A Case Report of Atrial Fibrillation Potentially Induced by Hydroxycut

2010 ◽  
Vol 23 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Abigail Karth ◽  
Noa Holoshitz ◽  
Clifford J. Kavinsky ◽  
Richard Trohman ◽  
Brian F. McBride
Keyword(s):  
Atrial Fibrillation ◽  
Weight Loss ◽  
De Novo ◽  
Normal Sinus Rhythm ◽  
Regulatory Oversight ◽  
Normal Sinus ◽  
Patients At Risk ◽  
Ventricular Response ◽  
History Of ◽  
Dietary Weight Loss

Multicomponent dietary weight loss supplements comprise the single largest segment of herbal preparations available to the public. As a result of limited de novo regulatory oversight, supplement-related adverse events are underreported secondary to the lack of adequate pharmacodynamic, pharmacokinetic, and clinical data. Here we report the case of an obese 63-year-old caucasian female with a 2-day history of symptomatic paroxysmal atrial fibrillation (AF) with rapid ventricular response following a 2-week course of therapy with hydroxycut, a multicomponent dietary weight loss supplement devoid of sympathomimetic amines. Upon presentation, the patient received 2 doses of intravenous diltiazem, was loaded with intravenous digoxin, and spontaneously converted to normal sinus rhythm 36 hours following her last dose of the product. Epigallocatechin (EGCG), a principal ingredient in the hydroxycut preparation is the suspected causative component. EGCG blocks the atrial-specific KCNA5 potassium channel. Loss of KCNA5 function has been reported in patients with familial lone AF. Thus, causal relationship between hydroxycut and AF in this patient is probable. Given the serious risks associated with AF, patients at risk of developing AF should avoid dietary supplements containing EGCG until more information on the adverse effects of EGCG is known.

Atrial fibrillation in a healthy adolescent after heavy smoking of contraband cigarettes

2015 ◽  
Vol 27 (3) ◽  
pp. 353-356 ◽  
Author(s):  
Isa Ozyilmaz ◽  
Sinem Ozyilmaz ◽  
Oyku Tosun ◽  
Hasan Tahsin Tola ◽  
Murat Saygi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Normal Sinus Rhythm ◽  
Public Health Problem ◽  
Tobacco Products ◽  
Heavy Smoking ◽  
Healthy Adolescent ◽  
Normal Sinus ◽  
Ventricular Response ◽  
History Of ◽  
Contraband Cigarettes

Abstract The use of contraband cigarettes is a serious public health problem. We present a case of atrial fibrillation in a healthy adolescent suspected to be caused by smoking contraband cigarettes. A 15-year-old man was admitted to our emergency department experiencing syncope and palpitations. He was a cigarette smoker, but he had never smoked any illicit tobacco products before. He had finished a pack of counterfeit cigarettes (20 pieces) in 1.5 h. His electrocardiogram showed atrial fibrillation with a rapid ventricular response and irregular RR intervals. The patient had no history of alcohol use, surgery, palpitations, hypertension, chronic bronchitis, or any infectious diseases. His atrial fibrillation was converted to a normal sinus rhythm after the cardioversion treatment. Our patient was discharged from the pediatric cardiology service and advised to quit smoking cigarettes, strictly warning against illicit tobacco products. In conclusion, intensive smoking of counterfeit cigarettes may lead to occurrences of atrial fibrillation.

scholarly journals Spectral characteristics of ventricular response to atrial fibrillation

1997 ◽  
Vol 273 (6) ◽  
pp. H2811-H2816 ◽  
Author(s):  
Junichiro Hayano ◽  
Fumiyasu Yamasaki ◽  
Seiichiro Sakata ◽  
Akiyoshi Okada ◽  
Seiji Mukai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Normal Sinus Rhythm ◽  
Spectral Characteristics ◽  
Short Term ◽  
Spectral Exponent ◽  
Linear Pattern ◽  
Regulatory Processes ◽  
Normal Sinus ◽  
Ventricular Response

To investigate the spectral characteristics of the fluctuation in ventricular response during atrial fibrillation (AF), R-R interval time series obtained from ambulatory electrocardiograms were analyzed in 45 patients with chronic AF and in 30 age-matched healthy subjects with normal sinus rhythm (SR). Although the 24-h R-R interval spectrum during SR showed a 1/ f noise-like downsloping linear pattern when plotted as log power against log frequency, the spectrum during AF showed an angular shape with a breakpoint at a frequency of 0.005 ± 0.002 Hz, by which the spectrum was separated into long-term and short-term components with different spectral characteristics. The short-term component showed a white noise-like flat spectrum with a spectral exponent (absolute value of the regression slope) of 0.05 ± 0.08 and an intercept at 10−2 Hz of 4.9 ± 0.3 log(ms2/Hz). The long-term component had a 1/ f noise-like spectrum with a spectral exponent of 1.26 ± 0.40 and an intercept at 10−4 Hz of 7.0 ± 0.3 log(ms2/Hz), which did not differ significantly from those for the spectrum during SR in the same frequency range [spectral exponent, 1.36 ± 0.06; intercept at 10−4 Hz, 7.1 ± 0.3 log(ms2/Hz)]. The R-R intervals during AF may be a sequence of uncorrelated values over the short term (within several minutes). Over the longer term, however, the R-R interval fluctuation shows the long-range negative correlation suggestive of underlying regulatory processes, and spectral characteristics indistinguishable from those for SR suggest that the long-term fluctuations during AF and SR may originate from similar dynamics of the cardiovascular regulatory systems.

scholarly journals TO DETERMINE THE ROLE OF RANOLAZINE FOR RHYTHM CONTROL STRATEGY IN PATIENTS WITH NON- VALVULAR ATRIAL FIBRILLATION- AN OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER. (RANOVA STUDY)

2020 ◽  
pp. 48-53
Author(s):  
Praveen Shukla ◽  
Awadhesh Kumar Sharma ◽  
Biswajit Majumder ◽  
Pritam Kumar Chatterjee ◽  
Vinay Krishna ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Control Strategy ◽  
Normal Sinus Rhythm ◽  
Rhythm Control ◽  
Normal Sinus ◽  
History Of ◽  
Group A ◽  
Group B

Objectives – Non- valvular atrial fibrillation (NVAF) is the most commonly occurring arrhythmia worldwide .Ranolazine is an emerging drug with a ray of hope in the management of NVAF. This is the first large observational study with longer follow up of one year. Methods - It is a hospital based observational prospective study. A total of 100 patients was recruited for the study .The primary objective was to determine the efficacy of ranolazine in converting NVAF to sinus rhythm & the secondary objective was to study epidemiological aspects of NVAF. Results –After 1 month of follow up conversion to normal sinus rhythm was 12% in group A & 6% in group B (6%), it was not significant statistically (Z=1.48p=0.13). After 6 months, conversion to normal sinus rhythm was increased from 12% to 18% in group A which was preserved at 12 months of follow up and statistically significant and higher than that of group B (6.0%) (Z=2.61p=0.009). In predisposing risk factors & other co-morbidities HTN was present in 61%, obesity together with overweight in 37%, smoking in 44%, history of moderate amount of alcohol intake in 35%, history of CVA/TIA in 13%, DM in 11%, CKD in 4%, CAD in 30%, COPD in 20% and congestive heart failure in 15% of the patients. Conclusion- Ranolazine is an effective option when used for rhythm control strategy in NVAF. HTN is the predominant predisposing risk factor.

Bradyarrhythmia secondary to vagus nerve stimulator 7 years after placement

2020 ◽  
Vol 13 (6) ◽  
pp. e235514
Author(s):  
Haresh Gandhi ◽  
Michelina Ippoliti ◽  
Farrukh Iqbal ◽  
Ajay Shah
Keyword(s):  
Normal Sinus Rhythm ◽  
Preoperative Evaluation ◽  
Transoesophageal Echocardiography ◽  
Conduction Delay ◽  
Nerve Stimulator ◽  
Loop Recorder ◽  
Vagal Nerve Stimulator ◽  
Normal Sinus ◽  
Ventricular Response ◽  
History Of

We present a case of a 38-year-old man with a previous medical history of asthma and refractory epilepsy requiring vagal nerve stimulator (VNS) placement 7 years prior to the presentation who was found to be in atrial fibrillation with a rapid ventricular response during a preoperative evaluation, which prompted transoesophageal echocardiography and subsequent cardioversion. In preparation for cardioversion, the VNS was turned off and the patient was cardioverted to normal sinus rhythm. Following cardioversion, the VNS was activated again. During recovery, the patient was experiencing several episodes of first-degree and second-degree Mobitz type-II atrioventricular (AV) block. In response, the VNS was deactivated indefinitely. On interrogation of a loop recorder 2 weeks after discharge, the patient did not have any further evidence of AV conduction delay.

Congenital Left Atrial Aneurysm

1993 ◽  
Vol 1 (4) ◽  
pp. 180-183
Author(s):  
Naresh Trehan ◽  
Zile Singh Meharwal ◽  
Vijay Kumar Sharma
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
History Of

A 13–year-old boy, who presented with a 4-year history of breathlessness and palpitation, was admitted with atrial fibrillation. Left atrial aneurysm was diagnosed with echocardiography and angiography. After excision of the aneurysm, the patient became asymptomatic and was in normal sinus rhythm.

Abstract P708: Artificial Intelligence Enabled-Electrocardiography for the Detection of Cerebral Infarcts in Patients With Atrial Fibrillation

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Erika Weil ◽  
Peter Noseworthy ◽  
Alejandro Rabinstein ◽  
Paul Friedman ◽  
Camden Lopez ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Continuous Measure ◽  
Cerebral Infarcts ◽  
Normal Sinus ◽  
History Of ◽  
Ecg Score ◽  
Age And Sex

Background: Atrial fibrillation (AF) is an established risk factor for ischemic stroke, but it can be paroxysmal and may go undiagnosed. An artificial intelligence (AI)-enabled ECG acquired during normal sinus rhythm was recently shown to detect silent AF. The objective of this study was to determine if AI-ECG AF score is associated with presence of cerebral infarcts. Methods: Participants from a population-based study ages 30 to 95 years with T2 fluid attenuation inversion recovery (FLAIR) MRI obtained between October 10, 2011, and November 2, 2017 were considered for inclusion. Participants without ECG were excluded. AI-ECG score was calculated using most recent ECG with normal sinus rhythm at the time of MRI. Presence of infarcts was determined on FLAIR MRI scans. Logistic regression was run to evaluate the relationship between AI-ECG AF score and presence of cerebral infarcts. Similar analyses were performed using history of AF rather than AI-ECG AF score as predictor. Age and sex were included as covariates. We also examined whether a high-threshold AI-ECG score was associated with infarcts. In a prior study, an AI-ECG AF score > 0.5 was associated with a cumulative incidence of AF of 21.5% at 2 years and 52.2% at 10 years. Results: This study included 1,373 individuals. Average age was 69.6 years and 53% of participants were male. There were 136 (10%) individuals with ECG-confirmed AF; 1237 (90%) participants had no AF history. Of participants with AF, 23% (n=31) were on anticoagulation, 47% (n=64) were on antiplatelet and 18% (n=24) were on dual therapy. Only 1.3% (n=16) of patients without AF were on anticoagulation and 47% (n=578) were on antiplatelet therapy. Ischemic infarcts were detected in 214 (15.6%) patients. As a continuous measure AI-ECG was associated with infarcts but not after adjusting for age and sex (p=0.46). AI-ECG AF score > 0.5 was associated with infarcts ( p < 0.001); even after adjusting for age and sex ( p = 0.03). History of AF was also associated with infarcts after adjusting for age and sex ( p = 0.018). Conclusion: AI-ECG AF score and history of AF were associated with presence of cerebral infarcts after adjusting for age and sex. This tool could be useful in select patients with cryptogenic stroke but further investigation would be required.

scholarly journals Left ventricular ejection fraction reduction due to atrial fibrillation: clinical and echocardiographic predictors

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
E Marcusohn ◽  
O Kobo ◽  
M Postnikov ◽  
D Epstein ◽  
Y Agmon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Prosthetic Valves ◽  
Ventricular Response ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background  The diagnosis of atrial fibrillation (AF) induced cardiomyopathy can be challenging. It relies on ruling out other causes of dilated cardiomyopathy, upon recovery of left ventricular ejection fraction (LVEF) following return to sinus rhythm (SR). Aim  The aim of this study was to identify clinical and echocardiographic predictors for developing new dilated cardiomyopathy in patients with AF or atrial flutter (AFL). Methods  This is a retrospective study conducted in a large tertiary care center. Patients that suffered deterioration of LVEF under 50% during AF demonstrated by pre-cardioversion trans-esophageal echocardiography (TEE) were compared to those with preserved LV function during AF. All patients had documented preserved LVEF at baseline (EF &gt;50%) while in SR. Patients with a previous history of reduced LVEF during SR were excluded. Results From a total of 482 patients included in the final analysis, 80 (17%) patients had reduced LV function and 402 (83%) had preserved LV function during the pre-cardioversion TEE. Patients with reduced LVEF were more likely to be male and with a more rapid ventricular response during AF/AFL. A history of prosthetic valves was also identified as a risk factor for reduced LVEF. Patients with reduced LVEF also had higher incidence of TR and RV dysfunction. Conclusion In "real world" experience, male patients with rapid ventricular response during AF or AFL are more prone to LVEF reduction. Patients with prosthetic valves are also at risk for LVEF reduction during AF/AFL. Lastly, TR and RV dysfunction may indicate relatively long-standing AF with an associated reduction in LVEF.

scholarly journals TASK-1 current is inhibited by phosphorylation during human and canine chronic atrial fibrillation

2015 ◽  
Vol 308 (2) ◽  
pp. H126-H134 ◽  
Author(s):  
Erin Harleton ◽  
Alessandra Besana ◽  
Parag Chandra ◽  
Peter Danilo ◽  
Tove S. Rosen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Normal Sinus Rhythm ◽  
Human Subjects ◽  
Phosphorylation Site ◽  
Chronic Atrial Fibrillation ◽  
Resting Membrane Potential ◽  
Atrial Remodeling ◽  
Protein Levels ◽  
Atrial Tissue ◽  
Normal Sinus

Atrial fibrillation (AF) is a common arrhythmia with significant morbidities and only partially adequate therapeutic options. AF is associated with atrial remodeling processes, including changes in the expression and function of ion channels and signaling pathways. TWIK protein-related acid-sensitive K+ channel (TASK)-1, a two-pore domain K+ channel, has been shown to contribute to action potential repolarization as well as to the maintenance of resting membrane potential in isolated myocytes, and TASK-1 inhibition has been associated with the induction of perioperative AF. However, the role of TASK-1 in chronic AF is unknown. The present study investigated the function, expression, and phosphorylation of TASK-1 in chronic AF in atrial tissue from chronically paced canines and in human subjects. TASK-1 current was present in atrial myocytes isolated from human and canine hearts in normal sinus rhythm but was absent in myocytes from humans with AF and in canines after the induction of AF by chronic tachypacing. The addition of phosphatase to the patch pipette rescued TASK-1 current from myocytes isolated from AF hearts, indicating that the change in current is phosphorylation dependent. Western blot analysis showed that total TASK-1 protein levels either did not change or increased slightly in AF, despite the absence of current. In studies of perioperative AF, we have shown that phosphorylation of TASK-1 at Thr383 inhibits the channel. However, phosphorylation at this site was unchanged in atrial tissue from humans with AF or in canines with chronic pacing-induced AF. We conclude that phosphorylation-dependent inhibition of TASK-1 is associated with AF, but the phosphorylation site responsible for this inhibition remains to be identified.

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