scholarly journals A study of the clinical profile of atrial fibrillation in a tertiary care super-specialty referral centre in Central Nepal

2013 ◽  
Vol 8 (3) ◽  
pp. 9-16
Author(s):  
MP Gautam ◽  
S Gautam ◽  
S Guru Prasad ◽  
G Subramanyam ◽  
U Ghimire
Keyword(s):  
Atrial Fibrillation ◽  
Tertiary Care ◽  
Clinical History ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Medical Sciences ◽  
Lone Atrial Fibrillation ◽  
Common Cause ◽  
Echocardiographic Study ◽  
Surface Ecg

Background The conventional causes and risk factors for atrial fibrillation (AF) are somewhat arbitrary; overlap exists, multiple aetiologies are often present in one individual, and clinical presentation is non- specific. This study was an attempt to study the clinical and echocardiographic profile of patients with AF in a tertiary care super-specialty hospital of a developing country. Materials and Methods This study was conducted in College of Medical Sciences, Chitwan, Nepal throughout the year 2010. Subjects with AF, diagnosed based on clinical history, medical records and surface ECG, were included in the study. The presentation, types and causes of AF and structural as well as functional abnormalities were assessed. Results A total of 136 consecutive subjects were included in the study. The mean age was 42.40 (20.48) years ranging from 17 to 80 years. Majority of the AF subjects were female (54.41%). Among symptomatic cases, palpitation was the most common (23.53%) presentation followed by dyspnea (17.65%) and stroke or transient ischemic attack (15.44%). Asymptomatic presentation was also not uncommon (25%). Persistent AF was the most common form (31.62%). Rheumatic heart disease was the most common cause (33.09%) followed by lone atrial fibrillation (23.52%), coronary artery disease (16.18%), hypertension (8.82%) and thyrotoxicosis (7.35%). Other causes included chronic obstructive airway disease (5.88%), diabetes (2.94%), cardiomyopathy (1.47%), constrictive pericarditis (1.47%), myocarditis (0.74%) and infective endocarditis (0.74%). Nearly 65 % subjects had either structural or functional abnormalities in echocardiographic study; dilated left atrium was the most prevalent abnormality. Conclusion In contrast to the studies reported from developed nations, our subjects with AF were younger and female, the most common cause was RHD and the majority had either structural or functional abnormalities in echocardiographic study. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 9-16 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8679

The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation: Literature review

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Rodríguez Miguel ◽  
◽  
Chinta Siddharth ◽  
Vittorio Timothy ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
The Other ◽  
Beta Agonist ◽  
Beta Blockade ◽  
Chronic Obstructive ◽  
Agonist Therapy ◽  
Obstructive Pulmonary Disease

Background: New advances have been made in medicine, but the incidence and prevalence of Chronic Obstructive Pulmonary Disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and beta-receptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1-selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient. Keywords: atrial fibrillation; pulmonary disease; obstructive pulmonary disease; chronic obstructive pulmonary disease (COPD); B-Agonist; B-Block (selective; non-selective); digitalis; other antiarrhythmic.

scholarly journals Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation

EP Europace ◽  
2000 ◽  
Vol 2 (1) ◽  
pp. 32-41 ◽  
Author(s):  
P.G. Platonov ◽  
J. Carlson ◽  
M.P. Ingemansson ◽  
A. Roijer ◽  
A. Hansson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Template Matching ◽  
P Wave ◽  
Control Group ◽  
Conduction Delay ◽  
Lone Atrial Fibrillation ◽  
Wave Duration ◽  
P Wave Duration ◽  
Surface Ecg ◽  
Wave Morphology

Abstract Aims To demonstrate a possible inter-atrial conduction delay in patients with lone paroxysmal atrial fibrillation (PAF) using ‘unfiltered’ signal-averaged P-wave ECG (PSAECG) and compare these results with those obtained with conventional filter settings. Methods and Results Twenty one patients with lone PAF and 20 healthy volunteers (control group) were enrolled in the study. An orthogonal lead surface ECG was high-pass filtered at 0·8 Hz, averaged with template matching, and combined into a spatial magnitude (‘unfiltered’ technique). Results were compared with conventionally filtered (40–300 Hz) PSAECG. The filtered technique revealed no differences in P-wave duration between the two groups (121±12 vs 128±15 ms, control and PAF groups respectively, ns). Double-peaked P-wave spatial magnitudes (interpeak distance >30 ms) were revealed in 11 of 21 PAF patients but only in two of 18 controls (P<0·01). The nadir in the spatial magnitude was located significantly later in the PAF group (114±13 vs 103±9 ms,P <0·01). Conclusion ‘Unfiltered’ PSAECG revealed significant differences in orthogonal P-wave morphology in patients with lone PAF, indicating the possibility of an inter-atrial conduction delay, while conventional P-wave duration analysis failed to discriminate between the two groups.

Mitral Regurgitation Associated with Mitral Annular Dilation in Patients with Lone Atrial Fibrillation: An Echocardiographic Study

2009 ◽  
Vol 26 (8) ◽  
pp. 885-889 ◽  
Author(s):  
Takashi Kihara ◽  
A. Marc Gillinov ◽  
Kunitsugu Takasaki ◽  
Shota Fukuda ◽  
Jong-Min Song ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Regurgitation ◽  
Lone Atrial Fibrillation ◽  
Echocardiographic Study ◽  
Annular Dilation

scholarly journals Co-existence of ischemic stroke in Rheumatic and non-rheumatic atrial Fibrillation in a tertiary care teaching hospital of Western Nepal

2017 ◽  
Vol 13 (4) ◽  
pp. 388-391
Author(s):  
Ram Chandra Kafle ◽  
Girija Shankar Jha ◽  
Navaraj Paudel ◽  
Vijay Madhav Alurkar
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
Age Distribution ◽  
Female Ratio ◽  
Common Cause ◽  
Screening Programs ◽  
Rheumatic Heart

Background & Objectives: Stroke is a major public health burden worldwide leading to long-term morbidity and even mortality. Atrial fibrillation (AF) is the most common sustained arrhythmia and is an independent factor to increase risk of ischemic stroke. The risk of stroke further enhanced in rheumatic atrial fibrillation and affects younger population of developing countries.  The study has aimed to find out frequency of co-existence of stroke in AF and secondarily to look for age distribution of stroke and risk factors of AF.Materials & Methods: A retrospective analysis of trans-thoracic echocardiographic records of patients from 1st June 2009 to 31st June 2016 was done. Data were collected in a pre-structured proforma and analyzed.Results: Among 15767 echocardiographies, 577 (3.65%) cases were recorded to have atrial fibrillation. Mean age 65(±15) years ranging from 14 to 100 years. Rheumatic heart disease was the second most common cause of atrial fibrillation after hypertension. The co-existence of ischemic stroke was seen in 87(15.07%) cases with male to female ratio of 1:1.3. The proportion of stroke in rheumatic Atrial fibrillation was 21(18.75%) which was higher than in non-Rheumatic atrial fibrillation 66(14.2%).Conclusion: Rheumatic heart disease is contributing as second most common cause of atrial fibrillation after hypertension, nearly one fourth of total stroke and most common (93%) cause of stroke below the age of 45 years. Preventive strategies aimed at health awareness about rheumatic fever, screening programs at community level, early detection and treatment for hypertension and Rheumatic heart disease can contribute in reduction of stroke burden. 

scholarly journals The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation

2021 ◽  
Vol 6 (12) ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Disease ◽  
Side Effect ◽  
Airway Disease ◽  
The Other ◽  
Beta Agonist ◽  
Obstructive Airway Disease ◽  
Beta Blockade ◽  
Chronic Obstructive ◽  
Agonist Therapy

Background: New advances have been made in medicine, but the incidence and prevalence of chronic obstructive pulmonary disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and betareceptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1- selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient.

scholarly journals PANCYTOPENIA;

2014 ◽  
Vol 21 (01) ◽  
pp. 060-065
Author(s):  
Atif Sitwat Hayat ◽  
Abdul Haque Khan ◽  
Ghulam Hussian Baloch ◽  
Naila Shaikh
Keyword(s):  
Clinical Practice ◽  
Aplastic Anemia ◽  
Clinical Features ◽  
Tertiary Care ◽  
Shortness Of Breath ◽  
Medical Sciences ◽  
Common Cause ◽  
The Mean

Background: Pancytopenia is an important hematological problem encounteredin our day-to-day clinical practice. The aim of our study was to evaluate clinical features andetiological pattern of pancytopenia at tertiary care settings in Abbottabad. Methods: Thisprospective study was conducted at Northern Institue of Medical Sciences (NIMS) and AyubTeaching Hospital Abbottabad from 25th August 2009 to 31st July 2010. A total of 85 patientsfulfilling the criteria of pancytopenia were randomly selected by time-based sampling.Pancytopenia was diagnosed by anemia (hemoglobin ≤ 10.0g/dl), leucopenia (WBC ≤ 4.0×109/L)and thrombocytopenia (platelets ≤ 150×109/L). All data has been entered and analyzed by SPSSversion 10.0. Results: Out of 85 patients, 62(72.94%) were males and 23(27.05%) females withM to F ratio of 2.69:1. The mean age (±SD) of males was 30.20±15.42 years, while that of females35.12±16.31 years (p=0.20). Among clinical features, anemia and generalized weakness werethe commonest (97.64%), followed by shortness of breath (88.23%). Majority 54(63.52%) hadnon-malignant disorders responsible for pancytopenia. Overall, the most common cause ofpancytopenia was aplastic anemia noted in 30(35.29%) cases, followed by megaloblastic anemia15(17.64%) and hypersplenism in 13(15.29%). Conclusions: On conclusion, aplastic anemiawas the most common cause of pancytopenia in our study predominantly affecting young adultmales. It

scholarly journals Chronic Obstructive Pulmonary Disease

2016 ◽  
Vol 11 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Sean O’Reilly
Keyword(s):  
Tobacco Smoke ◽  
Treatment Options ◽  
Airflow Obstruction ◽  
Clinical History ◽  
Pulmonary Function Testing ◽  
Accurate Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Cause ◽  
Function Testing

COPD is a common, preventable, and treatable disease characterized by persistent airflow obstruction associated with enhanced inflammation in the airways and the lung in response to noxious particles or gases. Clinical history and pulmonary function testing are necessary for accurate diagnosis. While exposure to tobacco smoke remains a common cause, other etiologies and underlying genetic predisposition play significant roles. Treatment options are numerous and should be individualized based on symptoms and exacerbation frequency.

scholarly journals Provisional Cycle of Reviews

2002 ◽  
Vol 1 (2) ◽  
pp. 71-71
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Gastrointestinal Bleeding ◽  
Diabetic Ketoacidosis ◽  
Airway Disease ◽  
Obstructive Airway Disease ◽  
Chronic Obstructive ◽  
Chronic Obstructive Airway Disease ◽  
Medical Emergencies ◽  
In Pregnancy

2002 Volume 1: 2 Cellulitis Diabetic Ketoacidosis Ventilation of the Asthmatic Pulmonary Embolism Anaphylaxis Volume 1: 3 Medical Emergencies in Pregnancy Non-Variceal Gastrointestinal Bleeding Atrial Fibrillation Chronic Obstructive Airway Disease Myaesthenia Gravis

scholarly journals Pulmonary rheumatoid nodules leading to spontaneous pneumothorax

2012 ◽  
Vol 6 (4) ◽  
pp. 57-60
Author(s):  
KR Dewan ◽  
SK Nanda ◽  
RS Twayana
Keyword(s):  
Rheumatoid Arthritis ◽  
Spontaneous Pneumothorax ◽  
Metastatic Cancer ◽  
Airway Disease ◽  
Methotrexate Therapy ◽  
Chronic Obstructive ◽  
Chronic Obstructive Airway Disease ◽  
Medical Sciences ◽  
Rheumatoid Nodules ◽  
Long Time

Several pulmonary diseases are associated with spontaneous pneumothorax, including bronchial asthma, chronic obstructive airway disease, bronchiectasis, pneumonia, abscess, primary or metastatic cancer, and chronic interstitial lung disease.1 Spontaneous pneumothorax secondary to rheumatoid nodules which is one of the extra-articular manifestations of rheumatoid arthritis is rare but occasionally described.2There are some reports resulting in spontaneous pneumothorax especially on patients on methotrexate or leflunomide treatment.3We describe a case of rheumatoid arthritis who was on methotrexate therapy from a long time complicating in right sided spontaneous pneumothorax. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 57-60 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6729

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