scholarly journals Cor Triatriatum Sinister: An Unusual Cause of Atrial Fibrillation in Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher Hayes ◽  
Shuangbo Liu ◽  
James W. Tam ◽  
Malek Kass
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Dysfunction ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Cor Triatriatum ◽  
Limited Evidence ◽  
Therapeutic Decisions ◽  
Increased Risk ◽  
Cor Triatriatum Sinister ◽  
Ventricular Response

Cor triatriatum is a rare congenital heart defect that is associated with an increased risk for developing atrial fibrillation. We report a case of a healthy 38-year-old man who presented in decompensated heart failure and atrial fibrillation with a rapid ventricular response. A transthoracic echocardiogram (TTE) demonstrated severe biventricular dysfunction and dilatation in addition to cor triatriatum sinister. He was diuresed with resolution of his symptoms and spontaneously converted back to sinus rhythm. There is limited evidence in the literature surrounding anticoagulation and associated left ventricular dysfunction in the setting of cor triatriatum which posed difficult therapeutic decisions.

scholarly journals Chronic atrial fibrillation causes left ventricular dysfunction in dogs but not goats: experience with dogs, goats, and pigs

2013 ◽  
Vol 305 (5) ◽  
pp. H725-H731 ◽  
Author(s):  
Derek J. Dosdall ◽  
Ravi Ranjan ◽  
Koji Higuchi ◽  
Eugene Kholmovski ◽  
Nathan Angel ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Dysfunction ◽  
Chronic Atrial Fibrillation ◽  
Left Ventricular ◽  
Atrial Pacing ◽  
Atrial Fibrosis ◽  
Functional Changes ◽  
Ventricular Response ◽  
Rate Controlled ◽  
Selection Of

Structural remodeling in chronic atrial fibrillation (AF) occurs over weeks to months. To study the electrophysiological, structural, and functional changes that occur in chronic AF, the selection of the best animal model is critical. AF was induced by rapid atrial pacing (50-Hz stimulation every other second) in pigs ( n = 4), dogs ( n = 8), and goats ( n = 9). Animals underwent MRIs at baseline and 6 mo to evaluate left ventricular (LV) ejection fraction (EF). Dogs were given metoprolol (50–100 mg po bid) and digoxin (0.0625–0.125 mg po bid) to limit the ventricular response rate to <180 beats/min and to mitigate the effects of heart failure. The pacing leads in pigs became entirely encapsulated and lost the ability to excite the heart, often before the onset of sustained AF. LV EF in dogs dropped from 54 ± 11% at baseline to 33 ± 7% at 6 mo ( P < 0.05), whereas LV EF in goats did not drop significantly (69 ± 8% at baseline vs. 60 ± 9% at 6 mo, P = not significant). After 6 mo of AF, fibrosis levels in dog atria and ventricles increased, whereas only atrial fibrosis levels increased in goats compared with control animals. In our experience, the pig model is not appropriate for chronic rapid atrial pacing-induced AF studies. Rate-controlled chronic AF in the dog model developed HF and LV fibrosis, whereas the goat model developed only atrial fibrosis without ventricular dysfunction and fibrosis. Both the dog and goat models are representative of segments of the patient population with chronic AF.

Thrombosis and Hemostasis in Cardiology: Review of Pathophysiology and Clinical Practice (Part I)

1998 ◽  
Vol 4 (1) ◽  
pp. 51-75 ◽  
Author(s):  
William F. Baker
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Severe Left Ventricular Dysfunction ◽  
Clinical Cardiology ◽  
Increased Risk ◽  
Artery Disease

The adverse consequences of thrombosis are per haps nowhere more evident than in clinical cardiology. Throm bosis and hemostasis are primary issues in the management of patients with atrial fibrillation, prosthetic heart valves, severe left ventricular dysfunction, and coronary artery disease. Clini cal trials have defined a crucial role for anticoagulation with warfarin in patients with atrial fibrillation to reduce the inci dence of stroke. Anticoagulation with warfarin and aspirin in combination offers significant protection from systemic emboli in patients with mechanical prosthetic valves, without a sub stantial increased risk of hemorrhage. The risk of systemic emboli may also be reduced by anticoagulation in patients with severe left ventricular dysfunction. Disturbance of the normal balance of hemostasis is a major factor in the pathophysiology of coronary artery disease. Antiplatelet therapy, antithrombin agents, anticoagulants, and fibrinolytic agents have been used to prevent and treat acute coronary thrombosis and to prevent reocclusion following thrombolysis and interventional therapy. Guidelines are presented for antithrombotic therapy in the prac tice of clinical cardiology.

Thrombosis and Hemostasis in Cardiology: Review of Pathophysiology and Clinical Practice (Part II)

1998 ◽  
Vol 4 (2) ◽  
pp. 143-147
Author(s):  
William F. Baker
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Severe Left Ventricular Dysfunction ◽  
Clinical Cardiology ◽  
Increased Risk ◽  
Artery Disease

The adverse consequences of thrombosis are per haps nowhere more evident than in clinical cardiology. Throm bosis and hemostasis are primary issues in the management of patients with atrial fibrillation, prosthetic heart valves, severe left ventricular dysfunction, and coronary artery disease. Clini cal trials have defined a crucial role for anticoagulation with warfarin in patients with atrial fibrillation to reduce the inci dence of stroke. Anticoagulation with warfarin and aspirin in combination offers significant protection from systemic emboli in patients with mechanical prosthetic valves, without a sub stantial increased risk of hemorrhage. The risk of systemic emboli may also be reduced by anticoagulation in patients with severe left ventricular dysfunction. Disturbance of the normal balance of hemostasis is a major factor in the pathophysiology of coronary artery disease. Antiplatelet therapy, antithrombin agents, anticoagulants, and fibrinolytic agents have been used to prevent and treat acute coronary thrombosis and to prevent reocclusion following thrombolysis and interventional therapy. Guidelines are presented for antithrombotic therapy in the prac tice of clinical cardiology. Key Words: Thrombosis— Cardiology—Coronary artery disease—Atrial fibrillation— Valvular heart disease.

Atrial Fibrillation in the Failing Heart – A Clinical Review

2010 ◽  
Vol 6 (1) ◽  
pp. 75
Author(s):  
Lori L McMullan ◽  
Gaston Vergara ◽  
Nassir F Marrouche ◽  
◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Six Minute Walk Test ◽  
Increased Risk ◽  
Randomised Controlled ◽  
Minute Walk ◽  
Viable Treatment

Not only are atrial fibrillation (AF) and heart failure (HF) the most commonly encountered disease conditions in clinical practice, they are also associated with an increased risk of both morbidity and mortality. Both diseases are affiliated with maladaptive neurohormonal changes and remodelling of the heart. Treatment of AF has focused on prevention of thromboembolism, rate control and rhythm maintenance. Rhythm maintenance with anti-arrhythmic drugs has been relatively ineffective in maintaining patients in sinus rhythm, with the addition of increased adverse side effects. Rhythm control of AF via catheter radiofrequency ablation is a viable treatment option, with several studies showing improvement in ejection fraction, quality of life and the six-minute-walk test. Future multicentre randomised controlled trials are pending, the first being Catheter Ablation Versus Standard Conventional Treatment in Patients With Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF), to determine whether catheter ablation of AF is superior to conventional therapy for patients suffering from AF and HF.

Antiarrhythmische Pharmakotherapie

2012 ◽  
Vol 31 (11) ◽  
pp. 826-829
Author(s):  
A. Goette ◽  
P. Kirchhof ◽  
A. Treszl ◽  
K. Wegscheider ◽  
T. Meinertz
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Angiotensin Ii ◽  
Catheter Ablation ◽  
Early Treatment ◽  
Stroke Prevention ◽  
Conventional Treatment ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Atrial Fibrillation Trial

ZusammenfassungEs werden die Ergebnisse von Studien sowie die Protokolle laufender „Megastudien“ mit Bezug zum Vorhofflimmer-Netzwerk dargestellt. Bei den abgeschlossenen Studien handelt es sich um die Flecainide Short-Long trial (Flec-SL) und die Angiotensin-II-Rezeptorblocker in Paroxysmal Atrial FibrillationStudie (ANTIPAF). Bei den „Megastudien“ um Studien mit den Kürzeln EAST (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), CABANA (Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial) und CASTLE-AF (Catheter Ablation versus Standard conventional Treatment in patients with LEft ventricular dysfunction and Atrial Fibrillation). Die Ergebnisse der Studien: Eine präventive Kurzzeittherapie nach Kardio-version ist sinnvoller als der Verzicht auf jegliche Antiarrhythmika-Nachbehandlung. Noch effektiver scheint eine antiarrhythmische Langzeit-Nachbehandlung über sechs Monate zu sein. In der ANTIPAF-Studie zeigte sich, dass bei Patienten mit paroxysmalem Vorhofflimmern (VHF) ohne strukturelle Herzkrankheit der Angiotensinrezeptorblocker Olmesartan nicht in der Lage ist, die Häufigkeit der Anfälle zu reduzieren. Wichtigstes therapeutisches Ziel ist die Verhinderung der Progression von VHF. In der EAST-Studie wird geprüft, ob eine frühzeitig eingeleitete, „aggressive“ Therapie zur Kontrolle des Herzrhythmus eher in der Lage ist, Morbidität und Mortalität von VHF zu senken als die Standardtherapie.

An Unusual Association: Right Atrial Myxoma and Severe Left Ventricular Dysfunction. Case Report and Review of the Literature

2015 ◽  
Vol 17 (6) ◽  
pp. 285
Author(s):  
Lucian Florin Dorobantu ◽  
Ovidiu Chioncel ◽  
Alexandra Pasare ◽  
Dorin Lucian Usurelu ◽  
Ioan Serban Bubenek-Turconi ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Systolic Dysfunction ◽  
Left Ventricular ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Cardiac Tumors ◽  
Severe Left Ventricular Dysfunction ◽  
Ventricular Ejection Fraction ◽  
Increased Risk

Myxomas comprise 50% of all benign cardiac tumors in adults, with the right atrium as their second most frequent site of origin. Surgical resection is the only effective therapeutic option for patients with these tumors. The association between right atrial myxomas and severe left ventricular systolic dysfunction is extremely rare and makes treatment even more challenging. This was the case for our patient, a 47-year-old male with a right atrial mass and a severely impaired left ventricular function, with a 20% ejection fraction. Global enlargement of the heart was also noted, with moderate right ventricular dysfunction. The tumor was successfully excised using the on-pump beating heart technique, with an immediate postoperative improvement of the left ventricular ejection fraction to 35%. The technique proved useful, with no increased risk to the patient.

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