058 * BETTER SINUS RHYTHM RESTORATION AND CONGESTIVE HEART FAILURE PROTECTION OF LEFT ATRIUM VOLUME REDUCTION IN A GIANT LEFT ATRIUM

A 70-year-old man who developed dilated cardiomyopathy with persistent atrial fibrillation (PSAF) was admitted to our hospital. He was already drug-resistant. The left atrium (LA) was severely enlarged. The left ventricular ejection fraction (LVEF) was 39%, and contraction was severely reduced. For AF ablation, catheter ablation (CA) was used for mild to moderate LV dysfunction without severe left atrial dilatation. In severe LV dysfunction, excessive intravenous drip volume may precipitate congestive heart failure. On the other hand, shorter isolation time has been reported with balloon ablation as compared to CA. Therefore, the intravenous drip volume is small. We planned to use the balloon technique for a patient with LA dilatation and severe LV dysfunction despite another hospital not having done so. After the procedure, the pulmonary veins were successfully isolated, and congestive heart failure recovered after sinus rhythm termination. There was no recurrence of AF after the procedure. Hot balloon ablation can be effective for PSAF with severe heart failure.

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Tangential Triangular Resection An Option to Treat the Giant Left Atrium

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3181d8c55c ◽

2010 ◽

Vol 5 (2) ◽

pp. 125-127

Author(s):

Pablo M. A. Pomerantzeff ◽

Carlos M. A. Brandão ◽

Marco A. V. Guedes ◽

Noedir A. G. Stolf

Keyword(s):

Heart Failure ◽

Magnetic Resonance ◽

Left Atrium ◽

Pulmonary Veins ◽

Posterior Wall ◽

Magnetic Resonance Study ◽

Tricuspid Insufficiency ◽

Size Evolution ◽

Giant Left Atrium ◽

Left Atrium Size

A 21-year-old woman presented with congestive heart failure caused by congenital mitral and tricuspid insufficiency, associated with great left atrium enlargement. Transthoracic echo-cardiogram revealed heart dextroversion associated with mitral and tricuspid severe insufficiency and left atrium enlargement (14 cm), confirmed by magnetic resonance study. The left atrium was reduced by a tangential triangular resection of the posterior wall, between the pulmonary veins, suturing the edges of the left atrium with bovine pericardium strip reinforcement. Mitral and tricuspid valves were repaired. The postoperative course was uneventful, and the patient was discharged in the 15th postoperative day. A control magnetic resonance study revealed a 50% reduction in left atrium size. Evolution of left atrium resection is excellent, with low recurrence of arrhythmias, embolism, or heart failure.

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Digitalis for treatment of congestive heart failure in patients in sinus rhythm

10.1002/14651858.cd002901 ◽

2001 ◽

Cited By ~ 3

Author(s):

WB Hood ◽

AL Dans ◽

GH Guyatt ◽

R Jaeschke ◽

JJV McMurray

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Sinus Rhythm

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Nonlinear Characterization of Heart Rate Variability in Normal Sinus Rhythm, Atrial Fibrillation and Congestive Heart Failure

Volume 3: Biomedical and Biotechnology Engineering ◽

10.1115/imece2016-66836 ◽

2016 ◽

Author(s):

Syed Hassan Zaidi ◽

Imran Akhtar ◽

Syed Imran Majeed ◽

Tahir Zaidi ◽

Muhammad Saif Ullah Khalid

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Heart Rate ◽

Congestive Heart Failure ◽

Heart Rate Variability ◽

Sinus Rhythm ◽

Time Series Data ◽

Normal Sinus Rhythm ◽

Series Data ◽

Normal Sinus

This paper highlights the application of methods and techniques from nonlinear analysis to illustrate their far superior capability in revealing complex cardiac dynamics under various physiological and pathological states. The purpose is to augment conventional (time and frequency based) heart rate variability analysis, and to extract significant prognostic and clinically relevant information for risk stratification and improved diagnosis. In this work, several nonlinear indices are estimated for RR intervals based time series data acquired for Healthy Sinus Rhythm (HSR) and Congestive Heart Failure (CHF), as the two groups represent different cases of Normal Sinus Rhythm (NSR). In addition to this, nonlinear algorithms are also applied to investigate the internal dynamics of Atrial Fibrillation (AFib). Application of nonlinear tools in normal and diseased cardiovascular states manifest their strong ability to support clinical decision support systems and highlights the internal complex properties of physiological time series data such as complexity, irregularity, determinism and recurrence trends in cardiovascular regulation mechanisms.

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