibrillation and heart failure: is atrial fibrillation a disease?

    Science.gov (United States)

    Tilman, V

    2014-09-01

    Atrial fibrillation in heart failure often occur together. The relationship between atrial fibrillation and heart failure has remained a subject of research. The main manifestation of the violation of hydrodynamics in heart failure is the increased end-diastolic pressure, which is transmitted through the intercommunicated system (left ventricle-left atrium-pulmonary veins-alveolar capillaries) causing increased pulmonary wedge pressure with the danger for pulmonary edema. End-diastolic pressure is the sum of left ventricle diastolic pressure and left atrial systolic pressure. Stopping the mechanical systole of the left atrium can reduce the pressure in the system in heart failure. Atrial fibrillation stops the mechanical systole of the left atrium and decreases the intercommunicating pressure and pulmonary wedge pressure. It is possible that atrial fibrillation is a mechanism for protection from increasing end-diastolic pressure and pulmonary wedge pressure, and prevents the danger of pulmonary edema. This hypothesis may explain the relationship between heart failure and atrial fibrillation and their frequent association.

  4. [Nosology and mechanism of monomorphous atrial tachycardia].

    Science.gov (United States)

    Puech, P

    1990-12-01

    Monomorphous atrial tachycardias have been classified taking into account the ectopic rhythm rate, atrial wave morphology, the mode of activation of the atrial studied by endocavitary cartography, stimulation tests and their natural history. Atrial flutter is a right intra-atrial macroreentry of anticlockwise (common flutter) or clockwise (atypical flutter) rotation, maintained by anisotropic conduction around two pivotal zones located at the posterior and inferior part of the atrium. Tachycardia is made possible by the existence of an excitable zone on the circuit. Paroxysmal atrial tachycardias are far more often linked to localised reentry (sino-atrial or intra-atrial microreentry) than to provoked activity, stimulation tests enabling the distinction to be made. "Digitalis tachycardias" must be seen in the context of activity induced by late post-potential. Focal atrial tachycardias linked to ectopic automatism are a separate entity. They follow a chronic course in the young individual and may lead to a cardiomyopathy purely due to the rhythm abnormality.

  5. Idiopathic giant right atrial aneurysm

    Science.gov (United States)

    Uppu, Santosh C; Sachdeva, Ritu; Imamura, Michiaki

    2013-01-01

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening. PMID:23626440

  6. Idiopathic giant right atrial aneurysm

    OpenAIRE

    Uppu, Santosh C; Ritu Sachdeva; Michiaki Imamura

    2013-01-01

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thicken...

  7. Idiopathic giant right atrial aneurysm

    Directory of Open Access Journals (Sweden)

    Santosh C Uppu

    2013-01-01

    Full Text Available A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening.

  8. Neovascularization in Left Atrial Myxoma

    Science.gov (United States)

    Dubey, Laxman; Chaurasia, Amit Kumar

    2012-01-01

    Abstract We report a case with a left atrial mass who underwent coronary angiography to rule out coronary artery disease. Coronary angiography revealed an anomalous tortuous vascular structure originating from the left circumflex coronary artery to the left atrial tumor suggestive of neovascularization. Preoperative coronary angiography is useful for coronary artery evaluation and also provides additional information regarding the feeding vessel supplying the mass. PMID:24757609

  9. Reversal of severe mitral regurgitation by device closure of a large patent ductus arteriosus in a premature infant.

    Science.gov (United States)

    Kheiwa, Ahmed; Ross, Robert D; Kobayashi, Daisuke

    2017-01-01

    We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.

  10. Probucol attenuates atrial autonomic remodeling in a canine model of atrial fibrillation produced by prolonged atrial pacing

    Institute of Scientific and Technical Information of China (English)

    GONG Yong-tai; LI Wei-min; LI Yue; YANG Shu-sen; SHENG Li; YANG Ning; SHAN Hong-bo; XUE Hong-jie; LIU Wei; YANG Bao-feng; DONG De-li; LI Bao-xin

    2009-01-01

    Background We hypothesize that increased atrial oxidative stress and inflammation may play an important role in atrial nerve sprouting and heterogeneous sympathetic hyperinnervation during atrial fibrillation (AF). To test the hypothesis, we examined whether the antioxidant and anti-inflammatory treatment with probucol attenuates atrial autonomic remodeling in a canine model of AF produced by prolonged rapid right atrial pacing. Methods Twenty-one dogs were divided into a sham-operated group, a control group and a probucol group. Dogs in the control group and probucol group underwent right atrial pacing at 400 beats per minute for 6 weeks, and those in the probucol group received probucol 1 week before rapid atrial pacing until pacing stopped. After 6-week rapid atrial pacing, general properties including left atrial structure and function, atrial hemodynamics and the inducibility and duration of AF were measured in all the groups. Atrial oxidative stress markers and serum C-reactive protein (CRP) concentration were estimated. The degree of nerve sprouting and sympathetic innervation at the right atrial anterior wall (RAAW) and the left atrial anterior wall (LAAW) were quantified by immunohistochemistry, atdal norepinephrine contents were also detected. Atrial beta-nerve growth factor (beta-NGF) mRNA and protein expression at the RAAW and LAAW were assessed by real-time quantitative RT-PCR and Western blotting respectively. Results Atrial tachypacing induced significant nerve sprouting and heterogeneous sympathetic hyperinnervation, and the magnitude of nerve sprouting and hyperinnervation was higher in the RAAW than in the LAAW. Atrial beta-NGF mRNA and protein levels were significantly increased at the RAAW and LAAW, and the upregulation of beta-NGF expression was greater at the RAAW than at the LAAW in the control group. The beta-NGF protein level was positively correlated with the density of sympathetic nerves in all groups. Probucol decreased the increase of

  11. Emotional stimuli and motor conversion disorder

    NARCIS (Netherlands)

    Voon, V.; Brezing, C.; Gallea, C.; Ameli, R.; Roelofs, K.; LaFrance, W.C.; Hallett, M.

    2010-01-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli,

  12. Your Premature Baby: Low Birthweight

    Science.gov (United States)

    ... many low-birthweight babies are born prematurely, many risk factors for having a low-birthweight baby are the same for preterm labor and ... risk for having a low-birthweight baby. Medical risk factors for having a low-birthweight baby Preterm labor . This is labor that starts ...

  13. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  14. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  15. Late atypical atrial flutter after ablation of atrial fibrillation.

    Science.gov (United States)

    Ferreira, Raquel; Primo, João; Adão, Luís; Gonzaga, Anabela; Gonçalves, Helena; Santos, Rui; Fonseca, Paulo; Santos, José; Gama, Vasco

    2016-10-01

    Cardiac surgery for structural heart disease (often involving the left atrium) and radiofrequency catheter ablation of atrial fibrillation have led to an increased incidence of regular atrial tachycardias, often presenting as atypical flutters. This type of flutter is particularly common after pulmonary vein isolation, especially after extensive atrial ablation including linear lesions and/or defragmentation. The authors describe the case of a 51-year-old man, with no relevant medical history, referred for a cardiology consultation in 2009 for paroxysmal atrial fibrillation. After failure of antiarrhythmic therapy, he underwent catheter ablation, with criteria of acute success. Three years later he again suffered palpitations and atypical atrial flutter was documented. The electrophysiology study confirmed the diagnosis of atypical left flutter and reappearance of electrical activity in the right inferior pulmonary vein. This vein was again ablated successfully and there has been no arrhythmia recurrence to date. In an era of frequent catheter ablation it is essential to understand the mechanism of this arrhythmia and to recognize such atypical flutters.

  16. Prostaglandin E2 and patent ductus arteriosus in premature infants

    Directory of Open Access Journals (Sweden)

    Mochammading,

    2016-01-01

    Full Text Available Background Patent ductus arteriosus (PDA is a congenital heart disease most commonly occurring in premature infants. Spontaneous ductus arteriosus (DA closure in premature infants has been suggested to be associated with duct lumen maturity and the DA sensitivity to prostaglandin E2 (PGE2. Objective To assess for a possible correlation between serum PGE2 levels and PDA size in premature infants. Methods This observational study using repeated measurements on premature infants with PDA detected at days 2-3 of life was undertaken in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, from April to May 2014. The PDA was diagnosed using 2-D echocardiography and PGE2 levels were measured by immunoassay. Pearson’s correlation test was used to evaluate a possible correlation between PGE2 level and DA diameter. Results Thirty-three premature infants of median gestational age 31 (range 28-32 weeks and median birth weight 1,360 (range 1,000-1,500 grams were enrolled. Almost two-thirds of the subjects were male. Almost all (30/33 subjects had spontaneous DA closure before the age of 10 days. Subjects’ mean DA diameter was 2.9 (SD 0.5 mm with maximum flow velocity of 0.2 (SD 0.06 cm/sec, and left atrial-to-aortic root ratio (LA/Ao of 1.5 (SD 0.2. Their mean PGE2 levels at the ages of 2-3, 5-7, and after 10 days were 5,238.6 (SD 1,225.2, 4,178.2 (SD 1,534.5, and 915.2 (SD 151.6 pg/mL, respectively. The PGE2 level at days 2-3 was significantly correlated with DA diameter (r = 0.667; P < 0.001, but not at days 5-7 (r = 0.292; P = 0.105 or at day 10 (r = 0.041; P = 0.941. Conclusion There is a strong, positive correlation between the PGE2 level and DA diameter in preterm infants at 2-3 days of age. However, there is no significant correlation between PGE2 level and persistence of PDA.

  17. Isolated Atrial Amyloidosis in Patients with Various Types of Atrial Fibrillation.

    Science.gov (United States)

    Sukhacheva, T V; Eremeeva, M V; Ibragimova, A G; Vaskovskii, V A; Serov, R A; Revishvili, A Sh

    2016-04-01

    The myocardium of the right and left atrial appendages (auricles) in patients with paroxysmal, persistent, and permanent forms of atrial fibrillation was examined by histological methods and electron microscopy. Isolated atrial amyloidosis was detected in the left (50.0-56.3% patients) and in the right (45.0-55.6% patients) atrial appendages. In all cases, immunohistochemistry revealed atrial natriuretic peptide in fibrillary amyloid deposits. Ultrastructurally, amyloid masses formed clusters of myofibrils 8-10 nm in diameter. They were chaotically located in the extracellular space along the sarcolemma as well as in membrane invaginations, dilated tubules of cardiomyocyte T-tubular system, and vascular walls. Amyloidosis was predominantly observed in women; its degree positively correlated with age of patients and duration of atrial fibrillation but negatively correlated with atrial fibrosis. The study revealed positive (in permanent atrial fibrillation) and negative (in paroxysmal atrial fibrillation) correlation of amyloidosis with myofibril content in atrial cardiomyocytes.

  18. MODERN PRODUCTS FOR FEEDING PREMATURE BABIES

    National Research Council Canada - National Science Library

    A. V. Surzhik

    2012-01-01

    .... Adequate feeding is one of the fundamental factors of premature babies nursing. To ensure a premature baby with all necessary components for power saving in breast milk intake, breast milk fortifiers...

  19. Left Atrial Linear Ablation of Paroxysmal Atrial Fibrillation Guided by Three-dimensional Electroanatomical System

    DEFF Research Database (Denmark)

    Zhang, Dai-Fu; Li, Ying; Qi, Wei-Gang

    2005-01-01

    Objective To investigate the safety and efficacy of Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system. Methods 29 patients with paroxysmal atrial fibrillation in this study. A nonfluoroscopic mapping system was used to generate a 3D...... attacks unchanged. No pulmonary vein narrowing was observed. Conclusion Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system was safe and effective....

  20. RELATION BETWEEN LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN DIFFERENT DISEASES

    Directory of Open Access Journals (Sweden)

    Rajith

    2014-11-01

    Full Text Available BACKGROUND: Atrial fibrillation is the most common cardiac dysrhythmia and left atrial size is an important factor in the development of atrial fibrillation. In the presence of atrial fibrillation an increase in left atrial size is associated with increased risk of stroke as well as increased morbidity and mortality. In this context, this study entitled “relation between left atrial size and atrial fibrillation in different diseases” was undertaken to study the left atrial size in different diseases causing atrial fibrillation and its relation to the atrial fibrillation. METHODS: A cross-sectional study was done from March 2004 to February 2006 in all medical units of Basaveshwar teaching and general hospital and Government general hospital Gulbarga. 70 cases of atrial fibrillation were studied in the present study. RESULTS: In the present study Atrial Fibrillation was common in >40 years age group (70%, left atrial enlargement was also more common in this age group (69.38%. Left atrial enlargement was seen in 70% of patients with Atrial Fibrillation. Rheumatic heart disease was the most common cause of Atrial Fibrillation (54.28% and left atrial enlargement was seen in 92% of these patients with mean left atrial size of 58.92 mm. Next most common cause was coronary artery disease (20% and left atrial enlargement was seen in 57.14% patients with a mean left atrial size of 39.5 mm. Left atrial size was normal in patients with thyrotoxicosis, congenital heart disease, lone Atrial Fibrillation and primary pulmonary hypertension. Left atrial enlargement was significantly associated with worsening of functional status (p<0.01, pulmonary arterial hypertension (p<0.005 and congestive cardial failure (p<0.02. 17.14% of patients with Atrial Fibrillation had embolic complications like stroke, of them left atrial enlargement was seen in 83.33% patients. 4.27% of patients with Atrial Fibrillation died during the hospital course, of them left atrial

  1. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  2. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant

  3. The internodal atrial myocardium.

    Science.gov (United States)

    Anderson, R H; Ho, S Y; Smith, A; Becker, A E

    1981-09-01

    The anatomical substrates of internodal conduction have long been a contentious topic. Debated first by the German Pathological Society in 1910, the consensus of established opinion for over half a century was that conduction between sinus and atrioventricular nodes occurred through plain myocardium. This was a conclusion supported by Truex in 1961. Despite his restatement of this fact in 1976, it has become fashionable to describe internodal conduction as being mediated by specialized internodal pathways. To reinvestigate this problem we studied 22 human fetal and 32 human infant hearts. In each case it was possible to cut the atrial tissues as a single block of tissue and to examine serial sections through the internodal myocardium. The sinus node, atrioventricular node, and segments of atrioventricular ring specialized tissue were recognized as specialized tissue using the light microscope in each heart. In contrast, there was nothing "special" about the myocardium between the nodes, nor was it possible to recognize tracts on the basis of either histological appearance or cellular architecture. It is concluded that, from the standpoint of light microscopy, there is no evidence whatsoever to support the purported concept of specialized anatomical substrates for internodal conduction.

  4. Outcomes for Extremely Premature Infants

    Science.gov (United States)

    Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, since therapy and supportive care continue to change, the outcomes of ELBW infants are ever evolving. Efforts to minimize injury, preserve

  5. Outcomes for extremely premature infants.

    Science.gov (United States)

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address developmental, learning, behavioral, and

  6. MODERN PRODUCTS FOR FEEDING PREMATURE BABIES

    Directory of Open Access Journals (Sweden)

    A. V. Surzhik

    2012-01-01

    Full Text Available In recent decades there has been substantial progress in the technology of premature infants nursing, especially with extremely low birth weight. Adequate feeding is one of the fundamental factors of premature babies nursing. To ensure a premature baby with all necessary components for power saving in breast milk intake, breast milk fortifiers — specifically developed additives that adjust the composition of food for premature babies, are used for more than 20 years (for premature babies receiving breast milk. On the one hand, to preserve all benefits of breastfeeding, on the other — to prevent the deficit development of necessary elements for adequate growth and development of nutrients.

  7. [Forensic importance of premature craniosynostosis].

    Science.gov (United States)

    Fehlow, P

    1991-01-01

    In agreement with Canabis craniosynostosis as a little known organic partial factor of sociopathy is demonstrated. A psychic syndrome of the frontal lobe with increased susceptibility in environmental damages is assumed to be basic disorder. In the criminals of the material sexual offenders were preponderating. Associated craniofacial dysplasias are a risk for psychic maldevelopment. The importance of premature craniosynostocis as a biological risk factor, incidence, diagnostic, indication for an operation, also in the meaning of a neurosurgical "Konflikttherapie" (cosmetical indication) are discussed.

  8. Visual and visuocognitive development in children born very prematurely.

    Science.gov (United States)

    Atkinson, Janette; Braddick, Oliver

    2007-01-01

    Preterm birth is a risk factor for deficits of neurological and cognitive development. Four cohort studies are reported investigating the effects of very premature birth (development correlated with the severity of brain abnormality observed on structural MRI at and before term, and were sensitive predictors of neurodevelopmental outcome at 2 years. The second study compared VERP measures for orientation-reversal and direction-reversal (DR) stimuli, from 2 to 5 months post-term age, in healthy very premature infants compared to infants born at term. The groups did not differ on the development of OR-VERP responses, but the development of the DR-VERP motion responses was delayed in the premature group despite the absence of any brain damage visible on ultrasound, consistent with the developmental vulnerability we have identified in the dorsal cortical stream. The third study used the Atkinson Battery of Child Development for Examining Functional Vision (ABCDEFV) to assess sensory, perceptual, cognitive and spatial visual functions, together with preschool tests of attention and executive function. The premature group showed delays on these tests in line with severity of observed perinatal brain damage on structural MRI at term age. Deficits on certain spatial tasks (e.g. block-construction copying) and executive function tests (e.g. the detour box task) were apparent even in children with minimal damage apparent on MRI. The fourth study tested a large cohort of 6- to 7-year old children born before 32 weeks gestation, across a wide range of cognitive domains, including new tests of spatial cognition and memory. The premature group as a whole showed significant deficits on both auditory and visual tests of attention and attentional control from the TEA-Ch battery, on tests of location memory, block construction and on many visuocognitive and visuomotor tests. Development was generally relatively normal on language tests and on WPPSI scores. Factor analysis showed

  9. Consistency of Border-Ownership Cells across Artificial Stimuli, Natural Stimuli, and Stimuli with Ambiguous Contours.

    Science.gov (United States)

    Hesse, Janis K; Tsao, Doris Y

    2016-11-02

    Segmentation and recognition of objects in a visual scene are two problems that are hard to solve separately from each other. When segmenting an ambiguous scene, it is helpful to already know the present objects and their shapes. However, for recognizing an object in clutter, one would like to consider its isolated segment alone to avoid confounds from features of other objects. Border-ownership cells (Zhou et al., 2000) appear to play an important role in segmentation, as they signal the side-of-figure of artificial stimuli. The present work explores the role of border-ownership cells in dorsal macaque visual areas V2 and V3 in the segmentation of natural object stimuli and locally ambiguous stimuli. We report two major results. First, compared with previous estimates, we found a smaller percentage of cells that were consistent across artificial stimuli used previously. Second, we found that the average response of those neurons that did respond consistently to the side-of-figure of artificial stimuli also consistently signaled, as a population, the side-of-figure for borders of single faces, occluding faces and, with higher latencies, even stimuli with illusory contours, such as Mooney faces and natural faces completely missing local edge information. In contrast, the local edge or the outlines of the face alone could not always evoke a significant border-ownership signal. Our results underscore that border ownership is coded by a population of cells, and indicate that these cells integrate a variety of cues, including low-level features and global object context, to compute the segmentation of the scene.

  10. Stimuli, Reinforcers, and Private Events

    Science.gov (United States)

    Nevin, John A.

    2008-01-01

    Radical behaviorism considers private events to be a part of ongoing observable behavior and to share the properties of public events. Although private events cannot be measured directly, their roles in overt action can be inferred from mathematical models that relate private responses to external stimuli and reinforcers according to the same…

  11. Stimuli, Reinforcers, and Private Events

    Science.gov (United States)

    Nevin, John A.

    2008-01-01

    Radical behaviorism considers private events to be a part of ongoing observable behavior and to share the properties of public events. Although private events cannot be measured directly, their roles in overt action can be inferred from mathematical models that relate private responses to external stimuli and reinforcers according to the same…

  12. Atrial fibrillation and delayed gastric emptying.

    Directory of Open Access Journals (Sweden)

    Isadora C Botwinick

    Full Text Available BACKGROUND: Atrial fibrillation and delayed gastric emptying (DGE are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7(th postoperative day. METHODS: We performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables. RESULTS: Approximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p = 0.0005. Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p = 0.03. 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p = 0.0007. This association held true when controlling for age. CONCLUSION: Patients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.

  13. [New antithrombotics for atrial fibrillation].

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2011-01-01

    Cerebral infarction is the most serious complication of atrial fibrillation. Coumarin derivatives (vitamin K antagonists) counteract systemic thromboembolism and reduce the risk of stroke by more than 60%, but carry a risk of serious bleeding. Antiplatelet therapy and subcutaneous low-molecular-weig

  14. Radiofrequency ablation of atrial fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Tan, ES; Van Veldhuisen, DJ; Crijns, HJGM; Van Gelder, IC

    2004-01-01

    Twenty-five patients (16 males, mean age 46 years.) underwent radiofrequency ablation because of either paroxysmal (13 patients) or persistent atrial fibrillation (12 patients). Ablation aimed at earliest activation of spontaneous and catheter-induced repetitive ectopy in left and right atria and ap

  15. Genetic basis of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Oscar Campuzano

    2016-12-01

    Full Text Available Atrial fibrillation is the most common sustained arrhythmia and remains as one of main challenges in current clinical practice. The disease may be induced secondary to other diseases such as hypertension, valvular heart disease, and heart failure, conferring an increased risk of stroke and sudden death. Epidemiological studies have provided evidence that genetic factors play an important role and up to 30% of clinically diagnosed patients may have a family history of atrial fibrillation. To date, several rare variants have been identified in a wide range of genes associated with ionic channels, calcium handling protein, fibrosis, conduction and inflammation. Important advances in clinical, genetic and molecular basis have been performed over the last decade, improving diagnosis and treatment. However, the genetics of atrial fibrillation is complex and pathophysiological data remains still unraveling. A better understanding of the genetic basis will induce accurate risk stratification and personalized clinical treatment. In this review, we have focused on current genetics basis of atrial fibrillation.

  16. Facts about Atrial Septal Defect

    Science.gov (United States)

    ... Living With Heart Defects Data & Statistics Tracking & Research Articles & Key Findings Free Materials Multimedia and Tools Links to Other Websites Information For... Media Policy Makers Facts about Atrial Septal Defect Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  17. Personalized management of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne

    2013-01-01

    The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to de...

  18. A study on stability analysis of atrial repolarization variability using ARX model in sinus rhythm and atrial tachycardia ECGs.

    Science.gov (United States)

    Sivaraman, J; Uma, G; Langley, P; Umapathy, M; Venkatesan, S; Palanikumar, G

    2016-12-01

    The interaction between the PTa and PP interval dynamics from the surface ECG is seldom explained. Mathematical modeling of these intervals is of interest in finding the relationship between the heart rate and repolarization variability. The goal of this paper is to assess the bounded input bounded output (BIBO) stability in PTa interval (PTaI) dynamics using autoregressive exogenous (ARX) model and to investigate the reason for causing instability in the atrial repolarization process. Twenty-five male subjects in normal sinus rhythm (NSR) and ten male subjects experiencing atrial tachycardia (AT) were included in this study. Five minute long, modified limb lead (MLL) ECGs were recorded with an EDAN SE-1010 PC ECG system. The number of minute ECGs with unstable segments (Nus) and the frequency of premature activation (PA) (i.e. atrial activation) were counted for each ECG recording and compared between AT and NSR subjects. The instability in PTaI dynamics was quantified by measuring the numbers of unstable segments in ECG data for each subject. The unstable segments in the PTaI dynamics were associated with the frequency of PA. The presence of PA is not the only factor causing the instability in PTaI dynamics in NSR subjects, and it is found that the cause of instability is mainly due to the heart rate variability (HRV). The ARX model showed better prediction of PTa interval dynamics in both groups. The frequency of PA is significantly higher in AT patients than NSR subjects. A more complex model is needed to better identify and characterize healthy heart dynamics. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. [Atrial fibrillation and cognitive function].

    Science.gov (United States)

    Duron, Emmanuelle; Hanon, Olivier

    2010-09-01

    Atrial fibrillation (AF), which prevalence increases with age, is a growing public health problem and a well known risk factor for stroke. On the other hand, dementia is one of the most important neurological disorders in the elderly, and with aging of the population in developed countries, the number of demented patients will increase in absence of prevention. In the past decade, several vascular risk factors (hypertension, obesity and metabolic syndrome, hypercholesterolemia) have been found, with various degree of evidence, to be associated with vascular dementia but also, surprisingly, with Alzheimer's disease. This review is devoted to the links between atrial fibrillation, cognitive decline and dementia. Globally, transversal studies showed a significant association between atrial fibrillation, cognitive decline and dementia. However, these studies are particularly sensitive to various biases. In this context, recent longitudinal studies of higher level of evidence have been conducted to assess the link between AF and dementia. One study disclosed a high incidence of dementia among patients suffering from atrial fibrillation during a 4.6 years follow-up. Similarly another study showed that atrial fibrillation was significantly associated with conversion from mild cognitive impairment to dementia during a 3 years follow-up. Nevertheless two other longitudinal studies did not find any significant association between AF and dementia, but this discrepancy should be interpreted taking into account that the comparability of all these studies is moderate because they were using different methodologies (population, cognitive testing, and mean follow-up). Possible explanatory mechanisms for the association between AF and the risk of dementia are proposed, such as thrombo-embolic ischemic damage and cerebral hypo perfusion due to fluctuations in the cardiac output. Thus, there is some evidence that FA could be associated with cognitive decline and dementia but this

  20. Premature birth and diseases in premature infants: common genetic background?

    Science.gov (United States)

    Hallman, Mikko

    2012-04-01

    It has been proposed that during human evolution, development of obligate bipedalism, narrow birth canal cross-sectional area and the large brain have forced an adjustment in duration of pregnancy (scaling of gestational age; Plunkett 2011). Children compared to other mammals are born with proportionally small brains (compared to adult brains), suggesting shortening of pregnancy duration during recent evolution. Prevalence of both obstructed delivery and premature birth is still exceptionally high. In near term infants, functional maturity and viability is high, and gene variants predisposing to respiratory distress syndrome (RDS) are rare. Advanced antenatal and neonatal treatment practices during the new era of medicine allowed survival of also very preterm infants (gestation premature birth. Specific genes associating with diseases in preterm infants may also contribute to the susceptibility to preterm birth. Understanding and applying the knowledge of genetic interactions in normal and abnormal perinatal-neonatal development requires large, well-structured population cohorts, studies involving the whole genome and international interdisciplinary collaboration.

  1. [Premature ejaculation: pills or sexology?].

    Science.gov (United States)

    Wisard, M; Audette, N

    2008-03-26

    Premature ejaculation (PE) is a frequent male sexual complaint that affects 20 to 30% of men. The exact aetiology is unknown: psychological/behavioristic and biogenic etiologies have been proposed. The introduction of selective serotonin reuptake inhibitors (SSRI) was revolutionary in the medical treatment of PE. However precautions should be taken because of potential adverse side effects. There is no clear consensus as to whether SSRI may represent an eventual cure of PE or will be required for life. The sexocorporal approach is an other treatment of PE, but convincing scientific treatment data are also lacking.

  2. Positional moulding in premature hydrocephalics.

    Directory of Open Access Journals (Sweden)

    Kumar R

    2002-04-01

    Full Text Available Seven premature hydrocephalics presenting with lambdoid positional moulding (LPM were reviewed. All were treated for hydrocephalus secondary to aqueductal stenosis, Dandy Walker Syndrome and infection. Parenchymal hemorrhage, intraventricular bleed, cortical atrophy, septal agenesis, cortical anomalies and subdural hygroma were the other common associations. These children did not show expected improvement in their higher mental functions at 6 months to 5.4 years of follow-up, following the management of hydrocephalus. It was not the LPM but associated intracranial anomalies, which were most probably responsible for their poor outcome. The differentiation from posterior plagiocephaly is also highlighted.

  3. Metabolic bone disease of prematurity

    Directory of Open Access Journals (Sweden)

    Stacy E. Rustico, MD

    2014-09-01

    Full Text Available Metabolic bone disease (MBD of prematurity remains a significant problem for preterm, chronically ill neonates. The definition and recommendations for screening and treatment of MBD vary in the literature. A recent American Academy of Pediatrics Consensus Statement may help close the gap in institutional variation, but evidence based practice guidelines remain obscure due to lack of normative data and clinical trials for preterm infants. This review highlights mineral homeostasis physiology, current recommendations in screening and monitoring, prevention and treatment strategies, and an added perspective of a bone health team serving a high volume referral neonatal intensive care center.

  4. Current therapies for premature ejaculation.

    Science.gov (United States)

    Gur, Serap; Kadowitz, Philip J; Sikka, Suresh C

    2016-07-01

    Premature ejaculation (PE) subjectively affects 20-30% of men globally. Until recently, understanding of PE was hampered by the absence of a widely accepted definition, paucity of evidence-based clinical studies, and the absence of an appropriate animal model. Here, we elaborate on the current definition of PE, its pathogenesis, currently available therapies, and future treatment prospects. Most treatments for PE are 'off-label' and include selective serotonin reuptake inhibitors (SSRIs), topical anesthetics, tramadol, and phosphodiesterase type 5 (PDE5) inhibitors. Such knowledge of the benefit and limitations of each treatment will help to direct future drug design and formulations.

  5. Premature ventricular contractions associated with isotretinoin use.

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case.

  6. Premature ventricular contractions associated with isotretinoin use*

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case. PMID:28099609

  7. Atrioverter : An implantable device for the treatment of atrial fibrillation

    NARCIS (Netherlands)

    Wellens, HJJ; Lau, CP; Luderitz, B; Akhtar, M; Waldo, AL; Camm, AJ; Timmermans, C; Tse, HF; Jung, W; Jordaens, L; Ayers, G

    1998-01-01

    Background-During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows pr

  8. Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Kenichi Hashimoto, MD

    2005-01-01

    Full Text Available Left atrial tachycardia (AT has been reported to occur after pulmonary vein isolation (PVI for the treatment of atrial fibrillation (AF. We treated 3 patients who developed AT of different mechanisms following PVI. In case 1, focal AT originating at the ostium of the left superior PV was demonstrated and focal radiofrequency ablation was performed at the breakthrough point at the ostium of the left superior PV terminated the AT. In case 2, AT was shown to be counterclockwise macroreentrant AT around the left inferior PV through the conduction gap of the left sided posterior wall for which linear ablation was performed between left superior and inferior PVs. Focal ablation at the conduction gap terminated the AT. In case 3, a macroreentrant AT propagating around the mitral annulus was demonstrated and linear ablation between left inferior pulmonary vein and mitral annulus (mitral isthmus terminated the AT.

  9. Premature temporal theta (PT theta).

    Science.gov (United States)

    Hughes, J R; Fino, J J; Hart, L A

    1987-07-01

    A distinctive pattern called premature temporal theta (PT theta) was studied in 436 infants, ranging in age from 24 to 46 weeks. The pattern is seen in early prematurity, maximizes at 29-31 weeks and then diminishes and disappears near term. Usually the pattern is found independently on both temporal areas, but with a right-sided preference. Patients without PT theta or with a significantly low amount had either neurological or non-neurological (medical) conditions. With age there is a tendency for an increase in frequency and a decrease in amplitude. Five different peaks in the amount of this pattern are seen at approximately every month. Unilateral PT theta tends to be seen in older babies, more often on the right side and with an abnormal EEG. An abnormal EEG is usually associated with a delay in both the appearance and disappearance of this wave form. PT theta is also associated mainly with REM or active sleep. A polynomial rather than an exponential or power function best describes these data with changes of age. PT theta may arise from the inferior temporal gyrus and/or especially the transverse gyrus.

  10. Atrial septal stenting - How I do it?

    Directory of Open Access Journals (Sweden)

    Kothandam Sivakumar

    2015-01-01

    Full Text Available A wide atrial communication is important to maintain hemodynamics in certain forms of congenital and acquired heart defects. In comparison to balloon septostomy or blade septostomy, atrial septal stenting provides a controlled, predictable, and long-lasting atrial communication. It often needs a prior Brockenbrough needle septal puncture to obtain a stable stent position. A stent deployed across a previously dilated and stretched oval foramen or tunnel form of oval foramen carries higher risk of embolization. This review provides technical tips to achieve a safe atrial septal stenting. Even though this is a "How to do it article," an initial discussion about the indications for atrial septal stenting is vital as the resultant size of the atrial septal communication should be tailored for each indication.

  11. Risk of atrial fibrillation in diabetes mellitus

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik L.; Schjerning, Anne-Marie; Lindhardt, Tommi B.

    2016-01-01

    AIM: Diabetes has been associated with atrial fibrillation but the current evidence is conflicting. In particular knowledge regarding young diabetes patients and the risk of developing atrial fibrillation is sparse. The aim of our study was to investigate the risk of atrial fibrillation in patients...... with diabetes compared to the background population in Denmark. METHODS AND RESULTS: Through Danish nationwide registries we included persons above 18 years of age and without prior atrial fibrillation and/or diabetes from 1996 to 2012. The study cohort was divided into a background population without diabetes...... and a diabetes group. The absolute risk of developing atrial fibrillation was calculated and Poisson regression models adjusted for sex, age and comorbidities were used to calculate incidence rate ratios of atrial fibrillation. The total study cohort included 5,081,087 persons, 4,827,713 (95%) in the background...

  12. Atrial – Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    T Panagiotopoulos

    2009-05-01

    Full Text Available Atrial and ventricular septal defect constitute the most common congenital heart disease.Aim: Τhe aim of the present retrospective study was to record data and factors that affect atrial and ventricular septal defect.Method and material: The sample study included patients of both sexes who were hospitalized with diagnosis atrial and ventricular septal defect in a Cardiac Surgery hospital of Athens. A specially constructed printed form was used for data collection, where were recorded the demographic and personal variables, the pathological, surgical, cardiology and obstetric history, the habits of adults, as well as the personal characteristics of mothers. Analysis of data was performed by descriptive statistical analysis.Results: The sample study consisted of 101 individuals with diagnosis atrial or ventricular Septal Defect, of which 40% were boys and 60% girls. The 70% of the sample study suffered from atrial Septal Defect and the 30% suffered from ventricular Septal Defect. Regarding age, 12% of the sample study was 0-1 years old, 35% was >1 years old, 8% was >12-18 years old and 45% over than 18 years old. Regarding educational status of the adult participants, 9% was of 0-6 years education, 22%>6 -12 years, 13%>12 years. 14% of the adult paticipants smoked, 4% consumed alcohol and 5% smoked in conjunction with alcohol. In terms of the obstetric history of the sample studied, 32% of the cases had normal birth, 4% had a twin birth and 1% had a triplet one. According to the variables related to mothers, the mean age of the mother was 30 years and 3 months, 10% were smokers at pregnancy and 3% used chemical substance and mainly hair color. Also, the results of the present study showed that individuals of 12-18 and >18 years old did not suffer from ventricular Septal Defect, whereas the infants 0-1 years old did not suffer from Atrial Septal Defect. The mean value of age at the admission in intensive care unit was 7 months (12% for the infants

  13. ANALYSIS OF RANDOMNESS OF ATRIAL AND VENTRICULAR RHYTHM IN ATRIAL-FIBRILLATION

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; HAAKSMA, J; BEL, KJ; CRIJNS, HJGM; DIJK, WA; LIE, KI

    1995-01-01

    The aim of the present study was top examine the relationship between randomness of atrial and ventricular rhythm during atrial fibrillation. Atrial fibrillation was induced in 10 open-chest pigs by application of metacholine on the surface of the right atrium followed by incremental pacing. Local a

  14. Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed Tomography

    NARCIS (Netherlands)

    Hof, Irene; Arbab-Zadeh, Armin; Scherr, Daniel; Chilukuri, Karuna; Dalal, Darshan; Abraham, Theodore; Lima, Joao; Calkins, Hugh

    2009-01-01

    Computed Tomography. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echoca

  15. The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash; Safi, Sanam; Nielsen, Emil E

    2017-01-01

    BACKGROUND: Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation...... as healthcare systems and healthcare economy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016051433....

  16. Congenital left atrial appendage aneurysm: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Mehdi Bamous

    2017-01-01

    Full Text Available Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.

  17. Emotional Stimuli and Motor Conversion Disorder

    Science.gov (United States)

    Voon, Valerie; Brezing, Christina; Gallea, Cecile; Ameli, Rezvan; Roelofs, Karin; LaFrance, W. Curt, Jr.; Hallett, Mark

    2010-01-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to…

  18. Subconscious Subliminal Stimuli And rrrsssssshhhppp!

    DEFF Research Database (Denmark)

    Lewis Brooks, Anthony

    2003-01-01

    in a ‘remarkable reductive retraction’ from ‘fixation centers’ such that a more human intuitive interaction to the ‘New World’ becomes apparent in design scenarios. Ubiquitous ‘Virtual Interactive Space’ (Brooks, 1999) will become a more utilized and higher resolution capture resource integrative to design...... of such issues as outlined in my opening statement. I suggest that successful design of the future will take much more into account the neural stimuli & potential subliminal synesthesia design aspects as an integrated element of the envisioned Virtual Interactive Space. Keywords: remarkable reductive retraction...

  19. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roger Kerzner; Michael W. Rich

    2005-01-01

    Atrial fibrillation (AF) is an extremely common condition in the elderly, with increasing prevalence around the world as the population ages. AF may be associated with serious health consequences, including stroke, heart failure, and decreased quality of life, so that careful management of AF by geriatric health care providers is required. With careful attention to anticoagulation therapy, and prudent use of medications and invasive procedures to minimize symptoms, many of the adverse health consequences of AF can be prevented.

  20. CORRELATION OF LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN RHD WITH MITRAL VALVE DISEASE

    Directory of Open Access Journals (Sweden)

    Raghavendra

    2016-03-01

    Full Text Available BACKGROUND Atrial fibrillation (AF, the most common sustained cardiac rhythm disturbance, commonly occurs with rheumatic heart disease, particularly mitral stenosis. Hemodynamic impairment and thromboembolic events result in significant morbidity& mortality. Left atrial (LA enlargement is one of the elements that evolve in the natural history of mitral stenosis. The objective of this study is to study the relation between echo cardio graphically determined left atrial size and atrial fibrillation in mitral valve disease (MVD. METHODOLOGY 50 Patients with rheumatic heart disease with mitral valve disease were studied using ECG and ECHO, excluding patients with congenital heart diseases, non-rheumatic mitral valve disease, essential hypertension, patients undergone PTMC or valvuloplasty or valve replacement, coronary artery diseases, patients on antiarrhythmic drugs, pregnant women. Left atrial dimensions measured by ECHO in patients of MVD and AF on ECG were compared with the left atrial dimension of patients in sinus rhythm. RESULTS In this study 42 patients had left atrial size >40 mm, 29(93.55% of them were in atrial fibrillation and only 13(68.42% were in sinus rhythm. Among 8 patients with left atrial size <40 mm, 2(6.45% were in atrial fibrillation and 06(31.58% were in sinus rhythm with p<0.02 which is significant. CONCLUSION Atrial fibrillation incidence was common when left atrial dimension was above 40 mm. There is a quantitative relation between left atrial size measured echocardiographically and the presence or absence of atrial fibrillation. These results may have therapeutic implication in that it may be possible with echocardiography, to identify patients in sinus rhythm, who are at high risk of developing atrial fibrillation. Prophylactic anticoagulation, antiarrhythmic therapy or both might be considered in management to prevent embolism.

  1. Functional vision assessment of a premature child with congenital blindness

    Directory of Open Access Journals (Sweden)

    Marcela Favilla

    2014-09-01

    Full Text Available In the program of early intervention in occupational therapy, the assessment of functional vision and infant development of children with visual impairment contributes to improve the development of their skills. The aim of this study was to present the results of the functional vision assessment of a premature child with congenital blindness and point out the importance of the findings for planning occupational therapy intervention and family orientation. The study participant was a preterm child with 6 months of corrected age and ophthalmological diagnosis of retinopathy of prematurity; she participated in the Visually Impaired Habilitation and Rehabilitation Program at a public university in the countryside of Sao Paulo state. For data collection, we used the Assessment of Functional Vision and Infant Development, an evaluation script that enables the record of children’s performance and behavior in response to different visual stimuli. We verified that, through the functional vision assessment, it is possible to learn the conditions that contribute to children’s ability to use their visual functioning and remaining sensory resources, pointing out the importance of material and environmental adaptations that favor children’s interaction with the external environment. The findings are relevant to aid in educating parents about children’s skills and understanding the different ways to encourage the use of functional vision in daily activities. Thus, the functional vision assessment of children with visual impairment is a relevant guiding parameter to complement the psychomotor development assessment in occupational therapy intervention.

  2. 7 CFR 29.2290 - Premature primings.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Premature primings. 29.2290 Section 29.2290 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... 21) § 29.2290 Premature primings. Ground leaves harvested before reaching complete growth and...

  3. 28 CFR 51.22 - Premature submissions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Premature submissions. 51.22 Section 51.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF... § 51.22 Premature submissions. The Attorney General will not consider on the merits: (a) Any proposal...

  4. Premature infants' health at multiple induced pregnancy.

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2015-09-01

    Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

  5. [Premature rupture of membranes and chorioamnionitis].

    Science.gov (United States)

    Lopez Garcia, R

    1988-01-01

    Despite advances in perinatal medicine in the past decade, the diagnosis and treatment of premature rupture of membranes remain controversial. Premature rupture occurs in 2.7-7.0% of pregnancies and most cases occur spontaneously without apparent cause. The disparity in reported rates of premature rupture is due to differences in the definition and diagnostic criteria for premature rupture and lack of comparability in the populations studied. Mexico's National Institute of Perinatology has adopted the definition of the American COllege of Gynecology and Obstetrics which views premature rupture as that occurring before regular uterine contractions that produce cervical dilation. 8.8% of its patients have premature rupture according to this definition. 20% of cases occur before the 36th week of pregnancy. Treatment of rupture occurring before 37 weeks must balance the threat of amniotic infection with the dangers of premature birth. Infections appear more common in low income patient populations. Chorioamnionitis is a serious complication of pregnancy and is the main argument against conservative treatment of premature rupture. The rate of maternal infection is directly related to the time elapsing between rupture of the membranes and birth. The rate increases after the 1st 24 hours and is at least 10 times higher after 72 hours. But recent studies suggest that there is no considerable increase in infection if vaginal explorations are avoided and careful techniques are used in treating the patient. Those who advise conservative treatment believe that prenatal outcomes are better because respiratory disease syndrome due to prematurity is avoided. Conservative management requires a white cell count at least every 24 hours and measurement of pulse, maternal temperature, and fetal heart rate ideally every 4 hours. Perinatal mortality rates due to premature rupture of membranes range from 2.5-50%. The principal causes are respiratory disease syndrome, infection, asphyxia

  6. Cortical activation elicited by unrecognized stimuli

    Directory of Open Access Journals (Sweden)

    Badgaiyan Rajendra D

    2006-05-01

    Full Text Available Abstract Background It is unclear whether a stimulus that cannot be recognized consciously, could elicit a well-processed cognitive response. Methods We used functional imaging to examine the pattern of cortical activation elicited by unrecognized stimuli during memory processing. Subjects were given a recognition task using recognizable and non-recognizable subliminal stimuli. Results Unrecognized stimuli activated the cortical areas that are associated with retrieval attempt (left prefrontal, and novelty detection (left hippocampus. This indicates that the stimuli that were not consciously recognized, activated neural network associated with aspects of explicit memory processing. Conclusion Results suggest that conscious recognition of stimuli is not necessary for activation of cognitive processing.

  7. Human milk for the premature infant

    Science.gov (United States)

    Underwood, Mark A.

    2012-01-01

    Synopsis Premature infants are a heterogeneous group with widely differing needs for nutrition and immune protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis increasing with decreasing gestational age and birth weight. Human milk from women delivering prematurely has more protein and higher levels of many bioactive molecules compared to milk from women delivering at term. Human milk must be fortified for small premature infants to achieve adequate growth. Mother’s own milk improves growth and neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and should therefore be the primary enteral diet of premature infants. Donor milk is a valuable resource for premature infants whose mothers are unable to provide an adequate supply of milk, but presents significant challenges including the need for pasteurization, nutritional and biochemical deficiencies and a limited supply. PMID:23178065

  8. Dynamics of AV coupling during human atrial fibrillation: role of atrial rate.

    Science.gov (United States)

    Masè, M; Marini, M; Disertori, M; Ravelli, F

    2015-07-01

    The causal relationship between atrial and ventricular activities during human atrial fibrillation (AF) is poorly understood. This study analyzed the effects of an increase in atrial rate on the link between atrial and ventricular activities during AF. Atrial and ventricular time series were determined in 14 patients during the spontaneous acceleration of the atrial rhythm at AF onset. The dynamic relationship between atrial and ventricular activities was quantified in terms of atrioventricular (AV) coupling by AV synchrogram analysis. The technique identified n:m coupling patterns (n atrial beats in m ventricular cycles), quantifying their percentage, maximal length, and conduction ratio (= m/n). Simulations with a difference-equation AV model were performed to correlate the observed dynamics to specific atrial/nodal properties. The atrial rate increase significantly affected AV coupling and ventricular response during AF. The shortening of atrial intervals from 185 ± 32 to 165 ± 24 ms (P AV patterns with progressively decreasing m/n ratios (from conduction ratio = 0.34 ± 0.09 to 0.29 ± 0.08, P AV block and coupling instability at higher atrial rates were associated with increased ventricular interval variability (from 123 ± 52 to 133 ± 55 ms, P AV pattern transitions and coupling instability in patients were predicted, assuming the filtering of high-rate irregular atrial beats by the slow recovery of nodal excitability. These results support the role of atrial rate in determining AV coupling and ventricular response and may have implications for rate control in AF. Copyright © 2015 the American Physiological Society.

  9. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2007-01-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  10. A novel and simple atrial retractor.

    Science.gov (United States)

    Kofidis, Theo; Lee, Chuen Neng

    2011-05-01

    Minimally invasive cardiac operations require specialized equipment. Atrial retractors are a frequently used tool to expose heart valves for minimally invasive and open procedures. The models currently available in the market are efficient; however, they may be complex, bulky, or expensive. We introduce a novel, very simple atrial retractor we designed using ubiquitously available materials.

  11. Atrial Arrhythmia Summit: Post Summit Report

    Science.gov (United States)

    Barr, Yael

    2010-01-01

    The Atrial Arrhythmia Summit brought together nationally and internationally recognized experts in cardiology, electrophysiology, exercise physiology, and space medicine in an effort to elucidate the mechanisms, risk factors, and management of atrial arrhythmias in the unique occupational cohort of the U.S. astronaut corps.

  12. Corticosteroids and the risk of atrial fibrillation

    NARCIS (Netherlands)

    van der Hooft, CS; Heeringa, J; Brusselle, GG; Hofman, A; Witteman, JCM; Kingma, JH; Sturkenboom, MCJM; Stricker, BHC

    2006-01-01

    Background: High-dose ( pulse) corticosteroid therapy has been associated with the development of atrial fibrillation. This association, however, is mainly based on case reports. Methods: To test the hypothesis that high-dose corticosteroid exposure increases the risk of new-onset atrial fibrillatio

  13. Premature Ventricular Complexes and Premature Ventricular Complex Induced Cardiomyopathy.

    Science.gov (United States)

    Latchamsetty, Rakesh; Bogun, Frank

    2015-09-01

    Presentation, prognosis, and management of premature ventricular complexes (PVCs) vary significantly among patients and depend on PVC characteristics as well as patient comorbidities. Presentation can range from incidental discovery in an asymptomatic patient to debilitating heart failure. Prognosis depends on, among other factors, the presence or absence of structural heart disease, PVC burden and other factors detailed in this review. Our understanding of the clinical significance of frequent PVCs, particularly as it relates to development of cardiomyopathy, has advanced greatly in the past decade. In this article, we explore the mechanisms governing PVC initiation and discuss prevalence and frequency of PVCs in the general population. We also explore prognostic implications based on PVC frequency as well as the presence or absence of underlying heart disease. We then take a focused look at PVC-induced cardiomyopathy and identify predictors for developing cardiomyopathy. Finally, we discuss clinical evaluation and management of patients presenting with frequent PVCs. Management can include clinical observation, addressing reversible causes, lifestyle modification, pharmacotherapy, or catheter ablation.

  14. Atrial Remodeling And Atrial Fibrillation: Mechanistic Interactions And Clinical Implications

    OpenAIRE

    2009-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The prevalence of AF increases dramatically with age and is seen in as high as 9% of individuals by the age of 80 years. In high-risk patients, the thromboembolic stroke risk can be as high as 9% per year and is associated with a 2-fold increase in mortality. Although the pathophysiological mechanism underlying the genesis of AF has been the focus of many studies, it remains only partially understood. Conventional th...

  15. Psychosocial interventions for premature ejaculation

    Directory of Open Access Journals (Sweden)

    Tamara Melnik

    Full Text Available BACKGROUND: Premature ejaculation (PE is a very common sexual dysfunction among patients, and with varying prevalence estimates ranging from 3% to 20%. Although psychological issues are present in most patients with premature PE, as a cause or as a consequence, research on the effects of psychological approaches for PE has in general not been controlled or randomised and is lacking in long-term follow up. OBJECTIVE: To assess the efficacy of psychosocial interventions for PE. CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: Trials were searched in computerized general and specialized databases, such as: MEDLINE by PubMed (1966 to 2010; PsycINFO (1974 to 2010; EMBASE (1980 to 2010; LILACS (1982 to 2010; the Cochrane Central Register of Controlled Trials (Cochrane Library, 2010; and by checking bibliographies, and contacting manufacturers and researchers. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials evaluating psychosocial interventions compared with different psychosocial interventions, pharmacological interventions, waiting list, or no treatment for PE. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The primary outcome measure for comparing the effects of psychosocial interventions to waiting list and standard medications was improvement in IELT (i.e., time from vaginal penetration to ejaculation. The secondary outcome was change in validated PE questionnaires. MAIN RESULTS: In one study behavioral therapy (BT was significantly better than waiting list for duration of intercourse (MD (mean difference 407.90 seconds, 95% CI 302.42 to 513.38, and couples' sexual satisfaction (MD -26.10, CI -50.48 to -1.72. BT was also significantly better for a new functional-sexological treatment (FS (MD 412.00 seconds, 95% CI 305.88 to 518.12, change over time in subjective perception of duration of intercourse (Women: MD 2

  16. Atrial fibrillation in patients with ischemic stroke

    DEFF Research Database (Denmark)

    Thygesen, Sandra Kruchov; Frost, Lars; Eagle, Kim A;

    2009-01-01

    BACKGROUND: Atrial fibrillation is a major risk factor for ischemic stroke. However, the prognostic impact of atrial fibrillation among patients with stroke is not fully clarified. We compared patient characteristics, including severity of stroke and comorbidity, quality of in-hospital care...... and outcomes in a cohort of first-time ischemic stroke patients with and without atrial fibrillation. METHODS: Based on linkage of public medical databases, we did a population-based follow-up study among 3,849 stroke patients from the County of Aarhus, Denmark admitted in the period of 2003......-2007 and prospectively registered in the Danish National Indicator Project. RESULTS: Atrial fibrillation was associated with an adverse prognostic profile but not with an overall poorer quality of in-hospital care. Patients with atrial fibrillation had a longer total length of stay (median: 15 vs 9 days), and were...

  17. Artificial atrial fibrillation in the dog. An artifact?

    NARCIS (Netherlands)

    Strackee, J.; Hoelen, A.J.; Zimmerman, A.N.E.; Meijler, F.L.

    1971-01-01

    R-R interval sequences during artificial atrial fibrillation in dogs were studied in the same way as in patients in a previous study and compared with results obtained in dogs with spontaneous atrial fibrillation. Artificial atrial fibrillation was effected by right atrial stimulation in three close

  18. Galectin-3 in patients undergoing ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Nicolas Clementy

    2014-11-01

    Conclusions: Persistent type of atrial fibrillation is an independent predictor of higher Galectin-3 concentration. This biomarker of fibrosis may be implied in the mechanisms of atrial remodeling and maintenance of atrial fibrillation, and thus be helpful for the design of therapeutic strategy in patients with atrial fibrillation.

  19. Sexuality in pregnancy and premature labour.

    Science.gov (United States)

    Georgakopoulos, P A; Dodos, D; Mechleris, D

    1984-09-01

    The relation of sexual behaviour during pregnancy to the initiation of labour was investigated in 358 patients of whom 58 were delivered after premature labour and 300 were delivered spontaneously at term. In all patients the mean weekly coital frequency and the frequency of orgasm were investigated by means of a retrospective questionnaire. There was no significant difference in coital or orgasmic frequency between the women who had a premature labour and those who had a spontaneous delivery at term. This was also true when those having premature labour were divided into those starting labour with ruptured membranes and those starting with contractions.

  20. Acute appendicitis in a premature baby

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero; Alberici, Elisa [Department of Radiodiagnosis, Section of Paediatric Radiology, IRCCS Policlinico S. Matteo, Piazzale Golgi 2, 27100 Pavia PV (Italy)

    2002-07-01

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  1. [Premature newborn: a case presentation].

    Science.gov (United States)

    Pastor Rodríguez, Jesús David; Pastor Bravo, María Del Mar; López García, Visitación; Cotes Teruel, María Isabel; Mellado, Jesús Eulogio; Cárceles, José Jara

    2010-01-01

    A case is presented of a premature newborn of 27 weeks gestation and weighing 420 grams who was delivered as a result of a maternal pre-eclampsia and retarded intra-uterine growth. During the 125 days of hospitalisation, an individual care plan based on the Virginia Henderson model was devised and applied to both the child and her parents using NANDA diagnostics, interventions according to the NIC classification, and the expected results according to the NOC classification. The Marjory Gordon functional patterns were used for the initial assessment. By applying the pre-term newborn (PTNB) plan, all their needs were provided and were modified throughout the hospital stay, with new needs that were added to the established ones. These required a continuous assessment with the subsequent adapting of the care plan. Likewise, the care required by the parents varied from the initial grief due to the possible loss of their child to learning the alarm signs and the home care that their child would need. The child was finally discharged weighing 2900 grams and with normal neurological and psychomotor development, although with a lower weight appropriate to her age. Currently, at 2 years old, the child has a normal neurological and psychomotor development, but with weight and size lower than the P(3) percentile. She requires speech therapy treatment due to paralysis of the right vocal cord.

  2. Psychosexual therapy for premature ejaculation.

    Science.gov (United States)

    Althof, Stanley E

    2016-08-01

    Premature ejaculation (PE) is a male sexual dysfunction that creates considerable anguish for the man, his partner and their relationship. PE is not one disorder but includes the four subtypes (lifelong, acquired, natural and subjective) each with unique psychological concerns and issues. Psychological treatment for men and couples with PE addresses sexual skills/techniques but also focuses on issues of self-esteem, performance anxiety and interpersonal conflict. The outcome studies for psychotherapy alone are difficult to interpret and compare because of poor methodological design (lack of control groups, small sample size, poor outcome measures and lack of follow-up). However, the few studies that surmount these methodological hurdles suggest that psychological intervention offers men and couples a promising treatment option. Combination pharmaco- and psychotherapy is the most promising intervention for lifelong and acquired PE and offers superior efficacy to drug alone. This is because men and couples learn sexual skills, address the intrapsychic, interpersonal and cognitive issues that precipitate and maintain the dysfunction.

  3. The epidemiology of premature ejaculation.

    Science.gov (United States)

    Saitz, Theodore Robert; Serefoglu, Ege Can

    2016-08-01

    Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

  4. [Sexological intervention on premature ejaculation].

    Science.gov (United States)

    San Martín Blanco, C

    2014-07-01

    Strategies, recommendations and techniques proposed by sex therapy for intervention on premature ejaculation, have represented for nearly four decades the most effective model of intervention in this sexual dysfunction, which currently is complemented by the efficacy of dapoxetine drug treatment. Clinical experience and recent studies support that combined intervention offers the best therapeutic results. In addition in sex therapy, etiologic diagnosis is obtained from the analysis of the interrelationship of the couple. Diagnostic and therapeutic intervention has to be always centered in the relationship, so the techniques and resources must be applied with the expectation of being implemented in the sexual interaction. It will therefore be the relationship that receive treatment, even if medication is used for one of the members of the couple. On the other hand, this model of intervention can be implemented by a professional with training, although not necessarily a specialist. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  5. Medical therapy for premature ejaculation

    Science.gov (United States)

    Mohee, Amar; Eardley, Ian

    2011-01-01

    Premature ejaculation (PE) is a common male sexual dysfunction. Advances in PE research have been hampered owing to a nonstandardized definition of PE, until the definition by the International Society of Sexual Medicine (ISSM) in 2009. Once the diagnosis of PE is established through a thorough history, a variety of medical therapies is available, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), centrally acting opiates, phosphodiesterase 5 inhibitors and topical desensitizing creams. Most of these treatments increase the intravaginal ejaculation latency time (IELT) and patient satisfaction scores, with the most convincing evidence for SSRIs and topical creams. Daily SSRIs such as paroxetine, although efficacious, do have a substantial and prolonged side effect profile. Dapoxetine, which is a on-demand SSRI, is the only licensed drug for the treatment of PE, increasing IELT by a factor of 2.5 to 3 with limited and tolerable side effects. In the near future, the topical aerosol PSD502 is due to be licensed for the treatment of PE, increasing IELT by up to a factor of 6 but having minimal local and negligible systemic side effects. PMID:22046199

  6. Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

    Directory of Open Access Journals (Sweden)

    Claudia Loardi

    2015-01-01

    Full Text Available Background. Maze procedure aims at restoring sinus rhythm (SR and atrial contractility (AC. This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation. Methods. 122 mitral and fibrillating patients underwent radiofrequency Maze. Rhythm check and echocardiographic control of biatrial contractility were performed at 3, 6, 12, and 24 months postoperatively. A multivariate Cox analysis of risk factors for absence of AC recuperation was applied. Results. At 2-years follow-up, SR was achieved in 79% of patients. SR-AC coexistence increased from 76% until 98%, while biatrial contraction detection augmented from 84 to 98% at late stage. Shorter preoperative arrhythmia duration was the only common predictor of SR-AC restoring, while pulmonary artery pressure (PAP negatively influenced AC recuperation. Early AC restoration favored future freedom from arrhythmia recurrence. Minor LA dimensions correlated with improved future A/E value and vice versa. Right atrial (RA contractility restoring favored better left ventricular (LV performance and volumes. Conclusions. SR and left AC are two interrelated Maze objectives. Factors associated with arrhythmia “chronic state” (PAP and arrhythmia duration are negative predictors of procedural success. Our results suggest an association between postoperative LA dimensions and “kick” restoring and an influence of RA contraction onto LV function.

  7. Left atrial ball valve thrombus

    Directory of Open Access Journals (Sweden)

    R. Balaji

    2013-10-01

    Full Text Available "Ball valve thrombus" which is a spherical free floating clot in left atrium is an often quoted, but uncommonly encountered complication in patients with severe mitral stenosis of rheumatic origin, who are in atrial fibrillation. We describe the case of a 31-year-old lady with rheumatic heart disease, severe mitral stenosis and moderately severe aortic stenosis who had undergone closed mitral valvotomy 13 years ago. The patient presented with an episode of non-exertional syncope and breathlessness on exertion of 6 months duration and was in normal sinus rhythm. Echocardiography facilitated ante-mortem diagnosis and prompt institution of surgery was life saving.

  8. Differential gene expression during atrial structural remodeling in human left and right atrial appendages in atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Hui Zhu; Wei Zhang; Ming Zhong; Gong Zhang; Yun Zhang

    2011-01-01

    Extracellular matrix (ECM) remodeling increases the vulnerability to atrial fibrillation (AF). Some gene expressions are crucial for the metabolism of ECM. The left atrium plays an important role in maintaining AF.However, most studies investigated only the right atrial tissue. We therefore chose human tissue samples from both the left and right atrial to detect the different gene expressions during structural remodeling in AF. The atrial appendages tissue samples from 24 patients with chronic AF and 12 patients with sinus rhythm were obtained when they were undergoing mitral/aortic valve replacement operation. The mRNA levels of matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), disintegrin, metalloproteases-15, and integrins β1 were determined by reverse transcriptionpolymerase chain reaction (RT-PCR). in AF group, the level of MMP-9 in left atrial appendage (LAA) was increased (P<0.001), while integrin β1 level was decreased (P< 0.05) compared with those expressed in right atrial appendage (RAA) tissue. The levels of disintegrin, metalloproteinases-15, and TIMP-1 genes in the LAA and RAA had no significant differences. The results demonstrated that the gene expressions in the LAA and RAA are different during AF, which implied that the mechanism of atrial structural remodeling in AF is due to multiple sources and is complicated.

  9. Atrial and ventricular volume and function in persistent and permanent atrial fibrillation, a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Therkelsen, Susette Krohn; Groenning, Bjoern Aaris; Svendsen, Jesper Hastrup

    2005-01-01

    Left atrial size is independently related to cardiovascular morbidity and mortality, and atrial fibrillation (AF) is strongly associated with atrial size. Our aims were to report atrial and ventricular dimensions in patients with AF evaluated with magnetic resonance imaging (MRI), and to assess t...

  10. Mapping strategy for multiple atrial tachyarrhythmias in a transplant heart

    DEFF Research Database (Denmark)

    Jin, Qi; Pehrson, Steen; Jacobsen, Peter Karl;

    2015-01-01

    BACKGROUND: Different atrial arrhythmias can coexist in the recipient and donor atria after heart transplantation. CASE PRESENTATION: We report an unusual case of a patient with three different types of atrial arrhythmia after heart transplantation: an atrial fibrillation in the recipient atria....... CONCLUSIONS: It is critical to understand the surgical anatomy of a bi-atrial anastomosis and its relevant electrical activation pattern before ablation. Appropriate electroanatomical mapping strategy with RMN can facilitate the successful ablation of post-transplant atrial arrhythmias....

  11. Conscious perception of emotional stimuli: brain mechanisms.

    Science.gov (United States)

    Mitchell, Derek G V; Greening, Steven G

    2012-08-01

    Emotional stimuli are thought to gain rapid and privileged access to processing resources in the brain. The structures involved in this enhanced access are thought to support subconscious, reflexive processes. Whether these pathways contribute to the phenomenological experience of emotional visual awareness (i.e., conscious perception) is unclear. In this review, it is argued that subcortical networks associated with the rapid detection of emotionally salient stimuli also play a key role in shaping awareness. This proposal is based on the idea that awareness of visual stimuli should be considered along a continuum, having intermediate levels, rather than as an all-or-none construct. It is also argued that awareness of emotional stimuli requires less input from frontoparietal structures that are often considered crucial for visual awareness. Evidence is also presented that implicates a region of the medial prefrontal cortex, involved in emotion regulation, in modulating amygdala output to determine awareness of emotional visual stimuli; when emotional stimuli are present, the conscious perception of alternative stimuli requires greater regulatory influences from cortical structures. Thus, emotional stimuli are privileged not only for neuronal representation and impact on subconscious processes, but also for awareness, allowing humans to deal flexibly rather than merely reflexively to biologically significant stimuli.

  12. Maternal assessment of pain in premature infants

    Directory of Open Access Journals (Sweden)

    Maria Carolina Correia dos Santos

    2015-12-01

    Full Text Available Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5% reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1% identified crying as a characteristic of pain sensation. Eleven (64.7% stated that uneasiness is a sign of pain in newborns. Conclusion: for the proper management of neonatal pain it is essential that mothers know the signs of pain in premature newborns, and that health professionals instruct this recognition, through the enhancement of the maternal presence and practice of effective communication between professionals and newborns’ families.

  13. Future Applications of Antioxidants in Premature Infants

    Science.gov (United States)

    Lee, Jennifer W.; Davis, Jonathan M.

    2012-01-01

    Purpose of Review This review will examine the unique susceptibility of premature infants to oxidative stress, the role of reactive oxygen species (ROS) in the pathogenesis of common disorders of the preterm infant, and potential for therapeutic interventions using enzymatic and/or non-enzymatic antioxidants. Recent Findings Oxidative stress is caused by an imbalance between the production of ROS and the ability to detoxify them with the help of antioxidants. The premature infant is especially susceptible to ROS-induced damage because of inadequate antioxidant stores at birth, as well as impaired upregulation in response to oxidant stress. Thus, the premature infant is at increased risk for the development of ROS-induced diseases of the newborn, such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and periventricular leukomalacia. Summary Potential therapies for ROS-induced disease include both enzymatic and non-enzymatic antioxidant preparations. More research is required to determine the beneficial effects of supplemental antioxidant therapy. PMID:21150443

  14. Apnea of prematurity: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Picone S

    2014-06-01

    Full Text Available Simonetta Picone, Roberto Aufieri, Piermichele PaolilloDivision of Neonatology and Neonatal Intensive Care, Department of Maternal and Child Health, Casilino General Hospital, Rome, ItalyAbstract: Apnea of prematurity is a developmental disorder that frequently affects preterm infants, especially those with lower gestational age. Even if apnea of prematurity is by definition a self-limiting condition, it can cause serious problems during the hospital stay and can potentially have long-term neurological and cognitive consequences depending on the severity and intensity of the episodes. The diagnosis of apnea of prematurity can be made only after excluding a number of diseases of the preterm infant in which apnea may be an epiphenomenon. Etiological diagnosis is essential for selection of appropriate treatment, which may be nonpharmacological or involve use of drugs.Keywords: apnea of prematurity, idiopathic and secondary apnea, caffeine

  15. Atrial fibrillation and survival in colorectal cancer

    Directory of Open Access Journals (Sweden)

    Justin Timothy A

    2004-11-01

    Full Text Available Abstract Background Survival in colorectal cancer may correlate with the degree of systemic inflammatory response to the tumour. Atrial fibrillation may be regarded as an inflammatory complication. We aimed to determine if atrial fibrillation is a prognostic factor in colorectal cancer. Patients and methods A prospective colorectal cancer patient database was cross-referenced with the hospital clinical-coding database to identify patients who had underwent colorectal cancer surgery and were in atrial fibrillation pre- or postoperatively. Results A total of 175 patients underwent surgery for colorectal cancer over a two-year period. Of these, 13 patients had atrial fibrillation pre- or postoperatively. Atrial fibrillation correlated with worse two-year survival (p = 0.04; log-rank test. However, in a Cox regression analysis, atrial fibrillation was not significantly associated with survival. Conclusion The presence or development of atrial fibrillation in patients undergoing surgery for colorectal cancer is associated with worse overall survival, however it was not found to be an independent factor in multivariate analysis.

  16. Cardiorespiratory interactions to external stimuli.

    Science.gov (United States)

    Bernardi, L; Porta, C; Spicuzza, L; Sleight, P

    2005-09-01

    Respiration is a powerful modulator of heart rate variability, and of baro- or chemo-reflex sensitivity. This occurs via a mechanical effect of breathing that synchronizes all cardiovascular variables at the respiratory rhythm, particularly when this occurs at a particular slow rate coincident with the Mayer waves in arterial pressure (approximately 6 cycles/min). Recitation of the rosary prayer (or of most mantras), induces a marked enhancement of these slow rhythms, whereas random verbalization or random breathing does not. This phenomenon in turn increases baroreflex sensitivity and reduces chemoreflex sensitivity, leading to increases in parasympathetic and reductions in sympathetic activity. The opposite can be seen during either verbalization or mental stress tests. Qualitatively similar effects can be obtained even by passive listening to more or less rhythmic auditory stimuli, such as music, and the speed of the rhythm (rather than the style) appears to be one of the main determinants of the cardiovascular and respiratory responses. These findings have clinical relevance. Appropriate modulation of breathing, can improve/restore autonomic control of cardiovascular and respiratory systems in relevant diseases such as hypertension and heart failure, and might therefore help improving exercise tolerance, quality of life, and ultimately, survival.

  17. Anticoagulation therapy for atrial fibrillation.

    Science.gov (United States)

    Hylek, Elaine M

    2013-03-01

    Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder, and its prevalence is increasing worldwide. Atrial fibrillation confers a fivefold increased risk of stroke, and these strokes are associated with significant mortality and disability. The vitamin K antagonist, warfarin, has been the mainstay of anticoagulant therapy for patients with AF, reducing the risk of stroke by 65%. Despite its efficacy, warfarin remains underused in clinical practice because of its variable dose response, diet and medication interactions, and need for frequent monitoring. Stroke prevention in AF has entered an exciting therapeutic era with new classes of targeted anticoagulants that avoid the many pitfalls of the vitamin K antagonists. Dabigatran, an oral thrombin inhibitor, and the factor Xa inhibitors, rivaroxaban and apixaban, have demonstrated efficacy for stroke prevention and a reduced risk of intracranial hemorrhage relative to warfarin. Translating the efficacy of clinical trials into effective use of these novel agents in clinical practice will require an understanding of their pharmacokinetic profiles, dose selection, and management in select clinical situations.

  18. Premature dental eruption: report of case.

    LENUS (Irish Health Repository)

    McNamara, C M

    2011-08-05

    This case report reviews the variability of dental eruption and the possible sequelae. Dental eruption of the permanent teeth in cleft palate children may be variable, with delayed eruption the most common phenomenon. A case of premature dental eruption of a maxillary left first premolar is demonstrated, however, in a five-year-old male. This localized premature dental eruption anomaly was attributed to early extraction of the primary dentition, due to caries.

  19. Neuro-ophthalmic manifestations of prematurity

    OpenAIRE

    Preeti Patil Chhablani; Ramesh Kekunnaya

    2014-01-01

    Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypopl...

  20. PECULIARITIES OF BREAST FEEDING OF PREMATURE CHILDREN

    Directory of Open Access Journals (Sweden)

    V.К. Kotlukov

    2011-01-01

    Full Text Available The article presents main strategies of breast feeding of prematurely born infants support, such as use of Philips AVENT breast pumpfor lactation formation and feeding of the infant with native breast milk.Key words: premature infants, nursing mother, breast feeding support, modern accessories for breast feeding support. (Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (6: 170–175

  1. The pathophysiology of acquired premature ejaculation

    OpenAIRE

    McMahon, Chris G; Jannini, Emmanuele A.; Serefoglu, Ege C.; Hellstrom, Wayne J.G.

    2016-01-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of ne...

  2. Incidence and clinical predictors of subsequent atrial fibrillation requiring additional ablation after cavotricuspid isthmus ablation for typical atrial flutter.

    Science.gov (United States)

    De Bortoli, Alessandro; Shi, Li-Bin; Ohm, Ole-Jørgen; Hoff, Per Ivar; Schuster, Peter; Solheim, Eivind; Chen, Jian

    2017-06-01

    We sought to investigate the incidence of atrial fibrillation after catheter ablation for typical atrial flutter and to determine the predictors for symptomatic atrial fibrillation that required a further additional dedicated ablation procedure. 127 patients underwent elective cavotricuspid isthmus ablation with the indication of symptomatic, typical atrial flutter. The occurrence of atrial flutter, atrial fibrillation, cerebrovascular events and the need for additional ablation procedures for symptomatic atrial fibrillation was assessed during long-term follow-up. The majority of patients (70%) manifested atrial fibrillation during a follow-up period of 68 ± 24 months, and a significant proportion (42%) underwent one or multiple atrial fibrillation ablation procedures after an average of 26 months from the index procedure. Recurrence of typical atrial flutter was rare. Ten patients (8%) suffered cerebrovascular events. Earlier documentation of atrial fibrillation (OR 3.53), previous use of flecainide (OR 3.33) and left atrial diameter (OR 2.96) independently predicted occurrence of atrial fibrillation during the follow-up. A combination of pre- and intra-procedural documentation of atrial fibrillation (OR 3.81) and previous use of flecainide (OR 2.43) independently predicted additional atrial fibrillation ablation. Atrial fibrillation occurred in the majority of patients after ablation for typical atrial flutter and 42% of them required an additional dedicated ablation procedure. Pre- and intraprocedural documentation of atrial fibrillation together with previous use of flecainide independently predicted atrial fibrillation occurrence and a need for additional ablation. Anticoagulation treatment should be continued in high-risk patients in spite of clinical disappearance of atrial flutter.

  3. Frequency of neonatal complications after premature delivery

    Directory of Open Access Journals (Sweden)

    Gordana Grgić

    2013-04-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

  4. Impact of pulmonary vein isolation on atrial vagal activity and atrial electrical remodeling

    Institute of Scientific and Technical Information of China (English)

    Yingxue Dong; Shulong Zhang; Lianjun Gao; Hongwei Zhao; Donghui Yang; Yunlong Xia; Yanzong Yang

    2008-01-01

    Objective Mechanisms of pulmonary vein isolation (PVI) for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling (AER) was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period (ERP),vulnerability window (VW) of atrial fibrillation,and sinus rhythm cycle length (SCL) were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage (RAA),left atrial appendage (LAA),distal coronary sinus (CSd) and proximal coronary sinus (CSp).Results (1) Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A (P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI (P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI (P<0.05).(2) Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A (P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B (P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.(J Geriatr Cardiol 2008;5:28-32)

  5. Response of atrial flutter to overdrive atrial pacing and intravenous disopyramide phosphate, singly and in combination.

    Science.gov (United States)

    Camm, J; Ward, D; Spurrell, R

    1980-01-01

    Ten patients who suffered spontaneous paroxysms of atrial flutter were investigated by electrophysiological techniques. Two had overt Wolff-Parkinson-White syndrome; three Lown-Ganong-Levine syndrome; and one a concealed accessory atrioventricular connection. Atrial flutter was initiated, at study, by right atrial pacing and electrograms from the right atrium and coronary sinus were observed for at least five minutes to ensure stable flutter in both atria. Atrial flutter was terminated by 2.5 s or 5 s bursts of atrial pacing at rates 10, 50, or 100 beats/min faster than the intrinsic flutter rate in only two patients. Atrial flutter, which was reinitiated in two patients, was then treated with intravenous disopyramide phosphate, 2 mg/kg body weight, infused over five minutes. In all 10 patients the atrial rate slowed from a mean of 310 +/- 39 beats/min to 217 +/- 27 beats/min and atrial flutter terminated in one case. Though the mean ventricular rate fell from 161 +/- 52 beats/min to 156 +/- 45 beats/min the atrioventricular conduction ratio fell from 2.17 +/- 0.86 to 1.55 +/- 0.59 and four patients were left with symptomatically significant increases of ventricular rate. In seven of nine patients overdrive atrial pacing, repeated after disopryamide, resulted in the conversion of atrial flutter to sinus rhythm. In this study, overdrive atrial pacing and intravenous disopyramide, singly and in combination, terminated atrial flutter in nine of the 10 patients and it is suggested that this method may provide an effective alternative to direct current cardioversion. PMID:7426181

  6. Navx-guided Cryoablation of Atrial Tachycardia Inside the Left Atrial Appendage

    Science.gov (United States)

    Pandozi, Claudio; Galeazzi, Marco; Lavalle, Carlo; Ficili, Sabina; Russo, Maurizio; Santini, Massimo

    2010-01-01

    Radiofrequency ablation procedures inside the left atrial appendage (LAA) are likely to involve dangerous complications because of a high thrombogenic effect. Cryoablation procedures are supposed to be safer. We describe two cases of successful cryoablation procedures. Two NavX-guided cryoablations of permanent focal atrial arrhythmias arising from the LAA were performed. Left atrial reconstruction and mapping allowed the zone of the earliest atrial potential to be recorded; the entire course of the ablation catheter was monitored. The arrhythmias were successfully ablated; no thrombotic complications were observed. PMID:21346824

  7. Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease.

    Science.gov (United States)

    Labombarda, Fabien; Hamilton, Robert; Shohoudi, Azadeh; Aboulhosn, Jamil; Broberg, Craig S; Chaix, Marie A; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Macle, Laurent; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Khairy, Paul

    2017-08-15

    Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers. Qualifying arrhythmias were classified by a blinded adjudicating committee. The most common presenting arrhythmia was intra-atrial re-entrant tachycardia (IART) (61.6%), followed by atrial fibrillation (28.8%), and focal atrial tachycardia (9.5%). The proportion of arrhythmias due to IART increased with congenital heart disease complexity from 47.2% to 62.1% to 67.0% in patients with simple, moderate, and complex defects, respectively (p = 0.0013). Atrial fibrillation increased with age to surpass IART as the most common arrhythmia in those ≥50 years of age (51.2% vs. 44.2%; p heart disease, with a predominantly paroxysmal pattern. However, atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. A Case Report of Renal Sympathetic Denervation for the Treatment of Polymorphic Ventricular Premature Complexes

    Science.gov (United States)

    Kiuchi, Márcio Galindo; Vitorio, Frederico Puppim; da Silva, Gustavo Ramalho; Paz, Luis Marcelo Rodrigues; Souto, Gladyston Luiz Lima

    2015-01-01

    Abstract Premature ventricular complexes are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Recently, Armaganijan et al reported the relevance of sympathetic activation in patients with ventricular arrhythmias and suggested a potential role for catheter-based renal sympathetic denervation in reducing the arrhythmic burden. In this report, we describe a 32-year-old hypertensive male patient presenting with a high incidence of polymorphic premature ventricular complexes on a 24 hour Holter monitor. Beginning 1 year prior, the patient experienced episodes of presyncope, syncope, and tachycardia palpitations. The patient was taking losartan 100 mg/day, which kept his blood pressure (BP) under control, and sotalol 160 mg twice daily. Bisoprolol 10 mg/day was used previously but was not successful for controlling the episodes. The 24 hour Holter performed after the onset of sotalol 160 mg twice daily showed a heart rate ranging between 48 (minimum)–78 (average)–119 (maximum) bpm; 14,286 polymorphic premature ventricular complexes; 3 episodes of nonsustained ventricular tachycardia, the largest composed of 4 beats at a rate of 197 bpm; and 14 isolated atrial ectopic beats. Cardiac magnetic resonance imaging with gadolinium perfusion performed at rest and under pharmacological stress with dipyridamole showed increased left atrial internal volume, preserved systolic global biventricular function, and an absence of infarcted or ischemic areas. The patient underwent bilateral renal sympathetic denervation. The only drug used postprocedure was losartan 25 mg/day. Three months after the patient underwent renal sympathetic denervation, the mean BP value dropped to 132/86 mmHg, the mean systolic/diastolic 24 hour ambulatory BP measurement was reduced to 128/83

  9. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  10. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipsett, Mark; Hamilton, Douglas; Lemery, Jay; Polk, James

    2011-01-01

    This slide presentation reviews a possible scenario of an astronaut having Atrial Fibrillation during a Mars Mission. In the case review the presentation asks several questions about the alternatives for treatment, medications and the ramifications of the decisions.

  11. POSTOPERATIVE ATRIAL FIBRILLATION – AN UPDATE

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2015-12-01

    Full Text Available Atrial fibrillation is the most common perioperative cardiac arrhythmia. Sympathetic overactivity, inflammatory state and oxidative stress are important contributors to the genesis of postoperative atrial fibrillation. Advancing age and mitral valve disease along with left atrial size are important parameters in noted in multivariate prediction model. Genetic predisposition has also been noted. Preventive strategies tried include beta blockers, statins, posterior pericardiotomy, carperitide infusion and thoracic epidural analgesia. Treatment options include rate and rhythm control along with anticoagulation if it persists more than 48 hours with high CHADS2 score. Some of the therapeutic modalities which have been found to be NOT useful in preventing post operative atrial fibrillation are dexamethasone, magnesium infusion and concomitant pulmonary vein isolation.

  12. Atrial Fibrillation and Stroke in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Geetanjali Dang

    2016-11-01

    Full Text Available The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although anticoagulation decreases the risk of thromboembolism, management in the elderly remains complex due to major concerns about bleeding. New anticoagulants and nonpharmacologic strategies are helpful to reduce the risk of bleeding, particularly in older-elderly patients. Herein, we review the pathogenesis and management of select issues of thromboembolism in the elderly with atrial fibrillation.

  13. [Cardiac rehabilitation in patients with atrial fibrillation].

    Science.gov (United States)

    Schlitt, Axel; Kamke, Wolfram; Guha, Manju; Haberecht, Olaf; Völler, Heinz

    2015-06-01

    The course of cardiac rehabilitation is often altered due to episodes of paroxysmal, predominantly postoperative atrial fibrillation. In symptomatic patients, a TEE-guided cardioversion - preferential DC shock - is indicated. In patients with persistent / permanent atrial fibrillation, a heart rate up to 110 / min and 170 / min at rest and during physical activity should, respectively, be tolerated. Therefore, training should not be quitted by heart rate but rather by load. The antithrombotic management is in addition a great task in treating patients with atrial fibrillation. With the exception of patients with a CHA2DS2-VASc-Score < 1, oral anticoagulation is indicated. Atrial fibrillation has little impact on social aspects, whereas the underlying heart disease and drug treatment (oral anticoagulation) has an important impact.

  14. Alcohol consumption and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Tolstrup, Janne Schurmann; Wium-Andersen, Marie Kim; Ørsted, David Dynnes

    2016-01-01

    BACKGROUND: The aim of this study was to test the hypothesis that alcohol consumption, both observational (self-reported) and estimated by genetic instruments, is associated with a risk of atrial fibrillation and to determine whether people with high cardiovascular risk are more sensitive towards...... register. As a measure of alcohol exposure, both self-reported consumption and genetic variations in alcohol metabolizing genes (ADH1B/ADH1C) were used as instrumental variables. The endpoint was admission to hospital for atrial fibrillation as recorded in a validated hospital register. RESULTS: A total...... of 3493 cases of atrial fibrillation occurred during follow-up. High alcohol consumption was associated with a risk of atrial fibrillation among men, but not among women. Among the men who drank 28-35 and 35+ drinks/week, the hazards ratios were 1.40 (95% confidence interval 1.09-1.80) and 1.62 (95...

  15. Atrial conduction delay predicts atrial fibrillation in paroxysmal supraventricular tachycardia patients after radiofrequency catheter ablation.

    Science.gov (United States)

    Xu, Zhen-Xing; Zhong, Jing-Quan; Zhang, Wei; Yue, Xin; Rong, Bing; Zhu, Qing; Zheng, Zhaotong; Zhang, Yun

    2014-06-01

    This study aimed to assess whether intra- and inter-atrial conduction delay could predict atrial fibrillation (AF) for paroxysmal supraventricular tachycardia (PSVT) patients after successful treatment by radiofrequency catheter ablation (RFCA). Echocardiography examination was performed on 524 consecutive PSVT patients (15 patients were excluded). Left atrial dimension, right atrial diameter and intra- and inter-atrial conduction delay were measured before ablation. Patients were divided into group A (n = 32): occurrence of AF after the ablation and group B (n = 477): remained in sinus rhythm during follow-up. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive value of intra- and inter-atrial conduction delay. Both intra- and inter-atrial conduction delay were higher in group A than in group B (4.79 ± 0.30 msec vs. 4.56 ± 0.32 msec; 21.98 ± 1.32 msec vs. 20.01 ± 1.33; p < 0.05). Binary logistic regression analysis showed that intra- and inter-atrial conduction were significant influential factors for the occurrence of AF (odds ratio [OR] = 13.577, 95% confidence interval [CI], 3.469-48.914; OR = 2.569, 95% CI, 1.909-3.459, p < 0.05). The ROC cure analysis revealed that intra-atrial conduction delay ≥ 4.45 msec and inter-atrial conduction delay ≥ 20.65 were the most optimal cut-off value for predicting AF in PSVT patients after RFCA. In conclusion, this is the first study to show that the intra- and inter-atrial conduction delay could effectively predict AF in post-ablation PSVT patients.

  16. Calpain I Inhibition prevents atrial structural remodeling in a canine model with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    XUE Hong-jie; SHAN Hong-bo; LIU Jie; LI Wei-min; LI Yue; GONG Yong-tai; YANG Bao-feng; JIN Cheng-luo; SHENG Li; CHU Shan; ZHANG Li

    2008-01-01

    Background Atrial fibrillation (AF) is accompanied by atrial structural remodeling. Calpain activity is induced during AR To lest a causal relationship between calpain activation and atrial structural changes, N-acetyl-Leu-Leu-Met (ALLM), a calpain inhibitor, was utilized in a canine AF model.Methods Fifteen dogs were randomly divided into 3 groups: sham-operated group, control group and calpain inhibitor group; each with 5 dogs. Sustained AF was induced by rapid right atrium pacing at 600 beats per minute for 3 weeks. ALLM was administered at a dosage of 1.0 mg-kg-1·d-1 in the calpain inhibitor group. Three weeks later, the proteolysis, protein expression of TnT and myosin, calpain l localization and expression and structural changes were examined in left atrial free walls, right atrial free walls and the interatrial septum respectively. Atrial size and contractile function were also measured by echocardiography.Results Long-term rapid atrial pacing induced marked structural changes such as enlarged atrial volume, myolysis, degradation of TnT and myosin, accumulation of glycogen and changes in mitochondrial shape and size, which were paralleled by an increase in calpain activity. The positive correlation between calpain activity and the degree of myolysis (rs=0.90 961, P<0.0001) was demonstrated. In addition to structural abnormalities, pacing-induced atrial contractile dysfunction was observed in this study. The pacing-induced atrial structural alterations and loss of contractility were partially prevented by the calpain inhibitor ALLM.Conclusions Activation of calpain represents key features in the progression towards overt structural remodeling. Calpain inhibitor, ALLM, suppressed the increased calpain activity and reversed structural remodeling caused by sustained atrial fibrillation in the present model. Calpain Inhibition may therefore provide a possibility for therapeutic Intervention in AF.

  17. Presence of accessory left atrial appendage/diverticula in a population with atrial fibrillation compared with those in sinus rhythm: a retrospective review.

    Science.gov (United States)

    Troupis, John; Crossett, Marcus; Scneider-Kolsky, Michal; Nandurkar, Dee

    2012-02-01

    Accessory left atrial appendages and atrial diverticula have an incidence of 10-27%. Their association with atrial fibrillation needs to be confirmed. This study determined the prevalence, number, size, location and morphology of accessory left atrial appendages/atrial diverticula in patients with atrial fibrillation compared with those in sinus rhythm. A retrospective analysis of 47 consecutive patients with atrial fibrillation who underwent 320 multidetector Coronary CT angiography (CCTA) was performed. A random group of 47 CCTA patients with sinus rhythm formed the control group. The presence, number, size, location and morphology of accessory left atrial appendages and atrial diverticula in each group were analysed. Twenty one patients had a total of 25 accessory left atrial appendages and atrial diverticula in the atrial fibrillation group and 22 patients had a total of 24 accessory left atrial appendages and atrial diverticula in the sinus rhythm group. Twenty-one atrial diverticula were identified in 19 patients in the atrial fibrillation group and 19 atrial diverticula in 17 patients in the sinus rhythm group. The mean length and width of accessory left atrial appendage was 6.9 and 4.7 mm, respectively in the atrial fibrillation group and 12 and 4.6 mm, respectively, in the sinus rhythm group, P = ns (not significant). The mean length and width of atrial diverticulum was 4.7 and 3.6 mm, respectively in the atrial fibrillation group and 6.2 and 5 mm, respectively in the sinus rhythm group (P = ns). Eighty-four % and 96% of the accessory left atrial appendages/atrial diverticula in the atrial fibrillation and sinus rhythm groups were located along the right anterosuperior left atrial wall. Accessory left atrial appendages and atrial diverticula are common structures with similar prevalence in patients with atrial fibrillation and sinus rhythm.

  18. [Anticoagulation in atrial fibrillation - an update].

    Science.gov (United States)

    Antz, Matthias; Hullmann, Bettina; Neufert, Christian; Vocke, Wolfgang

    2008-12-01

    The correct anticoagulation regimen for prevention of thromboembolic events is essential in patients with atrial fibrillation. However, only a minority of patients receives anticoagulation according to the guidelines. The current guidelines are intended to make the indication for anticoagulation more simple and are summarized in the present article. This includes recommendations for chronic anticoagulation, prevention of thromboembolic events after cardioversion and in ablation of atrial fibrillation.

  19. RR-Interval variance of electrocardiogram for atrial fibrillation detection

    Science.gov (United States)

    Nuryani, N.; Solikhah, M.; Nugoho, A. S.; Afdala, A.; Anzihory, E.

    2016-11-01

    Atrial fibrillation is a serious heart problem originated from the upper chamber of the heart. The common indication of atrial fibrillation is irregularity of R peak-to-R-peak time interval, which is shortly called RR interval. The irregularity could be represented using variance or spread of RR interval. This article presents a system to detect atrial fibrillation using variances. Using clinical data of patients with atrial fibrillation attack, it is shown that the variance of electrocardiographic RR interval are higher during atrial fibrillation, compared to the normal one. Utilizing a simple detection technique and variances of RR intervals, we find a good performance of atrial fibrillation detection.

  20. Premature Ejaculation and Utilization of Cognitive Techniques

    Directory of Open Access Journals (Sweden)

    Serkan AKKOYUNLU

    2013-03-01

    Full Text Available Introduction: Premature ejaculation is the most common male sexual dysfunction leading to distress in many couples. Master and Johnson emphasized the concept of early learned experiences and Kaplan emphasized lack of sensory awareness. For treatment sex therapists mainly utilize start-stop and squeeze techniques as homework. Couples enter sex therapy with some cognitive distortions and beliefs about sex and sexuality. These beliefs are also named sexual myths. For some couples using techniques to challenge cognitive distortions and maladaptive beliefs about sex and sexuality can be used. In this paper by presenting a case we discussed how cognitive techniques can be used along with behaviour techniques with couples. Case: Presenting clients are five years married couple who are thirty and twenty nine years old respectively. They attended to the outpatient clinic with the request of the female client. Their main complaint was premature ejaculation. They were diagnosed premature ejaculation using clinical interview. In treatment besides start and stop technique, cognitive techniques were utilized to address dysfunctional beliefs about sexuality. Discussion: Premature ejaculation is a male sexual dysfunction that causes distress and intimacy problems between couples. Stop start and squeeze techniques were accepted as the choice of treatment but their effectiveness is questioned recently. Also cognitive distortions and maladaptive beliefs may hamper therapy progress. Besides that, behavioral techniques utilizing cognitive techniques to lessen the degree of dysfunctional beliefs about sex and sexuality may help the couple to overcome premature ejaculation and enhance sexual satisfaction and intimacy.

  1. Effective stimuli for constructing reliable neuron models.

    Directory of Open Access Journals (Sweden)

    Shaul Druckmann

    2011-08-01

    Full Text Available The rich dynamical nature of neurons poses major conceptual and technical challenges for unraveling their nonlinear membrane properties. Traditionally, various current waveforms have been injected at the soma to probe neuron dynamics, but the rationale for selecting specific stimuli has never been rigorously justified. The present experimental and theoretical study proposes a novel framework, inspired by learning theory, for objectively selecting the stimuli that best unravel the neuron's dynamics. The efficacy of stimuli is assessed in terms of their ability to constrain the parameter space of biophysically detailed conductance-based models that faithfully replicate the neuron's dynamics as attested by their ability to generalize well to the neuron's response to novel experimental stimuli. We used this framework to evaluate a variety of stimuli in different types of cortical neurons, ages and animals. Despite their simplicity, a set of stimuli consisting of step and ramp current pulses outperforms synaptic-like noisy stimuli in revealing the dynamics of these neurons. The general framework that we propose paves a new way for defining, evaluating and standardizing effective electrical probing of neurons and will thus lay the foundation for a much deeper understanding of the electrical nature of these highly sophisticated and non-linear devices and of the neuronal networks that they compose.

  2. Radiofrequency Ablation Mapping with Circumferential Catheter for Paroxys-mal Atrial Fibrillation Originating From the Pulmonary Veins

    Institute of Scientific and Technical Information of China (English)

    刘震; 吴书林; 杨平珍; 方咸宏; 李海杰; 陈泗林; 詹贤章; 薛玉梅

    2002-01-01

    Objectives To assessed thefeasibility and effectiveness of electrophysiologicalmapping of pulmonary veins with a circumferential 10-electrode catheter and radiofrequency catheter abla-tion therapy for patients with paroxysmal atrial fibril-lation. Background Standard mapping and ablationof focal sources of atrial fibrillation are associated withvery long procedure times and low efficacy. Mappingand ablation pulmonary veins guide with a circularcatheter could overcome these limitations. Methods16 patients [male 11, female 5, mean age (51 +14.5) years] with paroxysmal atrial fibrillation refrac-tory to antiarrhythmic drugs were included in thisgroup. A circumferential 10-electrode catheter wasused to pulmonary vein mapping during sinus rhythm orCSd pacing to determine the origin of atrial prematurecontractions. When the ablative target pulmonary veinwas found, the pulmonary vein potentials' distributionand activation were assessment pulmonary veins' ostialablation was performed at the segments showing earliestactivation of pulnonary vein potentials. The end pointwas designed: 1 ) elimination of pulmonary vein po-tential; 2) pulmonary vein potential dissociation fromatrial waves; 3) atrial ectopic beats disappear. ResultsA total of 36 pulmonary veins were ablated, in-cluding 16 left superior, 12 right superior, 7 left in-ferior and 1 right inferior. 1 pulmonary vein in 2 pa-tients was ablated, 2 pulmonary veins in 8 patientswere ablated, 3 pulmonary veins were ablated in 5patients and 4 pulmonary veins were ablated in 1 pa-tient. Procedure duration and fluoroscopy time respec-tively were 186.7 _+ 63.8 min and 51.5 + 15.0 min.During the follow-up 1- 12 months, 11 patients(68.7 % ) were free of AF without any antiarrhythmicdrugs, 2 of them were reablation, effective in 3/16(18.7%) and unsuccessful in 2/16 (12.6%) . 2cases recurred with atrial premature, 1 was treated withamiodarone and the other was repeat electrophysiologi-cal mapping and ablation, 5 cases with

  3. Predictors of left atrial appendage stunning after electrical cardioversion of non-valvular atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    杨沙宁; 黄从新; 胡晓军; 金立军; 李凤翥; 彭水先

    2003-01-01

    Objective To identify predictors of left atrial appendage stunning after the use of electrical cardioversion to restore sinus rhythm in patients with non-valvular atrial fibrillation.Methods A total of 68 consecutive patients (45 men, 23 women, 60.5±8.7 years of age) with non-valvular atrial fibrillation undergoing electrical cardioversion were enlisted in this study. Clinical and echocardiographic variables were analyzed by univariate regression and multivariate logistic regression to investigate the relationship between occurrences of left atrial appendage stunning and these factors. Results Univariate analysis revealed that, in comparing patients without and with left atrial appendage stunning, there were significant differences in the duration of atrial fibrillation > 8 weeks (32.3% vs 75.5%, P 50 mm (29.0% vs 54.1%, P 8 weeks (OR=7.249, 95%CI=1.998-26.304, P 50 mm (OR=3.896, 95%CI=1.105-13.734, P8 weeks, left atrial diameter >50 mm, left ventricular ejection fraction <50%, and cumulative energy of electrical cardioversion are independent predictors of left atrial appendage stunning. Anticoagulation treatment should be individualized for patients undergoing electrical cardioversion to reduce the risk of both cardioversion-related thromboembolic events and hemorrhagic complications caused by warfarin treatment.

  4. Efficacy and safety of intravenous dofetilide for rapid termination of atrial fibrillation and atrial flutter

    NARCIS (Netherlands)

    Kingma, JH; Crijns, HJGM; Dunselman, PHJM

    2000-01-01

    Dofetilide may be advantageous in terminating atrial fibrillation/atrial flutter (AFl) when there are contraindications for class I drugs (left ventricular dysfunction and/or manifest myocardial ischemia) and beta blockers. In particular, its successful outcome in usually drug-resistant AFl is promi

  5. Prednisone prevents atrial fibrillation promotion by atrial tachycardia remodeling in dogs

    NARCIS (Netherlands)

    Shiroshita-Takeshita, A; Brundel, BJJM; Lavoie, J; Nattel, S

    2006-01-01

    Background: There is evidence suggesting involvement of oxidative stress, inflammation, and calcineurin/nuclear factor of activated T cell pathways in atrial fibrillation. This study evaluated the efficacy of anti-inflammatory and calcineurin-inhibitory drugs on promotion of atrial fibrillation by a

  6. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators

    DEFF Research Database (Denmark)

    van Walraven, Carl; Hart, Robert G; Connolly, Stuart

    2009-01-01

    on the relative efficacy of oral anticoagulants (OAC) and antiplatelet (AP) therapy (including acetylsalicylic acid and triflusal) on ischemic stroke, serious bleeding, and vascular events in patients with atrial fibrillation. METHODS: This is an analysis of the Atrial Fibrillation Investigators database, which...

  7. Cellulose conjugated FITC-labelled mesoporous silica nanoparticles: intracellular accumulation and stimuli responsive doxorubicin release

    Science.gov (United States)

    Hakeem, Abdul; Zahid, Fouzia; Duan, Ruixue; Asif, Muhammad; Zhang, Tianchi; Zhang, Zhenyu; Cheng, Yong; Lou, Xiaoding; Xia, Fan

    2016-02-01

    Herein, we design novel cellulose conjugated mesoporous silica nanoparticle (CLS-MSP) based nanotherapeutics for stimuli responsive intracellular doxorubicin (DOX) delivery. DOX molecules are entrapped in pores of the fabricated mesoporous silica nanoparticles (MSPs) while cellulose is used as an encapsulating material through esterification on the outlet of the pores of the MSPs to avoid premature DOX release under physiological conditions. In in vitro studies, stimuli responsive DOX release is successfully achieved from DOX loaded cellulose conjugated mesoporous silica nanoparticles (DOX/CLS-MSPs) by pH and cellulase triggers. Intracellular accumulation of DOX/CLS-MSPs in human liver cancer cells (HepG2 cells) is investigated through confocal microscope magnification. Cell viability of HepG2 cells is determined as the percentage of the cells incubated with DOX/CLS-MSPs compared with that of non-incubated cells through an MTT assay.Herein, we design novel cellulose conjugated mesoporous silica nanoparticle (CLS-MSP) based nanotherapeutics for stimuli responsive intracellular doxorubicin (DOX) delivery. DOX molecules are entrapped in pores of the fabricated mesoporous silica nanoparticles (MSPs) while cellulose is used as an encapsulating material through esterification on the outlet of the pores of the MSPs to avoid premature DOX release under physiological conditions. In in vitro studies, stimuli responsive DOX release is successfully achieved from DOX loaded cellulose conjugated mesoporous silica nanoparticles (DOX/CLS-MSPs) by pH and cellulase triggers. Intracellular accumulation of DOX/CLS-MSPs in human liver cancer cells (HepG2 cells) is investigated through confocal microscope magnification. Cell viability of HepG2 cells is determined as the percentage of the cells incubated with DOX/CLS-MSPs compared with that of non-incubated cells through an MTT assay. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr08753h

  8. Determinants of Left Atrial Volume in Patients with Atrial Fibrillation

    Science.gov (United States)

    Hochgruber, Thomas; Krisai, Philipp; Zimmermann, Andreas J.; Aeschbacher, Stefanie; Pumpol, Katrin; Kessel-Schaefer, Arnheid; Stephan, Frank-Peter; Handschin, Nadja; Sticherling, Christian; Osswald, Stefan; Kaufmann, Beat A.; Paré, Guillaume; Kühne, Michael; Conen, David

    2016-01-01

    Introduction Left atrial (LA) enlargement is an important risk factor for incident stroke and a key determinant for the success of rhythm control strategies in patients with atrial fibrillation (AF). However, factors associated with LA volume in AF patients remain poorly understood. Methods Patients with paroxysmal or persistent AF were enrolled in this study. Real time 3-D echocardiography was performed in all participants and analyzed offline in a standardized manner. We performed stepwise backward linear regression analyses using a broad set of clinical parameters to determine independent correlates for 3-D LA volume. Results We included 210 patients (70.9% male, mean age 61±11years). Paroxysmal and persistent AF were present in 95 (45%) and 115 (55%) patients, respectively. Overall, 115 (55%) had hypertension, 11 (5%) had diabetes, and 18 (9%) had ischemic heart disease. Mean indexed LA volume was 36±12ml/m2. In multivariable models, significant associations were found for female sex (β coefficient -10.51 (95% confidence interval (CI) -17.85;-3.16), p = 0.0053), undergoing cardioversion (β 11.95 (CI 5.15; 18.74), p = 0.0006), diabetes (β 14.23 (CI 2.36; 26.10), p = 0.019), body surface area (BSA) (β 34.21 (CI 19.30; 49.12), pglomerular filtration rate (β -0.21 (CI -0.36; -0.06), p = 0.0064) and plasma levels of NT-pro brain natriuretic peptide (NT-proBNP) (β 6.79 (CI 4.05; 9.52), p<0.0001), but not age (p = 0.59) or hypertension (p = 0.42). Our final model explained 52% of the LA volume variability. Conclusions In patients with AF, the most important correlates with LA volume are sex, BSA, diabetes, renal function and NT-proBNP, but not age or hypertension. These results may help to refine rhythm control strategies in AF patients. PMID:27701468

  9. Serum fructosamine and retinopathy of prematurity.

    Science.gov (United States)

    Bozdag, Senol; Oguz, Serife Suna; Gokmen, Tulin; Tunay, Zuhal; Tok, Levent; Uras, Nurdan; Erdeve, Omer; Dilmen, Ugur

    2011-12-01

    To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants. One hundred sixty seven premature infants who had a birth weight of < 1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants' eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first. Corrected fructosamine was 319.6 ± 59.6 and 272.8 ± 50.6 mmol/l for group 1 on 1(st) and 30(th) day respectively; 320 ± 61.7 and 268.2 ± 47.3 mmol/l for groups 2 + 3 on 1(st) and 30(th) day respectively which did not differ between groups (p = 0.766 and p = 0.665), whereas duration of hyperglycemia was 1.69 ± 1.1 day in group 1 compared with 3.05 ± 2.4 day in groups 2 + 3 which was significantly different (p = 0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09-9.80; p = 0.035). Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.

  10. Outcomes after ablation for typical atrial flutter (from the Loire Valley Atrial Fibrillation Project).

    Science.gov (United States)

    Clementy, Nicolas; Desprets, Laurent; Pierre, Bertrand; Lallemand, Bénédicte; Simeon, Edouard; Brunet-Bernard, Anne; Babuty, Dominique; Fauchier, Laurent

    2014-11-01

    Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.

  11. Atrial strain rate is a sensitive measure of alterations in atrial phasic function in healthy ageing.

    Science.gov (United States)

    Boyd, Anita C; Richards, David A B; Marwick, Thomas; Thomas, Liza

    2011-09-01

    Strain and strain rate measure local deformation of the myocardium and have been used to evaluate phasic atrial function in various disease states. The aim of this study was to define normal values for tissue Doppler-derived atrial strain measurements and examine age-related changes by decade in healthy individuals. Transthoracic echocardiograms were performed on 188 healthy subjects. Tissue Doppler-derived strain and strain rate were measured from the apical four and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate, early and late diastolic strain rate. Phasic left atrial volumes and fractions were calculated. Mitral inflow and tissue Doppler imaging were employed to estimate left ventricular diastolic function. A significant reduction in global systolic strain was observed from decade 6. Alterations in atrial strain rate were apparent from decade 5; systolic strain rate and early diastolic strain rate decreased, while late diastolic strain rate increased significantly. Changes in phasic atrial volume and function occurred in conjunction with age-related changes in left ventricular diastolic function. Importantly, age-related changes in global atrial systolic strain rate and early diastolic strain rate occurred a decade before corresponding changes in atrial phasic volume parameters. Atrial strain and strain rate can be used to quantify atrial phasic function and appear to be altered before traditional parameters with ageing. Strain analysis may therefore be more sensitive in detecting subclinical atrial dysfunction with alterations in strain rate parameters observed before traditional parameters.

  12. Modeling auditory evoked potentials to complex stimuli

    DEFF Research Database (Denmark)

    Rønne, Filip Munch

    The auditory evoked potential (AEP) is an electrical signal that can be recorded from electrodes attached to the scalp of a human subject when a sound is presented. The signal is considered to reflect neural activity in response to the acoustic stimulation and is a well established clinical...... clinically and in research towards using realistic and complex stimuli, such as speech, to electrophysiologically assess the human hearing. However, to interpret the AEP generation to complex sounds, the potential patterns in response to simple stimuli needs to be understood. Therefore, the model was used...... to simulate auditory brainstem responses (ABRs) evoked by classic stimuli like clicks, tone bursts and chirps. The ABRs to these simple stimuli were compared to literature data and the model was shown to predict the frequency dependence of tone-burst ABR wave-V latency and the level-dependence of ABR wave...

  13. Modeling Stimuli-Responsive Nanoparticle Monolayer

    Science.gov (United States)

    Yong, Xin

    2015-03-01

    Using dissipative particle dynamics (DPD), we model a monolayer formed at the water-oil interface, which comprises stimuli-responsive nanoparticles. The solid core of the nanoparticle encompasses beads arranged in an fcc lattice structure and its surface is uniformly grafted with stimuli-responsive polymer chains. The surface-active nanoparticles adsorb to the interface from the suspension to minimize total energy of the system and create a monolayer covering the interface. We investigate the monolayer formation by characterizing the detailed adsorption kinetics. We explore the microstructure of the monolayer at different surface coverage, including the particle crowding and ordering, and elucidate the response of monolayer to external stimuli. The collective behavior of the particles within the monolayer is demonstrated quantitatively by vector-vector autocorrelation functions. This study provides a fundamental understanding of the interfacial behavior of stimuli-responsive nanoparticles.

  14. Olfactory classical conditioning in neonatal mouse pups using thermal stimuli.

    Science.gov (United States)

    Bollen, Bieke; Matrot, Boris; Ramanantsoa, Nelina; Van den Bergh, Omer; D'Hooge, Rudi; Gallego, Jorge

    2012-04-01

    Mouse models are increasingly used to investigate genetic contributions to developmental disorders in children, especially newborns. In particular, early cognitive assessment in newborn mice is critical to evaluate pediatric drug efficacy and toxicity. Unfortunately, methods for behavioral tests in newborn mice are scarce. Therefore, developing such tests for newborn mice is a priority challenge for neurogenetics and pharmacological research. The aim of the present study was to develop a conditioning method well suited to high-throughput cognitive screening in newborn mice. To this end, we developed an odor-preference conditioning test using ambient temperature as an unconditioned stimulus (US) and artificial odors as conditioned stimuli (CS). First, we showed that mouse pups move toward the thermoneutral temperature when offered a choice between a thermoneutral and cold environment, thus showing thermotaxis. Second, we conducted a classical conditioning paradigm in pups aged six to ten days. In terms of central nervous system development, this period corresponds to extreme prematurity to early post-term period in humans. During acquisition, the pups were alternatively exposed to odor CS paired with either cold or warm temperatures. Immediately after acquisition, the pups underwent a two-odor choice test, which showed preference for the odor previously paired with the warm temperature, thus showing conditioning. The proposed paradigm is easy to conduct, and requires modest experimenter interference. The method is well suited for high-throughput screening of early associative disorders in newborn mice.

  15. Mechanism for Triggered Waves in Atrial Myocytes.

    Science.gov (United States)

    Shiferaw, Yohannes; Aistrup, Gary L; Wasserstrom, J Andrew

    2017-08-08

    Excitation-contraction coupling in atrial cells is mediated by calcium (Ca) signaling between L-type Ca channels and Ryanodine receptors that occurs mainly at the cell boundary. This unique architecture dictates essential aspects of Ca signaling under both normal and diseased conditions. In this study we apply laser scanning confocal microscopy, along with an experimentally based computational model, to understand the Ca cycling dynamics of an atrial cell subjected to rapid pacing. Our main finding is that when an atrial cell is paced under Ca overload conditions, Ca waves can then nucleate on the cell boundary and propagate to the cell interior. These propagating Ca waves are referred to as "triggered waves" because they are initiated by L-type Ca channel openings during the action potential. These excitations are distinct from spontaneous Ca waves originating from random fluctuations of Ryanodine receptor channels, and which occur after much longer waiting times. Furthermore, we argue that the onset of these triggered waves is a highly nonlinear function of the sarcoplasmic reticulum Ca load. This strong nonlinearity leads to aperiodic response of Ca at rapid pacing rates that is caused by the complex interplay between paced Ca release and triggered waves. We argue further that this feature of atrial cells leads to dynamic instabilities that may underlie atrial arrhythmias. These studies will serve as a starting point to explore the nonlinear dynamics of atrial cells and will yield insights into the trigger and maintenance of atrial fibrillation. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  16. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar;

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  17. Management and prognosis of atrial fibrillation in the diabetic patient

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring

    2015-01-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation. I...... and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients.......The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation...

  18. Preparing to grasp emotionally laden stimuli.

    Directory of Open Access Journals (Sweden)

    Laura Alice Santos de Oliveira

    Full Text Available BACKGROUND: Contemporary theories of motor control propose that motor planning involves the prediction of the consequences of actions. These predictions include the associated costs as well as the rewarding nature of movements' outcomes. Within the estimation of these costs and rewards would lie the valence, that is, the pleasantness or unpleasantness of a given stimulus with which one is about to interact. The aim of this study was to test if motor preparation encompasses valence. METHODOLOGY/PRINCIPAL FINDINGS: The readiness potential, an electrophysiological marker of motor preparation, was recorded before the grasping of pleasant, neutral and unpleasant stimuli. Items used were balanced in weight and placed inside transparent cylinders to prompt a similar grip among trials. Compared with neutral stimuli, the grasping of pleasant stimuli was preceded by a readiness potential of lower amplitude, whereas that of unpleasant stimuli was associated with a readiness potential of higher amplitude. CONCLUSIONS/SIGNIFICANCE: We show for the first time that the sensorimotor cortex activity preceding the grasping of a stimulus is affected by its valence. Smaller readiness potential amplitudes found for pleasant stimuli could imply in the recruitment of pre-set motor repertoires, whereas higher amplitudes found for unpleasant stimuli would emerge from a discrepancy between the required action and their aversiveness. Our results indicate that the prediction of action outcomes encompasses an estimate of the valence of a stimulus with which one is about to interact.

  19. Preparing to Grasp Emotionally Laden Stimuli

    Science.gov (United States)

    de Oliveira, Laura Alice Santos; Imbiriba, Luís Aureliano; Russo, Maitê Mello; Nogueira-Campos, Anaelli A.; Rodrigues, Erika de C.; Pereira, Mirtes G.; Volchan, Eliane; Vargas, Cláudia Domingues

    2012-01-01

    Background Contemporary theories of motor control propose that motor planning involves the prediction of the consequences of actions. These predictions include the associated costs as well as the rewarding nature of movements’ outcomes. Within the estimation of these costs and rewards would lie the valence, that is, the pleasantness or unpleasantness of a given stimulus with which one is about to interact. The aim of this study was to test if motor preparation encompasses valence. Methodology/Principal Findings The readiness potential, an electrophysiological marker of motor preparation, was recorded before the grasping of pleasant, neutral and unpleasant stimuli. Items used were balanced in weight and placed inside transparent cylinders to prompt a similar grip among trials. Compared with neutral stimuli, the grasping of pleasant stimuli was preceded by a readiness potential of lower amplitude, whereas that of unpleasant stimuli was associated with a readiness potential of higher amplitude. Conclusions/Significance We show for the first time that the sensorimotor cortex activity preceding the grasping of a stimulus is affected by its valence. Smaller readiness potential amplitudes found for pleasant stimuli could imply in the recruitment of pre-set motor repertoires, whereas higher amplitudes found for unpleasant stimuli would emerge from a discrepancy between the required action and their aversiveness. Our results indicate that the prediction of action outcomes encompasses an estimate of the valence of a stimulus with which one is about to interact. PMID:23024811

  20. Giant right atrial myxoma: characterization with cardiac magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    A 53-year-old woman presented to the emergency department with a 2-week history of dyspnoea and chest pain. Computed tomography pulmonary angiography was performed to exclude acute pulmonary embolism (PE). This demonstrated a large right atrial mass and no evidence of PE. Transthoracic echocardiography followed by cardiac magnetic resonance imaging confirmed a mobile right atrial mass. Surgical resection was then performed confirming a giant right atrial myxoma. We describe the typical clinical, radiologic, and pathologic features of right atrial myxoma.

  1. Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Tuinenburg, AE; Brundel, BJJM; Van Gelder, IC; Henning, RH; Van den Berg, MP; Driessen, C; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    1999-01-01

    Natriuretic Peptide System in AF. Introduction: Circulating cardiac natriuretic peptides play an important role in maintaining volume homeostasis, especially during conditions affecting hemodynamics. During atrial fibrillation (AF), levels of plasma atrial natriuretic peptide (ANP) becomes elevated.

  2. Interobserver variation in interpretation of electrocardiographic signs of atrial infarction

    DEFF Research Database (Denmark)

    Christensen, J H; Nielsen, F E; Falstie-Jensen, N

    1993-01-01

    The electrocardiogram (ECG) is the only means of diagnosing atrial infarction antemortem. Certain ECG changes (PR-segment displacements) have been taken earlier as signs of atrial infarction. The purpose of this study was to assess the interobserver variation on suggested ECG signs of atrial infa...

  3. Autonomic and surgical substrate modulation of atrial fibrillation

    NARCIS (Netherlands)

    Krul, S.P.J.

    2016-01-01

    This thesis focuses on the effects of fibrosis and the autonomic nervous system on conduction in patients with atrial fibrillation and the surgical ablation of the atria and autonomic nervous system as treatment of atrial fibrillation. Atrial fibrillation is the most common arrhythmia and results fr

  4. Atrial electromechanical delay in patients undergoing heart transplantation

    Directory of Open Access Journals (Sweden)

    Mustafa Bulut, MD

    2017-04-01

    Conclusion: Inter-AEMD and intra-AEMD were prolonged in patients who underwent heart transplantation as compared to a control population. This may explain the increased atrial fibrillation and other atrial arrhythmia incidences associated with the biatrial anastomosis heart transplantation technique and may contribute to the treatment of atrial fibrillation in this special patient group.

  5. Echocardiographic evaluation of patent foramen ovale and atrial septal defect.

    Science.gov (United States)

    Hari, Pawan; Pai, Ramdas G; Varadarajan, Padmini

    2015-01-01

    Patent foramen ovale (PFO) is a common variant present in up to 25% of the population. Atrial septal defect (ASD) is a direct communication between the 2 atrial chambers, of which the ostium secundum variety is the most common. This manuscript is an in depth review of the complex atrial septation, the diagnosis of PFO and ASD and its clinical and therapeutic implications.

  6. AMH as Predictor of Premature Ovarian Insufficiency

    DEFF Research Database (Denmark)

    Lunding, Stine Aa; Aksglæde, Lise; Anderson, Richard A

    2015-01-01

    CONTEXT: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women...

  7. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a

  8. [Nontraumatic chylopericardium and chylothorax in premature neonates].

    Science.gov (United States)

    Avrel'kina, E A; Ignat'eva, E N; Fediarova, M A; Pliukhin, S V

    2014-01-01

    Deaths of extremely premature babies undiagnosed as having spontaneous chylopericardium (CP) and chylothorax (CT) are analyzed. The specific features of these death cases are the polyetiology of CP/CT and the similarity of their pathogenesis in the absence of specific clinical symptomatology.

  9. Catheter ablation of parahisian premature ventricular complex.

    Science.gov (United States)

    Kim, Jun; Kim, Jeong Su; Park, Yong Hyun; Kim, June Hong; Chun, Kook Jin

    2011-12-01

    Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

  10. Liver Abscess: Increasing Occurrence in Premature Newborns

    Directory of Open Access Journals (Sweden)

    OKTAV BOSNALI

    2013-03-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  11. Liver Abscess: Increasing Occurrence in Premature Newborns

    Science.gov (United States)

    Bosnalı, Oktav; Moralıoğlu, Serdar; Pektaş, Osman

    2013-01-01

    Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management. PMID:26023443

  12. Liver Abscess: Increasing Occurrence in Premature Newborns

    Directory of Open Access Journals (Sweden)

    Oktav Bosnalı

    2013-04-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  13. Premature mortality in Japan due to ozone

    Science.gov (United States)

    Nawahda, Amin; Yamashita, Ken; Ohara, Toshimasa; Kurokawa, Junichi; Ohizumi, Tsuyoshi; Chen, Fang; Akimoto, Hajime

    2013-12-01

    In Japan, all 47 prefectures conduct routine air quality monitoring at 1145 stations throughout the country to assess environmental effects. This study aims to provide a better understanding of possible estimations of premature mortality in Japan caused by exposure to monitored and modeled concentrations of tropospheric ozone during the period from January to December, 2005. The spatial distribution and temporal variation of ozone concentrations were modeled using the Models-3 Community Multiscale Air Quality modeling system coupled with the Regional Emission Inventory in Asia (CMAQ/REAS). Premature mortality caused by exposure to ozone was calculated assuming a relative risk (RR) value of 1.003 [95% Confidence Interval (CI): 1.001-1.004] for concentrations above 35 ppb according to the SOMO35 index (annual Sum of daily maximum 8-h Ozone Means Over 35 ppb) recommended by WHO (2008). Based on CMAQ/REAS simulations, the estimated all-cause premature mortality in 2005 is about 13,000 (95% CI: 4320-17,300) cases. This value is 2.5 times greater than the estimated premature mortality based on monitored ozone concentrations, which is 5220 (95% CI: 1740-6960) cases.

  14. Optimal oxygen saturation in premature infants

    Directory of Open Access Journals (Sweden)

    Meayoung Chang

    2011-09-01

    Full Text Available There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2 is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2. Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

  15. New Information About Premature Births (For Consumers)

    Centers for Disease Control (CDC) Podcasts

    2006-10-06

    A new study finds that prematurity is the most frequent cause of infant death in the United States. Learn more.  Created: 10/6/2006 by CDC Division of Reproductive Health.   Date Released: 10/6/2006.

  16. Human cytomegalovirus infections in premature infants by ...

    African Journals Online (AJOL)

    Owner

    clinical importance of CMV infection in premature infants by breast-feeding is still unclear. This mini- ... Transmission of CMV by natural routes relates ... infection from the fresh breast milk containing the virus. ... As a result of transmission during the course of delivery ... hepatitis was speculated to be caused by primary.

  17. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  18. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  19. Laterality in Prematurely-Born Children.

    Science.gov (United States)

    Segalwitz, Sidney J.; Chapman, Jacqueline S.

    The study examined the relationship between perinatal stress and decreased right handedness and decreased left cerebral dominance for speech with 215 children born prematurely, followed from birth, and tested at age 5. Results indicated that neither hand preference nor hand performance correlated with degree of perinatal stress and that eye…

  20. Surgical Treatment of Atrial Fibrillation: A Review

    Directory of Open Access Journals (Sweden)

    Nadine Hiari

    2011-01-01

    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  1. RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

    Directory of Open Access Journals (Sweden)

    Maria URSACHI (BOLOTA

    2016-12-01

    Full Text Available The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amniotic sac (PRAS is defined as rupture of membranes before the onset of labor. Premature rupture of the fetal membrane, which occurs before 37 weeks of gestation, usually, refers to preterm premature rupture of membranes. Despite advances in the care period, premature rupture of membranes and premature rupture of membranes preterm continue to be regarded as serious obstetric complications. On the term 8% - 10% of pregnant women have premature rupture of membranes; these women are at increased risk of intrauterine infections, where the interval between membrane rupture and expulsion is rolled-over. Premature rupture of membranes preterm occurs in approximately 1% of all pregnancies and is associated with 30% -40% of preterm births. Thus, it is important to identify the cause of pre-term birth (after less than 37 completed weeks of "gestation" and its complications, including respiratory distress syndrome, neonatal infection and intraventricular hemorrhage. Objectives: the development of the protocol of the clinical trial on patients with impending preterm birth, study clinical and statistical on the socio-demographic characteristics of patients with imminent preterm birth; clinical condition of patients and selection of cases that could benefit from the application of interventional therapy; preclinical investigation (biological and imaging of patients with imminent preterm birth; the modality therapy; clinical investigation of the effectiveness of short

  2. Acute renal failure in premature neonates

    Directory of Open Access Journals (Sweden)

    Doronjski Aleksandra

    2009-01-01

    Full Text Available Background/Aim. Hemodynamic stress is the leading cause of acute renal failure (ARF in premature neonates. Incidence of ARF in this population is between 8 and 24%. The aim of this study was to determine the frequency of presence of ARF in premature neonates, as well as its impact on their survival. Methods. A retrospective study of 114 premature neonates [(gestational age, GA less than 37 gestation weeks (gw] admitted to the Intensive Care Unit (ICU at the Pediatric Clinic, Institute of Child and Youth Healthcare of Vojvodina in 2007 was conducted. Serum creatinine, urea and bilirubine were determined on the 3rd day of life in 65 newborns who met inclusion criteria. ARF was diagnosed in 16 newborns (n=16/65; 25%. Results. The premature neonates with ARF had significantly lower GA [<28 gw - 8/16 (50% vs. 5/49 (10%; p < 0.05], birth weight (BW (1 265 g vs. 1615 g; p < 0.05 and systolic blood pressure (43.37 mm Hg vs. 52.7 mmHg; p < 0.05 than ones without ARF. Non-olyguric ARF was diagnosed in 62% of newborns with ARF (n=10/16, while the rest had the olyguric type (n = 6/16; 38%. Twenty-five percent of premature neonates with ARF (n = 4/16 died in contrast to 10% of premature neonates without ARF (n = 5/49. ARF was treated conservatively in all but 3 cases when peritoneal dialysis was performed. Renal function has recovered completely in all of the survivors. In order to determine their predictivity in relation to ARF, following parameters were analyzed: GA, BW < 1 500 g, presence of concomitant sepsis and intracranial hemorrhage grade III/IV. BW < 1 500 g demonstrated the highest sensitivity (se 0.75, while GA < 28 gw, sepsis and intracranial hemorrhage grade III/IV showed high specificity (sp = 0.90, 0.89 0.88, respectively. Conclusion. Acute renal failure frequently occurs in population of premature neonates and requires meticulous fluid and electrolyte balance, especially in the case of low birth weight and extreme immaturity.

  3. GENETIC PREDICTORS OF ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    A. V. Kuskaeva

    2016-01-01

    Full Text Available Atrial fibrillation (AF is the most common heart rhythm disturbance. It is believed that the primary form of AF is genetically determined in most cases, but the genetic component cannot be excluded in the secondary form of AF. AF is a heterogeneous disease and many authors proved its relationship with other genetic heart disease. In most cases, certain combinations of polymorphisms of different genes promote the development of AF. The study of genes of renin-angiotensin-aldosterone system (RAAS is especially important, because the role of this system in AF pathogenesis is currently studding most intensively. These studies are of great practical interest, as associative effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists in the prevention of AF is revealed. RAAS blockers are able not only to reduce the risk of new-onset AF in hypertensive and normotensive patients but also prevent recurrence of AF. Furthermore, experimental studies showed that RAAS blockers prevent not only the remodeling of the left ventricle, and also the left atrium, pointing to the pathogenesis of AF. So, screening for susceptibility genes and the study of their polymorphism is currently an important focus in the study of AF.

  4. The effect of atrial preference pacing on atrial fibrillation electrophysiological substrate in Myotonic Dystrophy type 1 population

    OpenAIRE

    Russo, Vincenzo; NIGRO, GERARDO; DI MEO, FEDERICA; PAPA, ANDREA ANTONIO; CIOPPA, NADIA DELLA; PROIETTI, RICCARDO; Russo, Maria Giovanna; Calabrò, Raffaele; Politano, Luisa

    2014-01-01

    P-wave dispersion is a non invasive indicator of intra-atrial conduction heterogeneity producing substrate for reentry, which is a pathophysiological mechanism of atrial fibrillation. The relationship between P-wave dispersion (PD) and atrial fibrillation (AF) in Myotonic dystrophy type 1 (DM1) patients is still unclear. Atrial Preference Pacing (APP) is an efficient algorithm to prevent paroxysmal AF in patients implanted with dual-chamber pacemaker. Aim of our study was to evaluate the poss...

  5. Generalization of the disruptive effects of alternative stimuli when combined with target stimuli in extinction.

    Science.gov (United States)

    Podlesnik, Christopher A; Miranda-Dukoski, Ludmila; Jonas Chan, C K; Bland, Vikki J; Bai, John Y H

    2017-09-01

    Differential-reinforcement treatments reduce target problem behavior in the short term but at the expense of making it more persistent long term. Basic and translational research based on behavioral momentum theory suggests that combining features of stimuli governing an alternative response with the stimuli governing target responding could make target responding less persistent. However, changes to the alternative stimulus context when combining alternative and target stimuli could diminish the effectiveness of the alternative stimulus in reducing target responding. In an animal model with pigeons, the present study reinforced responding in the presence of target and alternative stimuli. When combining the alternative and target stimuli during extinction, we altered the alternative stimulus through changes in line orientation. We found that (1) combining alternative and target stimuli in extinction more effectively decreased target responding than presenting the target stimulus on its own; (2) combining these stimuli was more effective in decreasing target responding trained with lower reinforcement rates; and (3) changing the alternative stimulus reduced its effectiveness when it was combined with the target stimulus. Therefore, changing alternative stimuli (e.g., therapist, clinical setting) during behavioral treatments that combine alternative and target stimuli could reduce the effectiveness of those treatments in disrupting problem behavior. © 2017 Society for the Experimental Analysis of Behavior.

  6. Impact of rotavirus vaccine on premature infants.

    Science.gov (United States)

    Roué, Jean-Michel; Nowak, Emmanuel; Le Gal, Grégoire; Lemaitre, Thomas; Oger, Emmanuel; Poulhazan, Elise; Giroux, Jean-Dominique; Garenne, Armelle; Gagneur, Arnaud

    2014-10-01

    Infants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.).

  7. Stimuli-responsive smart gating membranes.

    Science.gov (United States)

    Liu, Zhuang; Wang, Wei; Xie, Rui; Ju, Xiao-Jie; Chu, Liang-Yin

    2016-02-07

    Membranes are playing paramount roles in the sustainable development of myriad fields such as energy, environmental and resource management, and human health. However, the unalterable pore size and surface properties of traditional porous membranes restrict their efficient applications. The performances of traditional membranes will be weakened upon unavoidable membrane fouling, and they cannot be applied to cases where self-regulated permeability and selectivity are required. Inspired by natural cell membranes with stimuli-responsive channels, artificial stimuli-responsive smart gating membranes are developed by chemically/physically incorporating stimuli-responsive materials as functional gates into traditional porous membranes, to provide advanced functions and enhanced performances for breaking the bottlenecks of traditional membrane technologies. Smart gating membranes, integrating the advantages of traditional porous membrane substrates and smart functional gates, can self-regulate their permeability and selectivity via the flexible adjustment of pore sizes and surface properties based on the "open/close" switch of the smart gates in response to environmental stimuli. This tutorial review summarizes the recent developments in stimuli-responsive smart gating membranes, including the design strategies and the fabrication strategies that are based on the introduction of the stimuli-responsive gates after or during membrane formation, and the positively and negatively responsive gating models of versatile stimuli-responsive smart gating membranes, as well as the advanced applications of smart gating membranes for regulating substance concentration in reactors, controlling the release rate of drugs, separating active molecules based on size or affinity, and the self-cleaning of membrane surfaces. With self-regulated membrane performances, smart gating membranes show great power for use in global sustainable development.

  8. Birthing and Parenting a Premature Infant in a Cultural Context

    Science.gov (United States)

    Brooks, Jada L.; Holdtich-Davis, Diane; Docherty, Sharron L.; Theodorou, Christina S.

    2015-01-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian (AI) mothers’ perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 AI mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of AI culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that healthcare providers deliver culturally appropriate care that fully supports AI mothers and their premature infants. PMID:25721716

  9. Birthing and Parenting a Premature Infant in a Cultural Context.

    Science.gov (United States)

    Brooks, Jada L; Holdtich-Davis, Diane; Docherty, Sharron L; Theodorou, Christina S

    2016-02-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian mothers' perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 American Indian mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of American Indian culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that health care providers deliver culturally appropriate care that fully supports American Indian mothers and their premature infants. © The Author(s) 2015.

  10. Fibrosis and electrophysiological characteristics of the atrial appendage in patients with atrial fibrillation and structural heart disease

    NARCIS (Netherlands)

    Brakel, T.J. van; Krieken, T. van der; Westra, S.W.; Laak, J.A.W.M. van der; Smeets, J.L.R.M.; Swieten, H.A. van

    2013-01-01

    PURPOSE: This study was conducted to investigate the degree of fibrosis in atrial appendages of patients with and without atrial fibrillation (AF) undergoing cardiac surgery. In addition, we hypothesized that areas of atrial fibrosis can be identified by electrogram fractionation and low voltage for

  11. Atrial tachycardia originating from the atrial septum in a patient with dextrocardia and complex structural heart disease.

    Science.gov (United States)

    Niu, Ya-Lei; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Lee, Pi-Chang; Chen, Shih-Ann

    2012-10-01

    We report a case with dextrocardia, corrected transposition of the great arteries. He also had an atrial septum defect (ASD) with patch repair. Activation map showed a centrifugal activation from a focal origin on the systemic lower left atrial ASD patch. Ablation of the origin can terminate the atrial tachycardia.

  12. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许端敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    @@ Atrial fibrillation (AF) is a kind of common arrhythmia, which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus.The incidence of left atrial thrombosis (LAT)could reach 25%-30%(1), the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more(2,3). To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  13. Bi-focal atrial tachycardia mimicking atrial fibrillation: fusion and interference between two distinct tachycardias.

    Science.gov (United States)

    Ejima, Koichiro; Shoda, Morio; Tanizaki, Kohei; Kasanuki, Hiroshi

    2007-11-01

    Irregular tachycardias mimicking atrial fibrillation (AF) have previously been described. We report a case of a 60-year-old man with an antiarrhythmic drug-resistant atrial tachycardia (AT) mimicking AF. The tachycardia consisted of two distinct ATs with interference of one repetitive AT with another sustained AT. Radiofrequency (RF) ablation of two distinct right atrial foci eliminated the irregular tachycardia. Although catheter-based pulmonary vein isolation has become a popular therapeutic approach for patients with symptomatic AF, careful evaluation of the intracardiac recordings in the patients undergoing RF ablation for AF is important.

  14. Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash; Safi, Sanam; Feinberg, Joshua

    2017-01-01

    BACKGROUND: Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation...... and secondary outcomes, we will create a 'Summary of Findings' table based on GRADE assessments of the quality of the evidence. DISCUSSION: The results of this systematic review have the potential to benefit millions of patients worldwide as well as healthcare economy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO...

  15. Atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. We present a case of atrial fibrillation associated with subclinical hyperthyroidism, in a 78-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  16. Effects of irbesartan on atrial cell electrophysiology

    Institute of Scientific and Technical Information of China (English)

    HUANG Cong-xin; CAO Feng; JIANG Hong; WANG Teng; LI Xia

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice.1 Its incidence increases with age and the presence of structural heart disease. It is a major cause of stroke, especially in the elderly. It has been shown that angiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardial infarction.2 Several studies have shown that activation of the rennin-angiotensin system is associated with the mechanisms of AF. Irbesartan is a long-acting angiotensin Ⅱ type 1 receptor antagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstrated that patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.4 These findings suggest that the inhibition of angiotensin Ⅱ may prevent AF, but its underlying electrophysiological mechanisms are obscure. The purpose of this study is to investigate the effects of irbesartan on atrial cell electrophysiology.

  17. Antihypertensive treatment and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Nielsen, Sune F; Benn, Marianne

    2014-01-01

    AIMS: To examine the associations between antihypertensive treatment with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs), β-blockers, diuretics, or calcium-antagonists, and risk of atrial fibrillation. We examined these associations using the entire Danish...... population from 1995 through 2010. METHODS AND RESULTS: Excluding medication used in atrial fibrillation, we matched individuals on ACEi monotherapy 1:1 with individuals on β-blocker (n = 48 658), diuretic (n = 69 630), calcium-antagonist (n = 57 646), and ARB monotherapy (n = 20 158). Likewise, individuals...... on ARB monotherapy were matched 1:1 with individuals on β-blocker (n = 20 566), diuretic (n = 20 832), calcium-antagonist (n = 20 232), and ACEi monotherapy (n = 20 158). All were free of atrial fibrillation and of predisposing diseases like heart failure, ischaemic heart disease, diabetes mellitus...

  18. Alterations in Functional Connectivity for Language in Prematurely Born Adolescents

    Science.gov (United States)

    Schafer, Robin J.; Lacadie, Cheryl; Vohr, Betty; Kesler, Shelli R.; Katz, Karol H.; Schneider, Karen C.; Pugh, Kenneth R.; Makuch, Robert W.; Reiss, Allan L.; Constable, R. Todd; Ment, Laura R.

    2009-01-01

    Recent data suggest recovery of language systems but persistent structural abnormalities in the prematurely born. We tested the hypothesis that subjects who were born prematurely develop alternative networks for processing language. Subjects who were born prematurely (n = 22; 600-1250 g birth weight), without neonatal brain injury on neonatal…

  19. 14 CFR 1214.806 - Premature termination of Spacelab flights.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Premature termination of Spacelab flights... FLIGHT Reimbursement for Spacelab Services § 1214.806 Premature termination of Spacelab flights. If a... are, in NASA's judgment, adversely affected by such premature termination. The basis for proration...

  20. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  1. The atrial fibrillation ablation pilot study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard

    2014-01-01

    AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analyse...... tachycardia, and 4 patients died (1 haemorrhagic stroke, 1 ventricular fibrillation in a patient with ischaemic heart disease, 1 cancer, and 1 of unknown cause). CONCLUSION: The AFib Ablation Pilot Study provided crucial information on the epidemiology, management, and outcomes of catheter ablation of AFib...

  2. VEP Responses to Op-Art Stimuli.

    Directory of Open Access Journals (Sweden)

    Louise O'Hare

    Full Text Available Several types of striped patterns have been reported to cause adverse sensations described as visual discomfort. Previous research using op-art-based stimuli has demonstrated that spurious eye movement signals can cause the experience of illusory motion, or shimmering effects, which might be perceived as uncomfortable. Whilst the shimmering effects are one cause of discomfort, another possible contributor to discomfort is excessive neural responses: As striped patterns do not have the statistical redundancy typical of natural images, they are perhaps unable to be encoded efficiently. If this is the case, then this should be seen in the amplitude of the EEG response. This study found that stimuli that were judged to be most comfortable were also those with the lowest EEG amplitude. This provides some support for the idea that excessive neural responses might also contribute to discomfort judgements in normal populations, in stimuli controlled for perceived contrast.

  3. VEP Responses to Op-Art Stimuli.

    Science.gov (United States)

    O'Hare, Louise; Clarke, Alasdair D F; Pollux, Petra M J

    2015-01-01

    Several types of striped patterns have been reported to cause adverse sensations described as visual discomfort. Previous research using op-art-based stimuli has demonstrated that spurious eye movement signals can cause the experience of illusory motion, or shimmering effects, which might be perceived as uncomfortable. Whilst the shimmering effects are one cause of discomfort, another possible contributor to discomfort is excessive neural responses: As striped patterns do not have the statistical redundancy typical of natural images, they are perhaps unable to be encoded efficiently. If this is the case, then this should be seen in the amplitude of the EEG response. This study found that stimuli that were judged to be most comfortable were also those with the lowest EEG amplitude. This provides some support for the idea that excessive neural responses might also contribute to discomfort judgements in normal populations, in stimuli controlled for perceived contrast.

  4. [Obesity as a risk factor for atrial fibrillation].

    Science.gov (United States)

    Duraj, Iwona; Broncel, Marlena

    2016-01-01

    Atrial fibrillation (AF) and obesity is a growing problem of public health both in Poland and in the whole world. AF risk factors may be summarized as elderliness, male sex, smoking, hypertension, diabetes, obesity, coronary heart disease, heart failure, valvular heart disease, cardiac surgery. Once obesity is an independent, potentially modifiable risk factor for AF. The connection between obesity and atrial fibrillation is very up-to-date because of incremental prevalence, almost epidemic of obesity in the whole world. The probability of AF among obese patients increases with concomitant obstructive sleep apnea. Regardless many researches it hasn't been assessed yet how obesity itself predisposes to AF. It could be an effect of change in the atrial anatomy, the rise of atrial pressure, mechanical stretch, interstitial atrial fibrosis and disruption of atrial electric integrity. A great role is ascribed to inflammation, especially proinflammatory cytokines increased by adipocites of left atrial epicardial adiposity.

  5. A rare large right atrial myxoma with rapid growth rate.

    Science.gov (United States)

    Kelly, Shawn C; Steffen, Kelly; Stys, Adam T

    2014-10-01

    Atrial myxomas are the most common benign intracavitary cardiac neoplasms. They most frequently occur in the left atrium. Right atrial tumors are rare, comprising 20 percent of myxomas achieving an incidence of 0.02 percent. Due to their rarity, right atrial tumor development and associated clinical symptoms has not been well described. The classical clinical triad for the presentation of left atrial myxomas--heart failure, embolic events, and constitutional symptoms--may not be applicable to right sided tumors. Also, natural development of myxoma is not well described, as surgical resection is the common practice. Previously ascribed growth rates of myxomas refer mostly to left atrial ones, as right atrial tumors are rare. We present a case of right atrial myxoma with growth rates exceeding those previously described.

  6. New risk factors for atrial fibrillation : causes of 'not-so-lone atrial fibrillation'

    NARCIS (Netherlands)

    Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.

    Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying

  7. Left atrial size in patients with cryptogenic stroke as a predictor of occurrence of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Antonio Cruz Culebras

    2017-04-01

    Full Text Available Objective: To determine whether the left atrial size can predict the development of atrial fibrillation (AF in patients with embolic stroke of undetermined source (ESUS. Methods: Patients with ischemic stroke were included prospectively (January 2015-July 2015 when ESUS was suspected. Clinical and cardiac imaging data were recorded. Patients with cardiac failure were excluded. Results: a total of 55 patients were included. Medium age was 71 years. The proportion of patients who developed AF during the follow-up (1 year was 23, 63%. 10 % of patients did not have any vascular risk factor. Basal ECG was normal in 98% of cases. The left atrial size volume was 36, 08 ml in patients who developed AF and 27, 14 ml in patients who did not. Conclusions: In patients with ESUS, left atrial size dimensions do not predict the occurrence of AF.

  8. New risk factors for atrial fibrillation : causes of 'not-so-lone atrial fibrillation'

    NARCIS (Netherlands)

    Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.

    2008-01-01

    Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying (cardiovascular

  9. Asymptomatic atrial fibrillation and stroke evaluation in pacemaker patients and the atrial fibrillation reduction atrial pacing trial (ASSERT)

    NARCIS (Netherlands)

    Holnloser, Stefan H.; Capucci, Alessandro; Fain, Eric; Gold, Michael R.; van Gelder, Isabelle C.; Healey, Jeff; Israel, Carsten W.; Lau, Chu P.; Morillo, Carlos; Connolly, Stuart J.

    Asymptomatic atrial fibrillation (AF) is common and may have the same prognostic implications as symptomatic AF. Among patients receiving dual-chamber pacemakers, it is now possible to quantify asymptomatic AF accurately. Most of these episodes are of short duration, often lasting only seconds to

  10. Stimuli responsive nanomaterials for controlled release applications

    KAUST Repository

    Li, Song

    2012-01-01

    The controlled release of therapeutics has been one of the major challenges for scientists and engineers during the past three decades. Coupled with excellent biocompatibility profiles, various nanomaterials have showed great promise for biomedical applications. Stimuli-responsive nanomaterials guarantee the controlled release of cargo to a given location, at a specific time, and with an accurate amount. In this review, we have combined the major stimuli that are currently used to achieve the ultimate goal of controlled and targeted release by "smart" nanomaterials. The most heavily explored strategies include (1) pH, (2) enzymes, (3) redox, (4) magnetic, and (5) light-triggered release.

  11. Left atrial appendage occlusion for stroke prevention in atrial fibrillation in Europe

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Dagres, Nikolaos; Proclemer, Alessandro;

    2013-01-01

    The purpose of this EP wire survey was to assess clinical practice in relation to the use of left atrial appendage occlusion (LAAO) devices for stroke prevention in atrial fibrillation (AF) among members of the European Heart Rhythm Association research network. The average number of performed LA...... are most often performed by interventional cardiologists. Experience varied widely, and this was reflected in the wide range of thromboembolic and procedural (tamponade, bleeding) complications reported by the respondents to this EP wire survey....

  12. Computational models of atrial cellular electrophysiology and calcium handling, and their role in atrial fibrillation.

    Science.gov (United States)

    Heijman, Jordi; Erfanian Abdoust, Pegah; Voigt, Niels; Nattel, Stanley; Dobrev, Dobromir

    2016-02-01

    The complexity of the heart makes an intuitive understanding of the relative contribution of ion channels, transporters and signalling pathways to cardiac electrophysiology challenging. Computational modelling of cardiac cellular electrophysiology has proven useful to integrate experimental findings, extrapolate results obtained in expression systems or animal models to other systems, test quantitatively ideas based on experimental data and provide novel hypotheses that are experimentally testable. While the bulk of computational modelling has traditionally been directed towards ventricular bioelectricity, increasing recognition of the clinical importance of atrial arrhythmias, particularly atrial fibrillation, has led to widespread efforts to apply computational approaches to understanding atrial electrical function. The increasing availability of detailed, atrial-specific experimental data has stimulated the development of novel computational models of atrial-cellular electrophysiology and Ca(2+) handling. To date, more than 300 studies have employed mathematical simulations to enhance our understanding of atrial electrophysiology, arrhythmogenesis and therapeutic responses. Future modelling studies are likely to move beyond current whole-cell models by incorporating new data on subcellular architecture, macromolecular protein complexes, and localized ion-channel regulation by signalling pathways. At the same time, more integrative multicellular models that take into account regional electrophysiological and Ca(2+) handling properties, mechano-electrical feedback and/or autonomic regulation will be needed to investigate the mechanisms governing atrial arrhythmias. A combined experimental and computational approach is expected to provide the more comprehensive understanding of atrial arrhythmogenesis that is required to develop improved diagnostic and therapeutic options. Here, we review this rapidly expanding area, with a particular focus on Ca(2+) handling, and

  13. Prematurity: an overview and public health implications.

    Science.gov (United States)

    McCormick, Marie C; Litt, Jonathan S; Smith, Vincent C; Zupancic, John A F

    2011-01-01

    The high rate of premature births in the United States remains a public health concern. These infants experience substantial morbidity and mortality in the newborn period, which translate into significant medical costs. In early childhood, survivors are characterized by a variety of health problems, including motor delay and/or cerebral palsy, lower IQs, behavior problems, and respiratory illness, especially asthma. Many experience difficulty with school work, lower health-related quality of life, and family stress. Emerging information in adolescence and young adulthood paints a more optimistic picture, with persistence of many problems but with better adaptation and more positive expectations by the young adults. Few opportunities for prevention have been identified; therefore, public health approaches to prematurity include assurance of delivery in a facility capable of managing neonatal complications, quality improvement to minimize interinstitutional variations, early developmental support for such infants, and attention to related family health issues.

  14. [Current developments on the physiology of the cardiac atrial pacemaker an excitation conduction of the left atrium].

    Science.gov (United States)

    Arrigo, L; Avanzino, G L

    1979-06-30

    According to recent developments the atrial pacemaker area and the right atrium show a peculiar morpho-functional organization, i.e.: 1) The pacemaker area is formed of clusters of cells containing relatively few myofibrils and showing embryologic characteristics. Such cells are known as nodal cells and between these and the atrial muscles are in general situated transitional cells. Each cluster is separated from the other by collagenous boundaries. The resistance of the membranes to the current flow seems to be relatively low between the cells of the same cluster but the collagenous boundaries are, according to TRAUTWEIN e UCHIZONO (1963), very poor conductors. The pacemaker activity seems to originate inside the various clusters. 2) The functional relationships between the sinoatrial node and the atrioventricular node as well as the interatrial relationship would take place through preferential pathways. These pathways corresponding approximately to the tracts described by JAMES (1966) (anterior, posterior and middle internodal tracts) and to the interatrial or Bachmann bundle, seems to show a higher velocity conduction. In general the fibres of which the tracts are composed are neither morphologically nor functionally isolated from the atrial muscle. The functional consequences of the above mentioned nodal and atrial organization seems to be: a) The possible conditioning of the pacemaker functions by the various clusters activity i.e. the dominance of one cluster over another. b) The shifting of the pacemaker activity from one cluster to anothr due to the arrival of nervous stimuli or chemical substances, etc. According to some Authors as a consequence of the shift the pacemaker area can sometimes move out side the nodal tissue and settle inside an area belonging to the internodal pathways. c) Another consequence of the shift can be the different involvement of the conducting pathways which can lead to a change in the dynamics of the atrial invasion by the

  15. The genetic basis of premature ovarian failure.

    Science.gov (United States)

    Woad, Kathryn J; Watkins, Wendy J; Prendergast, Deborah; Shelling, Andrew N

    2006-06-01

    Premature ovarian failure (POF) is a common condition, affecting approximately 1:100 women. It is characterised by amenorrhea, hypoestrogenism, and elevated gonadotrophin levels in women under the age of 40. It is often an unexpected and distressing diagnosis, which coincides with infertility and menopausal symptoms. There is a well recognised genetic basis to the development of POF. Our laboratory has identified several candidate genes associated with POF.

  16. Progeria: A rare genetic premature ageing disorder

    OpenAIRE

    Jitendra Kumar Sinha; Shampa Ghosh; Manchala Raghunath

    2014-01-01

    Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand...

  17. The drug treatment of premature ejaculation

    OpenAIRE

    Hisasue, Shin-ichi

    2016-01-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers ...

  18. Excessive supraventricular ectopic activity is indicative of paroxysmal atrial fibrillation in patients with cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Mark Weber-Krüger

    Full Text Available BACKGROUND: Detecting paroxysmal atrial fibrillation (PAF in patients with cerebral ischemia is challenging. Frequent premature atrial complexes (PAC/h and the longest supraventricular run on 24-h-Holter (SV-run(24 h, summarised as excessive supraventricular ectopic activity (ESVEA, may help selecting patients for extended ECG-monitoring, especially in combination with echocardiographic marker LAVI/a' (left atrial volume index/late diastolic tissue Doppler velocity. METHODS: Retrospective analysis from the prospective monocentric observational trial Find-AF (ISRCTN-46104198. Patients with acute stroke or TIA were enrolled at the University Hospital Göttingen, Germany. Those with sinus rhythm at presentation received 7-day Holter-monitoring. ESVEA was quantified in one 24-hour interval free from PAF. Echocardiographic parameters were assessed prospectively. RESULTS: PAF was detected in 23/208 patients (11.1%. The median was 4 [IQR 1; 22] for PAC/h and 5 [IQR 0; 9] for SV-run(24 h. PAF was more prevalent in patients with ESVEA: 19.6% vs. 2.8% for PAC/h >4 vs. ≤ 4 (p5 vs. ≤ 5 beats (p = 0.003. Patients with PAF showed more supraventricular ectopic activity: 29 PAC/h [IQR 9; 143] vs. 4 PAC/h [1]; [14] and longest SV-run(24 h = 10 [5]; [21] vs. 0 [0; 8] beats (both p4 and abnormal LAVI/a' showed high PAF-rates. CONCLUSIONS: ESVEA discriminated PAF from non-PAF beyond clinical factors including LAVI/a' in patients with cerebral ischemia. Normal LAVI/a'+PAC/h ≤ 4 ruled out PAF, while prevalence was high in those with abnormal LAVI/a'+PAC/h >4.

  19. Left atrial appendage closure devices for cardiovascular risk reduction in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Cruz-Gonzalez I

    2015-05-01

    Full Text Available Ignacio Cruz-Gonzalez,* Juan Carlos Rama-Merchan,* Javier Rodriguez-Collado, Javier Martin-Moreiras, Alejandro Diego-Nieto, Antonio Arribas-Jimenez, Pedro Luís SanchezDepartment of Cardiology, University Hospital of Cardiology and IBSAL, Salamanca, Spain *Ignacio Cruz-Gonzalez and Juan Carlos Rama-Merchan have contributed equally to this work and should be considered co-first authors Abstract: Atrial fibrillation (AF is the most common sustained arrhythmia in clinical practice. AF is associated with a 4–5-fold increased risk of stroke and systemic embolism. Oral anticoagulant is the first-line therapy for this purpose, but it has various limitations and is often contraindicated or underutilized. Autopsy and surgical data have suggested that 90% of atrial thrombi in nonvalvular AF patients originate from the left atrial appendage, leading to the development of percutaneous closure for thromboembolic prevention. This paper examines the current evidence on left atrial appendage closure devices for cardiovascular risk reduction in AF patients. Keywords: atrial fibrillation, left atrial appendage, stroke, oral anticoagulant, percutaneous closure, thromboembolic prevention

  20. Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes

    Directory of Open Access Journals (Sweden)

    Worthley Matthew I

    2008-12-01

    Full Text Available Abstract Background Percutaneous closure of atrial septal defects (ASDs should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure. Cardiovascular magnetic resonance (CMR is an accurate and reproducible imaging modality for the assessment of cardiac function and volumes. We assessed cardiac volumes pre- and post-percutaneous ASD closure using CMR. Methods Consecutive patients (n = 23 underwent CMR pre- and 6 months post-ASD closure. Steady state free precession cine CMR was performed using contiguous slices in both short and long axis views through the ASD. Data was collected for assessment of left and right atrial, ventricular end diastolic volumes (EDV and end systolic volumes (ESV. Data is presented as mean ± SD, volumes as mL, and paired t-testing performed between groups. Statistical significance was taken as p Results There was a significant reduction in right ventricular volumes at 6 months post-ASD closure (RVEDV: 208.7 ± 76.7 vs. 140.6 ± 60.4 mL, p Conclusion ASD closure leads to normalisation of ventricular volumes and also a reduction in right atrial volume. Further follow-up is required to assess how this predicts outcomes such as risk of atrial arrhythmias after such procedures.

  1. Structural and functional atrial remodeling in patients after catheter and surgical ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2016-03-01

    Full Text Available Atrial fibrillation (AF is the most common supraventricular arrhythmia which occurs in 1.5–2.0% of population. Morbidity of AF increased by 13% over the past two decades. Modern treatment of AF includes drug therapy, catheter radiofrequency ablation and various modifications of Cox Maze operations. The purpose of this review was to assess the atrial remodeling according to world literature. This involved a search of published articles in Medline, Web of Science, PubMed, Cochrane Central Register of Controlled Trials medical databases. During the primary stage of analysis 25 articles of 456 were identified. The researches carried out demonstrate that after catheter ablation and Cox Maze operation in patients with atrial fibrillation left atrium volume decrease, atrial contractile function improvment and sinus rhythm restoration are observed. In the absence of AF recurrence and postoperative atrial arrhythmias in early and late postoperative periods in some patients atrial remodeling is expressed. All data were confirmed by echocardiography, computer tomography and magnetic resonance imaging studies both before and after surgery.

  2. Characteristics of Residual Atrial Posterior Wall and Roof-Dependent Atrial Tachycardias after Pulmonary Vein Isolation.

    Science.gov (United States)

    Matsumoto, Akinori; Fukuzawa, Koji; Kiuchi, Kunihiko; Konishi, Hiroki; Ichibori, Hirotoshi; Imada, Hiroshi; Hyogo, Kiyohiro; Kurose, Jun; Takaya, Tomofumi; Mori, Shumpei; Yoshida, Akihiro; Hirata, Ken-Ichi; Nishii, Tatsuya; Kono, Atsushi

    2016-10-01

    Roof-dependent atrial tachycardia (roof AT) sometimes occurs after pulmonary vein isolation (PVI) of atrial fibrillation (AF). This study aimed to investigate the relationship between the anatomy of the residual left atrial posterior wall and occurrence of roof AT. A total of 265 patients with AF who underwent PVI were enrolled. After the PVI, induced or recurrent roof AT was confirmed by an entrainment maneuver or activation mapping using a three-dimensional (3D) mapping system. To identify the predictors of roof AT, the minimum distance between both PVI lines (d-PVI) was measured by a 3D mapping system and the anatomical parameters, including the left atrial (LA) diameter, left atrial volume index (LAVi), and shape of the left atrial roof, were analyzed by 3D computed tomography. Roof AT was documented in 11 (4.2%) of 265 patients. A multivariable analysis demonstrated that the d-PVI, Deep V shape of the LA roof, and LAVi were associated with roof AT occurrences (d-PVI: odds ratio: 0.72, confidence interval [CI]: 0.61-0.86, P PVI and LAVi, respectively. The shorter d-PVI at the LA roof, greater LAVi, and Deep V shape were associated with the occurrence of a roof AT. © 2016 Wiley Periodicals, Inc.

  3. The effect of asanguinous cardioplegic arrest on atrial preservation using atrial ATP as a marker.

    Science.gov (United States)

    Hines, G L; Scheaffer, P; Williams, L; Mantell, P; Cheifitz, P

    1990-01-01

    Changes in atrial adenosine triphosphate (ATP) and the presence of postoperative arrhythmias were studied in 14 patients during routine coronary artery bypass grafting to 1) attempt to evaluate atrial preservation, and 2) determine if a relationship exists between changes in ATP and the development of postoperative arrhythmias. Atrial biopsies were obtained at the time of cannulation (preischemic sample) and after the removal of the aortic crossclamp (postischemic sample). Methods of myocardial protection included systemic hypothermia (28 degrees C), periodic reinfusion of crystalloid cardioplegia into the aortic root and completed vein grafts, and iced slush in the pericardial well. Atrial temperature was monitored. Preischemic ATP was 0.412 +/- 0.32 mu mol/gm, and the postischemic value was 0.220 +/- 0.13 mu mol/gm (p less than .02). Atrial temperature routinely decreased to 13-18 degrees C after cardioplegic infusion but rose to 24 degrees C between infusions. There was no correlation between postoperative supraventricular arrhythmias (4 patients) and changes in ATP. In conclusion, routine coronary artery bypass grafting with standard methods of cardiac preservation does not appear to satisfactorily preserve atrial tissue. The clinical correlation and significance of this remains to be elucidated.

  4. Atrial Tachycardias Arising from Ablation of Atrial Fibrillation: A Proarrhythmic Bump or an Antiarrhythmic Turn?

    Directory of Open Access Journals (Sweden)

    Ashok J. Shah

    2010-01-01

    Full Text Available The occurrence of atrial tachycardias (AT is a direct function of the volume of atrial tissue ablated in the patients with atrial fibrillation (AF. Thus, the incidence of AT is highest in persistent AF patients undergoing stepwise ablation using the strategic combination of pulmonary vein isolation, electrogram based ablation and left atrial linear ablation. Using deductive mapping strategy, AT can be divided into three clinical categories viz. the macroreentry, the focal and the newly described localized reentry all of which are amenable to catheter ablation with success rate of 95%. Perimitral, roof dependent and cavotricuspid isthmus dependent AT involve large reentrant circuits which can be successfully ablated at the left mitral isthmus, left atrial roof and tricuspid isthmus respectively. Complete bidirectional block across the sites of linear ablation is a necessary endpoint. Focal and localized reentrant AT commonly originate from but are not limited to the septum, posteroinferior left atrium, venous ostia, base of the left atrial appendage and left mitral isthmus and they respond quickly to focal ablation. AT not only represents ablation-induced proarrhythmia but also forms a bridge between AF and sinus rhythm in longstanding AF patients treated successfully with catheter ablation.

  5. Delayed early primary visual pathway development in premature infants: high density electrophysiological evidence.

    Directory of Open Access Journals (Sweden)

    Emmanuel Tremblay

    Full Text Available In the past decades, multiple studies have been interested in developmental patterns of the visual system in healthy infants. During the first year of life, differential maturational changes have been observed between the Magnocellular (P and the Parvocellular (P visual pathways. However, few studies investigated P and M system development in infants born prematurely. The aim of the present study was to characterize P and M system maturational differences between healthy preterm and fullterm infants through a critical period of visual maturation: the first year of life. Using a cross-sectional design, high-density electroencephalogram (EEG was recorded in 31 healthy preterms and 41 fullterm infants of 3, 6, or 12 months (corrected age for premature babies. Three visual stimulations varying in contrast and spatial frequency were presented to stimulate preferentially the M pathway, the P pathway, or both systems simultaneously during EEG recordings. Results from early visual evoked potentials in response to the stimulation that activates simultaneously both systems revealed longer N1 latencies and smaller P1 amplitudes in preterm infants compared to fullterms. Moreover, preterms showed longer N1 and P1 latencies in response to stimuli assessing the M pathway at 3 months. No differences between preterms and fullterms were found when using the preferential P system stimulation. In order to identify the cerebral generator of each visual response, distributed source analyses were computed in 12-month-old infants using LORETA. Source analysis demonstrated an activation of the parietal dorsal region in fullterm infants, in response to the preferential M pathway, which was not seen in the preterms. Overall, these findings suggest that the Magnocellular pathway development is affected in premature infants. Although our VEP results suggest that premature children overcome, at least partially, the visual developmental delay with time, source analyses reveal

  6. ANTIARRHYTMIC EFFICACY OF SOTALOL IN PATIENTS WITH TACHY-BRADY SYNDROME HAVING ATRIAL PACEMAKER WITH DIFFERENT ATRIAL ELECTRODE POSITION

    Directory of Open Access Journals (Sweden)

    T. N. Novikova

    2009-01-01

    Full Text Available Aim. To evaluate efficacy of the combined therapy (sotalol and constant electric cardiostimulation in AAI regimen at two atrial electrode position: in low back part of interatrial septum (IAS and in right atrial auricle (RAA.Material and methods. 20 patients with tachy-brady syndrome were examined. They were randomized in 2 groups depending on atrial electrode position. Sotalol (160 mg daily was prescribed to all patients in a month after implantation of constant atrial pacemaker (CAP. A number of atrial fibrillation paroxysms (AFP was evaluated initially, in a month after CAP implantation and in a month after start of sotalol therapy.Results. Significant AFP reduction was observed in IAS stimulation, unlike RAA stimulation. Sotalol addition had essential significance in the termination or reduction of AFP. Sotalol effect did not depend on atrial electrode position.Conclusion. Sotalol usage together with constant electric cardiostimulation significantly reduces AFP irrespectively of atrial electrode position. 

  7. RhoA Activation Sensitizes Cells to Proteotoxic Stimuli by Abrogating the HSF1-Dependent Heat Shock Response.

    Directory of Open Access Journals (Sweden)

    Roelien A M Meijering

    Full Text Available The heat shock response (HSR is an ancient and highly conserved program of stress-induced gene expression, aimed at reestablishing protein homeostasis to preserve cellular fitness. Cells that fail to activate or maintain this protective response are hypersensitive to proteotoxic stress. The HSR is mediated by the heat shock transcription factor 1 (HSF1, which binds to conserved heat shock elements (HSE in the promoter region of heat shock genes, resulting in the expression of heat shock proteins (HSP. Recently, we observed that hyperactivation of RhoA conditions cardiomyocytes for the cardiac arrhythmia atrial fibrillation. Also, the HSR is annihilated in atrial fibrillation, and induction of HSR mitigates sensitization of cells to this disease. Therefore, we hypothesized active RhoA to suppress the HSR resulting in sensitization of cells for proteotoxic stimuli.Stimulation of RhoA activity significantly suppressed the proteotoxic stress-induced HSR in HL-1 atrial cardiomyocytes as determined with a luciferase reporter construct driven by the HSF1 regulated human HSP70 (HSPA1A promoter and HSP protein expression by Western Blot analysis. Inversely, RhoA inhibition boosted the proteotoxic stress-induced HSR. While active RhoA did not preclude HSF1 nuclear accumulation, phosphorylation, acetylation, or sumoylation, it did impair binding of HSF1 to the hsp genes promoter element HSE. Impaired binding results in suppression of HSP expression and sensitized cells to proteotoxic stress.These results reveal that active RhoA negatively regulates the HSR via attenuation of the HSF1-HSE binding and thus may play a role in sensitizing cells to proteotoxic stimuli.

  8. Right juxtaposition of the atrial appendages.

    Science.gov (United States)

    Mathew, R; Replogle, R; Thilenius, O G; Arcilla, R A

    1975-04-01

    We present an infant with right-sided juxtaposition of atrial appendages who had open heart surgery for ventricular septal defect and patent ductus arteriosus. Of 12 cases thus far reported, ventricular d-loop was observed in nine, and normal position of great vessels in four. Contrary to previous views, this condition may not be accompanied by severe conotruncal anomalies.

  9. Hypercoagulability promotes atrial fibrosis and fibrillation

    NARCIS (Netherlands)

    Spronk, Henri M.H.; De Jong, Anne-Margreet; De Boer, Hetty C.; Maas, Alexander; Verheule, Sander; Rienstra, Michiel; Kamphuisen, Pieter W.; Ten Cate, Hugo; Crijns, Harry J.; Van Gelder, Isabelle; Van Zonneveld, Anton Jan; Schotten, Ullrich

    2014-01-01

    Background: It is well known that atrial fibrillation (AF) induces a hypercoagulable state, which significantly increases stroke risk in patients with AF contributing to morbidity and mortality in these patients. Active coagulation factors can also provoke diverse cellular responses through stimulat

  10. Primary care aspects of atrial fibrillation

    NARCIS (Netherlands)

    Meijler, F.L.; Tweel, I. van der

    1985-01-01

    A better understanding of the pathophysiologic mechanisms that determine the random pattem of ventricular rhythm may assist the primary care physician in treating and guiding atrial fibrillation patients. These mechanisms also form the basis for our understanding of drug action and effect on ventric

  11. Spontaneous conversion of first onset atrial fibrillation

    DEFF Research Database (Denmark)

    Lindberg, Søren Østergaard; Hansen, Sidsel; Nielsen, Tonny

    2011-01-01

    Background  We studied all patients admitted to hospital with first onset atrial fibrillation (AF) to determine the probability of spontaneous conversion to sinus rhythm and to identify factors predictive of such a conversion. Methods and Results  We retrospectively reviewed charts of 438...

  12. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  13. Genetic aspects of lone atrial fibrillation

    DEFF Research Database (Denmark)

    Andreasen, Laura; Nielsen, Jonas B; Olesen, Morten S

    2015-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. A subgroup of patients presents with AF without traditional risk factors and is diagnosed before the age of 60 years. Such patients are commonly referred as having "lone AF" and comprise 10-20% of all cases. A number of studies have...

  14. Nonpenetrating right atrial and pericardial trauma.

    Science.gov (United States)

    Grande, Antonino M; Rinaldi, Mauro; Pasquino, Stefano; Dore, Roberto; Viganò, Mario

    2003-09-01

    Nonpenetrating chest trauma can cause cardiac rupture. Ventricles are affected more frequently than atria. Survival is rare and depends upon prompt diagnosis and immediate surgical intervention. We report the case of a 42-year-old man involved in a car accident with consequent right atrial rupture and pericardial tearing.

  15. Genetic Risk Prediction of Atrial Fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A; Yin, Xiaoyan; Lin, Henry; Kolek, Matthew; Smith, J Gustav; Trompet, Stella; Rienstra, Michiel; Rost, Natalia S; Teixeira, Pedro; Almgren, Peter; Anderson, Christopher D; Chen, Lin Y; Engström, Gunnar; Ford, Ian; Furie, Karen L; Guo, Xiuqing; Larson, Martin G; Lunetta, Kathryn; Macfarlane, Peter W; Psaty, Bruce M; Soliman, Elsayed Z; Sotoodehnia, Nona; Stott, David J; Taylor, Kent D; Weng, Lu-Chen; Yao, Jie; Geelhoed, Bastiaan; Verweij, Niek; Siland, Joylene E; Kathiresan, Sekar; Roselli, Carolina; Roden, Dan M; van der Harst, Pim; Darbar, Dawood; Jukema, J Wouter; Melander, Olle; Rosand, Jonathan; Rotter, Jerome I; Heckbert, Susan R; Ellinor, Patrick T; Alonso, Alvaro; Benjamin, Emelia J

    2016-01-01

    BACKGROUND: -Atrial fibrillation (AF) has a substantial genetic basis. Identification of individuals at greatest AF risk could minimize the incidence of cardioembolic stroke. METHODS: -To determine whether genetic data can stratify risk for development of AF, we examined associations between AF gene

  16. Imaging in percutaneous ablation for atrial fibrillation

    NARCIS (Netherlands)

    R. Maksimović (Ružica); T. Dill (Thorsten); A.D. Ristić (Arsen); P.M. Seferovic (Petar)

    2006-01-01

    textabstractPercutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant

  17. Endometrial Adenocarcinoma with Concomitant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Lisa N. Abaid

    2009-08-01

    Full Text Available Background: Atrial myxomas are the most common primary heart tumors and predominantly considered to be benign lesions. Case Study: We report a case involving a 77-year-old woman who presented with a pelvic mass. She was found to have a primary endometrial cancer and primary lung cancer with concomitant metastatic adrenal gland and mesenteric lesions. Her prior medical history also included an untreated 4.0 × 2.0-cm left atrial myxoma which was identified on CT scan during the workup of her pelvic mass. Results: A clinical decision was made to proceed with surgery for the pelvic mass with a subsequent recommendation for left atrial mass resection. Currently, the patient is scheduled to begin chemotherapy for primary lung cancer. Conclusion: The reported incidence of uterine cancer and a concurrent atrial myxoma is very rare. Consequently, the manner and timing in which treatment should be provided is imprecise. In the present case, the risk for cardiac complications was high, but given the presence of a partial bowel obstruction and the need to diagnose the primary site of her metastatic malignancy, the decision was made to proceed with exploratory abdominal surgery.

  18. Stimuli-responsive protamine-based biodegradable nanocapsules for enhanced bioavailability and intracellular delivery of anticancer agents

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Krishna; Thomas, Midhun B.; Pulakkat, Sreeranjini [Indian Institute of Science, Department of Materials Engineering (India); Gnanadhas, Divya P.; Chakravortty, Dipshikha [Indian Institute of Science, Department of Microbiology and Cell Biology (India); Raichur, Ashok M., E-mail: amr@materials.iisc.ernet.in [Indian Institute of Science, Department of Materials Engineering (India)

    2015-08-15

    Enzyme- and pH-responsive polyelectrolyte nanocapsules having diameters in the range of 200 ± 20 nm were fabricated by means of Layer-by-Layer assembly of biopolymers, protamine, and heparin, and then loaded with anticancer drug doxorubicin. The incorporation of the FDA-approved peptide drug protamine as a wall component rendered the capsules responsive to enzyme stimuli. The stimuli-responsive drug release from these nanocapsules was evaluated, and further modulation of capsule permeability to avoid premature release was demonstrated by crosslinking the wall components. The interaction of the nanocapsules with cancer cells was studied using MCF-7 breast cancer cells. These capsules were readily internalized and disintegrated inside the cells, culminating in the release of the loaded doxorubicin and subsequent cell death as observed by confocal microscopy and MTT Assay. The bioavailability studies performed using BALB/c mice revealed that the encapsulated doxorubicin exhibited enhanced bioavailability compared to free doxorubicin. Our results indicate that this stimuli-responsive system fabricated from clinically used FDA-approved molecules and exhibiting minimal premature release has great potential for drug-delivery applications.

  19. Computer programming for generating visual stimuli.

    Science.gov (United States)

    Bukhari, Farhan; Kurylo, Daniel D

    2008-02-01

    Critical to vision research is the generation of visual displays with precise control over stimulus metrics. Generating stimuli often requires adapting commercial software or developing specialized software for specific research applications. In order to facilitate this process, we give here an overview that allows nonexpert users to generate and customize stimuli for vision research. We first give a review of relevant hardware and software considerations, to allow the selection of display hardware, operating system, programming language, and graphics packages most appropriate for specific research applications. We then describe the framework of a generic computer program that can be adapted for use with a broad range of experimental applications. Stimuli are generated in the context of trial events, allowing the display of text messages, the monitoring of subject responses and reaction times, and the inclusion of contingency algorithms. This approach allows direct control and management of computer-generated visual stimuli while utilizing the full capabilities of modern hardware and software systems. The flowchart and source code for the stimulus-generating program may be downloaded from www.psychonomic.org/archive.

  20. [Prematurity risk according to prematurity risk score and postpartal morbidity of the newborn infants (author's transl)].

    Science.gov (United States)

    Coradello, H; Lubec, G; Simbruner, G

    1981-02-01

    Risk of premature birth was evaluated retrospectively in 610 women in the first days after delivery using the prematurity risk score published by Thalhammer 1973. The calculated risk of premature birth was compared than prospectively to postpartal morbidity of the newborn infants as determined by duration of hospital stay, incidence of respiratory distress syndrome, need of artificial ventilation and mortality. A positive correlation could be found between risk of premature birth and postpartal morbidity of the newborn infants especially in small premature infants with birthweights of 2000 grams and less. The same correlation existed also in two groups of infants out of two different obstetric clinics which showed the same distribution of prenatal risks and the same prenatal care frequencies. It clearly becomes evident that infants with the same prenatal risks but good prenatal care during pregnancy had much lower hospital stays, lower respiratory distress frequencies and lower mortality rates than babies delivered from pregnancies badly cared for. These prenatal care related differences in postpartum morbidity again were much more evident in infants out of lower birth weight classes.

  1. Effects of Breast Milk and Vanilla Odors on Premature Neonate's Heart Rate and Blood Oxygen Saturation During and After Venipuncture.

    Science.gov (United States)

    Neshat, Hanieh; Jebreili, Mahnaz; Seyyedrasouli, Aleheh; Ghojazade, Morteza; Hosseini, Mohammad Bagher; Hamishehkar, Hamed

    2016-06-01

    Different studies have shown that the use of olfactory stimuli during painful medical procedures reduces infants' response to pain. The main purpose of the current study was to investigate the effect of breast milk odor and vanilla odor on premature infants' vital signs including heart rate and blood oxygen saturation during and after venipuncture. A total of 135 preterm infants were randomly selected and divided into three groups of control, vanilla odor, and breast milk odor. Infants in the breast milk group and the vanilla group were exposed to breast milk odor and vanilla odor from 5 minutes prior to sampling until 30 seconds after sampling. The results showed that breast milk odor has a significant effect on the changes of neonatal heart rate and blood oxygen saturation during and after venipuncture and decreased the variability of premature infants' heart rate and blood oxygen saturation. Vanilla odor has no significant effect on premature infants' heart rate and blood oxygen saturation. Breast milk odor can decrease the variability of premature infants' heart rate and blood oxygen saturation during and after venipuncture. Copyright © 2015. Published by Elsevier B.V.

  2. Lower esophageal sphincter relaxation reflex kinetics: effects of peristaltic reflexes and maturation in human premature neonates.

    Science.gov (United States)

    Pena, Eneysis M; Parks, Vanessa N; Peng, Juan; Fernandez, Soledad A; Di Lorenzo, Carlo; Shaker, Reza; Jadcherla, Sudarshan R

    2010-12-01

    We defined the sensory-motor characteristics of the lower esophageal sphincter relaxation (LESR) (stimulus threshold volume, response onset, and relaxation period, relaxation magnitude, nadir) during maturation in human neonates. We hypothesized that LESR kinetics differs during maturation and with peristaltic reflex type. Basal and adaptive esophageal motility testing was performed (N = 20 premature neonates) at 34.7 and 39.1 wk (time 1 and time 2). Effects of midesophageal provocation with graded stimuli (N = 1,267 stimuli, air and liquids) on LESR kinetics during esophagodeglutition response (EDR) and secondary peristalsis (SP) were analyzed by mixed models. Frequency of LESR with basal primary peristalsis were different during maturation (P = 0.03). During adaptive responses with maturation, 1) the frequencies of peristaltic reflexes and LESR were similar; 2) liquid stimuli resulted in a shorter LESR response latency and LESR nadir and greater LESR magnitude (all P reflexes at both times (vs. none, P reflex, and postnatal maturation. Maturation modulates an increased recruitment of inhibitory pathways that favor LESR.

  3. Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Rađen Goran

    2005-01-01

    Full Text Available Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI. Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short − term episodes of atrial fibrillation, and a high level of atrial pacing (99%. Conclusion. In selected patients with bradycardia−tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

  4. Assessment of the dynamics of atrial signals and local atrial period series during atrial fibrillation: effects of isoproterenol administration

    Directory of Open Access Journals (Sweden)

    Mantica Massimo

    2004-10-01

    Full Text Available Abstract Background The autonomic nervous system (ANS plays an important role in the genesis and maintenance of atrial fibrillation (AF, but quantification of its electrophysiologic effects is extremely complex and difficult. Aim of the study was to evaluate the capability of linear and non-linear indexes to capture the fine changing dynamics of atrial signals and local atrial period (LAP series during adrenergic activation induced by isoproterenol (a sympathomimetic drug infusion. Methods Nine patients with paroxysmal or persistent AF (aged 60 ± 6 underwent electrophysiological study in which isoproterenol was administered to patients. Atrial electrograms were acquired during i sinus rhythm (SR; ii sinus rhythm during isoproterenol (SRISO administration; iii atrial fibrillation (AF and iv atrial fibrillation during isoproterenol (AFISO administration. The level of organization between two electrograms was assessed by the synchronization index (S, whereas the degree of recurrence of a pattern in a signal was defined by the regularity index (R. In addition, the level of predictability (LP and regularity of LAP series were computed. Results LAP series analysis shows a reduction of both LP and R index during isoproterenol infusion in SR and AF (RSR = 0.75 ± 0.07 RSRISO = 0.69 ± 0.10, p AF = 0.31 ± 0.08 RAFISO = 0.26 ± 0.09, p SR = 99.99 ± 0.001 LPSRISO = 99.97 ± 0.03, p AF = 69.46 ± 21.55 LPAFISO = 55 ± 24.75; p SR = 0.49 ± 0.08 RSRISO = 0.46 ± 0.09 p AF = 0.29 ± 0.09 RAFISO = 0.28 ± 0.08 n.s.. Conclusions The proposed parameters succeeded in discriminating the subtle changes due to isoproterenol infusion during both the rhythms especially when considering LAP series analysis. The reduced value of analyzed parameters after isoproterenol administration could reflect an important pro-arrhythmic influence of adrenergic activation on favoring maintenance of AF.

  5. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter.

    Science.gov (United States)

    Mont, Lluís; Elosua, Roberto; Brugada, Josep

    2009-01-01

    Although the benefits of regular exercise in controlling cardiovascular risk factors have been extensively proven, little is known about the long-term cardiovascular effects of regular and extreme endurance sport practice, such as jogging, cycling, rowing, swimming, etc. Recent data from a small series suggest a relationship between regular, long-term endurance sport practice and atrial fibrillation (AF) and flutter. Reported case control studies included less than 300 athletes, with mean age between 40 and 50. Most series recruited only male patients, or more than 70% males, who had been involved in intense training for many years. Endurance sport practice increases between 2 and 10 times the probability of suffering AF, after adjusting for other risk factors. The possible mechanisms explaining the association remain speculative. Atrial ectopic beats, inflammatory changes, and atrial size have been suggested. Some of the published studies found that atrial size was larger in athletes than in controls, and this was a predictor for AF. It has also been shown that the left atrium may be enlarged in as many as 20% of competitive athletes. Other proposed mechanisms are increased vagal tone and bradycardia, affecting the atrial refractory period; however, this may facilitate rather than cause the arrhythmia. In summary, recent data suggest an association between endurance sport practice and atrial fibrillation and flutter. The underlying mechanism explaining this association is unclear, although structural atrial changes (dilatation and fibrosis) are probably present. Larger longitudinal studies and mechanistic studies are needed to further characterize the association to clarify whether a threshold limit for the intensity and duration of physical activity may prevent AF, without limiting the cardiovascular benefits of exercise.

  6. 78 FR 11207 - Clinical Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation...

    Science.gov (United States)

    2013-02-15

    ... Treatment of Atrial Fibrillation; Guidance for Industry and Food and Drug Administration Staff; Availability... Ablation Devices for Treatment of Atrial Fibrillation.'' This guidance provides FDA's recommendations on clinical trial designs for surgical ablation devices intended for the treatment of atrial...

  7. Protein analysis of atrial fibrosis via label-free proteomics in chronic atrial fibrillation patients with mitral valve disease.

    Directory of Open Access Journals (Sweden)

    Peide Zhang

    Full Text Available BACKGROUND: Atrial fibrosis, as a hallmark of atrial structure remodeling, plays an important role in maintenance of chronic atrial fibrillation, but interrelationship of atrial fibrosis and atrial fibrillation is uncertain. Label-free proteomics can implement high throughput screening for finding and analyzing pivotal proteins related to the disease.. Therefore, we used label-free proteomics to explore and analyze differentially proteins in chronic atrial fibrillation patients with mitral valve disease. METHODS: Left and right atrial appendages obtained from patients with mitral valve disease were both in chronic atrial fibrillation (CAF, AF≥6 months, n = 6 and in sinus rhythm (SR, n = 6. One part of the sample was used for histological analysis and fibrosis quantification; other part were analyzed by label-free proteomic combining liquid chromatography with mass spectrometry (LC-MS, we utilized bioinformatics analysis to identify differential proteins. RESULTS: Degree of atrial fibrosis was higher in CAF patients than that of SR patients. 223 differential proteins were detected between two groups. These proteins mainly had vital functions such as cell proliferation, stress response, focal adhesion apoptosis. We evaluated that serine/threonine protein kinase N2 (PKN2, dermatopontin (DP, S100 calcium binding protein B (S100B, protein tyrosine kinase 2 (PTK2 and discoidin domain receptor tyrosine kinase 2 (DDR2 played important roles in fibrotic process related to atrial fibrillation. CONCLUSION: The study presented differential proteins responsible for atrial fibrosis in chronic atrial fibrillation patients through label-free proteomic analysis. We assessed some vital proteins including their characters and roles. These findings may open up new realm for mechanism research of atrial fibrillation.

  8. Retinopathy of prematurity outcome in infants with Prethreshold Retinopathy of Prematurity and oxygen saturation > 94% in room air : The High Oxygen Percentage in Retinopathy of Prematurity study

    NARCIS (Netherlands)

    McGregor, ML; Bremer, DL; Cole, C; McClead, RE; Phelps, DL; Fellows, RR; Oden, N

    2002-01-01

    Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo(2))

  9. [Atrial fibrillation as consequence and cause of structural changes of atria].

    Science.gov (United States)

    Aparina, O P; Chikhireva, L N; Stukalova, O V; Mironova, N A; Kashtanova, S Iu; Ternovoĭ, S K; Golitsyn, S P

    2014-01-01

    Changes of atrial structure and function are the contributors of atrial fibrillation clinical course, complications and treatment effectiveness. Effects of inflammation and mechanical stretch on atrial structural remodeling leading to atrial fibrillation are reviewed in the article. Contemporary invasive and non-invasive methods of evaluation (including late gadolinium enhancement magnetic resonance imaging) of patients with atrial structural remodeling in atrial fibrillation are also described.

  10. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery

    DEFF Research Database (Denmark)

    Kowey, Peter R; Dorian, Paul; Mitchell, L Brent

    2009-01-01

    Postoperative atrial arrhythmias are common and are associated with considerable morbidity. This study was designed to evaluate the efficacy and safety of vernakalant for the conversion of atrial fibrillation (AF) or atrial flutter (AFL) after cardiac surgery.......Postoperative atrial arrhythmias are common and are associated with considerable morbidity. This study was designed to evaluate the efficacy and safety of vernakalant for the conversion of atrial fibrillation (AF) or atrial flutter (AFL) after cardiac surgery....

  11. Premature menopause linked to CVD and osteoporosis.

    Science.gov (United States)

    Park, Claire; Overton, Caroline

    2010-03-01

    Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD.

  12. The pathophysiology of lifelong premature ejaculation.

    Science.gov (United States)

    Waldinger, Marcel D

    2016-08-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  13. The pathophysiology of lifelong premature ejaculation

    Science.gov (United States)

    2016-01-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  14. Dronedarone for atrial fibrillation: a new therapeutic agent

    Directory of Open Access Journals (Sweden)

    Pawan D Patel

    2009-08-01

    Full Text Available Pawan D Patel, Rohit Bhuriya, Dipal D Patel, Bhaskar L Arora, Param P Singh, Rohit R AroraDepartment of Cardiology, Chicago Medical School, Chicago, IL, USAAbstract: Atrial fibrillation is the most common of the serious cardiac rhythm disturbances and is responsible for substantial morbidity and mortality. Amiodarone is currently one of the most widely used and most effective antiarrhythmic agents for atrial fibrillation. But during chronic usage amiodarone can cause some serious extra cardiac adverse effects, including effects on the thyroid. Dronedarone is a newer therapeutic agent with a structural resemblance to amiodarone, with two molecular changes, and with a better side effect profile. Dronedarone is a multichannel blocker and, like amiodarone, possesses both a rhythm and a rate control property in atrial fibrillation. The US Food and Drug Administration approved dronedarone for atrial fibrillation on July 2, 2009. In this review, we discuss the role of dronedarone in atrial fibrillation.Keywords: dronedarone, amiodarone, atrial fibrillation

  15. Atrial infarction is a unique and often unrecognized clinical entity

    Directory of Open Access Journals (Sweden)

    Rosana G. G. Mendes

    1999-03-01

    Full Text Available 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 restricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.

  16. Atrial Myxoma in a Patient with Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Abdou, Mahmoud; Hayek, Salim; Williams, Byron R.

    2013-01-01

    Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures. PMID:24082380

  17. Blind Braille readers mislocate tactile stimuli.

    Science.gov (United States)

    Sterr, Annette; Green, Lisa; Elbert, Thomas

    2003-05-01

    In a previous experiment, we observed that blind Braille readers produce errors when asked to identify on which finger of one hand a light tactile stimulus had occurred. With the present study, we aimed to specify the characteristics of this perceptual error in blind and sighted participants. The experiment confirmed that blind Braille readers mislocalised tactile stimuli more often than sighted controls, and that the localisation errors occurred significantly more often at the right reading hand than at the non-reading hand. Most importantly, we discovered that the reading fingers showed the smallest error frequency, but the highest rate of stimulus attribution. The dissociation of perceiving and locating tactile stimuli in the blind suggests altered tactile information processing. Neuroplasticity, changes in tactile attention mechanisms as well as the idea that blind persons may employ different strategies for tactile exploration and object localisation are discussed as possible explanations for the results obtained.

  18. Contingent stimuli signal subsequent reinforcer ratios.

    Science.gov (United States)

    Boutros, Nathalie; Davison, Michael; Elliffe, Douglas

    2011-07-01

    Conditioned reinforcer effects may be due to the stimulus' discriminative rather than its strengthening properties. While this was demonstrated in a frequently-changing choice procedure, a single attempt to replicate in a relatively static choice environment failed. We contend that this was because the information provided by the stimuli was nonredundant in the frequently-changing preparation, and redundant in the steady-state arrangement. In the present experiments, 6 pigeons worked in a steady-state concurrent schedule procedure with nonredundant informative stimuli (red keylight illuminations). When a response-contingent red keylight signaled that the next food delivery was more likely on one of the two alternatives, postkeylight choice responding was reliably for that alternative. This effect was enhanced after a history of extended informative red keylight presentation (Experiment 2). These results lend support to recent characterizations of conditioned reinforcer effects as reflective of a discriminative, rather than a reinforcing, property of the stimulus.

  19. Discrimination of auditory stimuli during isoflurane anesthesia.

    Science.gov (United States)

    Rojas, Manuel J; Navas, Jinna A; Greene, Stephen A; Rector, David M

    2008-10-01

    Deep isoflurane anesthesia initiates a burst suppression pattern in which high-amplitude bursts are preceded by periods of nearly silent electroencephalogram. The burst suppression ratio (BSR) is the percentage of suppression (silent electroencephalogram) during the burst suppression pattern and is one parameter used to assess anesthesia depth. We investigated cortical burst activity in rats in response to different auditory stimuli presented during the burst suppression state. We noted a rapid appearance of bursts and a significant decrease in the BSR during stimulation. The BSR changes were distinctive for the different stimuli applied, and the BSR decreased significantly more when stimulated with a voice familiar to the rat as compared with an unfamiliar voice. These results show that the cortex can show differential sensory responses during deep isoflurane anesthesia.

  20. Photonic water dynamically responsive to external stimuli

    Science.gov (United States)

    Sano, Koki; Kim, Youn Soo; Ishida, Yasuhiro; Ebina, Yasuo; Sasaki, Takayoshi; Hikima, Takaaki; Aida, Takuzo

    2016-08-01

    Fluids that contain ordered nanostructures with periodic distances in the visible-wavelength range, anomalously exhibit structural colours that can be rapidly modulated by external stimuli. Indeed, some fish can dynamically change colour by modulating the periodic distance of crystalline guanine sheets cofacially oriented in their fluid cytoplasm. Here we report that a dilute aqueous colloidal dispersion of negatively charged titanate nanosheets exhibits structural colours. In this `photonic water', the nanosheets spontaneously adopt a cofacial geometry with an ultralong periodic distance of up to 675 nm due to a strong electrostatic repulsion. Consequently, the photonic water can even reflect near-infrared light up to 1,750 nm. The structural colour becomes more vivid in a magnetic flux that induces monodomain structural ordering of the colloidal dispersion. The reflective colour of the photonic water can be modulated over the entire visible region in response to appropriate physical or chemical stimuli.

  1. Preparation of stimuli for timbre perception studies.

    Science.gov (United States)

    Labuschagne, Ilse B; Hanekom, Johan J

    2013-09-01

    Stimuli used in timbre perception studies must be controlled carefully in order to yield meaningful results. During psychoacoustic testing of individual timbre properties, (1) it must be ensured that timbre properties do not co-vary, as timbre properties are often not independent from one another, and (2) the potential influence of loudness, pitch, and perceived duration must be eliminated. A mathematical additive synthesis method is proposed which allows complete control over two spectral parameters, the spectral centroid (corresponding to brightness) and irregularity, and two temporal parameters, log rise-time (LRT) and a parameter characterizing the sustain/decay segment, while controlling for covariation in the spectral centroid and irregularity. Thirteen musical instrument sounds were synthesized. Perceptual data from six listeners indicate that variation in the four timbre properties mainly influences loudness and that perceived duration and pitch are not influenced significantly for the stimuli of longer duration (2 s) used here. Trends across instruments were found to be similar.

  2. Physiological responses induced by pleasant stimuli.

    Science.gov (United States)

    Watanuki, Shigeki; Kim, Yeon-Kyu

    2005-01-01

    The specific physiological responses induced by pleasant stimuli were investigated in this study. Various physiological responses of the brain (encephaloelectrogram; EEG), autonomic nervous system (ANS), immune system and endocrine system were monitored when pleasant stimuli such as odors, emotional pictures and rakugo, a typical Japanese comical story-telling, were presented to subjects. The results revealed that (i) EEG activities of the left frontal brain region were enhanced by a pleasant odor; (ii) emotional pictures related to primitive element such as nudes and erotic couples elevated vasomotor sympathetic nervous activity; and (iii) an increase in secretory immunoglobulin A (s-IgA) and a decrease in salivary cortisol (s-cortisol) were induced by rakugo-derived linguistic pleasant emotion. Pleasant emotion is complicated state. However, by considering the evolutionary history of human being, it is possible to assess and evaluate pleasant emotion from certain physiological responses by appropriately summating various physiological parameters.

  3. The drug treatment of premature ejaculation.

    Science.gov (United States)

    Hisasue, Shin-Ichi

    2016-08-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers will be the next strategies of the drug treatment for PE in the future.

  4. Premature ejaculation: current and future treatments

    Institute of Scientific and Technical Information of China (English)

    Levent Gurkan; Matthew Oommen; Wayne J. G. Hellstrom

    2008-01-01

    Premature ejaculation (PE) is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition nor a medication approved by the Food and Drug Administration (FDA). Despite these shortcomings, physicians continue to diagnose their patients with PE according to major guidelines and treat them with either behavioral therapies or off-label medications. This review focuses on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.

  5. Association of Atrial Fibrillation with Morphological and Electrophysiological Changes of the Atrial Myocardium.

    Science.gov (United States)

    Matějková, Adéla; Šteiner, Ivo

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. For long time it was considered as pure functional disorder, but in recent years, there were identified atrial locations, which are involved in the initiation and maintenance of this arrhythmia. These structural changes, so called remodelation, start at electric level and later they affect contractility and morphology. In this study we attempted to find a possible relation between morphological (scarring, amyloidosis, left atrial (LA) enlargement) and electrophysiological (ECG features) changes in patients with AF. We examined grossly and histologically 100 hearts of necropsy patients - 54 with a history of AF and 46 without AF. Premortem ECGs were evaluated. The patients with AF had significantly heavier heart, larger LA, more severely scarred myocardium of the LA and atrial septum, and more severe amyloidosis in both atria. Severity of amyloidosis was higher in LAs vs. right atria (RAs). Distribution of both fibrosis and amyloidosis was irregular. The most affected area was in the LA anterior wall. Patients with a history of AF and with most severe amyloidosis have more often abnormally long P waves. Finding of long P wave may contribute to diagnosis of a hitherto undisclosed atrial fibrillation.

  6. Cardiac ion channels and mechanisms for protection against atrial fibrillation

    DEFF Research Database (Denmark)

    Grunnet, Morten; Bentzen, Bo Hjorth; Sørensen, Ulrik S;

    2011-01-01

    Atrial fibrillation (AF) is recognised as the most common sustained cardiac arrhythmia in clinical practice. Ongoing drug development is aiming at obtaining atrial specific effects in order to prevent pro-arrhythmic, devastating ventricular effects. In principle, this is possible due to a different...... to the recent discovery that Ca(2+)-activated small conductance K(+) channels (SK channels) are important for the repolarisation of atrial action potentials. Finally, an overview of current pharmacological treatment of AF is included....

  7. Echocardiographic assessment and percutaneous closure of multiple atrial septal defects

    Directory of Open Access Journals (Sweden)

    Timperley Jonathan

    2004-07-01

    Full Text Available Abstract Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is considerable morphological variation in size and location of the defects. A small proportion of atrial septal defects may have multiple fenestrations and these are often considered unsuitable for device closure. We report three cases of multiple atrial septal defects successfully closed with two Amplatzer septal occluders.

  8. Juxtaposed atrial appendages: A curiosity with some clinical relevance

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2016-01-01

    Full Text Available If the atrial appendages lie adjacent to each other on same side of the great arteries, instead of encircling their roots, they are referred as juxtaposed. Right juxtaposition of atrial appendages is less common than left juxtaposition. The images demonstrate the classical radiological, echocardiographic, and surgical images of juxtaposed atrial appendages. Their clinical incidence, associations, and relevance during interventional and surgical procedures are discussed.

  9. STRATEGIES OF PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    Dembele, A.

    2016-07-01

    Full Text Available This article analyses different strategies of prophylaxis and management of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG at different periods after acute myocardial infarction (AMI. It examines the efficacy of early administration of beta-adrenergic blocking agents (metoprolol and amiodarone (in prophylactic doses in the diminution of the risk of postoperative atrial fibrillation in different groups of patients. The article also discerns the effectiveness of digoxin in the management of episodes of postoperative atrial fibrillation.

  10. Genetics of Atrial Fibrillation and Possible Implications for Ischemic Stroke

    OpenAIRE

    Robin Lemmens; Sylvia Hermans; Dieter Nuyens; Vincent Thijs

    2011-01-01

    Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart...

  11. Simulation of Stimuli-Responsive Polymer Networks

    Directory of Open Access Journals (Sweden)

    Thomas Gruhn

    2013-11-01

    Full Text Available The structure and material properties of polymer networks can depend sensitively on changes in the environment. There is a great deal of progress in the development of stimuli-responsive hydrogels for applications like sensors, self-repairing materials or actuators. Biocompatible, smart hydrogels can be used for applications, such as controlled drug delivery and release, or for artificial muscles. Numerical studies have been performed on different length scales and levels of details. Macroscopic theories that describe the network systems with the help of continuous fields are suited to study effects like the stimuli-induced deformation of hydrogels on large scales. In this article, we discuss various macroscopic approaches and describe, in more detail, our phase field model, which allows the calculation of the hydrogel dynamics with the help of a free energy that considers physical and chemical impacts. On a mesoscopic level, polymer systems can be modeled with the help of the self-consistent field theory, which includes the interactions, connectivity, and the entropy of the polymer chains, and does not depend on constitutive equations. We present our recent extension of the method that allows the study of the formation of nano domains in reversibly crosslinked block copolymer networks. Molecular simulations of polymer networks allow the investigation of the behavior of specific systems on a microscopic scale. As an example for microscopic modeling of stimuli sensitive polymer networks, we present our Monte Carlo simulations of a filament network system with crosslinkers.

  12. Anagrus breviphragma Soyka Short Distance Search Stimuli

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    Elisabetta Chiappini

    2015-01-01

    Full Text Available Anagrus breviphragma Soyka (Hymenoptera: Mymaridae successfully parasitises eggs of Cicadella viridis (L. (Homoptera: Cicadellidae, embedded in vegetal tissues, suggesting the idea of possible chemical and physical cues, revealing the eggs presence. In this research, three treatments were considered in order to establish which types of cue are involved: eggs extracted from leaf, used as a control, eggs extracted from leaf and cleaned in water and ethanol, used to evaluate the presence of chemicals soluble in polar solvents, and eggs extracted from leaf and covered with Parafilm (M, used to avoid physical stimuli due to the bump on the leaf surface. The results show that eggs covered with Parafilm present a higher number of parasitised eggs and a lower probing starting time with respect to eggs washed with polar solvents or eggs extracted and untreated, both when the treatments were singly tested or when offered in sequence, independently of the treatment position. These results suggest that the exploited stimuli are not physical due to the bump but chemicals that can spread in the Parafilm, circulating the signal on the whole surface, and that the stimuli that elicit probing and oviposition are not subjected to learning.

  13. [Application of massage therapy in premature infant nursing care].

    Science.gov (United States)

    Chang, Shu-Min; Sung, Huei-Chuan

    2007-02-01

    Massage therapy has been used in the care of premature infants for many years in western countries, and a significant body of research has already shown the effectiveness of massage therapy in significantly increasing body weight, decreasing infant hospital durations, enhancing bone formation, and improving behavior. Key considerations when applying massage therapy on premature infants include gestational age, bodyweight, and physical condition. Nurses can teach parents to administer massage therapy on their premature infants to enhance parent-child attachment and interaction. This article introduces massage therapy principles and methods, the effectiveness of massage therapy in premature infant care, and an approach to teaching parents how to apply massage therapy on their premature infants. Massage therapy can be included in premature infant care programs in the future.

  14. [Developmental change in facial recognition by premature infants during infancy].

    Science.gov (United States)

    Konishi, Yukihiko; Kusaka, Takashi; Nishida, Tomoko; Isobe, Kenichi; Itoh, Susumu

    2014-09-01

    Premature infants are thought to be at increased risk for developmental disorders. We evaluated facial recognition by premature infants during early infancy, as this ability has been reported to be impaired commonly in developmentally disabled children. In premature infants and full-term infants at the age of 4 months (4 corrected months for premature infants), visual behaviors while performing facial recognition tasks were determined and analyzed using an eye-tracking system (Tobii T60 manufactured by Tobii Technologics, Sweden). Both types of infants had a preference towards normal facial expressions; however, no preference towards the upper face was observed in premature infants. Our study suggests that facial recognition ability in premature infants may develop differently from that in full-term infants.

  15. The Maze procedure: surgical therapy for refractory atrial fibrillation.

    Science.gov (United States)

    McCarthy, P M; Castle, L W; Trohman, R G; Simmons, T W; Maloney, J D; Klein, A L; White, R D; Cox, J L

    1993-01-01

    Although atrial fibrillation is well tolerated by most patients, in some patients the consequences may be severe. The Maze procedure is a new open-heart operation that creates a carefully designed maze of incisions in the atrial myocardium; this maze then acts as an electrical conduit to channel atrial impulses from the sinoatrial node to the atrioventricular node. The Maze procedure has been shown to restore sinus rhythm and atrial systole (thus reducing the risk of thromboembolism), improve hemodynamics, alleviate palpitations, and eliminate the need for antiarrhythmic and anticoagulant drugs. We describe our first patient to undergo this operation.

  16. Fibrosis in Atrial Fibrillation - Role of Reactive Species and MPO.

    Science.gov (United States)

    Friedrichs, Kai; Baldus, Stephan; Klinke, Anna

    2012-01-01

    Atrial fibrosis with enhanced turnover and deposition of matrix proteins leads to inhomogeneous atrial electrical conduction and gives rise to electrical reentry circuits resulting in atrial fibrillation. The multifactorial pathogenesis of atrial fibrosis involves resident cardiac cells as well as infiltrating leukocytes, both generating and sequestering matrix metalloproteinases (MMPs), a key enzyme family involved in fibrosis. A growing body of evidence points toward an important role of reactive oxygen species (ROS) in the release and activation of pro-MMPs and the stimulation of pro-fibrotic cascades. Myeloperoxidase (MPO), a bactericidal enzyme released from activated polymorphonuclear neutrophils (PMN) is not only associated with a variety of cardiovascular diseases, but has also been shown to be mechanistically linked to atrial fibrosis and fibrillation. MPO catalyzes the generation of reactive species like hypochlorous acid, which affect intracellular signaling cascades in various cells and advance activation of pro-MMPs and deposition of atrial collagen resulting in atrial arrhythmias. Thus, inflammatory mechanisms effectively promote atrial structural remodeling and importantly contribute to the initiation and perpetuation of atrial fibrillation.

  17. The Effects of Fetal Surgery on Retinopathy of Prematurity Development

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    Sudha Nallasamy

    2009-10-01

    Full Text Available Background: Fetal surgery is selectively offered for severe or life-threatening fetal malformations. These infants are often born prematurely and are thus at risk for retinopathy of prematurity (ROP. It is not known whether fetal surgery confers an increased risk of developing severe ROP relative to published rates in standard premature populations ≤37 weeks of age grouped by birth weight (

  18. Fibrilação atrial e demência: resultados do São Paulo ageing & health study Atrial fibrillation and dementia: results from the Sao Paulo ageing & health study

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    Liz Andrea Kawabata-Yoshihara

    2012-12-01

    Full Text Available FUNDAMENTO: A fibrilação atrial é um fator de risco controverso para demência. OBJETIVO: O objetivo deste estudo é avaliar a associação entre fibrilação atrial e demência em participantes do São Paulo Ageing & Health. MÉTODOS: O São Paulo Ageing & Health é um estudo transversal, de base populacional, de idosos residentes em um uma região de baixa renda da cidade de São Paulo, Brasil. Diagnóstico de demência foi realizado de acordo com o protocolo do grupo 10/66, com base em critérios do Manual de Diagnóstico e Estatística das Perturbações Mentais (DSM-IV. O diagnóstico de fibrilação atrial foi feito por eletrocardiograma de 12 derivações, avaliado por dois cardiologistas. Dados demográficos e de fatores de risco cardiovasculares também foram obtidos. RESULTADOS: A demência foi diagnosticada em 66 (4,3% e fibrilação atrial em 36 (2,4% de 1.524 participantes com um eletrocardiograma válido. A razão de chances bruta para demência em participantes com fibrilação atrial foi 2,8 (intervalo de confiança [IC] 95%: 1,0-8,1; p = 0,06 em comparação com indivíduos sem fibrilação atrial. Relação positiva foi encontrada em mulheres (RC 4,2; IC 95%: 1,2-15,1; p = 0,03. Após ajuste para idade, no entanto, essa associação tornou-se não significativa (RC 2,2, IC 95%: 0,6-8,9; p = 0,26. CONCLUSÃO: Não houve associação independente entre a fibrilação atrial e demência nessa amostra. A prevalência da fibrilação atrial pode ser baixa nesta população em virtude da mortalidade cardiovascular prematura.BACKGROUND: Atrial fibrillation (AF is a controversial risk factor for dementia. OBJECTIVE: The objective of this study was to assess the association between AF and dementia in the "Sao Paulo Ageing & Health" (SPAH study participants. METHODS: SPAH is a cross-sectional, population-based study of elderly people living in a deprived neighborhood in Sao Paulo, Brazil. Dementia diagnosis was performed according to

  19. [Atrial fibrillation concomitant with valvular heart disease].

    Science.gov (United States)

    Ishii, Yosuke

    2013-01-01

    Patients with valvular heart disease frequently have atrial fibrillation(AF) due to elevated pressure and dilatation of the left and right atria and pulmonary veins. Guidelines for valvular heart disease and AF recommend that surgical treatment for the valvular heart disease should be performed concomitantly with AF surgery. The Full-Maze procedure has evolved into the gold standard of treatment for medically refractory AF. In addition to the pulmonary vein isolation, the right and left atrial incisions of the Full-Maze procedure are designed to block potential macroreentrant pathways. According to the mechanisms of AF with valvular heart disease, the Full-Maze procedure is more effective for the patients than the pulmonary vein isolation alone.

  20. Propofol effects on atrial fibrillation wavefront delays.

    Science.gov (United States)

    Cervigón, Raquel; Moreno, Javier; Millet, José; Pérez-Villacastín, Julián; Castells, Francisco

    2010-08-01

    Since the cardiac activity during atrial fibrillation (AF) may be influenced by autonomic modulations, in this study, a novel method to quantify the effects of the most common anesthetic agent (propofol) in AF ablation procedures is introduced. This study has two main objectives: first, to assess whether the sedation earlier to radio frequency ablation affects the arrhythmia itself, and second, to provide new information that contributes to a better understanding of the influence of the autonomic nervous system on AF. The methodology presented is based on the measurement of synchronization and delay indexes between two atrial activations at adjacent intracavitary electrodes. These parameters aim to estimate whether two activations at different sites may be caused by the same propagating wavefront, or otherwise, are the consequence of independent wavefronts. The results showed that the mentioned indexes have a different behavior at both atria: the right atrium becomes more synchronized with propofol administration, whereas the synchronization index decreases at the left atrium.

  1. Pathogenic Mechanisms of Atrial Fibrillation in Obesity

    Directory of Open Access Journals (Sweden)

    O. M. Drapkina

    2016-01-01

    Full Text Available Atrial fibrillation (AF is one of the most common arrhythmias. It reduces quality of life and its duration due to thromboembolic complications. Obesity contributes to the structural and electrical remodeling of atrial myocardium. This leads to occurrence of ectopic foci in the mouths of the pulmonary veins and the disruption of normal electrical conduction in the atria. Systemic inflammation, myocardial fibrosis, cardiomyocyte overload by Na+ and Ca2+ ions, accumulation in the cells of unoxidized metabolic products, imbalance of the autonomic regulation are considered as the main mechanisms of arrhythmogenic substrate formation. Hypertension, insulin resistance, and obstructive sleep apnea, associated with obesity, increase the risk of development and progression of the arrhythmia. Study of pathogenetic mechanisms of AF in obesity is necessary to develop new strategies for its prevention and the creation of more effective methods of treatment of these patients.

  2. [Atrial fibrillation ablation: application of nurse methodology].

    Science.gov (United States)

    Ramos-González-Serna, Amelia; Mateos-García, M Dolores

    2011-01-01

    Ablation of pulmonary veins for treatment of atrial fibrillation involves applying radiofrequency energy wave by a catheter that causes a circumferential lesion to achieve electrical isolation and voltage drop in the interior. It is mainly applied when there is resistance to treatment and recurrence of symptoms affecting the quality of life of patients. The nurse is an important part of the multidisciplinary team who care for patients who undergo this procedure. The provision of comprehensive nursing care should include nursing procedures prior to, during, and after treatment to ensure the careful and systematic quality required. The aims of this article are: to provide specialised knowledge on the procedure of atrial fibrillation ablation, to describe the preparation of the electrophysiology laboratory, analyse nursing care and develop a standardized care plan for patients on whom this procedure is performed using the NANDA (North American Nursing Association) taxonomy and NIC (Nursing Intervention Classification).

  3. Retrieval of embolized left atrial appendage devices.

    Science.gov (United States)

    Fahmy, Peter; Eng, Lim; Saw, Jacqueline

    2016-09-28

    Percutaneous left atrial appendage (LAA) closure is gaining interest as an alternative option for prevention of strokes in patients with Atrial Fibrillation (AF), especially for those with contraindications to anticoagulation. Complications from these procedures are well described in the medical literature. LAA closures may lead to pericardial effusion, device-associated thrombus, and device embolization. Understanding the reasons for embolization, strategies to avoid embolization, and the techniques for retrieval of LAA devices (ACP/AMULET and WATCHMAN) should be appreciated by endovascular implanters. We describe two cases of LAA device embolization that were both successfully retrieved percutaneously and other percutaneous techniques to safely retrieve embolized LAA devices. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Animal models of premature and retarded ejaculation.

    Science.gov (United States)

    Waldinger, Marcel D; Olivier, Berend

    2005-06-01

    Most of our current understanding of the neurobiology of sexual behavior and ejaculatory function has been derived from animal studies using rats with normal sexual behaviour. However, none of these proposed models adequately represents human ejaculatory disorders. Based on the "ejaculation distribution theory", which postulates that the intravaginal ejaculation latency time in men is represented by a biological continuum, we have developed an animal model for the research of premature and delayed ejaculation. In this model, a large number of male Wistar rats are investigated during 4-6 weekly sexual behavioural tests. Based on the number of ejaculations during 30 min tests, rapid and sluggish ejaculating rats are distinguished, each representing approximately 10% at both ends of a Gaussian distribution. Together with other parameters, such as ejaculation latency time, these rats at either side of the spectrum resemble men with premature and delayed ejaculation, respectively. Comparable to the human situation, in a normal population of rats, endophenotypes exist with regard to basal sexual (ejaculatory) performance.

  5. Neuro-ophthalmic manifestations of prematurity.

    Science.gov (United States)

    Chhablani, Preeti Patil; Kekunnaya, Ramesh

    2014-10-01

    Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.

  6. [Intraventricular haemorrhage in premature newborn babies].

    Science.gov (United States)

    Nazar, N

    This work is the product of the checking of the pathogenesis, incidence, treatment, and prognostic of the intraventricular hemorrhage in the premature newborn. In the revised publications, that include important series of following, this pathology is present in 25% of the infants weighing less than 1,500 g, in which the mortality and morbidity is greater than that of normal newborns, since the development of intraventricular hemorrhage can produce alterations of cerebral blood flow in the immature germinal matrix and in the microvascular net. In consequence the prevention of the intraventricular hemorrhage is directly related with its pathogenesis. It is said that the use of dexamethasone steroids in low doses in the prenatal period, and low doses of indomethacin in the postnatal period, can give better neuroprotection. The surgical treatment is exceptional and has very precise indications, when a progresive hydrocephalus of later apparition is proven. Therefore in premature newborns with intraventricular hemorrhage the best actual treatment is to use an appropiate pharmacological and medical following

  7. The pathophysiology of acquired premature ejaculation.

    Science.gov (United States)

    McMahon, Chris G; Jannini, Emmanuele A; Serefoglu, Ege C; Hellstrom, Wayne J G

    2016-08-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE.

  8. Premature ovarian insufficiency: Pathogenesis and management

    Directory of Open Access Journals (Sweden)

    Anna J Fenton

    2015-01-01

    Full Text Available The term premature ovarian insufficiency (POI describes a continuum of declining ovarian function in a young woman, resulting in an earlier than average menopause. It is a term that reflects the variable nature of the condition and is substantially less emotive than the formerly used "premature ovarian failure" which signaled a single event in time. Contrary to the decline in the age of menarche seen over the last 3-4 decades there has been no similar change in the age of menopause. In developed nations, the average age for cessation of menstrual cycles is 50-52 years. The age is younger among women from developing nations. Much has been written about POI despite a lack of good data on the incidence of this condition. It is believed that 1% of women under the age of 40 years and 0.1% under the age of 30 years will develop POI. Research is increasingly providing information about the pathogenesis and treatments are being developed to better preserve ovarian function during cancer treatment and to improve fertility options. This narrative review summarizes the current literature to provide an approach to best practice management of POI.

  9. Treatment of threshold retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Deshpande Dhanashree

    1998-01-01

    Full Text Available This report deals with our experience in the management of threshold retinopathy of prematurity (ROP. A total of 45 eyes of 23 infants were subjected to treatment of threshold ROP. 26.1% of these infants had a birth weight of >l,500 gm. The preferred modality of treatment was laser indirect photocoagulation, which was facilitated by scleral depression. Cryopexy was done in cases with nondilating pupils or medial haze and was always under general anaesthesia. Retreatment with either modality was needed in 42.2% eyes; in this the skip areas were covered. Total regression of diseases was achieved in 91.1% eyes with no sequelae. All the 4 eyes that progressed to stage 5 despite treatment had zone 1 disease. Major treatment-induced complications did not occur in this series. This study underscores the importance of routine screening of infants upto 2,000 gm birth weight for ROP and the excellent response that is achieved with laser photocoagulation in inducing regression of threshold ROP. Laser is the preferred method of treatment in view of the absence of treatment-related morbidity to the premature infants.

  10. Neuro-ophthalmic manifestations of prematurity

    Directory of Open Access Journals (Sweden)

    Preeti Patil Chhablani

    2014-01-01

    Full Text Available Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI. Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.

  11. Atrial fibrillation in obstructive sleep apnea

    OpenAIRE

    Goyal, Sandeep K; Sharma, Abhishek

    2013-01-01

    Atrial fibrillation (AF) is a common arrhythmia with rising incidence. Obstructive sleep apnea (OSA) is prevalent among patients with AF. This observation has prompted significant research in understanding the relationship between OSA and AF. Multiple studies support a role of OSA in the initiation and progression of AF. This association has been independent of obesity, body mass index and hypertension. Instability of autonomic tone and wide swings in intrathoracic pressure are seen in OSA. T...

  12. Acute atrial fibrillation during dengue hemorrhagic fever

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    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  13. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipset, Mark A.; Lemery, Jay; Polk, J. D.; Hamilton, Douglas R.

    2010-01-01

    Background: A long-duration exploration class mission is fraught with numerous medical contingency plans. Herein, we explore the challenges of symptomatic atrial fibrillation (AF) occurring during an exploration class mission. The actions and resources required to ameliorate the situation, including the availability of appropriate pharmaceuticals, monitoring devices, treatment modalities, and communication protocols will be investigated. Challenges of Atrial Fibrillation during an Exploration Mission: Numerous etiologies are responsible for the initiation of AF. On Earth, we have the time and medical resources to evaluate and determine the causative situation for most cases of AF and initiate therapy accordingly. During a long-duration exploration class mission resources will be severely restricted. How is one to determine if new onset AF is due to recent myocardial infarction, pulmonary embolism, fluid overload, thyrotoxicosis, cardiac structural abnormalities, or CO poisoning? Which pharmaceutical therapy should be initiated and what potential side effects can be expected? Should anti-coagulation therapy be initiated? How would one monitor the therapeutic treatment of AF in microgravity? What training would medical officers require, and which communication strategies should be developed to enable the best, safest therapeutic options for treatment of AF during a long-duration exploration class mission? Summary: These questions will be investigated with expert opinion on disease elucidation, efficient pharmacology, therapeutic monitoring, telecommunication strategies, and mission cost parameters with emphasis on atrial fibrillation being just one illustration of the tremendous challenges that face a long-duration exploration mission. The limited crew training time, medical hardware, and drugs manifested to deal with such an event predicate that aggressive primary and secondary prevention strategies be developed to protect a multibillion-dollar asset like the

  14. The significance of genetics in pathophysiologic models of premature birth.

    Science.gov (United States)

    Uberos, Jose

    2017-05-31

    Prematurity is a major health problem in all countries, especially in certain ethic groups and increasing recurrence imply the influence of genetic factors. Published genetic polymorphisms are identified in relation to the 4 pathophysiological models of prematurity described: Chorioamniotic-decidual inflammation, premature contraction pathway, decidual haemorrhage and susceptibility to environmental toxins. 240 articles are identified, 52 articles are excluded because they are not original, not written in English or duplicated. From them 125 articles were included in qualitative analysis This review aims to update recent knowledge about genes associated with premature birth.

  15. Infection and prematurity and the role of preventive strategies.

    Science.gov (United States)

    Romero, Roberto; Espinoza, Jimmy; Chaiworapongsa, Tinnakorn; Kalache, Karim

    2002-08-01

    This article reviews the role of infection in spontaneous premature parturition, the pathways of ascending intrauterine infection, microbiology, and the frequency of intra-amniotic infection in obstetrical complications leading to premature delivery. The evidence that infection is causally linked to premature birth is critically examined, as is the relationship between urogenital tract infection/colonization with microorganisms and the risk of preterm birth. The effect of antibiotic administration in perinatal outcome in patients with preterm labor and intact membranes, preterm premature rupture of membranes, asymptomatic bacteriuria, Group B streptococcus and genital mycoplasmas of the lower genital tract, and bacterial vaginosis are critically examined.

  16. Atrial Substrate Modification in Atrial Fibrillation: Targeting GP or CFAE? Evidence from Meta-Analysis of Clinical Trials

    OpenAIRE

    Qin, Mu; Liu, Xu; Wu, Shao-Hui; Zhang, Xiao-dong

    2016-01-01

    Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of G...

  17. [Relationship between atrial fibroblast proliferation/fibrosis and atrial fibrillation in patients with rheumatic heart disease].

    Science.gov (United States)

    Lin, Ya-Zhou; Cai, Jin-Ming; Chen, Lin; Yang, Zhi-Ping; Zhang, Jian-Cheng; Wu, Wei; Ke, Dan; Xu, Chun-Xuan

    2009-09-01

    To investigate the association between gene expressions of basic fibroblast growth factor (bFGF), smooth muscle alpha-actin (alpha-SMA) and proliferating cell nuclear antigen (PCNA) and atrial fibrosis in patients with atrial fibrillation (AF). The right atrial tissue samples were taken from 75 patients with rheumatic heart disease underwent heart valve replacement surgery (34 patients with sinus rhythm, 11 patients with paroxysmal AF and 30 patients with persistent AF) and stained with picrosirius red for quantitative analysis of collagen accumulation. The mRNA and protein levels of bFGF, alpha-SMA and PCNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemical technique, respectively. The percent volume fraction of collagen (CVF) was the highest in persistent AF group and the lowest in the sinus rhythm group (all P fibrosis by promoting fibroblast proliferation in AF patients.

  18. The mechanisms of atrial fibrillation in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Bielecka-Dabrowa Agata

    2009-04-01

    Full Text Available Abstract Atrial fibrillation (AF is a complex condition with several possible contributing factors. The rapid and irregular heartbeat produced by AF increases the risk of blood clot formation inside the heart. These clots may eventually become dislodged, causing embolism, stroke and other disorders. AF occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and is more common in men and in patients with triiodothyronine (T3 toxicosis. The incidence of AF increases with advancing age. Also, subclinical hyperthyroidism is a risk factor associated with a 3-fold increase in development of AF. Thyrotoxicosis exerts marked influences on electrical impulse generation (chronotropic effect and conduction (dromotropic effect. Several potential mechanisms could be invoked for the effect of thyroid hormones on AF risk, including elevation of left atrial pressure secondary to increased left ventricular mass and impaired ventricular relaxation, ischemia resulting from increased resting heart rate, and increased atrial eopic activity. Reentry has been postulated as one of the main mechanisms leading to AF. AF is more likely if effective refractory periods are short and conduction is slow. Hyperthyroidism is associated with shortening of action potential duration which may also contribute to AF.

  19. Atrial fibrillation associated with exogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover acute myocardial infarction has been reported during L-thyroxine substitution therapy. Far more common and relatively less studied is exogenous subclinical hyperthyroidism caused by L-thyroxine administration to thyroidectomized or hypothyroid patients or patients with simple or nodular goiter. We present a case of atrial fibrillation associated with exogenous subclinical hyperthyroidism, in a 72-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  20. Fibrilación atrial: nuevos conceptos

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    Luis Gutiérrez-Jaikel

    2004-06-01

    Full Text Available La fibrilación atrial es la arritmia más frecuente en la práctica clínica, se presenta tanto en pacientes con cardiopatía estructural de base principalmente hipertensiva, isquémica y valvular, como en pacientes sin trastorno cardiaco de fondo al avanzar la edad. Debido a la morbilidad asociada a esta, es vital su reconocimiento temprano y el manejo adecuado, con la finalidad de reducir la incidencia de complicaciones asociadas y mejorar la calidad de vida de quienes la padecen.Atrial fibrillation is the most frequent arrhythmia seen in clinical practice.It occurs most commonly on patients with hypertensive, isquemic and valvular heart disease as well as in patients without cardiac disease principally in elderly patients. Due to the morbidity rate associated with it (atrial fibrillation, early diagnosis and adequate treatment is necessary in order to reduce any associated complication and to improve the health related quality of life of patients who suffer from it.

  1. Dronedarone for the treatment of atrial fibrillation and atrial flutter: approval and efficacy

    Directory of Open Access Journals (Sweden)

    Deborah Wolbrette

    2010-06-01

    Full Text Available Deborah Wolbrette, Mario Gonzalez, Soraya Samii, Javier Banchs, Erica Penny-Peterson, Gerald NaccarelliPenn State Heart and Vascular Institute, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USAAbstract: Dronedarone, a new Class III antiarrhythmic agent, has now been approved by the US Food and Drug Administration for use in patients with atrial fibrillation or atrial flutter. Approval came in March 2009 due to the positive results of the ATHENA trial showing significant reductions in all-cause mortality and cardiovascular hospitalization with dronedarone use. A post hoc analysis of the ATHENA data also suggested a decrease in stroke risk with this agent. However, due to safety concerns in the heart failure population in the earlier ANDROMEDA trial, dronedarone is not recommended for patients with an ejection fraction <35% and recent decompensated heart failure. Dronedarone is an amiodarone analog with multichannel blocking electrophysiologic properties similar to those of amiodarone, but several structural differences. Dronedarone’s lack of the iodine moiety reduces its potential for thyroid and pulmonary toxicity. Preliminary data from the DIONYSOS trial, and an indirect meta-analysis comparing amiodarone with dronedarone, showed amiodarone to be more effective in maintaining sinus rhythm, while dronedarone was associated with fewer adverse effects resulting in early termination of the drug. Dronedarone is the first antiarrhythmic drug for the treatment of atrial fibrillation and atrial flutter shown to reduce cardiovascular hospitalizations. In patients with structural heart disease who have an ejection fraction >35% and no recent decompensated heart failure, dronedarone should be considered earlier than amiodarone in the treatment algorithm.Keywords: dronedarone, amiodarone, atrial fibrillation, atrial flutter

  2. Atrial and ventricular volume and function in persistent and permanent atrial fibrillation, a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Therkelsen, Susette Krohn; Groenning, Bjoern Aaris; Svendsen, Jesper Hastrup

    2005-01-01

    Left atrial size is independently related to cardiovascular morbidity and mortality, and atrial fibrillation (AF) is strongly associated with atrial size. Our aims were to report atrial and ventricular dimensions in patients with AF evaluated with magnetic resonance imaging (MRI), and to assess...... the inter-study reproducibility of the measurements. Nineteen healthy volunteers, 19 patients with permanent AF, and 58 patients with persistent AF had cardiac dimensions evaluated by 6-mm cinematographic breath-hold MRI scans using a 1.5 Tesla Siemens Vision Magnetom scanner with a phased array chest coil...

  3. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许瑞敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    Atrialarrhythmia,fibrillation (AF) is a kind of common arrhythmia which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus. The incidence of left atrial thrombosis (LAT) could reach 25%—30%, the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more. To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  4. Efficacy of atrial substrate modification based on dominant frequency of paroxysmal atrial fibrillation

    OpenAIRE

    KUMAGAI, Koji; Minami, Kentaro; Kutsuzawa, Daisuke; Oshima, Shigeru

    2016-01-01

    Background The endpoint of ablation procedures is suggested to be non-inducibility of paroxysmal atrial fibrillation (PAF). However, the prognosis of induced AF/atrial tachycardia (AT) after pulmonary vein isolation (PVI) in PAF patients remains unclear. Methods A total of 122 PAF patients were divided into the following 3 groups: Group 1, 79 without AF/AT induced after PVI; Group 2, 21 with AF/AT induced or sustained after PVI, and followed by a high-dominant frequency (DF) and continuous co...

  5. Rotigaptide (ZP123) improves atrial conduction slowing in chronic volume overload-induced dilated atria.

    Science.gov (United States)

    Haugan, Ketil; Miyamoto, Takuya; Takeishi, Yasuchika; Kubota, Isao; Nakayama, Jun; Shimojo, Hisashi; Hirose, Masamichi

    2006-07-01

    Chronic atrial dilation is associated with atrial conduction velocity slowing and an increased risk of developing atrial tachyarrhythmias. Rotigaptide (ZP123) is a selective gap junction modifier that increases cardiac gap junctional intercellular communication. We hypothesised that rotigaptide treatment would increase atrial conduction velocity and reduce the inducibility to atrial tachyarrhythmias in a model of chronic volume overload induced chronic atrial dilatation characterized by atrial conduction velocity slowing. Chronic volume overload was created in Japanese white rabbits by arterio-venous shunt formation. Atrial conduction velocity and atrial tachyarrhythmias inducibility were examined in Langendorff-perfused chronic volume overload hearts (n=12) using high-resolution optical mapping before and after treatment with rotigaptide. Moreover, expression levels of atrial gap junction proteins (connexin40 and connexin43) were examined in chronic volume overload hearts (n=6) and compared to sham-operated controls (n=6). Rotigaptide treatment significantly increased atrial conduction velocity in chronic volume overload hearts, however, rotigaptide did not decrease susceptibility to the induction of atrial tachyarrhythmias. Protein expressions of Cx40 and Cx43 were decreased by 32% and 72% (P<0.01), respectively, in chromic volume overload atria compared to control. To conclude, rotigaptide increased atrial conduction velocity in a rabbit model of chromic volume overload induced atrial conduction velocity slowing. The demonstrated effect of rotigaptide on atrial conduction velocity did not prevent atrial tachyarrhythmias inducibility. Whether rotigaptide may possess antiarrhythmic efficacy in other models of atrial fibrillation remains to be determined.

  6. Esophageal sensation in premature human neonates: temporal relationships and implications of aerodigestive reflexes and electrocortical arousals.

    Science.gov (United States)

    Jadcherla, Sudarshan R; Parks, Vanessa N; Peng, Juan; Dzodzomenyo, Samuel; Fernandez, Soledad; Shaker, Reza; Splaingard, Mark

    2012-01-01

    Electrocortical arousal (ECA) as an effect of visceral provocation or of its temporal relationships with aerodigestive reflexes in premature neonates is not known. We tested the hypothesis that esophageal provocation results in both esophageal reflex responses and ECAs during sleep and that ECAs are dependent on the frequency characteristics of esophageal neuromotor responses. We defined the spatiotemporal relationship of ECAs in relation to 1) spontaneous pharyngoesophageal swallow sequences and gastroesophageal reflux (GER) events and 2) sensory-motor characteristics of esophageal reflexes. Sixteen healthy premature neonates born at 27.9 ± 3.4 wk were tested at 36.8 ± 1.9 wk postmenstrual age. Ninety-five midesophageal and 31 sham stimuli were given in sleep during concurrent manometry and videopolysomnography. With stimulus onset as reference point, we scored the response latency, frequency occurrence and duration of arousals, peristaltic reflex, and upper esophageal sphincter contractile reflex (UESCR). Changes in polysomnography-respiratory patterns and esophageal sensory-motor parameters were scored by blinded observers. Significantly (for each characteristic listed, P reflexes or clearance, sleep state modification, and prolonged respiratory arousal. Midesophageal stimuli (54%) provoked arousals and were associated with increased frequency, prolonged latency, prolonged response duration of peristaltic reflexes and UESCR, and increased frequency of sleep state changes and respiratory arousals. In human neonates, ECAs are provoked upon esophageal stimulation; the sensory-motor characteristics of esophageal reflexes are distinct when accompanied by arousals. Aerodigestive homeostasis is defended by multiple tiers of aerodigestive safety mechanisms, and when esophageal reflexes are delayed, cortical hypervigilance (ECAs) occurs.

  7. The Connexin40A96S mutation from a patient with atrial fibrillation causes decreased atrial conduction velocities and sustained episodes of induced atrial fibrillation in mice.

    Science.gov (United States)

    Lübkemeier, Indra; Andrié, René; Lickfett, Lars; Bosen, Felicitas; Stöckigt, Florian; Dobrowolski, Radoslaw; Draffehn, Astrid M; Fregeac, Julien; Schultze, Joachim L; Bukauskas, Feliksas F; Schrickel, Jan Wilko; Willecke, Klaus

    2013-12-01

    Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major cause of stroke. In the mammalian heart the gap junction proteins connexin40 (Cx40) and connexin43 (Cx43) are strongly expressed in the atrial myocardium mediating effective propagation of electrical impulses. Different heterozygous mutations in the coding region for Cx40 were identified in patients with AF. We have generated transgenic Cx40A96S mice harboring one of these mutations, the loss-of-function Cx40A96S mutation, as a model for atrial fibrillation. Cx40A96S mice were characterized by immunochemical and electrophysiological analyses. Significantly reduced atrial conduction velocities and strongly prolonged episodes of atrial fibrillation were found after induction in Cx40A96S mice. Analyses of the gating properties of Cx40A96S channels in cultured HeLa cells also revealed significantly lower junctional conductance and enhanced sensitivity voltage gating of Cx40A96S in comparison to Cx40 wild-type gap junctions. This is caused by reduced open probabilities of Cx40A96S gap junction channels, while single channel conductance remained the same. Similar to the corresponding patient, heterozygous Cx40A96S mice revealed normal expression levels and localization of the Cx40 protein. We conclude that heterozygous Cx40A96S mice exhibit prolonged episodes of induced atrial fibrillation and severely reduced atrial conduction velocities similar to the corresponding human patient.

  8. NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    F. Nili AA. Shams Ansari

    2003-07-01

    Full Text Available Premature rupture of membranes (PROM is one of the most common complications of pregnancy that has a major impact on neonatal outcomes. With respect to racial, nutritional and cultural differences between developed and developing countries, this study was conducted to detect the prevalence of neonatal complications following PROM and the role of the duration of rupture of membranes in producing morbidities and mortalities in these neonates in our hospital. Among 2357 pregnant women, we found 163 (6.91% cases of premature rupture of the fetal membranes in Tehran Vali-e-Asr Hospital during April 2001 to April 2002. Route of delivery was cesarean section in 65.6% of women. Urinary tract infection occured in 1.8%, maternal leukocytosis and fever in 20.2% and 5.5%, chorioamnionitis in 6.1%, fetal tachycardia in 1.2% and olygohydramnios in 4.9%. Gestational age in 138 (86% of neonates was less than 37 completed weeks. Thirty five infants (21.47% had respiratory distress syndrome and 33 (20.245% had clinical sepsis. Pneumonia in 6 (3.7% and skeletal deformity in 7 (4.294% were seen. Rupture of membrane of more than 24 hours duration occurred in 71 (43.6% of the patients. Comparison of morbidities between two groups of neonates and their mothers according to the duration of PROM (less and more than 24 hours showed significant differences in NICU admission, olygohydramnios, maternal fever, leukocytosis and chorioamnionitis rates (p24 hr of PROM with an odds ratio of 2.68 and 2.73, respectively. Positive blood and eye cultures were detected in 16 cases during 72 hours of age. Staphylococcus species, klebsiella, E.coli and streptococcus were the predominant organisms among positive blood cultures. Mortality was seen in 18 (11% of neonates because of respiratory failure, disseminated intravascular coagulation, septic shock, and a single case of congenital toxoplasmosis. In this study, the prevalence of prematurity, sepsis and prolonged rupture of membrane

  9. Emotion attribution to basic parametric static and dynamic stimuli

    NARCIS (Netherlands)

    Visch, V.; Goudbeek, M.B.; Cohn, J.; Nijholt, A.; Pantic, P.

    2009-01-01

    The following research investigates the effect of basic visual stimuli on the attribution of basic emotions by the viewer. In an empirical study (N = 33) we used two groups of visually minimal expressive stimuli: dynamic and static. The dynamic stimuli consisted of an animated circle moving

  10. Emotion attribution to basic parametric static and dynamic stimuli

    NARCIS (Netherlands)

    Visch, V.; Goudbeek, M.B.; Cohn, J.; Nijholt, A.; Pantic, P.

    2009-01-01

    The following research investigates the effect of basic visual stimuli on the attribution of basic emotions by the viewer. In an empirical study (N = 33) we used two groups of visually minimal expressive stimuli: dynamic and static. The dynamic stimuli consisted of an animated circle moving accordin

  11. Atrial Heterogeneity Generates Re-entrant Substrate during Atrial Fibrillation and Anti-arrhythmic Drug Action: Mechanistic Insights from Canine Atrial Models.

    Science.gov (United States)

    Varela, Marta; Colman, Michael A; Hancox, Jules C; Aslanidi, Oleg V

    2016-12-01

    Anti-arrhythmic drug therapy is a frontline treatment for atrial fibrillation (AF), but its success rates are highly variable. This is due to incomplete understanding of the mechanisms of action of specific drugs on the atrial substrate at different stages of AF progression. We aimed to elucidate the role of cellular, tissue and organ level atrial heterogeneities in the generation of a re-entrant substrate during AF progression, and their modulation by the acute action of selected anti-arrhythmic drugs. To explore the complex cell-to-organ mechanisms, a detailed biophysical models of the entire 3D canine atria was developed. The model incorporated atrial geometry and fibre orientation from high-resolution micro-computed tomography, region-specific atrial cell electrophysiology and the effects of progressive AF-induced remodelling. The actions of multi-channel class III anti-arrhythmic agents vernakalant and amiodarone were introduced in the model by inhibiting appropriate ionic channel currents according to experimentally reported concentration-response relationships. AF was initiated by applied ectopic pacing in the pulmonary veins, which led to the generation of localized sustained re-entrant waves (rotors), followed by progressive wave breakdown and rotor multiplication in both atria. The simulated AF scenarios were in agreement with observations in canine models and patients. The 3D atrial simulations revealed that a re-entrant substrate was typically provided by tissue regions of high heterogeneity of action potential duration (APD). Amiodarone increased atrial APD and reduced APD heterogeneity and was more effective in terminating AF than vernakalant, which increased both APD and APD dispersion. In summary, the initiation and sustenance of rotors in AF is linked to atrial APD heterogeneity and APD reduction due to progressive remodelling. Our results suggest that anti-arrhythmic strategies that increase atrial APD without increasing its dispersion are

  12. Brain ultrasonography in the premature infant.

    Science.gov (United States)

    Veyrac, Corinne; Couture, Alain; Saguintaah, Magali; Baud, Catherine

    2006-07-01

    Brain ultrasonography plays a central role in the detection and management of neonatal disease in the preterm infant. Although morphological study, using high-frequency transducers, remains the cornerstone of imaging, pulsed and colour Doppler scans provide additional information and improve the diagnostic and prognostic accuracy of ultrasonography. Particular features of normal brain US in the extremely preterm infant are reported. Cerebral haemorrhage and its different patterns (intraventricular haemorrhage and periventricular hemorrhagic infarction) are described. The value of Doppler techniques is emphasized, e.g. demonstration of coloured signal within the aqueduct of Sylvius, visualization of patency of the terminal veins, demonstration of Doppler spectrum fluctuations, recognition of low blood flow, and the detection of vasodilatation. The sonographic diagnosis of periventricular leucomalacia and its difficulties are documented. Some uncommon brain lesions of the premature infant are illustrated, e.g. gangliothalamic ischaemic damage, cortical necrosis, focal infarcts, etc. The importance of repeating the US examinations until near term is highlighted.

  13. Modern Approach in Premature Ovarian Failure

    Directory of Open Access Journals (Sweden)

    Pacu Irina

    2014-09-01

    Full Text Available Premature ovarian failure (POF is a condition affecting 1-2% of women younger than 40 years of age, characterized by amenorrhea, hypoestrogenism and elevated gonadotropin levels. In the last years it became a problem of social health interest as the frequency increased due to environmental factors and new, efficient methods for cancer treatment in young women. Few genes have beed identified to explain cases of POF but there are also autoimmune associated conditions and an increasing number of iatrogenic cases (chemotherapy, surgery, radiotherapy. Modern approach in POF means not only a precise etiological diagnosis, but also a correct counseling for these patients who often want to become parents, and a chance for a healthy life without the long term consequences of estrogen deprivation from an early age. In vitro fertilization (IVF techniques can be useful for certain cases but research is needed on strategies to improve fertility for women who have follicles remaining in the ovaries.

  14. Modeling premature brain injury and recovery

    Science.gov (United States)

    Scafidi, Joey; Fagel, Devon M.; Ment, Laura R.; Vaccarino, Flora M.

    2009-01-01

    Premature birth is a growing and significant public health problem because of the large number of infants that survive with neurodevelopmental sequelae from brain injury. Recent advances in neuroimaging have shown that although some neuroanatomical structures are altered, others improve over time. This review outlines recent insights into brain structure and function in these preterm infants at school age and relevant animal models. These animal models have provided scientists with an opportunity to explore in depth the molecular and cellular mechanisms of injury as well as the potential of the brain for recovery. The endogenous potential that the brain has for neurogenesis and gliogenesis, and how environment contributes to recovery, are also outlined. These preclinical models will provide important insights into the genetic and epigenetic mechanisms responsible for variable degrees of injury and recovery, permitting the exploration of targeted therapies to facilitate recovery in the developing preterm brain. PMID:19482072

  15. Gastric Pneumatosis in a Premature Neonate

    Directory of Open Access Journals (Sweden)

    Yuk Joseph Ting

    2011-09-01

    Full Text Available Gastric pneumatosis is extremely rare during infancy. It has been reported in association with necrotizing enterocolitis or congenital abnormalities such as pyloric stenosis. Here, we report a case of gastric pneumatosis in a premature neonate on synchronized nasal intermittent positive pressure ventilation. No pneumatosis was noted in the rest of the bowel or esophagus. There could have been mild damage in the gastric mucosa, either related to the placement of the feeding tube or secondary to the use of indomethacin or both. The condition was further aggravated by noninvasive ventilation. An increase in intragastric pressure resulted in the submucosal dissection of air followed by the development of gastric pneumatosis. Conservative management strategies, including the use of a nasogastric tube for decompression and the withholding of feeding, successfully managed the gastric pneumatosis in our patient. An uneventful recovery was made after conservative management. Prompt recognition and evaluation of this condition were essential for making the diagnosis.

  16. Classification and definition of premature ejaculation.

    Science.gov (United States)

    Parnham, Arie; Serefoglu, Ege Can

    2016-08-01

    Premature ejaculation (PE) is a poorly understood condition and is considered as the most common sexual disorder in men. The ambiguity surrounding PE is in part due to the difficulty in conducting and interpreting research in the absence of a standardised definition that adequately encompasses the characteristics of these patients. An enhanced awareness of sexual dysfunctions in the recent decades has lead to an increase in scientific research that has challenged the traditional paradigm regarding PE. This has also enabled to establish a universal definition and classification of the disease. A move to a more evidence based approach has improved the clinicians' ability to define those who need medical treatment, as well as perform further research in this complex condition.

  17. Bmi-1 absence causes premature brain degeneration.

    Directory of Open Access Journals (Sweden)

    Guangliang Cao

    Full Text Available Bmi-1, a polycomb transcriptional repressor, is implicated in cell cycle regulation and cell senescence. Its absence results in generalized astrogliosis and epilepsy during the postnatal development, but the underlying mechanisms are poorly understood. Here, we demonstrate the occurrence of oxidative stress in the brain of four-week-old Bmi-1 null mice. The mice showed various hallmarks of neurodegeneration including synaptic loss, axonal demyelination, reactive gliosis and brain mitochondrial damage. Moreover, astroglial glutamate transporters and glutamine synthetase decreased in the Bmi-1 null hippocampus, which might contribute to the sporadic epileptic-like seizures in these mice. These results indicate that Bmi-1 is required for maintaining endogenous antioxidant defenses in the brain, and its absence subsequently causes premature brain degeneration.

  18. Periodic heart rate decelerations in premature infants.

    Science.gov (United States)

    Flower, Abigail A; Moorman, J Randall; Lake, Douglas E; Delos, John B

    2010-04-01

    The pacemaking system of the heart is complex; a healthy heart constantly integrates and responds to extracardiac signals, resulting in highly complex heart rate patterns with a great deal of variability. In the laboratory and in some pathological or age-related states, however, dynamics can show reduced complexity that is more readily described and modeled. Reduced heart rate complexity has both clinical and dynamical significance - it may provide warning of impending illness or clues about the dynamics of the heart's pacemaking system. In this paper, we describe simple and interesting heart rate dynamics that we have observed in premature human infants - reversible transitions to large-amplitude periodic oscillations - and we show that the appearance and disappearance of these periodic oscillations can be described by a simple mathematical model, a Hopf bifurcation.

  19. Enteral nutrition of the premature infant

    Directory of Open Access Journals (Sweden)

    Su Jin Cho

    2010-01-01

    Full Text Available Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

  20. Premature and accelerated ageing: HIV or HAART?

    Directory of Open Access Journals (Sweden)

    Reuben Luke Smith

    2013-01-01

    Full Text Available Highly Active Anti-Retroviral Therapy (HAART has significantly increased life expectancy of the HIV-positive population. Nevertheless, the average lifespan of HIV patients remains shorter compared to uninfected individuals. Immunosenescence, a current explanation for this difference invokes heavily on viral stimulus despite HAART efficiency in viral suppression. We propose here that the premature and accelerated ageing of HIV patients can also be caused by adverse effects of antiretroviral drugs, specifically those that affect the mitochondria. The Nucleoside Reverse Transcriptase Inhibitor (NRTI antiretroviral drug class for instance, is known to cause depletion of mitochondrial DNA via inhibition of the mitochondrial specific DNA polymerase-ƴ. Besides NRTIs, other antiretroviral drug classes such as Protease Inhibitors also cause severe mitochondrial damage by increasing oxidative stress and diminishing mitochondrial function. We also discuss important areas for future research and argue in favour of the use of C. elegans as a novel model system for studying these effects.

  1. Prolonged and fractionated right atrial electrograms during sinus rhythm in patients with paroxysmal atrial fibrillation and sick sinus node syndrome.

    Science.gov (United States)

    Tanigawa, M; Fukatani, M; Konoe, A; Isomoto, S; Kadena, M; Hashiba, K

    1991-02-01

    Intraatrial catheter mapping of the right atrium was performed during sinus rhythm in 92 patients: Group I = 43 control patients without paroxysmal atrial fibrillation or sick sinus node syndrome; Group II = 31 patients with paroxysmal atrial fibrillation but without sick sinus node syndrome; and Group III = 18 patients with both paroxysmal atrial fibrillation and sick sinus node syndrome. Atrial electrograms were recorded at 12 sites in the right atrium. The duration and number of fragmented deflections of the atrial electrograms were quantitatively measured. The mean duration and number of fragmented deflections of the 516 atrial electrograms in Group I were 74 +/- 11 ms and 3.9 +/- 1.3, respectively. The criteria for an abnormal atrial electrogram were defined as a duration of greater than or equal to 100 ms or eight or more fragmented deflections, or both. Abnormal atrial electrograms were observed in 10 patients (23.3%) in Group I, 21 patients (67.7%) in Group II and 15 patients (83.3%) in Group III (Group II versus Group I, p less than 0.001; Group III versus Group I, p less than 0.001). The mean number of abnormal electrograms per patient with an abnormal electrogram was 1.3 +/- 0.7 in Group I, 2.5 +/- 1.9 in Group II and 3.5 +/- 2.5 in Group III (Group I versus Group II, p less than 0.01; Group II versus Group III, p less than 0.05). A prolonged and fractionated atrial electrogram characteristic of paroxysmal atrial fibrillation can be closely related to the vulnerability of the atrial muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Mechanical ventilation of the premature neonate.

    Science.gov (United States)

    Brown, Melissa K; DiBlasi, Robert M

    2011-09-01

    Although the trend in the neonatal intensive care unit is to use noninvasive ventilation whenever possible, invasive ventilation is still often necessary for supporting pre-term neonates with lung disease. Many different ventilation modes and ventilation strategies are available to assist with the optimization of mechanical ventilation and prevention of ventilator-induced lung injury. Patient-triggered ventilation is favored over machine-triggered forms of invasive ventilation for improving gas exchange and patient-ventilator interaction. However, no studies have shown that patient-triggered ventilation improves mortality or morbidity in premature neonates. A promising new form of patient-triggered ventilation, neurally adjusted ventilatory assist (NAVA), was recently FDA approved for invasive and noninvasive ventilation. Clinical trials are underway to evaluate outcomes in neonates who receive NAVA. New evidence suggests that volume-targeted ventilation modes (ie, volume control or pressure control with adaptive targeting) may provide better lung protection than traditional pressure control modes. Several volume-targeted modes that provide accurate tidal volume delivery in the face of a large endotracheal tube leak were recently introduced to the clinical setting. There is ongoing debate about whether neonates should be managed invasively with high-frequency ventilation or conventional ventilation at birth. The majority of clinical trials performed to date have compared high-frequency ventilation to pressure control modes. Future trials with premature neonates should compare high-frequency ventilation to conventional ventilation with volume-targeted modes. Over the last decade many new promising approaches to lung-protective ventilation have evolved. The key to protecting the neonatal lung during mechanical ventilation is optimizing lung volume and limiting excessive lung expansion, by applying appropriate PEEP and using shorter inspiratory time, smaller tidal

  3. Delayed umbilical cord clamping in premature neonates.

    Science.gov (United States)

    Kaempf, Joseph W; Tomlinson, Mark W; Kaempf, Andrew J; Wu, YingXing; Wang, Lian; Tipping, Nicole; Grunkemeier, Gary

    2012-08-01

    Delayed umbilical cord clamping is reported to increase neonatal blood volume. We estimated the clinical outcomes in premature neonates who had delayed umbilical cord clamping compared with a similar group who had early umbilical cord clamping. This was a before-after investigation comparing early umbilical cord clamping with delayed umbilical cord clamping (45 seconds) in two groups of singleton neonates, very low birth weight (VLBW) (401-1,500 g) and low birth weight (LBW) (greater than 1,500 g but less than 35 weeks gestation). Neonates were excluded from delayed umbilical cord clamping if they needed immediate major resuscitation. Primary outcomes were provision of delivery room resuscitation, hematocrit, red cell transfusions, and the principle Vermont Oxford Network outcomes. In VLBW neonates (77 delayed umbilical cord clamping, birth weight [mean±standard deviation] 1,099±266 g; 77 early umbilical cord clamping 1,058±289 g), delayed umbilical cord clamping was associated with less delivery room resuscitation, higher Apgar scores at 1 minute, and higher hematocrit. Delayed umbilical cord clamping was not associated with significant differences in the overall transfusion rate, peak bilirubin, any of the principle Vermont Oxford Network outcomes, or mortality. In LBW neonates (172 delayed umbilical cord clamping, birth weight [mean±standard deviation] 2,159±384 g; 172 early umbilical cord clamping 2,203±447 g), delayed umbilical cord clamping was associated with higher hematocrit and was not associated with a change in delivery room resuscitation or Apgar scores or with changes in the transfusion rate or peak bilirubin. Regression analysis showed increasing gestational age and birth weight and delayed umbilical cord clamping were the best predictors of higher hematocrit and less delivery room resuscitation. Delayed umbilical cord clamping can safely be performed in singleton premature neonates and is associated with a higher hematocrit, less delivery room

  4. Beryllium induces premature senescence in human fibroblasts.

    Science.gov (United States)

    Coates, Shannon S A; Lehnert, Bruce E; Sharma, Sunil; Kindell, Susan M; Gary, Ronald K

    2007-07-01

    After cells have completed a sufficient number of cell divisions, they exit the cell cycle and enter replicative senescence. Here, we report that beryllium causes proliferation arrest with premature expression of the principal markers of senescence. After young presenescent human fibroblasts were treated with 3 microM BeSO(4) for 24 h, p21 cyclin-dependent kinase inhibitor mRNA increased by >200%. Longer periods of exposure caused mRNA and protein levels to increase for both p21 and p16(Ink4a), a senescence regulator that prevents pRb-mediated cell cycle progression. BeSO(4) also caused dose-dependent induction of senescence-associated beta-galactosidase activity (SA-beta-gal). Untreated cells had 48 relative fluorescence units (RFU)/microg/h of SA-beta-gal, whereas 3 microM BeSO(4) caused activity to increase to 84 RFU/microg/h. In chromatin immunoprecipitation experiments, BeSO(4) caused p53 protein to associate with its DNA binding site in the promoter region of the p21 gene, indicating that p53 transcriptional activity is responsible for the large increase in p21 mRNA elicited by beryllium. Forced expression of human telomerase reverse transcriptase (hTERT) rendered HFL-1 cells incapable of normal replicative senescence. However, there was no difference in the responsiveness of normal HFL-1 fibroblasts (IC(50) = 1.9 microM) and hTERT-immortalized cells (IC(50) = 1.7 microM) to BeSO(4) in a 9-day proliferation assay. The effects of beryllium resemble those of histone deacetylase-inhibiting drugs, which also cause large increases in p21. However, beryllium produced no changes in histone acetylation, suggesting that Be(2+) acts as a novel and potent pharmacological inducer of premature senescence.

  5. Ethnic Differences in Atrial Fibrillation Identified Using Implanted Cardiac Devices

    NARCIS (Netherlands)

    Lau, Chu-Pak; Gbadebo, T. David; Connolly, Stuart J.; Van Gelder, Isabelle C.; Capucci, Alessandro; Gold, Michael R.; Israel, Carsten W.; Morillo, Carlos A.; Siu, Chung-Wah; Abe, Haruhiko; Carlson, Mark; Tse, Hung-Fat; Hohnloser, Stefan H.; Healey, Jeff S.

    2013-01-01

    Ethnic Difference in Atrial Fibrillation Incidence.Introduction: Atrial fibrillation (AF) is suggested to be less common among black and Asian individuals, which could reflect bias in symptom reporting and access to care. In the Asymptomatic AF and Stroke Evaluation in Pacemaker Patients and the AF

  6. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L;

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  7. Dynamics of Focal Fibrillation Waves during Persistent Atrial Fibrillation.

    Science.gov (United States)

    Lanters, Eva A H; Allessie, Maurits A; DE Groot, Natasja M S

    2016-04-01

    The incidence and appearance of focal fibrillation waves on the right and left atrial epicardial surface were visualized during 10 seconds of persistent atrial fibrillation in a 71-year-old woman with valvular heart disease. The frequent, nonrepetitive, widespread, and capricious distribution of focal waves suggests that transmural conduction of fibrillation waves is most likely the mechanism underlying focal fibrillation waves.

  8. Rising rates of hospital admissions for atrial fibrillation

    DEFF Research Database (Denmark)

    Friberg, Jens; Buch, Nina Pernille Gardshodn; Scharling, Henrik;

    2003-01-01

    Atrial fibrillation is a common arrhythmia associated with excess morbidity and mortality. We studied temporal changes in hospital admission rates for atrial fibrillation using data from a prospective population-based cohort study spanning 2 decades (the Copenhagen City Heart Study)....

  9. Atrial fibrillation: Is ablation the way of the future?

    Institute of Scientific and Technical Information of China (English)

    Brian Olshansky

    2004-01-01

    @@ This issue of the Journal of Geriatric Cardiology features a manuscript entitled "A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation".Dr. Lexin Wang addresses an important issue, and is to be congratulated for taking a new look at an approach to ablate atrial fibrillation.

  10. KCNE3 R53H substitution in familial atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Dai-fu; LIANG Bo; LIN Jie; LIU Ban; ZHOU Qin-shu; YANG Yi-qing

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common cardiac arrhythmia with debilitating compli-cations of stroke. Multiple-wavelet re-entry and focal activation from pulmonary vein foci are two dominant electrophysiological theories of AF. Atrial electrical remodeling plays a role in the maintenance of AF. However, molecular mechanisms of the arrhythmia are still poorly understood.

  11. The immediate future for the medical treatment of atrial fibrillation

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2002-01-01

    Atrial fibrillation is the most commonly sustained cardiac arrhythmia and a common reason for mortality and morbidity. Atrial fibrillation causes disease for three reasons: i) the ventricular rate is often high, which leads to symptoms ranging from discomfort to life threatening heart failure; ii...

  12. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial...... fibrillation and whether adding vascular disease improves Congestive heart failure, Hypertension, Age 75 years, Diabetes, previous Stroke (CHADS(2)) risk stratification....

  13. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Cosedis Nielsen, Jens; Johannessen, Arne; Raatikainen, Pekka;

    2012-01-01

    There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation.......There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation....

  14. Atrial fibrillation: a new look at an old arrhythmia

    NARCIS (Netherlands)

    Meijler, F.L.

    1983-01-01

    The ventricular rhythm during atrial fibrillation in human beings is random because the excitatory process of atrial fibrillation itself is almost certainly a random phenomenon. It remains random because A V junctional memory is too short to inftuence the sequence of conducted impulses . In human be

  15. Monitoring the complexity of ventricular response in atrial fibrillation

    Directory of Open Access Journals (Sweden)

    H. Käsmacher

    2000-01-01

    Full Text Available Atrial fibrillation does not present a uniform extent of variability of the ventricular response exemplifying periodicities and more complex fluctuations, due to varying number and shape of atrial wavelets and aberrant conduction in the AV-junction. It was sought to categorise different degrees of complexity introducing an uncomplicated monitoring method for that objective.

  16. Atrial fibrillation and bleeding complication - risk factors and risk marker

    NARCIS (Netherlands)

    Breithardt, G.; Ravens, U.; Kirchhof, P.; van Gelder, I. C.

    2012-01-01

    The development of atrial fibrillation (AF) is closely linked to risk factors like hypertension and heart failure, diabetes mellitus, myocardial infarction and valvular heart disease. These factors partly overlap with those which determine the progression of atrial fibrillation and the incidence of

  17. Atrial Arrhythmias and Their Implications for Space Flight - Introduction

    Science.gov (United States)

    Polk, J. D.; Barr, Y. R.; Bauer, P.; Hamilton, D. R.; Kerstman, E.; Tarver, B.

    2010-01-01

    This panel will discuss the implications of atrial arrhythmias in astronauts from a variety of perspectives; including historical data, current practices, and future challenges for exploration class missions. The panelists will present case histories, outline the evolution of current NASA medical standards for atrial arrhythmias, discuss the use of predictive tools, and consider potential challenges for current and future missions.

  18. Sotalol for atrial tachycardias after surgery for congenital heart disease

    NARCIS (Netherlands)

    BeaufortKrol, GCM; BinkBoelkens, MTE

    1997-01-01

    Atrial tachycardias, in particular atrial flutter after surgery for congenital heart disease, is associated with a high mortality. Treatment with various antiarrhythmic drugs and/or antitachycardia pacemakers is not very successful. Sotalol, a Class III drug, has shown to be a promising drug in adul

  19. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Singhi Anil

    2010-01-01

    Full Text Available Pulmonary edema after device closure of atrial septal defect (ASD is a rare complication. We present illustrative images of a case of pulmonary edema after device closure of ASD in a 53 year old adult. Older patients undergoing ASD closure can benefit from their left atrial and left ventricular end diastolic pressures measurement before and after temporary balloon occlusion of ASD.

  20. Atrial rate and rhythm abnormalities in a patient with hyperkalemia.

    Science.gov (United States)

    Rosman, Jonathan; Thiagarajah, Prashan; Schweitzer, Paul; Rachko, Maurice; Hanon, Sam

    2009-05-15

    A 67 year old man presented with a serum potassium of 7.7 mEq/L and slow atrial flutter with variable A-V block and peaked T waves. Initial treatment for hyperkalemia was followed by an increase in the atrial flutter rate to 300 beats per minute. After hemodialysis the rhythm converted to sinus.

  1. [Complete triploidy in a liveborn premature (author's transl)].

    Science.gov (United States)

    Rico, S; Skinner, C; Lechuga, J L; Fernández, E; Serrano, J; Casanova, M; Argemí, J; López, A; Castro, J M

    1980-01-01

    Authors describe the clinical, pathological and cytogenetic data of a polymalformed premature with a complete a triploidy 69,XXY). This rare condition (30 cases in the literature) may be suspected in a premature with broad posterior fontanella, eye and ear anomalies, syndactily between IV and III fingers/toes, intersexual status and mielomeningocele. Frequently the placenta presents a molar or micromolar degeneration.

  2. Lipid profile of women with premature ovarian failure

    NARCIS (Netherlands)

    Knauff, Erik A. H.; Westerveld, Hendrika E.; Goverde, Angelique J.; Eijkemans, Marinus J.; Valkenburg, Olivier; van Santbrink, Evert J. P.; Fauser, Bart C. J. M.; van der Schouw, Yvonne T.

    2008-01-01

    Objective: Earlier menopause is associated with a higher incidence of cardiovascular events later in life. Concurrent with the ages of menopausal transition, a shift in lipid profile takes place. Premature ovarian failure (POF) or premature menopause allows LIS to Study the effect of cessation of

  3. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining…

  4. Acupuncture Treatment for 98 Cases of Ventricular Premature Beat

    Institute of Scientific and Technical Information of China (English)

    Han Baojie; Wang Feng; Wang Xinzhong

    2008-01-01

    @@ Ventricular premature beat is a commonly encountered arrhythmia,which can occur in patients with and without cardiac diseases.In TCM.ventricular premature beat fall into the category of palpitation and obstruction of qi in the chest.The authors treated it with acupuncture and obtained satisfactory thera-peutic effects.A summary follows.

  5. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite th

  6. Acetaminophen developmental pharmacokinetics in premature neonates and infants

    DEFF Research Database (Denmark)

    Anderson, Brian J; van Lingen, Richard A; Hansen, Tom G

    2002-01-01

    The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens.......The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens....

  7. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining…

  8. Feeding premature infants banked human milk homogenized by ultrasonic treatment.

    Science.gov (United States)

    Rayol, M R; Martinez, F E; Jorge, S M; Gonçalves, A L; Desai, I D

    1993-12-01

    Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants.

  9. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite th

  10. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A.; Yin, Xiaoyan; Fontes, Joao D.; Magnani, Jared W.; Rienstra, Michel; Pai, Manju; Villalon, Mark L.; Vasan, Ramachandran S.; Pencina, Michael J.; Levy, Daniel; Larson, Martin G.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2010-01-01

    CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. DESIGN, SETTING, AND

  11. Atrial metabolism and tissue perfusion as determinants of electrical and structural remodelling in atrial fibrillation.

    Science.gov (United States)

    Opacic, Dragan; van Bragt, Kelly A; Nasrallah, Hussein M; Schotten, Ulrich; Verheule, Sander

    2016-04-01

    Atrial fibrillation (AF) is the most common tachyarrhythmia in clinical practice. Over decades of research, a vast amount of knowledge has been gathered about the causes and consequences of AF related to cellular electrophysiology and features of the tissue structure that influence the propagation of fibrillation waves. Far less is known about the role of myocyte metabolism and tissue perfusion in the pathogenesis of AF. However, the rapid rates of electrical activity and contraction during AF must present an enormous challenge to the energy balance of atrial myocytes. This challenge can be met by scaling back energy demand and by increasing energy supply, and there are several indications that both phenomena occur as a result of AF. Still, there is ample evidence that these adaptations fall short of redressing this imbalance, which may represent a driving force for atrial electrical as well as structural remodelling. In addition, several 'metabolic diseases' such as diabetes, obesity, and abnormal thyroid function precipitate some well-known 'culprits' of the AF substrate such as myocyte hypertrophy and fibrosis, while some other AF risk factors, such as heart failure, affect atrial metabolism. This review provides an overview of metabolic and vascular alterations in AF and their involvement in its pathogenesis.

  12. Increased TRPM6 expression in atrial fibrillation patients contribute to atrial fibrosis.

    Science.gov (United States)

    Zhang, Yun-Jiao; Ma, Nan; Su, Feng; Liu, Hao; Mei, Ju

    2015-06-01

    Transient receptor potential (TRP) family plays important roles in cardiovascular system. We investigated the relationship between transient receptor potential channel subfamily M6 (TRPM6) and atrial fibrosis in rheumatic heart disease patients with atrial fibrillation (AF). The right atrial tissue samples were obtained from 64 patients with rheumatic heart diseases who underwent heart valve replacement surgery, and composed of 34 sinus rhythm (SR) patients and 30 AF patients. Hematoxylin and Eosin (HE) staining was used to observe cross-sectional area (CSA) of myocardial cell. Masson staining and measurement of connective tissue growth factor (CTGF), transforming growth factor beta 1 (TGF-β 1), and collagen type I/III (Collagen I/III) were performed to determine atrial fibrosis. The mRNA and protein levels of TRPM6 were detected by real-time quantitative polymerase chain reaction (RT-PCR) and western blotting, respectively. Marked increases were observed in CSA of myocardial cell and myocardial collagen volume fraction in AF group compared with the SR group (all Pfibrosis markers (CTGF, TGF-beta 1, Collagen I/III) in AF group increased significantly compared to the SR group (all Pfibrosis, and suggested that TRPM6 might be involved in AF development by promoting fibrogenesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Recurrent patterns of atrial depolarization during atrial fibrillation assessed by recurrence plot quantification.

    Science.gov (United States)

    Censi, F; Barbaro, V; Bartolini, P; Calcagnini, G; Michelucci, A; Gensini, G F; Cerutti, S

    2000-01-01

    The aim of this study was to determine the presence of organization of atrial activation processes during atrial fibrillation (AF) by assessing whether the activation sequences are wholly random or are governed by deterministic mechanisms. We performed both linear and nonlinear analyses based on the cross correlation function (CCF) and recurrence plot quantification (RPQ), respectively. Recurrence plots were quantified by three variables: percent recurrence (PR), percent determinism (PD), and entropy of recurrences (ER). We recorded bipolar intra-atrial electrograms in two atrial sites during chronic AF in 19 informed subjects, following two protocols. In one, both recording sites were in the right atrium; in the other protocol, one site was in the right atrium, the other one in the left atrium. We extracted 19 episodes of type I AF (Wells' classification). RPQ detected transient recurrent patterns in all the episodes, while CCF was significant only in ten episodes. Surrogate data analysis, based on a cross-phase randomization procedure, decreased PR, PD, and ER values. The detection of spatiotemporal recurrent patterns together with the surrogate data results indicate that during AF a certain degree of local organization exists, likely caused by deterministic mechanisms of activation.

  14. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A.; Yin, Xiaoyan; Fontes, Joao D.; Magnani, Jared W.; Rienstra, Michel; Pai, Manju; Villalon, Mark L.; Vasan, Ramachandran S.; Pencina, Michael J.; Levy, Daniel; Larson, Martin G.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2010-01-01

    CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. DESIGN, SETTING, AND P

  15. Molecular mechanisms of early atrial remodeling by rapid atrial pacing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To establish a rabbit atrial fibrillation model with rapid atrial pacing (RAP) and investigate its ultrastructural changes and expressions of L-type calcium channel subunits and potassium channel Ky4.3. Methods: Thirty-six rabbits were performed electrical stimulation through bipolar endocardial led by surgical technique, 600 beat per min from 0 to 48 h. Atrial ultrastructure was observed by transmission electron microscope (TEM) after different pacing times. mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: Atrial ultrastructure had alteration after 3 hours' pacing, such as mitochondria vacuolization, myofilament lysis and glucogen aggregation. The mRNA of the Ca2+ channel β1 and α1 subunits began to decrease after pacing of 6 h, which were paralleled with the change of Kv4.3 mRNA. But the auxiliary subunit α2 were not affected. Conclusion: Ultrastructural changes and mRNA levels of L-type calcium channel subunits and potassium channel Kv4.3 are decreased after RAP, with a mechanism of transcriptional down-regulation of underlying ion channels due to calcium overloading after RAP.

  16. Does Myocardial Infarction Beget Atrial Fibrillation and Atrial Fibrillation Beget Myocardial Infarction?

    NARCIS (Netherlands)

    Vermond, Rob A.; Van Gelder, Isabelle C.; Crijns, Harry J.; Rienstra, Michiel

    2015-01-01

    Atrial fibrillation (AF) affects millions of people worldwide.(1) It is already known several decades that AF is not a benign condition, and it's associated with a 5-fold increased risk of stroke, 3-fold increased risk of heart failure, and doubling of risk of dementia and death.(2-4) Myocardial

  17. Characteristic analysis and prevention on premature convergence in genetic algorithms

    Institute of Scientific and Technical Information of China (English)

    徐宗本; 高勇

    1997-01-01

    The identification and characteristics of premature convergence in genetic algorithms (GAs) are investigated Through a detailed quantitative analysis on the search capability and the degree of population diversity, the cause of premature convergence in GAs is recognized, and attributed to the maturation effect of the GAs: The minimum schema deduced from current population, which is the largest search space of a GA, converges to a homogeneous population in probability 1 ( so the search capability of the GA decreases and premature convergence occurs). It is shown that, as quantitative features of the maturation effect, the degree of population diversity converges to zero with probability 1, and the tendency for premature convergence is inversely proportional to the population size and directly proportional to the variance of the fitness ratio of zero allele at any gene position of the current population. Based on the theoretical analysis, several strategies for preventing premature convergence are suggest

  18. [Report on threatened premature labor: etiology, management, results].

    Science.gov (United States)

    Terzibahcian, J J; Mida, M; David, E; Weber, L; Boulanger, J C; Vitse, M

    1990-12-01

    The studies on the aetiological factors of a premature delivery constitute an old fear of obstetricians and epidemiologists. However, they remain confused and the very definition of prematurity is among the first sources of confusion. There are many therapeutic methods considered as preventive. Their efficacy is debatable whilst their secondary effects are obvious. In this article, the authors report the results of a retrospective study of observations of patients who presented threats of premature labour and analyzed the epidemiological aspects, the aetiological factors and the therapeutic methods. It seems important to consider the risk factors in order to prevent premature labour. A decrease in the use of betamimetics and an increase in that of therapies said to be of replacement does not seem to be accompanied by a relative increase in the incidence of prematurity.

  19. Premature ejaculation: A clinical review for the general physician.

    Science.gov (United States)

    Chung, Eric; Gilbert, Brent; Perera, Marlon; Roberts, Matthew J

    2015-10-01

    Premature ejaculation is one of the most common sexual dysfunctions in men. Recent epidemiological studies suggest its prevalence in Australia may range from 21-31% This article will discuss the current definition of premature ejaculation from a urological perspective. It will provide an understanding of the pathogenesis of premature ejaculation, as well as assessment and management options. Premature ejaculation can have a significant adverse effect on the quality of life for the patient and his sexual partners. It can potentially lead to psychological distress, diminished self- esteem, anxiety, erectile dysfunction, reduced libido and poor interpersonal relationships. Most men feel reluctant to discuss premature ejaculation with their general practitioner despite its psychological, emotional and relational effects. Effective, evidence-based treatment options are available and physicians should feel confident when exploring ways to improve the quality of life for men with sexual dysfunction.

  20. Hypothyroxinemia of prematurity: rite of passage or therapeutic necessity?

    Science.gov (United States)

    Beeram, M R; Wilson, D P

    2000-11-01

    Hypothyroxinemia is a common finding in premature infants, presumably resulting from an immature hypothalamic-pituitary-thyroid axis. Because dynamic studies of thyroid function in premature infants are normal and the condition resolves spontaneously, HOP has been considered physiologic rather than pathologic. Thus, thyroid hormone supplementation has been assumed to be not required in premature infants. True hypothyroidism of hypothalamic pituitary or thyroid origin, however, does occur in premature as well as in term infants and should be investigated aggressively and treated appropriately. Current studies in premature infants with hypothyroxinemia suggest the following: infants with more than 27 weeks of gestation do not appear to benefit and may, in fact, be harmed by thyroid hormone supplementation; and short-term thyroid hormone supplementation in infants born before 27 weeks of gestation may be important to diminish morbidity and to improve neurodevelopmental outcome.

  1. Atrial Arrhythmias in Astronauts. Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael; Watkins, Sharmila; Polk, J. D.

    2011-01-01

    This slide presentation reviews the findings of a panel of heart experts brought together to study if atrial arrhythmias more prevalent in astronauts, and potential risk factors that may predispose astronauts to atrial arrhythmias. The objective of the panel was to solicit expert opinion on screening, diagnosis, and treatment options, identify gaps in knowledge, and propose relevant research initiatives. While Atrial Arrhythmias occur in approximately the same percents in astronauts as in the general population, they seem to occur at younger ages in astronauts. Several reasons for this predisposition were given: gender, hypertension, endurance training, and triggering events. Potential Space Flight-Related Risk factors that may play a role in precipitating lone atrial fibrillation were reviewed. There appears to be no evidence that any variable of the space flight environment increases the likelihood of developing atrial arrhythmias during space flight.

  2. Genetics of Atrial Fibrillation and Possible Implications for Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Robin Lemmens

    2011-01-01

    Full Text Available Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart failure and ischemic stroke. Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are also implicated in cerebrovascular disease. Ischemic stroke is a multifactorial, complex disease where multiple environmental and genetic factors interact. Whether genetic variants associated with a risk factor for ischemic stroke also increase the risk of a particular vascular endpoint still needs to be confirmed in many cases. Here we review the current knowledge on the genetic background of atrial fibrillation and the consequences for cerebrovascular disease.

  3. Atrial Strain and Strain Rate: A Novel Method for the Evaluation of Atrial Stunning

    Science.gov (United States)

    Ozkan, Hakan; Binici, Suleyman; Tenekecioglu, Erhan; Ari, Hasan; Bozat, Tahsin

    2016-01-01

    Background Atrial fibrillation (AF) is the most common arrhythmia seen in adults. Atrial stunning is defined as the temporary mechanical dysfunction of the atrial appendage developing after AF has returned to sinus rhythm (SR). Objectives We aimed to evaluate atrial contractile functions by strain and strain rate in patients with AF, following pharmacological and electrical cardioversion and to compare it with conventional methods. Methods This study included 41 patients with persistent AF and 35 age-matched control cases with SR. All the AF patients included in the study had transthoracic and transesophageal echocardiography performed before and after. Septum (SEPsSR), left atrium (LAsSR) and right atrium peak systolic strain rate (RAsSR) were defined as the maximum negative value during atrial contraction and septum (SEPε), left atrium (LAε) and right atrium peak systolic strain (RAε) was defined as the percentage of change. Parameters of two groups were compared. Results In the AF group, 1st hour and 24th hour LAε, RAε, SEPε, LAsSR, RAsSR, SEPsSR found to be significantly lower than in the control group (LAε: 2.61%±0.13, 3.06%±0.19 vs 6.45%±0.27, p<0.0001; RAε: 4.03%±0.38, 4.50%±0.47 vs 10.12%±0.64, p<0.0001; SEPε: 3.0%±0.22, 3.19%±0.15 vs 6.23%±0.49, p<0.0001; LAsSR: 0.61±0.04s-1, 0.75±0.04s-1 vs 1.35±0.04s-1, p<0.0001; RAsSR: 1.13±0.06s-1, 1.23±0.07s-1 vs 2.10±0.08s- 1, p<0.0001; SEPsSR: 0.76±0.04s- 1, 0.78±0.04s- 1 vs 1.42±0.06 s- 1, p<0.0001). Conclusion Atrial strain and strain rate parameters are superior to conventional echocardiographic parameters for the evaluation of atrial stunning in AF cases where SR has been achieved. PMID:27627221

  4. Effect of renal sympathetic denervation on atrial substrate remodeling in ambulatory canines with prolonged atrial pacing.

    Directory of Open Access Journals (Sweden)

    Xule Wang

    Full Text Available We have previously demonstrated that catheter-based renal sympathetic denervation (RSD could suppress atrial fibrillation (AF in canines with short-time rapid right atrial pacing (RAP. However, the role of renal denervation on atrial remodeling is unclear. The aim of the present study was to explore the long-term effect of RSD on the atrial remodeling during prolonged RAP. Twenty mongrel dogs were implanted with a high-frequency cardiac pacemaker with a transvenous lead inserted into the right atrial appendage. The dogs were divided into three groups: a sham-operated group (n = 6, the chronic RAP (CRAP group (n = 7, and the CRAP+RSD group (n = 7. In the CRAP+RSD group, a pacemaker was implanted 6 weeks after RSD was performed bilaterally for recovery. RAP was maintained for 5 weeks in CRAP group and CRAP+RSD group. The plasma levels of Angiotensin II and aldosterone were significantly increased in CRAP group compared with sham-operated group, but the increasing trend was inhibited in CRAP+RSD group compared with CRAP group (P<0.05. Similarly, RSD suppressed the increasing trend that prolonged RAP produced in the left atrial levels of ANP, TNF-α and IL-6. Compared with the sham-operated group, the CRAP group had significantly increased levels of caspase-3, bax and Cx40 whereas the level of Bcl-2 decreased (P<0.05. RSD markedly reduced the upregulation of caspase-3, bax and Cx40 and the downregulation of Bcl-2 expression compared with the CRAP group (P<0.05. Picric acid-sirius red staining study suggested that RSD could markedly alleviate the lesion degree of cardic fibrosis induced by CRAP (P<0.05. Immunohistochemistry results showed that the densities of TH- and GAP43- positive nerves were significantly elevated in the CRAP group compared with the sham-operated group, while RSD operation signicantly inhibited the these changes produced by CRAP. These findings suggest that renal denervation could suppress the atrial remodeling after

  5. Results of Atrial Fibrillation Ablation in Patients With or Without a History of Atrial Flutter

    Institute of Scientific and Technical Information of China (English)

    Lu chunshan; Liu Xingpeng; Dong Jianzeng; Ma Changsheng

    2006-01-01

    Objectives There are two kind of atrial flutter during circumferential ablation for atrial fibrillation (AF): new onset left atrial flutter (LAFL), with a history of atrial flutter (AFL). What is the relationship of AFL and AF? Whether there are some differences in clinical course and mechanism between the new onset LAFL and the with a history of AFL remained unclear. The aim of this study was to assess the impacts of circumferential ablation on the occurrence of arrhythmias in follow-up in 2 groups:( 1 ) patients with a history of AFL and AF, and (2)patients with new onset LAFL. Methods Data from 465 patients who had circumferential pulmonary vein ablation (CPVA) or segmental pulmonary vein ablation (SPVA) were analyzed. Patients with a history of AFL ablation and patients who had concomitant AFL ablation were included from analysis. Forty-one patients constituted the history of AFL group (group 1, aged 57±13 years, 7 females) and twenty-eight patients constituted the new onset LAFL group (group 2, aged 55±12 years, 6 females). bipolar recordings were obtained from the tricuspid annulus, coronary sinus,interatrial septum and left atrium. Target sites were identified by early, fragmented or double potentials and by concealed entrainment. Linear lesions were created between target sites and nearby anatomical barriers (1) typical atrial flutter (cycle length, 242±39 ms). cavotricuspid isthmus ablation was performed.(2) new onset LAFL (cycle length, 282±153 ms). 20 episodes of AAFs were documented in 20/28 (71.4%)patients. Target sites were identified around pulmonary veins (n=10), gap in linear lesion (n=7), left atrial roof lines (1 case). For those cases the ablation line between PV and mitral annulus was performed.Patients in Group 2 had larger left atria, higher incidence of AFL pre-CPVA, and lower ejection fraction. Results There was no significant difference in post-CPVA AF recurrence between Groups 1 and 2, but AFL incidence after CPVA was higher in Group

  6. Left atrial dimension and atrial fibrillation in surgical heart disease patients

    Institute of Scientific and Technical Information of China (English)

    Kaihu Shi; Peisheng Liu; David Shek; Hongwei Shi; Ying Yu; Fei Ye; Xinwei Mu; Youxiang Zhang; Leiyang Zhang; Junjie Shao; Rui Wang

    2008-01-01

    Objective The effect of left atrial (LA) dimension on the occurrence of atrial fibrillation (AF) has been examined in some small studies.Less is known about the relationship of LA dimension,hemodynamic with AF during echocardiographic evaluation,especially,the flow dynamics in LA poorly described.The objective of this study was to investigate the relationship between LA dimension and the occurrence of AE Methods Two hundred and forty-five consecutive patients with heart disease scheduled to undergo open heart surgery were prospectively enrolled in the study.Patients were divided into 2 groups according to atrial fibrillation:AF group (n=148,99 men and 49 women,with a mean age 59.3+8.4 years),and no-AF group (n= 97,60 men and 37 womem).Echocardiography was performed before surgery.All measurements were performed following the American Society of Echocardiography recommendations.Results There were more patients with congestive heart failure in AF group than in no-AF group (45.9% vs 39.1%,P <0.05).The mean LA volume was 49.2±12.2 ml/m2 in AF group and 33.1±10.8 ml/m2 in no-AF group.There were also significant differences between two groups in left atrial end systolic dimension (LAESD) (50±13mm vs 27±14mm),left atrial end diastolic dimension (LAEDD) (79±17mm vs 53±13mm),PA pressure ( 41.3+11.6 mmHg vs 37.5±10.4 mmHg),and ratio of mitral E velocity and septal mitral annulus motion velocity (E/E') .The percentage of abnormal diastolic function grades (DGF) was also higher in AF than in no-AF group (89.9% versus 59.8% );.Conclusion Atrial fibrillation is associated more frequently with an increased LA dimension and more severe atrial hemodynamics disorder.(J Geriatr Cardiol 2008;5:11-4)

  7. Insight on pathogenesis of lifelong premature ejaculation: inverse relationship between lifelong premature ejaculation and obesity.

    Science.gov (United States)

    Gökçe, A; Ekmekcioglu, O

    2010-01-01

    Although both biological and psychological factors are important in the etiology, the exact pathogenesis of lifelong premature ejaculation (PE) remains to be clarified. Obesity is a worldwide epidemic that contributes to many chronic diseases. Obesity is associated with erectile dysfunction, but the relationship between obesity and PE has not yet been specifically investigated. The aim of this study was to evaluate the relationships of these two conditions. Between January 2008 and December 2009, we evaluated consecutive patients with lifelong PE in the urology outpatient clinic. Control cases without lifelong PE were selected randomly among cases attending the department of internal medicine for a checkup procedure. The age and sex of control group were matched with that of the study group. Body mass index (BMI) of each case was calculated using the World Health Organization criteria by the measurements of the physician instead of relying on verbal expressions. The mean (+/-s.d.) age of the premature ejaculators was 31.7+/-5.7 (range 21-51) years and in the control cases it was 32.3+/-6.7 (range 22-54) years. The comparison of the mean (+/-s.d.) weight between the study (74.1+/-11.2 kg) and control groups (81.9+/-6.4 kg) revealed a significant difference (Pobese cases in the control group (n=26, 24.1%) was three times greater than the obese premature ejaculators (Pobesity, and we found that patients with lifelong PE were leaner than the healthy control cases.

  8. Mode of delivery and neurosonographic findings in premature infants

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2007-01-01

    Full Text Available Introduction Fetal and preterm infant brain is especially vulnerable to hemorrhagic and ischemic damage at the end of the second and at the beginning of the third trimester. This is due to vascular, cellular and anatomic characteristics of the brain during development. In premature babies, there is a physiological instability and limited autoregulation of cerebral circulation. Hemorrhagic and ischemic damages often occur together, though pathophysiological processes leading to lesions are different. Material and methods The paper deals with a detailed analysis of 860 ultrasound brain scans of prematurely born children. The examinations were performed at the Ultrasound Department of the Institute of Child and Youth Health Care in Novi Sad. 707 vaginally born premature infants and 153 premature infants born by Cesarean section were examined. The bleeding was graded according to the Papile classification. Results and Discussion Out of 384 children with diagnosed grade I hemorrhage, 75 premature infants (19.5% were born by Cesarean section. In the group of children with grade II hemorrhage, operative deliveries account for 14.7%. From the total of 85 children with grade III hemorrhage, (intraventricular bleeding with chamber dilatation, only 6 premature infants were born by Cesarean section (7%. Intra-parenchymal bleeding was diagnosed in a very small number of premature infants; 0.32% of all diagnosed hemorrhages were grade IV hemorrhages. In this group there were no children born by Cesarean section. The increase of hemorrhage grade is accompanied by a greater rate of pelvic presentation and manual assistance by Bracht. There were 240 prematurely born children with no echosonographically diagnosed hemorrhage, 38% of all examined premature infants. From this number, 13.3% of neonates were born by Cesarean section. Conclusion In the etiology of neonatal intracranial hemorrhage, especially prematurely born ones, apart from the trauma, which plays a

  9. Anomalous muscle bundle in the right atrium; Implication to trans atrial device closure

    Directory of Open Access Journals (Sweden)

    Saji Philip

    2017-09-01

    Full Text Available Intracavitary muscle bands or aberrant bands have been well described in all four chambers of the heart but rarely seen thick muscular band crossing right atrium. We report a case of devisable secundum atrial septal defect with an intra-atrial anomalous muscular band, crossing right atrial wall to the rim of the secundum atrial septal defect warranting surgical closure.

  10. Impact of dronedarone in atrial fibrillation and flutter on stroke reduction

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.......Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone....

  11. Silent Atrial Fibrillation: Definition, Clarification, and Unanswered Issues.

    Science.gov (United States)

    Kennedy, Harold L

    2015-11-01

    Silent or subclinical asymptomatic atrial fibrillation has currently gained wide interest in the epidemiologic, neurologic and cardiovascular communities. The association of brief episodes of paroxysmal atrial fibrillation or surrogate atrial arrhythmias which predict future clinical adverse events have been established. Nevertheless there exists a confounding array of definitions to indicate its presence without discrete indication of which populations should be examined. Moreover the term "atrial fibrillation burden" (AFB) has emerged from such studies with a plethora of descriptions to prognosticate both arrhythmic and clinical adverse events. This presentation suggests clarification of diagnostic definitions associated with silent atrial fibrillation, and a more precise description of AFB. It examines the populations across the current disease and cardiovascular invasive therapeutic spectrum that lead to both silent atrial fibrillation and AFB. It describes the diagnostic methods of arrhythmia detection utilizing the surface ECG, subcutaneous ECG or intra-cardiac devices and their relationship in seeking meaningful arrhythmic markers of silent atrial fibrillation. Whereas a wide range of clinical risk factors of silent atrial fibrillation have been validated in the literature, there is an ongoing search for those arrhythmic risk factors that precisely identify and prognosticate outcome events in diverse populations at risk of atrial fibrillation and its complications. This presentation identifies this chaos, and focuses attention on the issues to be addressed to facilitate descriptive and comparative scientific studies in the future. It is a call to action specifically to the medical arrhythmic community and its specialty societies (i.e., ISHNE, HRS, EHRA) to begin a quest to unravel the arrhythmic quagmire associated with "silent atrial fibrillation."

  12. EFFECT OF METOPROLOL ON ATRIAL FIBRILLATORY RATE, ATRIOVENTRICULAR NODAL CONCEALED CONDUCTION, AND VENTRICULAR RESPONSE DURING ATRIAL-FIBRILLATION IN PIGS

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; CRIJNS, HJGM; HAAKSMA, J; BEL, KJ; WESSELING, H; LIE, KI

    1994-01-01

    We wished to elucidate the effect of beta-blockade on fibrillatory rate and atrioventricular (AV) nodal concealed conduction during atrial fibrillation (AF). Subsequent to determination of the effect on atrial functional refractoriness with the extrastimulus technique (basic cycle length 400 ms), th

  13. Effect of mmPs/TIMPs on Atrial Structural Remodeling in A Chronic Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Yang guirong; Zhang wei; Li li; Wang sujia; Zhu hui; Zhang yun

    2004-01-01

    @@ Objective Atrial fibrillation (AF) is commonly associatedwith atrial dilation and fibrosis, but the mechanism underlying these abnormalities remains unclear. The purpose of this study is to investigate the effect of matrix metalloproteinase-9 (mmP-9)and tissue in hibitor metalloproteinase -1 (TIMP-1) on extracellular matrix of atrium.

  14. Electrophysiological properties and the results of catheter ablation of symptomatic atrial tachyarrhythmia after surgical ablation of atrial fibrillation

    OpenAIRE

    Bockeria L.A.; Bockeria O.L.; Sergeev A.V.; Melikulov A.Kh.; Klimchuk I.Ya.; Temirbulatov I.A.; Fatulaev Z.F.

    2016-01-01

    Objective. To characterize electrophysiological properties of postablational arrhythmia and to assess shortand long-term efficacy of catheter radiofrequency ablation of these arrhythmias. Material and methods. We analyzed retrospectively 20 consecutive patients with highly symptomatic postsurgical atrial arrhythmia operated on valvular heart disease in conjunction with paroxysmal, persistent, longstanding persistent and permanent forms of atrial fibrillation during 2010–2013. Medi...

  15. Atrial-based pacing has no benefit over ventricular pacing in preventing atrial arrhythmias in adults with congenital heart disease

    NARCIS (Netherlands)

    Opic, P.; Yap, S.C.; Kranenburg, M. van; Dijk, A.P.J. van; Budts, W.; Vliegen, H.W.; Erven, L. van; Can, A.; Sahin, G.; Groot, N.M. de; Witsenburg, M.; Roos-Hesselink, J.W.

    2013-01-01

    AIMS: To determine whether atrial-based pacing prevents atrial arrhythmias in adults with congenital heart disease (CHD) compared with ventricular pacing. METHODS AND RESULTS: All adult CHD patients from four participating centres with a permanent pacemaker were identified. Patients with permanent a

  16. Progression of atrial fibrillation in the REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation cohort

    DEFF Research Database (Denmark)

    De Vos, Cees B; Breithardt, Günter; Camm, A John;

    2012-01-01

    Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression.......Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression....

  17. Rapid slowing of the atrial fibrillatory rate after administration of AZD7009 predicts conversion of atrial fibrillation

    DEFF Research Database (Denmark)

    Aunes, Maria; Egstrup, Kenneth; Frison, Lars

    2014-01-01

    BACKGROUND: Effects on the atrial fibrillatory rate (AFR) were studied during infusion with the combined potassium and sodium channel blocker AZD7009. METHODS AND RESULTS: Patients with persistent atrial fibrillation (AF) were randomized to AZD7009 or placebo. Thirty-five patients converted...

  18. Ion channel remodeling is related to intraoperative atrial effective refractory periods in patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Brundel, BJJM; Van Gelder, IC; Henning, RH; Tieleman, RG; Tuinenburg, AE; Wietses, M; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    2001-01-01

    Background-Sustained shortening of the atrial effective refractory period (AERP), probably due to reduction in the L-type calcium current, is a major factor in the initiation and maintenance of atrial fibrillation (AF), We investigated underlying molecular changes by studying the relation between ge

  19. Left atrial appendage occlusion with the Amplatzer Amulet for stroke prevention in atrial fibrillation: the first case in Greece.

    Science.gov (United States)

    Tzikas, Apostolos; Karagounis, Lambros; Bouktsi, Maria; Drevelegas, Antonios; Parcharidou, Despina; Ioannidis, Stathis; Krasopoulos, George; Giannakoulas, George

    2013-01-01

    Left atrial appendage (LAA) occlusion has been introduced into clinical practice as a valuable alternative to oral anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation. In this case presentation we describe the first LAA occlusion in Greece using the Amplatzer Amulet device. We also briefly discuss issues related to procedural safety and multimodality imaging for LAA occlusion.

  20. Ionic Remodeling and Direct Effects of Valsartan on Ionic Currentsin Human Atrial Myocytes with Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    Xue Yumei; Wu Shulin; Deng Chunyu; Qian Weimin; Chen Chunbo

    2004-01-01

    Objectives Previous studies demonstrated that angiotensin receptor antagonists had effects on some potassium channels in guinea pig myocytes and cloned channels that expressed in human cardiac myocytes. This study determined the direct effects of Valsartan on I caL, INa, IKur, IK1 and Ito1 in isolated human atrial myocytes. Methods and Results Specimens of right atrial appendage tissue were obtained from 39 patients with coronary artery and valvular heart diseases during cardiopulmonary bypass procedure. Pre- operation cardiac rhythm was sinus (SR)in 19 patients and was atrial fibrillation (AF) in the others. Single atrial myocyte was isolated by enzymatic dissociation with the chunk method. The ionic currents were recorded using the whole cell coffiguration of the voltage clamp technique. ICaL and Ito1 densities in AF patients were significantly lower than those in SR patients by 74% and 60%, respectively, while IK1density was significantly higher by 34% at command potential of - 120 mV. With 10 μmol/L Valsartan, INa density was significantly decreased by 59% in SR patients and by 66% in AF patients. IKur and IKl density were significantly decreased in only AF patients by 31% and23%, respectively. Conclusions Conclusions Decreased IcaL and Itol and increased IKl at hyperpolarizing potentials in AF patients' atrial myocytes may result from the electrophysiological remodeling by AF. Valsartan significantly decreases INa, IK1 and IKur current densities in AF patients' myocyte, but decreases only INa in SR patients' myocyte, suggesting that Valsartan may be beneficial to the recovering of remolded atria.

  1. Relationship between local production of microRNA-328 and atrial substrate remodeling in atrial fibrillation.

    Science.gov (United States)

    Soeki, Takeshi; Matsuura, Tomomi; Bando, Sachiko; Tobiume, Takeshi; Uematsu, Etsuko; Ise, Takayuki; Kusunose, Kenya; Yamaguchi, Koji; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Wakatsuki, Tetsuzo; Shimabukuro, Michio; Sata, Masataka

    2016-12-01

    The underlying mechanism of atrial substrate remodeling in atrial fibrillation (AF) remains unknown. In this study, we investigated whether local and systemic levels of microRNA (miR) might be associated with the presence of AF and with left atrial (LA) substrate properties. Blood from the periphery, pulmonary vein (PV), and left atrial appendage (LAA) was sampled from 30 patients with AF undergoing PV isolation, and from 10 control subjects with Wolff-Parkinson-White syndrome and without AF. We measured peripheral, PV, and LAA plasma levels of miR-1, -26, -133a, -328, and -590 by reverse transcription-polymerase chain reaction. LA global contact mapping during sinus rhythm was performed before PV isolation. Plasma levels of miR-328 were higher in patients with AF than in control subjects. Plasma miR-328 levels were significantly higher in the LAA than in the periphery and PV in patients with AF, but not in control subjects. Plasma miR-1 levels were also higher in the LAA than in the PV in AF patients. Interestingly, LAA plasma levels of miR-328 showed a positive correlation with the LA voltage zone index (area with voltage <0.5mV divided by total LA surface area) and a weak correlation with LA volume. Local production of miR-328 in the left atrium may be involved in the process of atrial remodeling in patients with AF. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  2. Extra-atrial expression of the gene for atrial natriuretic factor.

    Science.gov (United States)

    Gardner, D G; Deschepper, C F; Ganong, W F; Hane, S; Fiddes, J; Baxter, J D; Lewicki, J

    1986-01-01

    Atrial natriuretic factor (ANF) is a group of peptides, originally isolated from the cardiac atria, that have a number of important effects on blood pressure, renal function, and salt balance. In the current study, expression of the ANF gene in certain extra-atrial tissues of the rat has been examined by radioimmunoassay of extracted ANF protein and by blot-hybridization, nuclease S1 analysis, and primer-extension analysis of the ANF mRNA. ANF peptides and mRNA were detected in cardiac ventricles, lung, and pituitary gland at levels generally less than or equal to 1% those of cardiac atria. The ANF transcripts in extra-atrial tissue appear to be very similar to those synthesized in the atria. They are polyadenylylated, are equivalent in overall length (950-1050 nucleotides), and have identical 5' termini. A secondary transcription start site mapping approximately 80 base pairs upstream from the primary start site is employed in atria and to a lesser extent in other tissues. The ANF transcript is present throughout the cardiac ventricles from apex to base and in the septum as well as the ventricular free walls. The transcript is more prevalent in the left ventricle and interventricular septum than in the right ventricle. Immunocytochemistry using various anti-rat ANF antibodies localized ANF immunoreactivity to the atrial myocytes; the ventricular myocytes, particularly along the endothelial surface of the ventricular chamber; perialveolar cells in the lung; and the gonadotropin-producing cells of the pituitary. The data indicate that the capacity for ANF gene expression extends beyond atrial tissue, albeit at much reduced levels, and may suggest alternative, perhaps paraendocrine, functions for the peptide in these tissues. Images PMID:2428040

  3. Minimally invasive surgery for atrial fibrillation.

    Science.gov (United States)

    Zembala, Michael O; Suwalski, Piotr

    2013-11-01

    Atrial fibrillation (AF) remains the most common cardiac arrhythmia, affecting nearly 2% of the general population worldwide. Minimally invasive surgical ablation remains one of the most dynamically evolving fields of modern cardiac surgery. While there are more than a dozen issues driving this development, two seem to play the most important role: first, there is lack of evidence supporting percutaneous catheter based approach to treat patients with persistent and long-standing persistent AF. Paucity of this data offers surgical community unparalleled opportunity to challenge guidelines and change indications for surgical intervention. Large, multicenter prospective clinical studies are therefore of utmost importance, as well as honest, clear data reporting. Second, a collaborative methodology started a long-awaited debate on a Heart Team approach to AF, similar to the debate on coronary artery disease and transcatheter valves. Appropriate patient selection and tailored treatment options will most certainly result in better outcomes and patient satisfaction, coupled with appropriate use of always-limited institutional resources. The aim of this review, unlike other reviews of minimally invasive surgical ablation, is to present medical professionals with two distinctly different, approaches. The first one is purely surgical, Standalone surgical isolation of the pulmonary veins using bipolar energy source with concomitant amputation of the left atrial appendage-a method of choice in one of the most important clinical trials on AF-The Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) Trial. The second one represents the most complex approach to this problem: a multidisciplinary, combined effort of a cardiac surgeon and electrophysiologist. The Convergent Procedure, which includes both endocardial and epicardial unipolar ablation bonds together minimally invasive endoscopic surgery with electroanatomical mapping, to deliver best of the

  4. Radiofrequency ablation for treatment of atrial fibrillation.

    Science.gov (United States)

    Safaei, Nasser; Montazerghaem, Hossein; Azarfarin, Rasoul; Alizadehasl, Azin; Alikhah, Hossein

    2011-01-01

    Atrial Fibrillation (AF) is the most common cardiac arrhythmia which represents a major public health problem. The main purpose of this research is to evaluate the Radiofrequency (RF) ablation effects in the patients with chronic AF scheduled for cardiac surgery because of different heart diseases. The descriptive and prospective study was conducted on 60 patients with AF scheduled for surgery along with RF ablation. The data were collected by questionnaire and included: patients' age, sex, NYHA class, operation type, past medical history, type and cause of valvular heart disease, preoperative ECG (electrocardiogram), duration of surgery, clamping time, cardiopulmonary bypass, and RF ablation time. RF ablation was followed by the main operation. The follow up examination, ECG, and echocardiography were performed 3 and 6 months after operation. The mean age of patients was 48±10 years (18-71 years). Forty one patients had permanent AF and 19 had the persistent AF. The left ventricular ejection fraction was 48.27±9.75 percent before operation, and reached to 56.27±7.87 percent after the surgery (P<0.001). The mean NYHA class before the surgery was 2.83±0.68 which decreased to 1.34±0.46 6 months after the surgery with RF ablation (P<0.001). One patient (1.6%) died after surgery. Complete relief and freedom from AF recurrence was observed in 70% of patients in the mean follow up in 7 months after the surgery. The sinus rhythm with efficient atrial contraction was established in 100% of discharged patients. RF ablation is an effective procedure to cure atrial fibrillation in patients undergoing cardiac surgeries.

  5. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  6. A mutation in the atrial-specific myosin light chain gene (MYL4) causes familial atrial fibrillation.

    Science.gov (United States)

    Orr, Nathan; Arnaout, Rima; Gula, Lorne J; Spears, Danna A; Leong-Sit, Peter; Li, Qiuju; Tarhuni, Wadea; Reischauer, Sven; Chauhan, Vijay S; Borkovich, Matthew; Uppal, Shaheen; Adler, Arnon; Coughlin, Shaun R; Stainier, Didier Y R; Gollob, Michael H

    2016-04-12

    Atrial fibrillation (AF), the most common arrhythmia, is a growing epidemic with substantial morbidity and economic burden. Mechanisms underlying vulnerability to AF remain poorly understood, which contributes to the current lack of highly effective therapies. Recognizing mechanistic subtypes of AF may guide an individualized approach to patient management. Here, we describe a family with a previously unreported syndrome characterized by early-onset AF (age <35 years), conduction disease and signs of a primary atrial myopathy. Phenotypic penetrance was complete in all mutation carriers, although complete disease expressivity appears to be age-dependent. We show that this syndrome is caused by a novel, heterozygous p.Glu11Lys mutation in the atrial-specific myosin light chain gene MYL4. In zebrafish, mutant MYL4 leads to disruption of sarcomeric structure, atrial enlargement and electrical abnormalities associated with human AF. These findings describe the cause of a rare subtype of AF due to a primary, atrial-specific sarcomeric defect.

  7. Heart failure after transvenous closure of atrial septal defect associated with atrial standstill and thiamine-responsive megaloblastic anemia.

    Science.gov (United States)

    Doğan, Vehbi; Senocak, Filiz; Orün, Utku Arman; Ceylan, Ozben

    2013-10-01

    Despite advances in device closure for atrial septal defect, post-closure heart failure remains a clinical problem in adult patients but is seen only rarely in children. An eight-year-old boy, who had been followed by a local pediatrician with the diagnosis of diabetes mellitus and congenital heart disease, was consulted to us for cardiac re-evaluation. Electrocardiography demonstrated absent P waves, and echocardiography revealed enlargement of the right ventricle and both atria and secundum atrial septal defect. With the diagnosis of atrial standstill, secundum atrial septal defect and thiamine-responsive megaloblastic anemia, acute heart failure developed after transvenous closure of the atrial septal defect, which improved dramatically with thiamine and supportive treatment.

  8. NASA's First Atrial Fibrillation Case - Deke Slayton

    Science.gov (United States)

    Tarver, William J.

    2010-01-01

    Concerns about heart dysrhythmia have been present since the earliest days of the US manned space program. While information about an astronaut's health is general kept private, one of the original seven American astronaut's health status was played out in a very public forum. Donald "Deke" Slayton was removed from the second manned space flight when it was discovered he had idiopathic atrial fibrillation. Referencing the original medical documents, details of how this was discovered and managed from the medical perspective will be reviewed. This is NASA's first heart dysrhythmia case in an astronaut and it proves quite interesting when placed in historic perspective.

  9. Atrial fibrillation in China: a brief review

    Institute of Scientific and Technical Information of China (English)

    MA Chang-sheng; DU Xin; JIANG Chen-xi

    2009-01-01

    @@ Atrial fibrillation (AF) is the most common heart rhythm disturbance encountered in clinical practice.It affects at least ten million Chinese, constituting a major public health epidemic. For the shortness of resource in the initial stage of new China and the chaos during the culture revolution, there was a scarcity of AF data on the Chinese population. However, Chinese physicians had never stopped exploring in this field, which has provided a solid foundation for today's flourishing development in the research of AF. This paper aims to review the major achievements in dealing with AF in the past 60 years in China, especially in the latest 15 years.

  10. Current approaches in atrial fibrillation treatment

    Directory of Open Access Journals (Sweden)

    Cenk Sarı

    2014-09-01

    Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia encountered in clinical practice. Its incidence increases with age. AF is classified into subtypes according to the duration and/or able to provide sinus rhytym. İnitially, patients should be evaluated for rhythm or rate control for appropriate treatment. Second stage of strategy aimed to investigate the feasibility of anticoagulation therapy. Recently, due to the progress made in treatment with rhythm control and anticoagulation therapy, either American or European guidelines have been renovated. These developments have taken place in the newly published guide. In this article, the current change in the management of AF is discussed.

  11. Fibrilación atrial: nuevos conceptos

    Directory of Open Access Journals (Sweden)

    Luis Gutiérrez-Jaikel

    2004-06-01

    Full Text Available La fibrilación atrial es la arritmia más frecuente en la práctica clínica, se presenta tanto en pacientes con cardiopatía estructural de base principalmente hipertensiva, isquémica y valvular, como en pacientes sin trastorno cardiaco de fondo al avanzar la edad. Debido a la morbilidad asociada a esta, es vital su reconocimiento temprano y el manejo adecuado, con la finalidad de reducir la incidencia de complicaciones asociadas y mejorar la calidad de vida de quienes la padecen.

  12. The polyuria of paroxysmal atrial tachycardia

    Science.gov (United States)

    Kinney, M. J.; Stein, R. M.; Discala, V. A.

    1974-01-01

    Two patients with paroxysmal atrial fibrillation and an associated polyuria were studied to delineate the mechanism of the increase in urine flow. A striking saluresis was noted in both patients. The increased sodium excretion was probably due to decreased sodium reabsorption, perhaps at proximal tubular nephron sites. This inhibition of sodium reabsorption could explain both the saluresis and some part or all of the polyuria. Re-evaluation of earlier case reports reveals patterns of concomitant salt and water excretion consistent with this mechanism. The saluresis cannot be explained by the previously favored hypothesis of antidiuretic hormone inhibition.

  13. Echocardiographic study of left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Dalal J

    1979-01-01

    Full Text Available Four cases of left atrial myxoma were diagnosed pre-operatively by echocardiography. All cases showed characteristic echocardio-graphic features of variegated shadows behind the mitral valve in diastole and within the left atrium in systole. In two cases the my-xomas were surgically removed and confirmed on histology. In one case the post-operative echocardiogram showed complete dis-appearance of the abnormal shadows. Echocardiography is the most reliable method today for the diagnosis of a myxoma.

  14. Fibroblast growth factor-21 is positively associated with atrial fibrosis in atrial fibrillation patients with rheumatic heart disease.

    Science.gov (United States)

    Wang, Rui; Yi, Xin; Li, Xiaoyan; Jiang, Xuejun

    2015-01-01

    Fibroblast growth factor-21 (FGF-21) has been discovered as a strong hormone, plays an important role in lipid metabolism, glucose metabolism, associated with several diseases such as obesity, metabolic syndrome, diabetes mellitus, and cardiovascular events; however, no evidence is available concerning the relationship of FGF-21 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD). Twenty-four rheumatic heart disease patients were divided into two groups, 12 cases with AF and 12 cases with sinus rhythm (SR). Clinical characteristics and blood samples were collected before surgery; right atrial appendage samples were taken in the surgery of valve replacement. HE staining was performed to determine cross-sectional area of atrial myocytes; Masson stained sections and mRNA levels of cardiac fibrosis biomarkers were used to evaluate the degree of cardiac fibrosis; the level of FGF-21 was evaluated via enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, and real-time polymerase chain reaction (PCR). Compared with SR group, cross-sectional area of atrial myocytes and collagen volume fraction were significantly increased in the atrial tissue of AF group. The distribution of FGF-21 in the AF group was remarkably higher than SR group. In addition, plasma and mRNA levels of FGF-21 in atrial tissue of AF showed the same trend as the result of immunohistochemistry. Using linear correlation analysis, the expression level of FGF-21 was found to be positively related to the degree of atrial fibrosis. FGF-21 might involve in the development and maintenance of atrial fibrosis in atrial fibrillation with rheumatic heart disease, and FGF-21 could be used as a novel biomarker to evaluate myocardial fibrosis in the future.

  15. Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients

    Science.gov (United States)

    Gudul, Naile Eris; Karabag, Turgut; Sayin, Muhammet Rasit; Bayraktaroglu, Taner; Aydin, Mustafa

    2017-01-01

    Background/Aims The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. Results The mitral E/A and E’/A’ ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E’/A’. Conclusions In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients. PMID:27919159

  16. Termination of pinned spirals by local stimuli

    Science.gov (United States)

    Chen, Jiang-Xing; Guo, Ming-Ming; Ma, Jun

    2016-02-01

    The termination of pinned spirals on a defect by means of local stimuli is studied. On a completely unexcitable defect, the elimination process is discussed and its corresponding mechanism is presented. Especially, the mechanism of unpinning spirals on a partially unexcitable defect, which has not been investigated so far, is explored. With fixed pacing frequency ω L , there exists a maximal radius R max above which the pinned spiral cannot be removed. It is found that the value of R max does not increase as ω L in a dynamical regime, forming a platform in the R\\textit{max}\\text-ωL curves. Based on analyzing the dispersion relation on the spiral tip around the obstacle, the underlying mechanism is clarified. Also, it is found that when multiple spirals are pinned, the value of R max decreases on a partially unexcitable defect while the change is very slight on a completely unexcitable one.

  17. Working memory of emotional stimuli: Electrophysiological characterization.

    Science.gov (United States)

    Kessel, Dominique; García-Rubio, María J; González, E Kirstin; Tapia, Manuel; López-Martín, Sara; Román, Francisco J; Capilla, Almudena; Martínez, Kenia; Colom, Roberto; Carretié, Luis

    2016-09-01

    Memorizing emotional stimuli in a preferential way seems to be one of the adaptive strategies brought on by evolution for supporting survival. However, there is a lack of electrophysiological evidence on this bias in working memory. The present study analyzed the influence of emotion on the updating component of working memory. Behavioral and electrophysiological indices were measured from a 3-back task using negative, neutral, and positive faces. Electrophysiological data evidenced an emotional influence on the working memory sensitive P3 component, which presented larger amplitudes for negative matching faces compared to neutral ones. This effect originated in the superior parietal cortex, previously reported to be involved in N-back tasks. Additionally, P3 results showed a correlation with reaction times, where higher amplitudes were associated with faster responses for negative matching faces. These findings indicate that electrophysiological measures seem to be very suitable indices of the emotional influence on working memory.

  18. Detecting and Diagnosing Atrial Fibrillation (D2AF): study protocol for a cluster randomised controlled trial

    OpenAIRE

    Uittenbogaart, Steven B.; Verbiest-van Gurp, Nicole; Erkens, Petra M. G.; Lucassen, Wim A M; Knottnerus, J. André; Winkens, Bjorn; van Weert, Henk C P M; Stoffers, Henri E. J. H.

    2015-01-01

    Background Atrial fibrillation is a common cause of stroke and other morbidity. Adequate treatment with anticoagulants reduces the risk of stroke by 60 %. Early detection and treatment of atrial fibrillation could prevent strokes. Atrial fibrillation is often asymptomatic and/or paroxysmal. Case-finding with pulse palpation is an effective screening method, but new methods for detecting atrial fibrillation have been developed. To detect paroxysmal atrial fibrillation ambulatory rhythm recordi...

  19. Atrial fibrillation increases medical cost and complicates hospital outcome of traffic accident-related physical trauma--a nationwide population-based study.

    Science.gov (United States)

    Lai, Hui-Chin; Chien, Wu-Chien; Chung, Chi-Hsiang; Lee, Wen-Lieng; Wang, Kuo-Yang; Liu, Chia-Ning; Liu, Tsun-Jui

    2014-12-20

    Traffic accidents account substantially for premature disability and deaths in the modern world. Whether atrial fibrillation complicates the outcome of traffic injury remains under-investigated. From 1998 to 2010, all inpatient records stored in the Taiwan National Health Insurance database were screened. Those related with traffic accidents were aggregated to individuals and enrolled. The medical expenses and hospital outcomes were compared between patients with atrial fibrillation (AF group) and either the rest patients (No-AF group) or the propensity-matched patients without atrial fibrillation (No-AF-matched group). Prognostic predictive variables for adverse in-hospital events were further identified by multivariate regression analysis. Within the 13-year time span, of the 776,620 individuals ever admitted for traffic accidents, there were 1233 patients with AF. Compared with No-AF and No-AF-matched groups respectively, AF patients stayed longer in hospital (10.9 ± 10.6 vs. 6.8 ± 7.2 and vs. 8.2 ± 8.7 days, both p traffic accidents, those with AF consume more surgical resources and medical expenses yet end up with poorer hospital outcome, especially those with higher CHA2DS2-VASC scores and other relevant variables. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Evaluation of optimal treatment approach in patients with early recurrence of atrial fibrillation after the first ablation procedure

    Directory of Open Access Journals (Sweden)

    В. В. Шабанов

    2015-10-01

    Full Text Available 182 patients with paroxysmal AF underwent ablation (circumferential pulmonary vein isolation with linear lesions and were monitored with an implantable cardiac monitor (Reveal XT, Medtronic. Patients were randomly assigned to group 1 or group 2. Group 1 patients were treated only with antiarrhythmic drugs for 6 weeks, with no early reablation during the 3-month postablation period. In the case of AF recurrence after the 3-month postablation period, patients underwent reablation. Group 2 patients were treated according to the onset mechanism of AF recurrences, as detected and stored by the implantable cardiac monitor: antiarrhythmic drug therapy, but no reablation if AF was not preceded by triggers; early reablation if premature atrial beats or atrial tachycardias or flutter triggered AF. All patients were followed up for 1 year to assess the sinus rhythm maintenance in each group. On 12-month follow-up examination, 67 patients (76% out of 88 in group 1 and 78 patients (92% out of 89 in group 2 had no AF recurrences (P<0,009 versus group 1. The patients with AF recurrences caused by a trigger mechanism after the first ablation demonstrated high long-term efficacy after early reablation.

  1. Imaging atrial arrhythmic intracellular calcium in intact heart.

    Science.gov (United States)

    Xie, Wenjun; Santulli, Gaetano; Guo, Xiaoxiao; Gao, Melanie; Chen, Bi-Xing; Marks, Andrew R

    2013-11-01

    Abnormalities in intracellular Ca(2+) signaling have been proposed to play an essential role in the pathophysiology of atrial arrhythmias. However, a direct observation of intracellular Ca(2+) in atrial myocytes during atrial arrhythmias is lacking. Here, we have developed an ex vivo model of simultaneous Ca(2+) imaging and electrocardiographic recording in cardiac atria. Using this system we were able to record atrial arrhythmic intracellular Ca(2+) activities. Our results indicate that atrial arrhythmias can be tightly linked to intracellular Ca(2+) waves and Ca(2+) alternans. Moreover, we applied this strategy to analyze Ca(2+) signals in the hearts of WT and knock-in mice harboring a 'leaky' type 2 ryanodine receptor (RyR2-R2474S). We showed that sarcoplasmic reticulum (SR) Ca(2+) leak increases the susceptibility to Ca(2+) alternans and Ca(2+) waves increasing the incidence of atrial arrhythmias. Reduction of SR Ca(2+) leak via RyR2 by acute treatment with S107 reduced both Ca(2+) alternans and Ca(2+) waves, and prevented atrial arrhythmias.

  2. Atrial Fibrillation Predictors: Importance of the Electrocardiogram.

    Science.gov (United States)

    German, David M; Kabir, Muammar M; Dewland, Thomas A; Henrikson, Charles A; Tereshchenko, Larisa G

    2016-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in adults and is associated with significant morbidity and mortality. Substantial interest has developed in the primary prevention of AF, and thus the identification of individuals at risk for developing AF. The electrocardiogram (ECG) provides a wealth of information, which is of value in predicting incident AF. The PR interval and P wave indices (including P wave duration, P wave terminal force, P wave axis, and other measures of P wave morphology) are discussed with regard to their ability to predict and characterize AF risk in the general population. The predictive value of the QT interval, ECG criteria for left ventricular hypertrophy, and findings of atrial and ventricular ectopy are also discussed. Efforts are underway to develop models that predict AF incidence in the general population; however, at present, little information from the ECG is included in these models. The ECG provides a great deal of information on AF risk and has the potential to contribute substantially to AF risk estimation, but more research is needed.

  3. [Progress of anticoagulation therapy in atrial fibrillation].

    Science.gov (United States)

    Hernández Olmedo, Miguel; Suárez Fernández, Carmen

    2015-08-07

    Atrial fibrillation is currently a very prevalent disease and it represents one of the most common causes of disabling stroke. Antithrombotic therapies have reduced the incidence of this complication although they pose many limitations and difficulties. As a result, a large number of high risk patients do not receive an appropriate treatment. In recent years, four new oral anticoagulants (NOAC) with relevant advantages in comparison to vitaminK antagonists have been released. Four large phaseiii clinical trials have demonstrated that NOAC are at least as safe and efficacious as warfarin in stroke prevention in non-valve atrial fibrillation patients with moderate-high thrombotic risk, being their main advantage the reduction in intracranial hemorrhage. The arrival of these drugs has caused great expectations in the management of these patients but also new doubts. Lacking data in some subgroups of frail patients, the absence of specific antidotes available and specially their high cost represent nowadays the main limitations for their generalization. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Right Atrial Metastatic Melanoma with Unknown Primaries

    Directory of Open Access Journals (Sweden)

    Robin Kuriakose

    2015-01-01

    Full Text Available A 54-year-old male with history of anemia and rheumatoid arthritis presented with a three-month history of dyspnea on exertion and lower extremity edema. Patient was referred for a transthoracic echocardiogram that revealed a large right atrial mass with reduced ejection fraction of 40% and an incidental large liver mass. Subsequent cardiac MRI revealed a lobulated right atrial mass measuring 5.4 cm × 5.3 cm with inferior vena cava compression and adjacent multiple large liver lesions confirmed to be malignant melanoma through biopsy. Interestingly, no primaries were found in the patient. PET/CT imaging displayed hypermetabolic masses within the right atrium and liver that likely represent metastases, as well as bilateral pleural effusions, most likely due to heart failure. Preoperative coronary angiogram demonstrated perfusion to the mass by a dense network of neovasculature arising from the mid right coronary artery. The cardiac melanoma was surgically removed, and the right atrium was reconstructed with a pericardial patch. After surgery, all cardiac chambers appeared normal in size and function with associated moderate tricuspid regurgitation. The patient is currently being administered ipilimumab for systemic therapy of metastatic melanoma.

  5. [Metabolic syndrome and chronic persistent atrial fibrillation].

    Science.gov (United States)

    Onuchina, E L; Solov'ev, O V; Mochalova, O V; Kononov, S K; Onuchin, S G

    2011-01-01

    The aim of the study was to elucidate specific features of chronic recurrent atrial fibrillation (AF) in patients with metabolic syndrome (MS) and disturbed carbohydrate metabolism compared with AF patients without MS. It enrolled 145 patients aged 44-83 years: 117 with abdominal obesity (BMI >30 kg/m2, waist circumference >80 and 94 cm in women and men respectively) including 30 without metabolic disturbances; 35 with impaired glucose tolerance (IGT), 52 with type 2 DM, and 28 controls without MS. Parameters measured included frequency and severity of AF, carbohydrate and lipid metabolism, albuminurea, C-reactive peptide level, quality of AH control, results of echocardiography and 24 hour ECG monitoring (sinus rhythm), and insulin resistance index (HOMA IRindex). Groups of AF and MS patients were dominated by women. The frequency and severity of AF relapses in MS patients were higher than in controls (especially in the presence of IGT and DM). IGT and DM2 associated with structural changes in myocardium (left atrial dilatation, prevalence of LV concentric hypertrophy, diastolic dysfunction) coupled to higher systolic AH and marked metabolic disorders (hyperglycemia, IR, elevated microalbuminurea and C-reactive protein level, dyslipidemia). These conditions contribute to the frequency and severity of AF relapses. Development of AF in MS is a multifactor problem necessitating strict control of AH, dyslipidemia, DM2 and IGT, reduction of body weight and abdominal obesity.

  6. Left Atrial Appendage Occlusion for Stroke Prevention.

    Science.gov (United States)

    Chanda, Arijit; Reilly, John P

    More than 2.3 million adults in the United States have atrial fibrillation (AF), which exposes them to a 5-fold increased risk of stroke. The left atrial appendage (LAA) appears to be the source of thrombus formation in the vast majority of these patients. Anticoagulation significantly reduces the risk of stroke, but often we encounter patients who have absolute or relative contraindication to anticoagulation. Percutaneous LAA exclusion offers an alternative to anticoagulation to decrease the risk of stroke. Three device systems are currently available in the United States. The WATCHMAN® device is the most studied and approved by Food and Drug Administration (FDA) to be used in patients with AF unsuitable for anticoagulation who are at a high risk of stroke. The Amulet® device is currently being used as part of the AMPLATZER® Amulet® LAA Occluder trial, which is a non-inferiority randomized trial comparing the Amulet® to the WATCHMAN® device. The third device in use is the LARIAT®, which is an FDA approved snare and pre-tied stich system. It is used to approximate soft tissue which in this case is the LAA. It is a hybrid system and requires both epicardial and endocardial access. The main obstacle to percutaneous LAA closure is procedural related complications, which can be minimized with optimum operator experience. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Clinical characteristics, management, and control of permanent vs. nonpermanent atrial fibrillation: insights from the RealiseAF survey.

    LENUS (Irish Health Repository)

    Murin, Jan

    2014-01-01

    Atrial fibrillation can be categorized into nonpermanent and permanent atrial fibrillation. There is less information on permanent than on nonpermanent atrial fibrillation patients. This analysis aimed to describe the characteristics and current management, including the proportion of patients with successful atrial fibrillation control, of these atrial fibrillation subsets in a large, geographically diverse contemporary sample.

  8. Preventing the premature death of relationship marketing.

    Science.gov (United States)

    Fournier, S; Dobscha, S; Mick, D G

    1998-01-01

    Relationship marketing is in vogue. And why not? The new, increasingly efficient ways that companies have of understanding and responding to customers' needs and preferences seemingly allow them to build more meaningful connections with consumers than ever before. These connections promise to benefit the bottom line by reducing costs and increasing revenue. Unfortunately, a close look suggests that the relationships between companies and customers are troubled ones, at best. Companies may delight in learning more about their customers and in being able to provide features and services to please every possible palate. But customers delight in neither. In fact, customer satisfaction rates in the United States are at an all-time low, while complaints, boycotts, and other expressions of consumer discontent are on the rise. This mounting wave of unhappiness has yet to reach the bottom line. Sooner or later, however, corporate performance will suffer unless relationship marketing becomes what it is supposed to be--the epitome of customer orientation. Ironically, the very things that marketers are doing to build relationships with customers are often the things that are destroying those relationships. Relationship marketing is powerful in theory but troubled in practice. To prevent its premature death, marketers need to take the time to figure out how and why they are undermining their own best efforts, as well as how they can get things back on track.

  9. Nuclear Chk1 prevents premature mitotic entry.

    Science.gov (United States)

    Matsuyama, Makoto; Goto, Hidemasa; Kasahara, Kousuke; Kawakami, Yoshitaka; Nakanishi, Makoto; Kiyono, Tohru; Goshima, Naoki; Inagaki, Masaki

    2011-07-01

    Chk1 inhibits the premature activation of the cyclin-B1-Cdk1. However, it remains controversial whether Chk1 inhibits Cdk1 in the centrosome or in the nucleus before the G2-M transition. In this study, we examined the specificity of the mouse monoclonal anti-Chk1 antibody DCS-310, with which the centrosome was stained. Conditional Chk1 knockout in mouse embryonic fibroblasts reduced nuclear but not centrosomal staining with DCS-310. In Chk1(+/myc) human colon adenocarcinoma (DLD-1) cells, Chk1 was detected in the nucleus but not in the centrosome using an anti-Myc antibody. Through the combination of protein array and RNAi technologies, we identified Ccdc-151 as a protein that crossreacted with DCS-310 on the centrosome. Mitotic entry was delayed by expression of the Chk1 mutant that localized in the nucleus, although forced immobilization of Chk1 to the centrosome had little impact on the timing of mitotic entry. These results suggest that nuclear but not centrosomal Chk1 contributes to correct timing of mitotic entry.

  10. Diagnostic Modalities in Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Fatma Eskicioğlu

    2015-04-01

    Full Text Available Objectives: Rupture of membranes prior to the onset of labor is known as Premature Rupture of Membranes (PROM. Early and correct diagnosis is crucial in order to prevent fetal and maternal risks that can be life threatening. We aimed to investigate the diagnostic ability of the tests in PROM. Materials and Methods: Nitrazine test, fern test, amnio-dye test, biochemical tests (insulin-like growth factor binding protein-1 and placental alpha microglobulin-1 were evaluated in terms of effectiveness in diagnosis of PROM. Results: A gold standard method has not yet been defined in PROM. Diagnostic tests (nitrazine test, fern test, Insulin-like Growth Factor Binding Protein-1 “IGFBP-1” and Placental Alpha Microglobulin-1 “PAMG-1” should be used when the diagnosis is not certain following history, examination with sterile speculum and ultrasonography evaluation. Conclusion: IGFBP-1 and PAMG-1 are tests based on bedside immunochromatographic method. Especially, PAMG-1 comes into prominence with its high sensitivity and specificity.

  11. Progeria: a rare genetic premature ageing disorder.

    Science.gov (United States)

    Sinha, Jitendra Kumar; Ghosh, Shampa; Raghunath, Manchala

    2014-05-01

    Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand the cellular and molecular basis of a number of clinically heterogeneous rare genetic disorders that come under the umbrella of progeroid syndromes (PSs). As per the latest clinical trial reports, Lonafarnib, a farnesyltranferase inhibitor, is a potent 'drug of hope' for Hutchinson-Gilford progeria syndrome (HGPS) and has been successful in facilitating weight gain and improving cardiovascular and skeletal pathologies in progeroid children. This can be considered as the dawn of a new era in progeria research and thus, an apt time to review the research developments in this area highlighting the molecular aspects, experimental models, promising drugs in trial and their implications to gain a better understanding of PSs.

  12. Progeria: A rare genetic premature ageing disorder

    Directory of Open Access Journals (Sweden)

    Jitendra Kumar Sinha

    2014-01-01

    Full Text Available Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand the cellular and molecular basis of a number of clinically heterogeneous rare genetic disorders that come under the umbrella of progeroid syndromes (PSs. As per the latest clinical trial reports, Lonafarnib, a farnesyltranferase inhibitor, is a potent ′drug of hope′ for Hutchinson-Gilford progeria syndrome (HGPS and has been successful in facilitating weight gain and improving cardiovascular and skeletal pathologies in progeroid children. This can be considered as the dawn of a new era in progeria research and thus, an apt time to review the research developments in this area highlighting the molecular aspects, experimental models, promising drugs in trial and their implications to gain a better understanding of PSs.

  13. Premature birth: An Enigma for the Society?

    Directory of Open Access Journals (Sweden)

    Sribas Goswami

    2014-12-01

    Full Text Available Infants born preterm are at greater risk than infants born at term for mortality and a variety of health and developmental problems. Complications include acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems, as well as longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. The greatest risk of mortality and morbidity is for those infants born at the earliest gestational ages. However, those infants born nearer to term represent the greatest number of infants born preterm and also experience more complications than infants born at term. Preterm birth is a complex cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, neighborhood characteristics, environmental exposures, medical conditions, infertility treatments, biological factors and genetics. Many of these factors occur in combination, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. The empirical investigation was carried out to draw correlation between preterm birth and eventuality. This paper deals with various issues related to the premature deliveries from socio-biological perspectives.

  14. Telomeres, telomerase and premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Renata Košir Pogačnik

    2011-11-01

    Full Text Available Telomeres are specialized structures at the ends of chromosomes, consisting of six repeated nucleotides in TTAGGG sequence. Genome stability is partly maintained by the architecture of telomeres and is gradually lost as telomeres progressively shorten with each cell replication. Critically shortened telomeres are recognized by DNA repair mechanisms as DNA damage and the cell replication cycle stops. The cell eventually dies or undergoes cell apoptosis. Telomere represents a cellular marker of biological age and are therefore also called cell mitotic clock. The enzyme that counteracts telomere shortening by adding nucleotides to the 3’ end of DNA strand is called telomerase. It is composed of the RNA subunit (TR, which is special type of messenger RNA (mRNA, the catalytic protein subunit (TERT, which works as a reverse transcriptase and numerous additional proteins. Telomerase is active in some germline, epithelial and haemopoietic cells, but in most somatic cells the activity is undetectable. In literature, the length of telomeres is closely connected with premature ovarian failure (POF. POF is generally defined as the onset of menopause before the age of 40. The causes of disease are genetical, autoimmune, iatrogenic or if we cannot establish the cause – idiopathic. A lot of studies examined correlation between idiopathic POF, length of telomeres and telomerase activity. The studies mostly show that women with POF have shortened telomeres and decreased activity of telomerase as compared to healthy women.

  15. Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

    Directory of Open Access Journals (Sweden)

    P.R. Benchimol-Barbosa

    2009-03-01

    Full Text Available Atrial fibrillation (AF affects subjects with Chagas' disease and is an indicator of poor prognosis. We investigated clinical, echocardiographic and electrocardiographic variables of Chagas' disease in a long-term longitudinal study as predictors of a new-onset AF episode lasting >24 h, nonfatal embolic stroke and cardiac death. Fifty adult outpatients (34 to 74 years old, 62% females staged according to the Los Andes classification were enrolled. During a follow-up of (mean ± SD 84.2 ± 39.0 months, 9 subjects developed AF (incidence: 3.3 ± 1.0%/year, 5 had nonfatal stroke (incidence: 1.3 ± 1.0%/year, and nine died (mortality rate: 2.3 ± 0.8%/year. The progression rate of left ventricular mass and left ventricular ejection fraction was significantly greater in subjects who experienced AF (16.4 ± 20.0 g/year and -8.6 ± 7.6%/year, respectively than in those who did not (8.2 ± 8.4 g/year; P = 0.03, and -3.0 ± 2.5%/year; P = 0.04, respectively. In univariate analysis, left atrial diameter ≥3.2 cm (P = 0.002, pulmonary arterial hypertension (P = 0.035, frequent premature supraventricular and ventricular contraction counts/24 h (P = 0.005 and P = 0.007, respectively, ventricular couplets/24 h (P = 0.002, and ventricular tachycardia (P = 0.004 were long-term predictors of AF. P-wave signal-averaged ECG revealed a limited long-term predictive value for AF. In chronic Chagas' disease, large left atrial diameter, pulmonary arterial hypertension, frequent supraventricular and ventricular premature beats, and ventricular tachycardia are long-term predictors of AF. The rate of left ventricular mass enlargement and systolic function deterioration impact AF incidence in this population.

  16. Atrial Arrhythmias in Astronauts - Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael R.; Watkins, Sharmila D.; Polk, J. D.

    2010-01-01

    Background and Problem Definition: To evaluate NASA s current standards and practices related to atrial arrhythmias in astronauts, Space Medicine s Advanced Projects Section at the Johnson Space Center was tasked with organizing a summit to discuss the approach to atrial arrhythmias in the astronaut cohort. Since 1959, 11 cases of atrial fibrillation, atrial flutter, or supraventricular tachycardia have been recorded among active corps crewmembers. Most of the cases were paroxysmal, although a few were sustained. While most of the affected crewmembers were asymptomatic, those slated for long-duration space flight underwent radiofrequency ablation treatment to prevent further episodes of the arrhythmia. The summit was convened to solicit expert opinion on screening, diagnosis, and treatment options, to identify gaps in knowledge, and to propose relevant research initiatives. Summit Meeting Objectives: The Atrial Arrhythmia Summit brought together a panel of six cardiologists, including nationally and internationally renowned leaders in cardiac electrophysiology, exercise physiology, and space flight cardiovascular physiology. The primary objectives of the summit discussions were to evaluate cases of atrial arrhythmia in the astronaut population, to understand the factors that may predispose an individual to this condition, to understand NASA s current capabilities for screening, diagnosis, and treatment, to discuss the risks associated with treatment of crewmembers assigned to long-duration missions or extravehicular activities, and to discuss recommendations for prevention or management of future cases. Summary of Recommendations: The summit panel s recommendations were grouped into seven categories: Epidemiology, Screening, Standards and Selection, Treatment of Atrial Fibrillation Manifesting Preflight, Atrial Fibrillation during Flight, Prevention of Atrial Fibrillation, and Future Research

  17. A roadmap to improve the quality of atrial fibrillation management : proceedings from the fifth Atrial Fibrillation Network/European Heart Rhythm Association consensus conference

    NARCIS (Netherlands)

    Kirchhof, Paulus; Breithardt, Guenter; Bax, Jeroen; Benninger, Gerlinde; Blomstrom-Lundqvist, Carina; Boriani, Giuseppe; Brandes, Axel; Brown, Helen; Brueckmann, Martina; Calkins, Hugh; Calvert, Melanie; Christoffels, Vincent; Crijns, Harry; Dobrev, Dobromir; Ellinor, Patrick; Fabritz, Larissa; Fetsch, Thomas; Freedman, S. Ben; Gerth, Andrea; Goette, Andreas; Guasch, Eduard; Hack, Guido; Haegeli, Laurent; Hatem, Stephane; Haeusler, Karl Georg; Heidbuechel, Hein; Heinrich-Nols, Jutta; Hidden-Lucet, Francoise; Hindricks, Gerd; Juul-Moeller, Steen; Kaeaeb, Stefan; Kappenberger, Lukas; Kespohl, Stefanie; Kotecha, Dipak; Lane, Deirdre A.; Leute, Angelika; Lewalter, Thorsten; Meyer, Ralf; Mont, Lluis; Muenzel, Felix; Nabauer, Michael; Nielsen, Jens C.; Oeff, Michael; Oldgren, Jonas; Oto, Ali; Piccini, Jonathan P.; Pilmeyer, Art; Potpara, Tatjana; Ravens, Ursula; Reinecke, Holger; Rostock, Thomas; Rustige, Joerg; Savelieva, Irene; Schnabel, Renate; Schotten, Ulrich; Schwichtenberg, Lars; Sinner, Moritz F.; Steinbeck, Gerhard; Stoll, Monika; Tavazzi, Luigi; Themistoclakis, Sakis; Tse, Hung Fat; Van Gelder, Isabelle C.; Vardas, Panagiotis E.; Varpula, Timo; Vincent, Alphons; Werring, David; Willems, Stephan; Ziegler, Andre; Lip, Gregory Y. H.; Camm, A. John

    2016-01-01

    At least 30 million people worldwide carry a diagnosis of atrial fibrillation (AF), and many more suffer from undiagnosed, subclinical, or 'silent' AF. Atrial fibrillation-related cardiovascular mortality and morbidity, including cardiovascular deaths, heart failure, stroke, and hospitalizations,

  18. Effect of Interventions for Premature Ejaculation in the Treatment of Chronic Prostatitis with Secondary Premature Ejaculation.

    Science.gov (United States)

    Chen, Chang-Qing; Yi, Qing-Tong; Chen, Chu-Hong; Gong, Min

    2016-08-01

    Objective To evaluate the effect of interventions for premature ejaculation (PE) in the management of patients with chronic prostatitis and secondary premature ejaculation. Methods Totally 90 patients diagnosed as chronic prostatitis with PE were randomly divided into control group (n=45) and interventional group (n=45). Control group received a conventional therapy consisted of oral administration of antibiotics,α-receptor blocker,and proprietary Chinese medicine for clearing away heat and promoting diuresis. Interventional group received a conventional therapy combined with treatment for ameliorating the PE symptom (oral dapoxetine on-demand and ejaculation control exercise).National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI),Chinese Index of Sexual Function for Premature Ejaculation (CIPE)-5 questionnaires,intravaginal ejaculatory latency time,and the number of coituses per week were applied for evaluating the treatment outcomes. Results Follow-up was accomplished in 35 and 38 patients in the control and interventional group.The CIPE-5 score,intravaginal ejaculatory latency time,and the number of coituses per week were significantly improved in both two groups but more significantly in interventional group (all P<0.05). The NIH-CPSI pain,urination,and quality of life subscores and total score were improved significantly in both two groups after treatment,but the NIH-CPSI pain and quality of life subscores had been improved more significantly in the interventional group (all P<0.05). The variation of NIH-CPSI was negatively correlated with that of CIPE-5 in both two groups (r=-0.362,P=0.016;r=-0.330,P=0.021). Conclusions For CP with secondary PE patients,the interventions for PE can not only improve the quality of sexual life but also help improve the NIH-CPSI pain and quality of life subscores. PE should be routinely screened and treated during the management of CP.p.

  19. Individual perception of different stimuli: Implications for managers

    Directory of Open Access Journals (Sweden)

    Santos- Álvarez, M.V.

    2012-01-01

    Full Text Available Managerial perception is the process by which managers form an image of the stimuli they receive. According to research, perception is conditioned by the individual’s cognitive profile. But the different nature of incoming stimuli suggests that it would be interesting to study whether the cognitive profile’s influence varies in the presence of different stimuli. This paper analyses the effect of the cognitive profile on perception of differently-structured stimuli. The results clearly show that the cognitive style, tolerance of ambiguity, and proactivity have an effect. Specifically, they condition the recognition of stimuli, particularly when the stimuli are relatively unstructured. The results also show that the cognitive variables have less influence in the interpretation stage.

  20. YKL-40 levels and atrial fibrillation in the general population

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Benn, Marianne; Johansen, Julia S

    2013-01-01

    BACKGROUND: Atrial fibrillation is associated with inflammation. In contrast to inflammatory markers like C-reactive protein (CRP) and fibrinogen produced in the liver, YKL-40 is produced at the site of inflammation including in the myocardium. We hypothesized that elevated plasma YKL-40 levels...... associate with increased risk of atrial fibrillation. METHOD AND RESULTS: We measured plasma YKL-40 in 8731 participants from the prospective Copenhagen City Heart Study including 896 individuals who developed atrial fibrillation during up to 18years of follow-up. Additionally, we measured YKL-40 in 6621...

  1. 'Real-world' atrial fibrillation management in Europe

    DEFF Research Database (Denmark)

    Proietti, Marco; Laroche, Cécile; Opolski, Grzegorz;

    2016-01-01

    AIMS: Atrial fibrillation (AF) is commonly associated with a high risk of stroke, thromboembolism, and mortality. The 1-year follow-up of the EURObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot Registry demonstrated a high mortality but good outcomes with European Society...... (61.8%). Atrial fibrillation readmissions were frequent, particularly related to arrhythmias and heart failure. On multivariate analyses, any cardiovascular reason for admission rather than AF was significantly associated with increased mortality during the 2-year follow-up. CONCLUSION: In this 2-year...

  2. Platypnea-orthodeoxia induced by fenestrated atrial septal aneurysm.

    Science.gov (United States)

    Giombolini, Claudio; Notaristefano, Salvatore; Santucci, Stefano; Savino, Ketty; Pasquino, Stefano; Ragni, Temistocle; Ambrosio, Giuseppe

    2005-02-01

    Platypnea-orthodeoxia is a peculiar syndrome characterized by a right-to-left shunt, which occurs in the upright position. The diagnosis is made by contrast transesophageal echocardiography, paying attention to include contrast visualization in the orthostatic decubitus. The association of this syndrome with a fenestrated atrial septal aneurysm is rare and probably underlies a peculiar and also rare mechanism of shunting in presence of normal pulmonary pressure. We report of a case of a 58-year-old man with a fenestrated atrial septal aneurysm and platypnea-orthodeoxia syndrome treated by surgical closure of the atrial defect.

  3. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2015-01-01

    Full Text Available We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.

  4. Atrial natriuretic peptide and feeding activity patterns in rats

    Directory of Open Access Journals (Sweden)

    Oliveira M.H.A.

    1997-01-01

    Full Text Available This review presents historical data about atrial natriuretic peptide (ANP from its discovery as an atrial natriuretic factor (ANF to its role as an atrial natriuretic hormone (ANH. As a hormone, ANP can interact with the hypothalamic-pituitary-adrenal axis (HPA-A and is related to feeding activity patterns in the rat. Food restriction proved to be an interesting model to investigate this relationship. The role of ANP must be understood within a context of peripheral and central interactions involving different peptides and pathways

  5. Prevention of atrial flutter with cryoablation may be proarrhythmogenic

    DEFF Research Database (Denmark)

    Lukac, Peter; Hjortdal, Vibeke E; Pedersen, Anders K;

    2007-01-01

    BACKGROUND: Atrial flutter is a serious problem after surgery for congenital heart disease. METHODS: We performed an intraoperative linear one-minute cryolesion between a right atriotomy and the tricuspid annulus to prevent atrial flutter in 17 consecutive adult patients undergoing surgery...... for congenital heart disease. Coronary angiography and electrophysiology study using an electroanatomic mapping system to assess the conduction across the line and to try to induce atrial flutter were performed three months after the operation in 15 patients. RESULTS: Eleven patients had bidirectional block...

  6. Acute Pulmonary Edema Caused by a Giant Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Andrea Fisicaro

    2013-01-01

    Full Text Available Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention.

  7. Pulmonary edema following transcatheter closure of atrial septal defect

    Science.gov (United States)

    Chigurupati, Keerthi; Reshmi, Liza Jose; Gadhinglajkar, Shrinivas; Venkateshwaran, S.; Sreedhar, Rupa

    2015-01-01

    We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation. PMID:26139760

  8. TGF-beta1 expression and atrial myocardium fibrosis increase in atrial fibrillation secondary to rheumatic heart disease.

    Science.gov (United States)

    Xiao, Hua; Lei, Han; Qin, Shu; Ma, Kanghua; Wang, Xi

    2010-03-01

    Atrial fibrosis was considered a structural basis for the development and sustaining of atrial fibrillation (AF). Transforming growth factor-beta1 (TGF-beta1) was one of the main factors for accelerating collagen production. The contribution of TGF-beta1 in the pathogenesis of AF needs further investigation. The altered expression and distribution of TGF-beta1 will be associated with the changes in atrial fibrosis in different types of AF patients with rheumatic heart disease (RHD). Right atrial specimens obtained from 38 RHD patients undergoing mitral valve replacement surgery were divided into 3 groups: the sinus rhythm group (n = 8), the paroxysmal AF group (pAF; n = 10), and the chronic AF group (cAF; AF lasting >/= 6 mo; n = 20). The degree of atrial fibrosis, collagen content, serum levels, messenger RNA (mRNA), and protein expression of TGF-beta1 were detected. The collagen content, serum level, TGF-beta1 mRNA, and protein expression of the atrial tissue increased gradually in sinus rhythm, for both pAF and cAF groups, respectively. A positive correlation between TGF-beta1 and the degree of atrial fibrosis was also demonstrated (P fibrosis in AF and was associated with the type of AF, which suggests that TGF-beta1 is possibly involved in the pathogenesis of AF in RHD patients. Copyright (c) 2010 Wiley Periodicals, Inc.

  9. Valuation of Go Stimuli or Devaluation of No-Go Stimuli? Evidence of an Increased Preference for Attended Go Stimuli Following a Go/No-Go Task.

    Science.gov (United States)

    Inoue, Kazuya; Sato, Nobuya

    2017-01-01

    Attentional inhibition that occurs during discrimination tasks leads to the negative evaluation of distractor stimuli. This phenomenon, known as the distractor devaluation effect also occurs when go/no-go tasks require response inhibition. However, it remains unclear whether there are interactions between attention and response controls when the distractor devaluation effect occurs. The aims of this study were to investigate whether attention to stimuli in the go/no-go task plays a facilitative role in distractor devaluation through response inhibition, and to clarify whether this effect reflects a decreased preference for no-go stimuli. Participants evaluated the preference for pictures before and after a go/no-go task. In Experiments 1 and 2, they made a go or no-go response depending on the category of pictures displayed (gummy candies or rice crackers), whereas in Experiment 3 they did on the basis digit category, even or odd numbers, superimposed on such pictures. Experiments 1 and 2 demonstrated that the pictures presented as no-go stimuli in the preceding go/no-go task were evaluated as less positive than the pictures presented as go stimuli. This devaluation effect reflected an increased preference for the go stimuli but not a decreased preference for the no-go stimuli. Experiment 3 indicated that response inhibition did not affect the preference for the pictures that had not received attention in a preceding go/no-go task. These results suggest that although attention plays an important role in differential ratings for go and no-go stimuli, such differences, in fact, reflect the valuation of go stimuli.

  10. Association of left atrial endothelin-1 with atrial rhythm, size, and fibrosis in patients with structural heart disease.

    Science.gov (United States)

    Mayyas, Fadia; Niebauer, Mark; Zurick, Andrew; Barnard, John; Gillinov, A Marc; Chung, Mina K; Van Wagoner, David R

    2010-08-01

    Atrial fibrillation (AF) promotes atrial remodeling and can develop secondary to heart failure or mitral valve disease. Cardiac endothelin-1 (ET-1) expression responds to wall stress and can promote myocyte hypertrophy and interstitial fibrosis. We tested the hypothesis that atrial ET-1 is elevated in AF and is associated with AF persistence. Left atrial appendage tissue was studied from coronary artery bypass graft, valve repair, and/or Maze procedure in patients in sinus rhythm with no history of AF (SR, n=21), with history of AF but in SR at surgery (AF/SR, n=23), and in AF at surgery (AF/AF, n=32). The correlation of LA size with atrial protein and mRNA expression of ET-1 and ET-1 receptors (ETAR and ETBR) was evaluated. LA appendage ET-1 content was higher in AF/AF than in SR, but receptor levels were similar. Immunostaining revealed that ET-1 and its receptors were present both in atrial myocytes and in fibroblasts. ET-1 content was positively correlated with LA size, heart failure, AF persistence, and severity of mitral regurgitation. Multivariate analysis confirmed associations of ET-1 with AF, hypertension, and LA size. LA size was associated with ET-1 and MR severity. ET-1 mRNA levels were correlated with genes involved in cardiac dilatation, hypertrophy, and fibrosis. Elevated atrial ET-1 content is associated with increased LA size, AF rhythm, hypertension, and heart failure. ET-1 is associated with atrial dilatation, fibrosis, and hypertrophy and probably contributes to AF persistence. Interventions that reduce atrial ET-1 expression and/or block its receptors may slow AF progression.

  11. Intra-atrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog.

    Science.gov (United States)

    Allessie, M A; Lammers, W J; Bonke, I M; Hollen, J

    1984-07-01

    In the isolated blood-perfused canine heart we produced episodes of rapid atrial flutter by continuous infusion of acetylcholine and rapid pacing. The spread of excitation during atrial flutter was mapped with the aid of two endocavitary mapping electrodes containing 960 leads and recording from 192 different sites simultaneously. The flutter maps clearly showed that intra-atrial reentry was the mechanism responsible for the arrhythmia. However, the localization and size of the intra-atrial circuits differed from case to case even in the same heart. The orifices of the venae cavae or the atrioventricular ring did not serve as a central anatomic obstacle for circus movement. We also failed to identify a special role of the internodal pathways in the formation of the loop. Instead, the intra-atrial circuits could be found everywhere, provided sufficient atrial mass was available to accommodate the circuit. The diameter of the circuits varied between 1.5 and 3 cm at a cycle length between 65 and 155 msec. The average conduction velocity of the circulating impulse varied between 60 and 80 cm/sec. Spontaneous termination of atrial flutter frequently occurred and was based on local conduction block in a narrow part of the circuit. Another interesting aspect of these studies is the finding that during continuous circus movement of the impulse, the amount of myocardium that is activated may vary considerably. This marked periodicity in excited tissue mass during atrial flutter could adequately explain the continuously undulating baseline or typical sawtoothlike F waves as seen in the surface electrocardiogram during atrial flutter.

  12. Premature death rates diverge in the United States

    Science.gov (United States)

    An NCI press release on a study that shows premature death rates have declined in the United States among Hispanics, blacks, and Asian/Pacific Islanders but increased among whites and American Indian/Alaska Natives.

  13. Hypothalamic-pituitary-gonadotropic function in girls with premature thelarche.

    Science.gov (United States)

    Pasquino, A M; Piccolo, F; Scalamandre, A; Malvaso, M; Ortolani, R; Boscherini, B

    1980-01-01

    Hypothalamic-pituitary-gonadotropic activity was investigated in 9 girls with premature thelarche, and compared with that in 9 healthy girls and 6 girls with true precocious puberty. The gonadotropin stimulation test with luteinising hormone-releasing hormone was used. Girls with premature thelarche showed luteinising hormone response resembling that of normal girls, and follicle-stimulating hormone (FSH) response quite similar to that of girls with precocious puberty. This suggests that in premature thelarche there is a partial activation of the diencephalic-hypophyseal-gonadal axis, which affects FSH only. Premature thelarche therefore, should be considered as one of the disorders due to altered sensitivity of the hypothalamic receptors which regulate sex maturation. PMID:6779715

  14. PREMATURE BIRTH, MORPHOLOGY OF PLACENTA AND INTRAUTERINE GROWTH RETARDATION

    Directory of Open Access Journals (Sweden)

    L.V. Vasilenko

    2007-09-01

    Full Text Available Retrospectively studied following and outcome of pregnancy, women with non carrying of pregnancy, women that give birth to children with development delay (1 group and women that give birth in proper time (2 group. Premature birth arranged 4,4% of 2962 delivery. Fetus development delay was established by 38,1% of premature babies and by 10,5% of borne in proper time. Non carrying of pregnancy stipulated by motherґs urogenital infection, high expressed gestosis and others obsterical and extra genital complications. Each third of women that give birth to premature babies with development delay, have inflammatory overpatching in placenta, each fifth have morphological proved FPI. Realized researches allowed to conclude, that for decreasing frequencies of premature births and fetus development delay is necessary doing opportunely urogenital tract sonation, pre-clinical diagnostics of gestosis Noncarryng of pregnancy and treat this disease preventive.

  15. [Histologic chorioamnionitis prevalence in patients with premature rupture membranes].

    Science.gov (United States)

    Garcia-de la Torre, José Ignacio; Delgado-Rosas, Antonio; Gonzélez-Cantú, Gerardo

    2014-12-01

    Search Histologic Chorioamnionitis frequency in patients in week 28 (+/-) and pregnancy with premature rupture of membranes. Retrospective and observational study in which we studied all patients who came between June 28, 2011 and November 15, 2011 to receive obstetric care in the service of Tocochirurgical of the University Hospital of Saltillo, with greater than or equal 28 weeks of pregnancy. 598 patients were studied, and the frequency of premature rupture of membranes with histologic chorioamnionitis at term patients was, respectively, 1.7 and 5.3% in preterm labor. In the total sample frequency of histologic chorioamnionitis was 0.6% (4 patients) and, of these, 25% were term and 75% with preterm rupture. In patients with premature rupture of membranes the clinical chorioamnionitis was 0% valued by the criteria of Gibbs. The premature rupture of membranes is a risk factor important for histological chorioamnionitis. To decrease risk factors and possible complications, an established protocol must be taken.

  16. Ichthyosis prematurity syndrome: a well-defined congenital ichthyosis subtype

    DEFF Research Database (Denmark)

    Bygum, Anette; Westermark, Per; Brandrup, Flemming

    2008-01-01

    . The parents recalled that his elder sister had similar but milder skin changes and respiratory distress syndrome at birth. Ichthyosis prematurity syndrome was suggested and the diagnosis supported by electron microscopy of a skin biopsy specimen showing pathognomonic trilamellar membrane aggregations...... birth he developed respiratory distress and needed intubation. Remarkable skin changes were noticed with universal red, edematous and desquamating, spongy skin giving an impression of excessive vernix caseosa. Marked regression of the edema and ichthyotic scaling was observed within a few weeks......Ichthyosis prematurity syndrome is a rare syndrome characterized by the clinical triad of premature birth, thick caseous desquamating epidermis, and neonatal asphyxia. We describe two siblings with ichthyosis prematurity syndrome. The index patient was born at gestational week 34. Immediately after...

  17. Premature discharge of children from hospital admission at Ahmadu ...

    African Journals Online (AJOL)

    Premature discharge of children from hospital admission at Ahmadu Bello University ... The commonest diagnoses were protein-energy malnutrition and pneumonia and ... Conclusion: Socio-economic factors were significant determinants of ...

  18. Premature rupture of membranes at term: immediate induction of ...

    African Journals Online (AJOL)

    Premature rupture of membranes at term: immediate induction of labor versus expectant ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING ... Methods: One hundred and fifty two women with PROM at term were ...

  19. Atrial ectopy predicts late recurrence of atrial fibrillation after pulmonary vein isolation

    DEFF Research Database (Denmark)

    Gang, Uffe J O; Nalliah, Chrishan J; Lim, Toon Wei

    2015-01-01

    BACKGROUND: Late recurrence of atrial fibrillation (AF) after radiofrequency ablation remains significant. Asymptomatic recurrence poses a difficult clinical problem as it is associated with an equally increased risk of stroke and death compared with symptomatic AF events. Meta-analyses reveal th...... with a significantly increased risk of late AF recurrence. These results could have important clinical implications for the design of post-PVI follow-up. CLINICAL TRIAL REGISTRATION: URL: http://www.anzctr.org.au. Unique identifier: ACRTN12606000467538....

  20. Assessment of left atrial volume and function in patients with permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Agner, Bue F Ross; Kühl, Jørgen Tobias; Linde, Jesper James

    2014-01-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with substantial morbidity and mortality. AF is associated with enlargement of the left atrium (LA), and the LA volume has important prognostic implications for the disease. The objective of the study was to determine how ...... measurements of LA volume and function obtained by transthoracic echocardiography (TTE), cardiac magnetic resonance (CMR), and 320-slice multi-detector computed tomography (MDCT) correlate in patients with permanent AF....