scholarly journals The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Simon W. Rabkin ◽  
Jacky K. K. Tang
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Qt Interval ◽  
Atrial Arrhythmias ◽  
Exclusion Criteria ◽  
Bundle Branch Block ◽  
Qt Intervals ◽  
Ecg Database ◽  
Age And Sex ◽  
Important Marker

A short QT interval has been difficult to define, and there is debate whether it exists outside of an extremely small group of individuals with inherited channelopathies and whether it predicts cardiac arrhythmias. The objective was to identify cases with short QT and their consequences. Our hospital ECG database was screened for cases with a QTc based on the Bazett formula (QTcBZT) of less than 340 ms. The QTc was recalculated using the spline (QTcRBK) formula, which more accurately adjusts for the heart rate and identifies cases based on percentile distribution of the QT interval. The exclusion criteria were presence of bundle branch block, arrhythmias, or electronic pacemakers. An age- and sex-matched cohort was obtained from individuals with normal QT intervals with the same exclusion criteria. There were 28 cases with a short QTc (QTcRBK < 380 ms). The age was 69.6 ± 14.6 years (mean ± SD) (50% males). The QT interval was 305.7 ± 61.1 ms with QTcRBK 308.4 ± 31.4 ms. Subsequent ECGs showed atrial flutter in 21%, atrial fibrillation in 18%, and atrial tachycardia in 4% of cases. Thus, atrial arrhythmias occurred in 43% of cases. This incidence was significantly ( p < 0.0001 ) greater than the incidence of atrial arrhythmias in age- and sex-matched controls. In conclusion, a short QT interval can be readily identified based on the first percentile of the new QTc formula. A short QTc is an important marker for the development of atrial arrhythmias, including atrial flutter and atrial fibrillation, with the former predominating. It should be part of patient assessment and warrants consideration to develop strategies for detection and prevention of atrial arrhythmias.

Arrhythmias, conduction disturbances, and neurocardiogenic syncope

2010 ◽  
pp. 113-174
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Paroxysmal Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Acute Onset ◽  
Atrial Arrhythmias ◽  
Neurocardiogenic Syncope ◽  
Conduction Disturbances ◽  
Permanent Atrial Fibrillation ◽  
Onset Atrial Fibrillation

Atrial fibrillation 114 New (acute)-onset atrial fibrillation 116 Paroxysmal atrial fibrillation 118 Persistent atrial fibrillation 120 Permanent atrial fibrillation 122 Secondary atrial fibrillation 124 Drugs used in electrical and chemical cardioversion 126 Antithrombotic treatment 128 Atrial flutter 132 Supraventricular (narrow complex) tachycardias 134 Landmark trials for atrial arrhythmias ...

Abstract 13624: Perceived Health and Physical Activity among Patients treated with Ablation for Atrial Fibrillation or Atrial Flutter compared with a Healthy General Population - Results from a Nationwide Survey

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Signe S Risom ◽  
Selina K Berg ◽  
Anne V Christensen ◽  
Ann-Dorthe Zwisler ◽  
Jesper H Svendsen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
General Population ◽  
Atrial Flutter ◽  
Short Form ◽  
Perceived Health ◽  
Activity Levels ◽  
Sf 36 ◽  
Physical Activity Levels ◽  
Age And Sex

Introduction: Patients with atrial fibrillation (AF) or atrial flutter (AFL) report poor perceived health and avoidance behavior when suffering the arrhythmia. It is important to investigate if this perception and behavior changes after treatment with ablation, so that normality is regained. Objective: To describe patients’ perceived health and physical activity 6-12 months after ablation for AF or AFL and compare with an age- and sex- matched healthy general population. Methods: The nationwide cross-sectional survey was mailed to participants >18 years old who had been hospitalized for ablation for AF or AFL from January to June 2011. The patients were identified in the Danish National Patient Register (n=714). The mailed questionnaire included Short Form 36 (SF-36) and a question about physical activity and was sent in Dec 2011 to eligible patients (n=627). The nationally representative Danish Health Interview Survey 2005 was used to sample an age- and sex-matched reference population. Differences in perceived health (SF-36) were tested with t-test and chi2-test was used to determine the differences in physical activity levels. Results: The questionnaire was answered by 462 patients (74%). We found in all domains on SF-36 significantly lower scores for patients treated for AF and AFL compared with the reference group (p=0.0001) (see Table 1). Physical activity levels were also significantly lower for the patients treated for AF and AFL (p<0.0001). Conclusions: We found that patients treated for AF or AFL’s perceived health and physical activity levels were significantly impaired compared with a healthy general population. This is vital information for the health professional seeing the patients for follow-up after the ablation and rehabilitation should be considered.

Model assisted biosignal analysis of atrial electrograms

2016 ◽  
Vol 83 (2) ◽  
pp. 102-111
Author(s):  
Olaf Dössel ◽  
Gustavo Lenis ◽  
Axel Loewe ◽  
Markus Rottmann ◽  
Gunnar Seemann ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Data Analysis ◽  
Atrial Flutter ◽  
Human Heart ◽  
Plane Waves ◽  
Ground Truth ◽  
Atrial Arrhythmias ◽  
Biosignal Analysis ◽  
Electric Signals ◽  
Extract Information

Abstract Cardiologists measure electric signals inside the human heart aiming at a better diagnosis and optimized therapy of atrial arrhythmias like atrial flutter and atrial fibrillation. The catheters that are used for this purpose are improving: now they are able to pick up the electric signals at up to 64 positions inside the heart simultaneously. The patterns of electric depolarization are sometimes very simple, comparable to plane waves. But in case of patients with severe atrial arrhythmias they can be quite complex: U-turns around a line of block, ectopic centres, break throughs, reentry circuits, rotors, fractionated signals and chaotic patterns are often observed. Methods of biosignal analysis can support the cardiologists in classifying the signals and extract information of high diagnostic relevance. Computer models of the electrophysiology of the human heart can serve to design better algorithms for data analysis and to test algorithms, because the “ground truth” is known.

scholarly journals Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

2018 ◽  
Vol 7 (1) ◽  
pp. 43 ◽  
Author(s):  
Brett Wanamaker ◽  
Thomas Cascino ◽  
Vallerie McLaughlin ◽  
Hakan Oral ◽  
Rakesh Latchamsetty ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Hypertension ◽  
Atrial Flutter ◽  
Clinical Outcomes ◽  
Current Evidence ◽  
Atrial Arrhythmias ◽  
Practical Implications

Atrial arrhythmias, including atrial fibrillation and atrial flutter, are common in patients with pulmonary hypertension and are closely associated with clinical decompensation and poor clinical outcomes. The mechanisms of arrhythmogenesis and subsequent clinical decompensation are reviewed. Practical implications and current evidence for the management of atrial arrhythmias in patients with pulmonary hypertension are summarised.

scholarly journals Flecainide-Induced Atrial Flutter With 1:1 Conduction Complicated by Ventricular Fibrillation After Electrical Cardioversion

2021 ◽  
Vol 48 (2) ◽  
Author(s):  
Timothy Colangelo ◽  
Drew Johnson ◽  
Reginald Ho
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
High Risk ◽  
Ventricular Fibrillation ◽  
Atrial Flutter ◽  
Electrical Cardioversion ◽  
Emergency Medical Technicians ◽  
Atrial Arrhythmias ◽  
High Risk Patients ◽  
Risk Patients

Flecainide, a widely prescribed class IC agent used to treat atrial arrhythmias, can in rare cases cause 1:1 atrial flutter with rapid conduction. We describe the case of a 59-year-old man who was on a maintenance regimen of flecainide for refractory atrial fibrillation. When 1:1 atrial flutter with rapid conduction developed, emergency medical technicians attempted synchronized cardioversion, which caused ventricular fibrillation necessitating defibrillation. The patient ultimately underwent radiofrequency ablation and cryoablation to resolve his symptomatic atrial flutter. We discuss the atrial proarrhythmic effects of flecainide and how to mitigate complications in high-risk patients.

scholarly journals Subjective identification and ablation of drivers in persistent atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Franco ◽  
C Lozano-Granero ◽  
R Matia ◽  
A Hernandez-Madrid ◽  
I Sanchez-Perez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrium ◽  
Atrial Flutter ◽  
Pulmonary Vein ◽  
Persistent Atrial Fibrillation ◽  
Atrial Arrhythmias ◽  
Ablation Success ◽  
Tailored Approach ◽  
Approach Group

Abstract Background Ablation of drivers in persistent atrial fibrillation (AF) has shown controversial results. Purpose To test the efficacy of a tailored approach for persistent AF ablation which includes pulmonary vein isolation (PVI) plus “subjective” identification and ablation of drivers. Methods From May 2017 to December 2019, selected patients with persistent AF and ongoing AF at the beginning of the ablation procedure were included. Conventional high-density mapping catheters (PentaRay NAV, IntellaMap Orion or Advisor HD Grid) were used. Drivers were subjectively identified as: a) fractionated continuous (or quasi-continuous) electrograms on 1–2 adjacent bipoles, without dedicated software (Figure 1A, dashed line; PR = PentaRay NAV); and b) sites with spatiotemporal dispersion (i.e. all the cycle length comprised within the mapping catheter) plus non-continuous fractionation on single bipoles (Figure 1B, arrows; in panels A and B: paper speed 200 mm/s; ORB = 24-pole ORBITER Woven catheter, blue bipoles around tricuspid annulus and green bipoles into the coronary sinus). Ablation included PVI + focal or linear ablation targeting sites with drivers. Ablation success was defined as conversion to sinus rhythm or atrial flutter during ablation. Follow-up included visits with 24h Holter ECG at 3–6–12 months. Survival free from atrial arrhythmias lasting &gt;30 seconds was compared between patients ablated with this tailored approach, and all consecutive patients with persistent AF treated with a PVI-only strategy during the same period. Results 158 Patients received ablation: 35 with the tailored approach (61,7±10,2 years; 29% females) and 123 with only PVI (62,5±9,6 years; 25% females; 89% cryoablation). Basal characteristics were similar (Table 1). In the tailored-approach group, 14 patients (40%) presented 28 detectable sites with continuous fractionated electrograms, 26 on the left atrium and 2 on the right atrium, which was only mapped if ablation of drivers in the left atrium was not successful; 12 (43%) were located within the pulmonary vein antra. 27 patients (77%) showed 103 sites with spatiotemporal dispersion (4 [3–5] per patient). Ablation success was achieved in 17 patients (48%; conversion to sinus rhythm, n=7; conversion to atrial flutter, n=10) in the tailored-approach group and 1 patient (0,8%, sinus rhythm) in the PVI-only group. Excluding a 3-month blanking period, the tailored approach, compared to only PVI, improved one-year freedom from atrial arrhythmias (71% Vs 51%, p=0,05) and mean survival free from atrial arrhythmias (26±3 months; 95% CI 21–32 months Vs 18±2 months; 95% CI 15–22 months) (Figure 1C), at the cost of a longer median procedural time (246 [212–277] vs 108 [81–143] min, p&lt;0,001) and fluoroscopy time (51 [36–76] vs 33 [21–45] min, p&lt;0,001). Conclusion Subjective identification and ablation of drivers, added to PVI, improved freedom from atrial arrhythmias. FUNDunding Acknowledgement Type of funding sources: None. Table 1. Basal characteristics Figure 1

scholarly journals Frequency of Atrial Arrhythmias in the Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 15 (7) ◽  
pp. 1693-1696
Author(s):  
M. Mueed Yasin ◽  
A Zeeshan Khan Chachar ◽  
Sajjad Ali ◽  
Sajjad Ali ◽  
Asim M. Khan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Atrial Flutter ◽  
Atrial Tachycardia ◽  
Chronic Obstructive ◽  
Atrial Arrhythmias ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Medical Division

Background: Chronic obstructive pulmonary disease (COPD) has been linked with various kind of cardiac arrhythmias. The risk of arrhythmias in patients with COPD has been driven by the stage and disease state, with a higher frequency of supraventricular tachycardia during exacerbations. Aim: To evaluate the frequency of atrial arrhythmias (which include atrial fibrillation, atrial flutter, and multifocal atrial tachycardia) in the patients who were suffering from COPD. Methods: It was a cross sectional analysis or prevalence study. This research was piloted in the Medicine Department, Medical Division IV, Services Hospital, Lahore. This research was ended in 365 days after endorsement of synopsis from 1st June, 2017 to 30th May 2018. Results: In our study, 111(46.25%) were in range 40-55 years of age while 129(53.75%) were in range 56-70 years of age, the calculated mean standard deviation was 56.23±8.19 years, 134(55.83%) were male and 106(44.17%) were females, 142(59.17%) between 1-2 years and 98(40.83%) had >2 years of duration. Frequency of atrial arrhythmias in the patients who were suffering from COPD was recorded as 22(9.17%) having Atrial Fibrillation, 53(22.08%) had Atrial flutter and 31(12.92%) had Multifocal atrial tachycardia. Conclusion: Atrial arrhythmias are common findings in patients with COPD. So, it is very important for treating physicians that every patient having COPD, should undergo Electrocardiogram (ECG) for picking up the atrial arrhythmias. Keywords: Chronic obstructive pulmonary disease, atrial arrhythmias, frequency

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