scholarly journals Lack of effect of statins on maintenance of normal sinus rhythm following electrical cardioversion of persistent atrial fibrillation

2010 ◽  
Vol 64 (8) ◽  
pp. 1116-1120 ◽  
Author(s):  
A. Bhardwaj ◽  
N. A. Sood ◽  
J. Kluger ◽  
C. I. Coleman
2022 ◽  
Vol 2022 ◽  
pp. 1-4
Author(s):  
Joshua H. Arnold ◽  
Neil Brandon

We present the case of a 61-year-old male who developed persistent hiccups concurrently with the onset of atrial fibrillation (AF). The hiccups were refractory to traditional treatment but resolved immediately upon electrical cardioversion (ECV) to normal sinus rhythm (NSR). The patient has remained in NSR and free of hiccups. The potential etiologies for hiccups are numerous and varied, and the management of persistent hiccups can be difficult. Cardiac associations including myocardial infarction and pericarditis have been described, while few cases of first-time onset of atrial fibrillation leading to hiccups have been documented. This case discusses a unique instance demonstrating a connection between hiccups and cardiac pathology and an overview of its management.


2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Brian Doyle ◽  
Mark Reeves

Objective. Acute atrial fibrillation often spontaneously resolves. This study aimed to investigate the outcomes and satisfaction of an evidence-based ED protocol employing a “wait and see” approach.Methods. A prospective observational cohort study of adult patients presenting to the Emergency Department with stable acute atrial fibrillation was performed. Patients were excluded if they were considered to be unstable, need hospitalization, or poor candidates for ED procedural sedation. Routine care was provided on the index visit, and suitable candidates were discharged and asked to return to the ED the following day for possible electrical cardioversion. Outcome measures included spontaneous reversion to sinus rhythm, success of cardioversion, length of stay, adverse event and return visits for AF within 30 days, and patient satisfaction.Results. Thirty five patient encounters were analysed over a 21-month period. Twenty two of the 35 patients (63%) had spontaneous resolution of atrial fibrillation upon presentation for potential cardioversion. All of the remaining patients underwent successful cardioversion to normal sinus rhythm without significant adverse events recorded. No patients required hospitalization. Three patients (9%) returned to the ED within 30 days for recurrence of atrial fibrillation. All patients were reported to be “very satisfied” with this approach.Conclusion. A “wait and see” approach to the ED electrical cardioversion of atrial fibrillation showed that almost two-thirds of patients had spontaneous resolution without requiring cardioversion or observation in the ED or hospital. All patients were successfully reverted to normal sinus rhythm and had a high degree of satisfaction.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
ANL Hermans ◽  
NAHA Pluymaekers ◽  
TAR Lankveld ◽  
MJW Van Mourik ◽  
S Zeemering ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background. Knowledge about the association between symptoms and rhythm status (symptom-rhythm correlation) has potential clinical implications as it may identify patients with atrial fibrillation (AF) who profit from rhythm control in regard to reduction in symptom burden and improvement in quality of life. However, standardized strategies to assess symptom-rhythm correlation in AF patients are currently not available. Purpose. This study aimed to assess symptom-rhythm correlation in patients with persistent AF using electrical cardioversion (ECV) as a diagnostic probe. Methods. We used ECV to examine symptom-rhythm correlation in 81 patients with persistent AF. The presence of self-reported symptoms before ECV and at the first outpatient AF clinic follow-up visit (within 1-month) was assessed to determine the prevalence of a symptom-rhythm correlation (defined as self-reported symptoms present during AF and absent in sinus rhythm or absent in AF and yet relief during sinus rhythm). The symptom-rhythm correlation was absent in patients with symptoms before ECV who remained symptomatic during sinus or in patients with symptoms prior to ECV and without symptoms in AF after ECV. Asymptomatic patients before ECV with or without symptoms in AF or sinus rhythm afterwards had no symptom-rhythm correlation as well. The symptom-rhythm correlation was unevaluable in patients who were symptomatic in AF before ECV and at the first outpatient AF clinic follow-up visit. In addition, predominant self-reported symptoms (symptoms with highest self-reported symptom burden) were assessed to evaluate the symptom patterns around ECV. Intra-individually variable symptom patterns were defined as changes in predominant self-reported symptoms within patients around ECV. Results. Symptom-rhythm correlation was assessed in all patients. Only in 18 patients (22%), a symptom-rhythm correlation could be documented. Twenty-eight patients (35%) did not show any symptom-rhythm correlation and 35 patients (43%) had an unevaluable symptom-rhythm correlation as these patients were in symptomatic AF both at baseline and at the first outpatient AF clinic follow-up visit. Importantly, self-reported symptom patterns around ECV were intra-individually variable in 10 patients (12%) without symptom-rhythm correlation (of which 9 patients (11%) had AF recurrence) and in 2 patients (2%) with an unevaluable symptom-rhythm correlation. Conclusions. In patients with persistent AF, the prevalence of a symptom-rhythm correlation around ECV is low, but ECV often changes symptom pattern. Further studies are warranted to identify more optimal strategies to assess symptom-rhythm correlation in patients with persistent AF. Abstract Figure. Symptom-rhythm correlation and patterns


2018 ◽  
Vol 7 (2.24) ◽  
pp. 453
Author(s):  
S. Sathish ◽  
K Mohanasundaram

Atrial fibrillation is an irregular heartbeat (arrhythmia) that can lead to the stroke, blood clots, heart failure and other heart related complications. This causes the symptoms like rapid and irregular heartbeat, fluttering, shortness of breath etc. In India for every around 4000 people eight of them are suffering from Atrial Fibrillation. P-wave Morphology.  Abnormality of P-wave (Atrial ECG components) seen during sinus rhythm are associated with Atrial fibrillation. P-wave duration is the best predictor of preoperative atrial fibrillation. but the small amplitudes of atrial ECG and its gradual increase from isometric line create difficulties in defining the onset of P wave in the Standard Lead Limb system (SLL).Studies shows that prolonged P-wave have duration in patients (PAF) In this Study, a Modified Lead Limb (MLL) which solves the practical difficulties in analyzing the P-ta interval for both in healthy subjects and Atrial Fibrillation patients. P-Ta wave interval and P-wave duration can be estimated with following proposed steps which is applicable for both filtered and unfiltered atrial ECG components which follows as the clinical database trials. For the same the p-wave fibrillated signals that escalates the diagnosis follows by providing minimal energy to recurrent into a normal sinus rhythm.  


2019 ◽  
Vol 89 (3) ◽  
Author(s):  
Renato De Vecchis ◽  
Andrea Paccone ◽  
Marco Di Maio

In the present retrospective cohort study, we have evaluated the missed or delayed atrial mechanical recovery in a population of patients with persistent or long-lasting persistent AF who achieved restoration of sinus rhythm on the ECG by electrical cardioversion (ECV).  The endpoint of our   study was   the failure to recover the normal mechanics of the left atrium.  Inclusion criterion was the persistent or long-lasting persistent atrial fibrillation successfully treated by means of    ECV , provided that  a pertinent documentation  was made available, comprising ECG, conventional 2D echo-color-Doppler and   speckle tracking echocardiography(STE)  evaluation, with also a STE assessment  of the atria at the days 1, 30 and 90  from the ECV freely available within  the clinical record  of the patient. Out of a total of 80 patients with persistent or long-standing persistent AF, retrospectively enrolled, as many as  22.5% of them did not achieve the normalization of their  atrial STE profile, even though they had been converted to sinus rhythm on the ECG by means of ECV.  The building of ROC curves allowed us to establish that early measurements of global atrial strain could serve to predict  both the risk of failure to recover the atrial mechanical function and the one of AF relapses over a 12 month follow-up. The   values of 18% and 17% were also calculated  to serve as cut off values, respectively,  for the risk  of atrial mechanical dysfunction and for the risk of AF  relapses over a 12 month follow-up. Failure to recover the atrial reservoir function can accompany a restoration of sinus rhythm on the ECG in patients with long-standing persistent AF. In this case, a serial STE evaluation could be useful to evaluate the atrial hypofunction over time.


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