- Clinical characteristics and outcome of lone atrial fibrillation at a tertiary referral centre: the Groote Schuur Hospital experience. [Journal Article]
- CJCardiovasc J Afr 2018 Sep/Oct; 29(5):268-272
- CONCLUSIONS: Lone AF is not an uncommon arrhythmia, with a preponderance in thin, middle-aged males. The symptoms of lone AF can be debilitating. It has associated morbidity, including tachycardia-related cardiomyopathy and thromboembolism. Rate control and appropriate anticoagulation are the cornerstones of patient management.
- Role of the monocyte-to-high-density lipoprotein ratio in predicting atrial high-rate episodes detected by cardiac implantable electronic devices. [Journal Article]
- NCNorth Clin Istanb 2018; 5(2):96-101
- CONCLUSIONS: The M/H ratio is an indicator of inflammation and oxidative stress, both of which play an important role in the pathogenesis of AF. This ratio was found to be statically higher in patients with AHREs detected by CIEDs than in those without AHREs.
- Sick Sinus Syndrome After the Maze Procedure Performed Concomitantly With Mitral Valve Surgery. [Journal Article]
- JAJ Am Heart Assoc 2018 Oct 02; 7(19):e009629
- Background To characterize the development of sick sinus syndrome ( SSS ) after the additive maze procedure ( MP ) during mitral valve surgery. Methods and Results Follow-up data (median, 3.6 years) ...
Background To characterize the development of sick sinus syndrome ( SSS ) after the additive maze procedure ( MP ) during mitral valve surgery. Methods and Results Follow-up data (median, 3.6 years) of 750 patients with a prevalence of rheumatic cause of 57.6% were analyzed. SSS occurred in 35 patients with a time-dependent increase: the incidence rates at 1, 2, and 4 years after surgery were 2.9%, 3.7%, and 4.3%, respectively. The additive MP showed higher risks of SSS development (hazard ratio, 7.44; 95% confidence interval, 3.45-16.05; P<0.001) and pacemaker implantation (hazard ratio, 3.61; 95% confidence interval, 1.95-6.67; P<0.001). Patients who developed SSS showed higher 4-year rates of clinical events (death, stroke, and hospital admission) (67.5±8.5% versus 33.0±1.9%; P<0.001). After adjustment for age and preoperative peak systolic pulmonary artery pressure, the lesion extent (biatrial versus left atrial MP ), not the underlying cause (rheumatic versus nonrheumatic), was independently associated with SSS development (hazard ratio, 3.58; 95% confidence interval, 1.08-11.86; P=0.037). The adverse effect of the biatrial MP was confirmed in patients with trivial or mild preoperative tricuspid regurgitation showing higher SSS incidence (4.6±1.4% versus 1.0±0.7%; P=0.023), not in those with moderate-to-severe tricuspid regurgitation (6.8±1.7% versus 3.8±3.8%; P=0.337). Recurrence of atrial fibrillation was not associated with the lesion extent of the MP . Conclusions After the additive MP , the ongoing risk of SSS development should be acknowledged irrespective of the underlying cause. Considering additive risk of biatrial MP with similar atrial fibrillation recurrence rate, minimizing lesion extent is warranted.
- Sex-Dependent Phenotypic Variability of an SCN5A Mutation: Brugada Syndrome and Sick Sinus Syndrome. [Journal Article]
- JAJ Am Heart Assoc 2018 Sep 18; 7(18):e009387
- Background Brugada syndrome ( BS ) is known to be 9 times more prevalent in males than females. However, little is known about the development of sick sinus syndrome in female members with familial B...
Background Brugada syndrome ( BS ) is known to be 9 times more prevalent in males than females. However, little is known about the development of sick sinus syndrome in female members with familial BS . Methods and Results Familial BS patients and family members, both from our institutions and collaborating sites that specialize in clinical care of BS , participated in this study. We collected information on their clinical and genetic background, along with the inheritance patterns of BS . Detailed information on each case with familial BS is described. A total of 7 families, including 25 BS patients (12 females and 13 males), were included. Seven were probands and 18 were family members. Ten out of the 12 female patients and none of the 13 male patients developed sick sinus syndrome. Sudden death or spontaneous ventricular fibrillation occurred in 7 out of 13 male patients and 2 out of 12 female patients. Conclusions Familial BS existed in which female patients developed sick sinus syndrome but male patients did not. Some of those female patients with sick sinus syndrome had unrecognized BS . Information should be collected not only regarding a family history of sudden death or BS , but also whether a pacemaker was implanted in female members.
- Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma. [Journal Article]
- BCBMJ Case Rep 2018 Oct 21; 2018
- Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, ma...
Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, malabsorption or bleeding. Furthermore, patients identified with GI amyloidosis, without previous diagnosis of a plasma cell disorder, are extremely rare. We report an elderly woman who presented with acute on chronic cardiac dysfunction, sick sinus syndrome and acute renal failure. While admitted, she developed intermittent dysphagia to both solids and liquids. Oesophagogastroduodenoscopy showed ulcerations of oesophagus and duodenum. Biopsies revealed focal amyloid deposition, stained with Congo red. Renal biopsy revealed amyloid deposition in renal arterioles. She underwent a bone marrow biopsy confirming MM, represented by more than 15% plasma cell population. She was started on treatment for heart failure, induction chemotherapy for MM and percutaneous gastrostomy tube for feeding. However, she continued to deteriorate, eventually opting for hospice, and ultimately died 2 days after discharge from hospital.
- Safety and efficacy of AAIR pacing in selected patients with sick sinus syndrome. [Journal Article]
- MMedicine (Baltimore) 2018; 97(42):e12833
- CONCLUSIONS: This study looks at safety of AAIR pacemakers with only 2.4% of patients developing AV block requiring urgent upgrade. Approximately 91.8% of patients remained with their original AAIR pacemakers (mean follow-up 10.6 vs 5.4 years in DANPACE). Our findings are similar to the DANPACE study but our conclusions are different as we believe AAIR pacing should be considered for selected patients with sick sinus syndrome without AV block.
- The limitations and potential adverse effects of the premature ventricular contraction response. [Journal Article]
- JAJ Arrhythm 2018; 34(5):572-575
- A 69-year-old man, who had undergone surgery for mitral and tricuspid regurgitation with the Maze procedure for paroxysmal atrial fibrillation, was admitted with an episode of syncope due to sick sin...
A 69-year-old man, who had undergone surgery for mitral and tricuspid regurgitation with the Maze procedure for paroxysmal atrial fibrillation, was admitted with an episode of syncope due to sick sinus syndrome. Three days after implantation of a dual-chamber pacemaker (Accent MRI™, St. Jude Medical Inc.,), ventricular pacing on T-wave was recorded multiple times. St. Jude Medical Inc. pacemakers have a unique additional algorithm, called premature ventricular contraction response, related to preventing pacemaker-mediated tachycardia. This algorithm was determined to be a cause of ventricular pacing on T-wave. We report the limitations and potential adverse effects of such automated algorithms.
- Tbx18 sets the pace. [Journal Article]
- JPJ Physiol 2018 Oct 15
- Takotsubo syndrome with severe bradycardia initiated by seizure: Is the implantation of a permanent pacemaker necessary? [Journal Article]
- BCBMJ Case Rep 2018 Oct 12; 2018
- Although arrhythmias are frequent in patients with Takotsubo syndrome (TTS), data on sick sinus syndrome remain elusive. Here, we report a case of TTS initiated by a seizure as a physical trigger tha...
Although arrhythmias are frequent in patients with Takotsubo syndrome (TTS), data on sick sinus syndrome remain elusive. Here, we report a case of TTS initiated by a seizure as a physical trigger that led to sinus arrest. The patient presented with cardiogenic shock and bradycardia which required intensive cardiovascular care. However, in the subacute phase of TTS, the sinus function recovered significantly, and pacemaker implantation was deferred.
New Search Next
- Home Monitoring for Fetal Heart Rhythm During Anti-Ro Pregnancies. [Journal Article]
- JACCJ Am Coll Cardiol 2018 Oct 16; 72(16):1940-1951
- CONCLUSIONS: Home FHRM confirms the rapid progression of normal rhythm to AVB and can define a window of time for successful therapy. (Prospective Maternal Surveillance of SSA [Sjögren Syndrome A] Positive Pregnancies Using a Hand-held Fetal Heart Rate Monitor; NCT02920346).