scholarly journals B-PO05-148 ARTIFICIAL INTELLIGENCE-ENABLED ELECTROCARDIOGRAPHY TO DETECT ATRIAL FIBRILLATION IN SINUS RHYTHM: TREND OF PROBABILITY BEFORE AND AFTER PAROXYSMAL ATRIAL FIBRILLATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S432
Author(s):  
Georgios Christopoulos ◽  
Zachi I. Attia ◽  
Rickey E. Carter ◽  
Xiaoxi Yao ◽  
Holly K. Van Houten ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Before And After

scholarly journals Altered left atrial 4D flow characteristics in patients with paroxysmal atrial fibrillation in the absence of apparent remodeling

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahmet Demirkiran ◽  
Raquel P. Amier ◽  
Mark B. M. Hofman ◽  
Rob J. van der Geest ◽  
Lourens F. H. J. Robbers ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Flow Velocity ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Peak Flow ◽  
Thrombus Formation ◽  
Clinical Value ◽  
4D Flow ◽  
Ssfp Cine

AbstractThe pathophysiology behind thrombus formation in paroxysmal atrial fibrillation (AF) patients is very complex. This can be due to left atrial (LA) flow changes, remodeling, or both. We investigated differences for cardiovascular magnetic resonance (CMR)-derived LA 4D flow and remodeling characteristics between paroxysmal AF patients and patients without cardiac disease. In this proof-of-concept study, the 4D flow data were acquired in 10 patients with paroxysmal AF (age = 61 ± 8 years) and 5 age/gender matched controls (age = 56 ± 1 years) during sinus rhythm. The following LA and LA appendage flow parameters were obtained: flow velocity (mean, peak), stasis defined as the relative volume with velocities < 10 cm/s, and kinetic energy (KE). Furthermore, LA global strain values were derived from b-SSFP cine images using dedicated CMR feature-tracking software. Even in sinus rhythm, LA mean and peak flow velocities over the entire cardiac cycle were significantly lower in paroxysmal AF patients compared to controls [(13.1 ± 2.4 cm/s vs. 16.7 ± 2.1 cm/s, p = 0.01) and (19.3 ± 4.7 cm/s vs. 26.8 ± 5.5 cm/s, p = 0.02), respectively]. Moreover, paroxysmal AF patients expressed more stasis of blood than controls both in the LA (43.2 ± 10.8% vs. 27.8 ± 7.9%, p = 0.01) and in the LA appendage (73.3 ± 5.7% vs. 52.8 ± 16.2%, p = 0.04). With respect to energetics, paroxysmal AF patients demonstrated lower mean and peak KE values (indexed to maximum LA volume) than controls. No significant differences were observed for LA volume, function, and strain parameters between the groups. Global LA flow dynamics in paroxysmal AF patients appear to be impaired including mean/peak flow velocity, stasis fraction, and KE, partly independent of LA remodeling. This pathophysiological flow pattern may be of clinical value to explain the increased incidence of thromboembolic events in paroxysmal AF patients, in the absence of actual AF or LA remodeling.

scholarly journals Are Three Weeks of Oral Anticoagulation Sufficient for Safe Cardioversion in Atrial Fibrillation?

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 554
Author(s):  
Stefan Naydenov ◽  
Nikolay Runev ◽  
Emil Manov
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Open Label ◽  
Before And After ◽  
Individualized Approach ◽  
Baseline Factors ◽  
And Function

Background and Objectives: Patients with atrial fibrillation (AF), lasting >48 h, considered for cardioversion, are recommended ≥3 weeks of oral anticoagulation before sinus rhythm restoration because of high risk of development of left atrial thrombosis (LAT) and stroke. However, the optimal duration of anticoagulation in the presence of overt LAT is unknown. Materials and Methods: An open-label study aimed to investigate the prevalence of spontaneous echo contrast (SEC) and LAT before and after 3 weeks of direct oral anticoagulant (DOAC) treatment. We included 51 consecutive patients (50.9% males), mean age 69.3 ± 7.4 years with paroxysmal/unknown duration of AF, considered for cardioversion, who agreed to have transesophageal echocardiography at enrollment and 3 weeks later. Results: At baseline SEC was present in 26 (50.9%) and LAT in 10 (19.6%) of 51 patients. After 3 weeks on DOAC, SEC persisted in 12 (25.0%) and LAT in 7 (14.5%) of 48 patients, p < 0.05 vs. baseline. Factors, associated most strongly with persistence of SEC/LAT, were left atrial appendage (LAA) emptying velocity <20 cm/s (OR = 2.82), LAA lobes >2 (OR = 1.84), and indexed left atrial volume ≥34 mL/m2 (OR = 1.37). Conclusions: In our study the incidence of SEC/LAT, particularly in AF with unknown duration, was not as low as we expected. The prevalence of SEC/LAT seemed to be dependent on factors not routinely evaluated in AF patients planned for cardioversion (indexed LA volume, LAA morphology and number of lobules, LAA emptying velocity, etc.). Our data suggested an individualized approach for DOAC duration in AF patients before an attempt for restoration of sinus rhythm is made, taking into consideration the LAA morphology and function.

scholarly journals The value of class IC antiarrhythmic drugs for acute conversion of paroxysmal atrial fibrillation or flutter to sinus rhythm

1990 ◽  
Vol 16 (7) ◽  
pp. 1722-1727 ◽  
Author(s):  
Maarten J. Suttorp ◽  
J.Herre Kingma ◽  
Emile R. Jessurun ◽  
Loraine Lie-A-Huen ◽  
Norbert M. Van Hemel ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Drugs

scholarly journals MEDICATION FOR PHARMACOLOGICAL CARDIOVERSION OF PAROXYSMAL ATRIAL FIBRILLATION AT THE PREHOSPITAL STAGE: STUDY OF EFFICACY AND SAFETY

2018 ◽  
Vol 18 (4) ◽  
pp. 43-47
Author(s):  
I. Y. Lukianova ◽  
A. V. Kuzneztov ◽  
V. M. Komarnitzkii ◽  
A. G. Kozyreva
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Efficacy And Safety ◽  
Pharmacological Cardioversion

This study demonstrates the effectiveness of procainamide, propafenone and amiodaronefor pharmacological cardioversion in patients with paroxysmal atrial fibrillation. The restoration of the sinus rhythm within 60 minutes was observed for propafenone 73,2%, for procainamide 55,00% and for amiodarone 16,13% of cases.

scholarly journals Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1694
Author(s):  
Dimitrios Tachmatzidis ◽  
Dimitrios Filos ◽  
Ioanna Chouvarda ◽  
Anastasios Tsarouchas ◽  
Dimitrios Mouselimis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
P Wave ◽  
P Value ◽  
Wave Analysis ◽  
P Waves ◽  
History Of

Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF. To this end, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained from 33 consecutive, antiarrhythmic therapy naïve patients, with a short history of low burden PAF, and from 56 age- and sex-matched individuals with no AF history. For both groups, SPWIs were calculated, while the VCG recordings were analyzed on a B2B basis, and the P-waves were classified to a primary or secondary morphology. Wavelet transform was used to further analyze P-wave signals of main morphology. Univariate analysis revealed that none of the SPWIs performed acceptably in PAF detection, while five B2B features reached an AUC above 0.7. Moreover, multivariate logistic regression analysis was used to develop two classifiers—one based on B2B analysis derived features and one using only SPWIs. The B2B classifier was found to be superior to SPWIs classifier; B2B AUC: 0.849 (0.754–0.917) vs. SPWIs AUC: 0.721 (0.613–0.813), p value: 0.041. Therefore, in the studied population, the proposed B2B P-wave analysis outperforms SPWIs in detecting patients with PAF while in sinus rhythm. This can be used in further clinical trials regarding the prognosis of such patients.

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