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1

Atrial myxoma  

MedlinePLUS

An atrial myxoma is a noncancerous tumor in the upper left or right side of the heart. It grows on ... The rest are in the right atrium. Right atrial myxomas are sometimes associated with tricuspid stenosis and atrial ...

2

Atrial Myxoma  

PubMed Central

A 55-year-old woman had an inferior myocardial infarction due to a coronary artery embolus from a large, polypoid, left atrial mass. The mass had an irregular surface and was prolapsing into the mitral valve orifice during diastole. Coronary angiography revealed tumor vascularization next to the right coronary artery. The other coronary arteries were normal. The tumor was removed surgically; pathologic examination confirmed the diagnosis of myxoma. The patient did well after the procedure and was discharged on postoperative day 10.

Demir, Mesut; Akpinar, Onur; Acarturk, Esmeray

2005-01-01

3

Left atrial myxoma prolapsing into the left ventricle. Case report and review of the literature.  

PubMed

Cardiac myxomas are rare tumors which may present differently. Left atrial myxoma is an entity from anatomopathological and clinical aspects. To the best of our knowledge, only 2 cases of infected left atrial myxomas treated surgically have been reported in the last 6 years. Herein, we present a patient with a left atrial myxoma prolapsing into the left ventricle in the diastolic phase, which was infected with Streptococcus viridans. Combined therapy, consisting of surgical management and antimicrobial therapy, was used. Clinical presentation, diagnosis and treatment are reviewed. PMID:15608446

Karachalios, G; Bablekos, G; Karachaliou, I; Zoganas, L; Charalabopoulos, A; Charalabopoulos, K

2004-12-08

4

Atypical atrial myxomas in two asymptomatic patients: a case report  

PubMed Central

Background Atypical cardiac myxomas are a rare occurrence and may present with a variety of clinical manifestations depending on the morphology and location. Case presentation Two cases of cardiac myxomas atypically located in asymptomatic patients, diagnosed by transthoracic and transoesophageal echocardiography, are presented. In the first case a myxoma is located under the anterior mitral valve leaflet and in the second case a myxoma is located in the right atrium. Conclusion We emphasize the leading role of transthoracic and transoesophageal echocardiography in the diagnosis of intracavitary cardiac tumours.

Charokopos, Nicholas A; Rouska, Efthymia; Pliakos, Christodoulos; Pagourelias, Efstathios D; Artemiou, Panagiotis; Foroulis, Christoforos; Papadopoulos, Nikolaos

2009-01-01

5

Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report.  

PubMed

Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment. PMID:20565878

Azevedo, Olga; Almeida, Jorge; Nolasco, Tânia; Medeiros, Rosa; Casanova, Jorge; Bartosch, Carla; Almeida, João; Pinho, Paulo

2010-06-18

6

Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report  

PubMed Central

Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment.

2010-01-01

7

[Secondary pulmonary embolism to right atrial myxoma].  

PubMed

A case of pulmonary thromboembolism secondary to atrial myxoma right. The myxoma is a primary cardiac tumor, namely, has his origin in the cardiac tissue. Primary cardiac tumors are rare, including myxomas, the most common type. Have a predilection for females and the most useful tool for diagnosis is echocardiography. About 75% of myxomas occur in the left atrium of the heart and rest are in the right atrium. Right atrial myxomas in some sometimes associated with tricuspid stenosis and atrial fibrillation. The most common clinical manifestations include symptoms of this neoplasm constitutional, and embolic phenomena resulting from the obstruction to the flow intracavitary. The treatment of this condition is surgical. PMID:24095171

Vico Besó, L; Zúñiga Cedó, E

2012-07-17

8

Polypoid atrial myxoma.  

PubMed

Myxomas are by far the most common tumours of the heart. A 75-year-old man with no notable medical history presented with a 2-month progressive weight loss and dyspnoea on exertion. Physical examination revealed an opening snap and a diastolic decrescendo murmur at the apex. Transthoracic echocardiography showed a large, 85?×?30? mm, mobile, polypoid mass arising from the atrial fossa ovalis and protruding into the left ventricle during diastole. Irregular shape, multilobated surface and soft-tissue echogenicity were consistent with emboligenic myxoma. Surgical inspection confirmed a reddish gelatinous myxoma with villous, friable, thrombus-like surface prone to embolize. The mass was successfully removed and the histologic report confirmed the diagnosis.At 3-year follow-up, the patient is asymptomatic and no further mass has been detected. The case confirms that echocardiography remains a primary tool for the assessment of cardiac masses, providing morphological clues to define the potential risk of complications such as valve obstruction and systemic embolization. PMID:22037712

Grimaldi, Antonio; Fumero, Andrea; Taramasso, Maurizio; Pappalardo, Federico; Sanvito, Francesca; Ammirati, Enrico; Capritti, Elvia; Castiglioni, Alessandro; Collu, Egidio; Pala, Maria Grazia; Zangrillo, Alberto; Alfieri, Ottavio

2012-08-01

9

Atrial myxoma: a tumour in search of its origins  

Microsoft Academic Search

OBJECTIVE--To determine whether atrial myxomas express antigens suggesting a neural origin. DESIGN--A retrospective analysis based on immunohistochemical examination of myxoma tissue. SETTING--Atrial myxomas excised by two tertiary referral cardiothoracic surgical units. SUBJECTS--24 excised atrial myxomas. Three were from known cases of familial myxoma syndrome. METHODS--Immunohistochemical identifications of three neuroendocrine markers (protein gene product (PGP) 9.5, neurone specific enolase (NSE), synaptophysin)

D M Krikler; J Rode; M J Davies; N Woolf; E Moss

1992-01-01

10

Tumorectomy with right thoracotomy for synchronous left atrial myxomas from Carney complex: report of a case.  

PubMed

This report describes a case of synchronous left atrial myxomas from Carney complex resected through a right thoracotomy. The patient was a 30-year-old female that had previously been diagnosed with Carney complex following a genetic examination. Preoperative echocardiography showed a left atrial tumor, but intraoperative inspection revealed another tumor in the left atrium. Carney complex was first described in the 1980s and cardiac myxoma from Carney complex can occur in any cardiac chamber, presenting multiple times with postoperative recurrences, occurring at any age and without any predilection for gender, and is inherited in an autosomal-dominant manner. Treatment for cardiac myxoma from Carney complex is very important for patient mortality and morbidity and, despite the endocrine nature of the disorder, cardiologists and cardiac surgeons play an important role. PMID:23052755

Ishida, Narihiro; Shimabukuro, Katsuya; Matsuno, Yukihiro; Arakawa, Yuki; Takemura, Hirofumi

2012-10-11

11

Atrial myxoma presenting with orthostatic hypotension in an 84-year-old Hispanic man: a case report  

Microsoft Academic Search

INTRODUCTION: Left atrial myxomas remain the most common benign primary cardiac tumors, and these cardiac growths can masquerade as mitral stenosis, infective endocarditis and collagen vascular disease. Atrial myxomas are found in approximately 14-20% of the population and can lead to embolization, intercardiac obstructions, conduction disturbances and lethal valve obstructions. CASE PRESENTATION: An 84-year-old Hispanic man presented with complaints of

Ralph M Vicari; Enrique Polanco; Norberto Schechtmann; José O Santiago; Kautilya Shaurya; Michael Halstead; Danielle Marszal; Tamsin Grosskreutz; Shalini Thareja

2009-01-01

12

Left Atrial Myxoma Mimicking Mitral Stenosis  

PubMed Central

Cardiac myxoma is a benign (non-malignant) neoplasm that represents the most common primary tumour of the heart. We present the case of a 36 year old woman with background hypertension who presented with features of left ventricular failure and seizures, and was found during transthoracic echocardiography to have left atrial myxoma protruding through the mitral valve orifice. She subsequently had excision of the atrial myxoma. The usefulness of early transthoracic echocardiography in any patient presenting with features of heart failure even when the aetiology seems obvious cannot be over-emphasised.

Ojji, Dike B; Mamven, Manmak H; Omonua, Odiase; Habib, Zaiyad; Osaze, Hamamatu; Sliwa, Karen

2012-01-01

13

Large Left Atrial Myxoma with Severe Mitral Regurgitation  

PubMed Central

Cardiac myxomas are primary cardiac tumors. In some cases of atrial myxoma, the standard left atriotomy alone does not enable safe tumor resection and easy access to the mitral valve. We report the cases of 2 patients with huge left atrial myxomas associated with severe mitral valve regurgitation who underwent an inverted T-shaped biatrial incision for tumor excision and mitral repair. This approach reduces tumor fragmentation and permits good mitral valve exposure.

Davoli, Giuseppe; Muzzi, Luigi; Lucchese, Gianluca; Uricchio, Nicola; Chiavarelli, Mario

2006-01-01

14

Atrial myxoma in a patient with hypertrophic cardiomyopathy.  

PubMed

Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures. PMID:24082380

Abdou, Mahmoud; Hayek, Salim; Williams, Byron R

2013-01-01

15

Atrial Myxoma in a Patient with Hypertrophic Cardiomyopathy  

PubMed Central

Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures.

Abdou, Mahmoud; Hayek, Salim; Williams, Byron R.

2013-01-01

16

[Syncope as first and only sign of left atrial myxoma].  

PubMed

Myxoma is the most frequent primary heart tumor. It is localised in the left atrium in majority of cases, but each of heart chambers may be affected. Left atrial myxoma becomes symptomatic in case it leads into mitral valve obstruction, systemic embolisation or it manifests with unspecific systemic symptoms. Echocardiography is a golden standard of myxoma diagnostics. We present a case of 61-years old woman patient in whom exercise induced syncope was the first and only sign of far gone left atrial myxoma with left ventricle inflow tract obstruction, leading to mitral pseudostenosis. PMID:23461403

Samoš, M; K?azeje, M; Dvorský, J; Ková?, F; Galajda, P; Moká?, M

2013-02-01

17

Rapid Growth of Left Atrial Myxoma after Radiofrequency Ablation  

PubMed Central

Atrial myxoma is the most common benign tumor of the heart, but its appearance after radiofrequency ablation is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in the left atrium after radiofrequency ablation. Two months after the procedure, cardiovascular magnetic resonance, performed to evaluate the right ventricular anatomy, revealed a 10 × 10-mm mass (assumed to be a thrombus) attached to the patient's left atrial septum. Three months later, transthoracic echocardiography revealed a larger mass, and the patient was diagnosed with myxoma. Two days later, a 20 × 20-mm myxoma weighing 37 g was excised. To our knowledge, the appearance of an atrial myxoma after radiofrequency ablation has been reported only once before. Whether tumor development is related to such ablation or is merely a coincidence is uncertain, but myxomas have developed after other instances of cardiac trauma.

Alvarez, Jose Rubio; de Alegria, Anxo Martinez; Quiroga, Juan Sierra; Nazar, Belen Adrio; Taboada, Carola Rubio; Comendador, Jose Manuel Martinez

2013-01-01

18

Rapid growth of left atrial myxoma after radiofrequency ablation.  

PubMed

Atrial myxoma is the most common benign tumor of the heart, but its appearance after radiofrequency ablation is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in the left atrium after radiofrequency ablation. Two months after the procedure, cardiovascular magnetic resonance, performed to evaluate the right ventricular anatomy, revealed a 10 × 10-mm mass (assumed to be a thrombus) attached to the patient's left atrial septum. Three months later, transthoracic echocardiography revealed a larger mass, and the patient was diagnosed with myxoma. Two days later, a 20 × 20-mm myxoma weighing 37 g was excised. To our knowledge, the appearance of an atrial myxoma after radiofrequency ablation has been reported only once before. Whether tumor development is related to such ablation or is merely a coincidence is uncertain, but myxomas have developed after other instances of cardiac trauma. PMID:24082379

Alvarez, José Rubio; de Alegria, Anxo Martinez; Quiroga, Juan Sierra; Nazar, Belen Adrio; Taboada, Carola Rubio; Comendador, José Manuel Martinez

2013-01-01

19

Left Atrial Myxoma.  

National Technical Information Service (NTIS)

Cardiac myxomas are benign tumors of the heart and arise most commonly from the interatrial septum, typically on the left side. They may grow to be fairly large at presentation, often associated with intracardiac obstruction, embolic events, or constituti...

J. D. Hirsch V. B. Ho

2006-01-01

20

Obstruction of the tricuspid valve orifice by a huge right atrial myxoma associated with the Carney complex: a case report.  

PubMed

Carney complex (CNC) is an inherited autosomal dominant disorder associated with multiple neoplasms. Myxomas associated with CNC differ from their sporadic forms because the former usually develop at a younger age and they may be multicentric and have a tendency to recur. Furthermore, their localization may be atypical. We report the case of a 57-year-old man, with a huge right atrial myxoma obstructing the tricuspid valve orifice. A diagnosis of CNC was established by genetic analysis. The importance of early diagnosis and an adequate follow-up is emphasized. PMID:20880078

Affronti, Alessandro; Di Bella, Isidoro; Prontera, Paolo; Da Col, Uberto; Ramoni, Enrico; Donti, Emilio; Paris, Marco; Ragni, Temistocle

2010-09-29

21

Left atrial myxoma complicated with an acute upper extremity embolism.  

PubMed

Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myxoma usually present with cardiac obstruction, arrhythmia, or peripheral embolization. We encountered an unusual case of acute upper extremity ischemia due to a massive atrial myxoma in a young man. A 38-year-old man was admitted to our hospital with an acute onset of severe, right upper extremity pain and paralysis while working. Neurologic examination yielded normal results, but the patient showed no palpable right radial or ulnar artery. Routine sonographic evaluation revealed acute aortic embolism in his right brachial artery. Because of his young age and otherwise healthy condition, we decided to perform transthoracic echocardiography, which showed a huge left atrial tumor, which we suspected to be myxoma. We then performed urgent concurrent open heart surgery and embolectomy to avoid further embolism. The microscopic findings of the resected tumor and embolism specimens were myxoma. He was discharged without complications. PMID:22293305

Chiba, Kiyoshi; Abe, Hiroyuki; Kitanaka, Yosuke; Makuuchi, Haruo

2012-01-31

22

Recurrent non-aneurysmal, metastatic intraparenchymal haemorrhages following resection of atrial myxoma - case report and literature review.  

PubMed

Atrial myxomas are the commonest cardiac neoplasms. The most common extra-cardiac manifestations are embolic infarcts from tumour embolisation. Infrequently, aneurysm formation and intracranial haemorrhages also occur. Incredibly rare are space-occupying lesions and malignant transformation. The authors report a case of a previously healthy middle-aged lady who developed recurrent and expanding intraparenchymal haemorrhages following resection of a left atrial myxoma without any primary disease recurrence. The case described is completely different from the described literature in that her intracranial vasculature was free of aneurysms on angiography despite central nervous system haemorrhage and no myxomatous or malignant features were seen on histology of the resected symptomatic occipital lesion. The authors compare this case to the available literature and also provide a literature review. PMID:23104629

Raza, Emmon; Kamal, Ayeesha Kamran

2012-10-26

23

Entire left atrial myxoma presenting as a saddle embolus  

Microsoft Academic Search

A case is presented in which a complete left atrial myxoma became detached and lodged in the aortic bifurcation. Shortly after it had been removed the patient suffered cardiac arrest and could not be revived.

M. Kulkarni; I. Mc D. Jessiman

1969-01-01

24

Large left atrial myxoma in an oligosymptomatic young woman.  

PubMed

We present the case of a young female with a large sporadic left atrial myxoma. Interestingly, despite the tumor's large size, this patient had only mild exertional dyspnea without any embolic events or constitutional symptoms. PMID:23340131

Lazaros, George; Masoura, Constantina; Brili, Stella; Stavropoulos, George; Kafiri, Georgia; Stefanadis, Christodoulos

25

Left Atrial Myxoma Presenting with Unusual Cystic Form  

PubMed Central

Cardiac myxomas are the most common primary benign tumors of uncertain etiology. They usually present as polypoid or oval-shaped masses projecting into a heart chamber from the interatrial septum and have a soft, gelatinous consistency without a cystic structure. We report a case of left atrial myxoma with a single cystic form.

Park, Kwon Jae; Park, Jong Yoon

2013-01-01

26

[Atrial myxoma: A histologically benign tumor with potentially serious manifestations].  

PubMed

Atrial myxoma is the most prevalent primary heart tumor. Although it is considered histologically benign, it may course with serious complications. We report the clinical case of a 35 years old man, previously asymptomatic, admitted due to an acute ischemia of the lower limbs, consequence of an embolic complication of a left atrial myxoma. We conclude with a brief review of the literature on the topic. PMID:23894736

Rangel, Inês; Rolim, Dalila; Martins, Elisabete; Maciel, Maria Júlia; Teixeira, José

27

Right atrial giant myxoma occupying the right ventricular cavity.  

PubMed

We report a case of a giant right atrial myxoma mimicking the right ventricular tumor. The 75-year-old patient underwent cardiac surgery, and the tumor was excised along with the stalk. Tricuspid valve annuloplasty was performed before closure of the right atriotomy. The tumor may have caused intraventricular stenosis, hepatic dysfunction, and progressive fatigue as a result of low cardiac output. This case is of special interest because the myxoma was very large compared with those ever reported, and a right atrial myxoma occupying the right ventricular cavity is rare. PMID:22579896

Sato, Teruki; Watanabe, Hiroyuki; Okawa, Megumi; Iino, Takako; Iino, Kenji; Ishibashi, Kazuyuki; Yamamoto, Hiroshi; Yamamoto, Fumio; Ito, Hiroshi

2012-05-11

28

Atypical size and location of a right atrial myxoma: a case report  

PubMed Central

Introduction Primary intracardiac tumors are rare and approximately 50% are myxomas. The majority of myxomas are located in the left atrium and have variable clinical presentation. We report a case of a large myxoma in the right atrium, which is an uncommon location for this type of tumor. Case presentation A 45-year-old Caucasian woman with a history of palpitation had dyspnea on great exertion and discrete weight loss. A cardiac evaluation showed splitting of S1. An echocardiogram showed a large mass in the right atrium, suggesting myxoma; chest computed tomography confirmed the diagnostic hypothesis. Our patient underwent surgical treatment with excision of a 10 cm multilobulated mass. She presented with supraventricular tachycardia during the operation. She was placed in the intensive care unit and her condition improved after the use of amiodarone. The diagnosis of myxoma was confirmed by histopathological study. Conclusions In this case report, we emphasize the rarity of large myxomas in the right atrium and the difficulty of differential diagnosis given their dimension and location.

2012-01-01

29

An unusual case of giant cardiac fibroelastoma mimicking left atrial myxoma in a patient presenting with syncope.  

PubMed

Cardiac papillary fibroelastomas are the most common primary valvular tumors. Generally benign, they account only for about 10% of all primary cardiac neoplasms, can occur in normal or diseased hearts, and are associated strongly with open heart surgery and radiotherapy. They are, in most cases, incidental findings, but can be discovered after syncope. We report the case of an elderly female, who was referred for syncope and was found to have a large fibroelastoma at the mitral valve annulus, intermittently obstructing the left ventricular inflow tract, and mimicking the presentation of left atrial myxoma. This case illustrates another potential mechanism of syncope in patients with fibroelastomas. PMID:22505235

Khoueiry, Georges; Geha, Fady; Meghani, Mustafain; Abi Rafeh, Nidal; Azab, Basem; Torbey, Estelle; Asgarian, Kourosh T; Sicat, Michael

2012-04-14

30

Cutaneous emboli of atrial myxoma: unusual case report and review of the literature.  

PubMed

Cardiac myxomas are difficult to diagnose, not only because of a lack of specific systemic symptoms but also because, even in those cases presenting with embolic disease, emboli are exceptional. The skin is one of the organs most frequently involved by myxomatous emboli. We report an extraordinary case in which emboli of a cardiac myxoma was present in the skin biopsy, but "camouflaged" among the normal Vater-Pacini corpuscles of the palm of the hand, We also review the existing literature on myxomatous emboli identified in skin biopsies. PMID:22573018

Alonso de Celada, Ricardo M; Maldonado Cid, Paola; Beato, María J; Herranz Pinto, Pedro

2012-07-01

31

Acute pulmonary edema caused by a giant atrial myxoma.  

PubMed

Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention. PMID:23762077

Fisicaro, Andrea; Slavich, Massimo; Agricola, Eustachio; Marini, Claudia; Margonato, Alberto

2013-05-16

32

[Giant left atrial myxoma presenting as acute myocardial infarction].  

PubMed

Myxomas are the most common type of benign cardiac tumor. The most frequent clinical presentations are symptoms resulting from atrioventricular valve obstruction or systemic embolization. Coronary embolization is a rare, although real and potentially fatal, complication of cardiac myxomas. We present a case report and review of the literature on this disease association. A 57-year-old woman was admitted to our coronary care unit with a diagnosis of non-ST elevation acute myocardial infarction. Transthoracic echocardiography showed a large left atrial mass attached to the interatrial septum, coral-like and with a friable appearance, suggestive of myxoma. Coronary angiography revealed no significant lesions and the patient underwent surgical excision of the mass, which histological study showed to be compatible with myxoma. The postoperative period was uneventful and the patient is doing well, with no recurrence of myxoma. PMID:23138051

Marta, Liliana; Peres, Marisa; Alves, Miguel; Ferreira da Silva, Graça

2012-11-06

33

Systemic Embolization and Myocardial Infarction due to Clinically Unrecognized Left Atrial Myxoma  

PubMed Central

Myxomas are the most common primary tumors of the heart. We report an extraordinary severe case of left atrial myxoma, presenting with stroke, myocardial infarction, and multiple arterial embolism including aorta, splenic and renal arteries, and several peripheral arteries. The patient had previously been diagnosed with systemic vasculitis, a typical but less common finding caused by multiple emboli mimicking vasculitis. The myxoma was removed and atrial septum reconstruction was performed. In summary, early diagnostic differentiation of myxoma from vasculitis is critical, and immediate surgical removal of myxoma is required as the probability of thromboembolic complications increases over time.

Vogel, Britta; Thomas, Dierk; Mereles, Derliz; Rottbauer, Wolfgang; Katus, Hugo A.

2011-01-01

34

[Left atrial myxoma with a coronary artery steal syndrome due to the coronary artery to left atrial fistula; report of a case].  

PubMed

A 73-year-old woman with dyspnea was diagnosed with a left atrial myxoma by echocardiography. Right and left circumflex coronary angiography showed neovascularity in the tumor and the blood flow jet extending from the tumor to the left atrial cavity, which led to the steal phenomenon in the left anterior descending artery. Surgical excision of the left atrial tumor and the maze procedure were performed with a cardiopulmonary circuit. To our knowledge, this is the 1st study to report the development of the coronary artery steal syndrome due to a cardiac myxoma. Exercise testing would involve risks such as embolism and left ventricular inflow disturbance; furthermore, the presence of concomitant chest symptoms with cardiac myxoma is not rare. Therefore, preoperative coronary angiography would be used for differential diagnosis and for detecting the coronary artery disease, which is reported to be common in patient with cardiac myxomas. PMID:23575189

Sogabe, Osanori; Inokawa, Hidetoshi; Tanaka, Shin; Yamamoto, Hiroyuki; Hashimoto, Kouhei

2013-04-01

35

Multiple cerebral and coronary aneurysms in a patient with left atrial myxoma.  

PubMed

Cardiac myxomas accompanied by multiple embolic complications in cerebral and visceral arteries have been well documented in scientific literature. However, cerebral artery aneurysms have rarely been reported as a possible embolic complication of myxomas. This study describes a patient who had multiple episodes of cerebral infarctions and was found to have left atrial myxoma with old renal infarction as well as cerebral and coronary artery aneurysms. This is the first case report of coronary artery aneurysms associated with cardiac myxoma. PMID:23097127

Kim, Hyungjin; Park, Eun-Ah; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung

2012-10-25

36

Recurrent atrial myxoma: resection for Carney complex through a minimally invasive approach.  

PubMed

Carney's complex is an autosomal dominant syndrome characterized by recurrent atrial myxomas with concurrent endocrinopathies and characteristic dermatologic features. We present the case of a woman who presented with a recurrent atrial myxoma after two previous resections for myxomas through median sternotomies. As a consequence, we utilized a minimally invasive right thoracotomy approach. We discuss the clinical and pathologic features of Carney complex and the importance of identifying individuals and families with this condition for treatment and counseling. PMID:20487111

Greelish, James P; Chatterjee, Subhasis; Byrne, John G

2010-09-01

37

Left atrial myxoma associated with mitral valve pathology in pregnancy.  

PubMed

We report a case of a left atrial myxoma associated with mitral valve regurgitation in a pregnant patient, describing the importance of transoesophageal or transthoracic echocardiography, preoperatively and during the operation, as a useful tool to rule out any associated valvular damage or mitral annular dilatation as an underlying cause of mitral regurgitation. PMID:23557615

Koukis, Ioannis; Velissaris, Theodore; Pandian, Alex

38

Successful Surgical Treatment of a Right Atrial Myxoma Complicated by Pulmonary Embolism  

PubMed Central

A 76-year-old woman with hypertension was admitted to the hospital with complaints of chest pain and dyspnea. An echocardiogram and pulmonary computed tomography angiography showed right atrial myxoma complicated with pulmonary thromboembolism. An operation to resect the right atrial myxoma and pulmonary embolism was recommended; however, the patient refused and was discharged with anticoagulation therapy. Two years later, she developed dyspnea. Radiological studies and echocardiography showed similar results with the previous findings. The patient underwent mediastinotomy with resection of the right atrial myxoma and pulmonary embolectomy. As there are few reports on right atrial myxoma complicated with pulmonary embolism, we report a successful case of surgical removal of right atrial myxoma and pulmonary embolism.

Jung, Joonho; Lee, Cheol Joo; Lim, Sang-Hyun; Choi, Ho; Lee, Sungsoo

2013-01-01

39

Successful surgical treatment of a right atrial myxoma complicated by pulmonary embolism.  

PubMed

A 76-year-old woman with hypertension was admitted to the hospital with complaints of chest pain and dyspnea. An echocardiogram and pulmonary computed tomography angiography showed right atrial myxoma complicated with pulmonary thromboembolism. An operation to resect the right atrial myxoma and pulmonary embolism was recommended; however, the patient refused and was discharged with anticoagulation therapy. Two years later, she developed dyspnea. Radiological studies and echocardiography showed similar results with the previous findings. The patient underwent mediastinotomy with resection of the right atrial myxoma and pulmonary embolectomy. As there are few reports on right atrial myxoma complicated with pulmonary embolism, we report a successful case of surgical removal of right atrial myxoma and pulmonary embolism. PMID:23423469

Jung, Joonho; Hong, You Sun; Lee, Cheol Joo; Lim, Sang-Hyun; Choi, Ho; Lee, Sungsoo

2013-02-06

40

Understanding cardiac myxoma recurrence: a case report.  

PubMed

Recurrence of cardiac myxoma is a rare condition, observed in about 3% of patients in sporadic cases, although it is more frequent in familial ones. Several mechanisms have been proposed to explain such recurrence, and the importance of increased vascularization as a facilitating feature is the subject of debate. The authors report the case of a non-familial right atrial myxoma, unusual for both its histopathology and recurrence. PMID:23454069

Carvalho, Maria Salomé; Andrade, Maria João; Abecasis, João; Gouveia, Rosa; Branco, Luísa; Neves, José Pedro; Mendes, Miguel

2013-02-28

41

Cerebral embolism from atrial myxoma in pediatric patients.  

PubMed

We describe 2 children with cerebrovascular events caused by emboli from left atrial myxomas and review 7 other pediatric cases from the literature. Transient cutaneous eruptions involving the extremities preceded the cerebrovascular events and were most likely attributable to fragmentation of the atrial tumor with peripheral embolization. Our first case demonstrates the more common presentation with acute hemiplegia caused by cerebral infarction and the second case a transient ischemic attack manifested by more subtle features as a result of involvement of the vertebrobasilar circulation. Neither child had a history or other signs of cardiac disease. Atrial myxoma should be considered in the differential diagnosis when children present with neurologic symptoms or with signs of embolization, because surgical removal of the tumor is critical and may be curative. PMID:12897323

Al-Mateen, Majeed; Hood, Margaret; Trippel, Don; Insalaco, Samuel J; Otto, Randolph K; Vitikainen, Kari J

2003-08-01

42

Left atrial myxoma with neovascularization presenting as a sick sinus syndrome.  

PubMed

Myxoma is benign tumor of the heart. It is mostly located in the left atrium and revascularized by the left and right coronary artery in 30% to 40% of cases. Symptoms of these neovascularized cardiac myxomas are typically quite variable, from obstruction of mitral valve to coronary embolism resulting in acute myocardial infarction. In this case, left atrial myxoma that is revascularized by nodal branches of the right coronary artery presented as a sick sinus syndrome, which is rare in literature. PMID:22917824

Bayramo?lu, Zehra; Caynak, Bar?s; Oral, Kerem; Erdim, Refik; Teyyareci, Yelda; Akp?nar, Belhan

2012-08-01

43

[Left atrial myxoma who presented cardiac arrest immediately after the onset of coldness of a leg; report of a case].  

PubMed

A 55-year-old woman visited the emergency department of our hospital with complaint of coldness and pain in her right leg. Two hours after the onset, she suddenly felt dyspnea and temporarily suffered cardiac arrest. Echocardiography revealed a left atrial tumor prolapsing into the left ventricle through the mitral valve. By emergency operation, both the cardiac tumor and the embolus were diagnosed as myxomas. The postoperative course was uneventful. Cardiac failure and arterial embolism are major symptoms of a left atrial myxoma, but there have been no reports of both symptoms occurring at the same time. It is supposed that the changing form of the tumor because of embolus separation could have caused heart failure. We must consider the use of echocardiography to examine cardiac tumors in patients with arterial embolism who do not have cardiac arrhythmias. PMID:23023550

Tano, Kazutoshi; Ichikawa, Yoichi

2012-10-01

44

Mucin-producing adenocarcinoma arising in an atrial myxoma.  

PubMed

We describe the unique autopsy findings of a patient who died of a metastasizing giant right atrial adenocarcinoma containing few areas of typical myxoma. That no mucin-producing extracardiac tumor was detected pointed to the atrial adenocarcinoma as being the primary. We hypothesize that the adenocarcinoma may have developed from coexistent bland glandular structures within the myxoma. PMID:22464912

Berger, Martin D; Schneider, Jakob; Ballmer, Peter E; Eckhardt, Boris P; Dommann-Scherrer, Corina

2012-03-29

45

[Ischemic stroke induced by a left atrial myxoma].  

PubMed

We reported a case of ischemic stroke induced by a left atrial myxoma. A 76-year-old man was found unconscious and transferred to the emergency ward in our hospital. He experienced consciousness disturbance, motor dominant aphasia, and severe right hemiparesis. His neurological and radiological findings indicated that he had ischemic stroke and was eligible to undergo intravenous thrombolysis. Alteplase was administrated 155 min after the onset of stroke. Intracerebral hemorrhage was not seen 24h after thrombolysis. A tumor in the left atrium was detected on transthoracic echocardiography, and this finding suggested that the tumor was a myxoma. Although cardiac surgery was scheduled, hemorrhagic transformation was found on day 11, which made us postpone the surgery. After the hemorrhage was disappeared, the tumor was resected by open-heart surgery and it was confirmed to be a myxoma. Neither his neurological symptom nor intracerebral hemorrhage was not deteriorated after the operation. Thrombolytic treatment seemed a safe option for ischemic stroke caused by left atrial myxoma. However, we should carefully monitor the extent of anticoagulation therapy because hemorrhagic transformation might alter the timing of surgery for tumor resection. PMID:23037608

Hatayama, Sayaka; Ogata, Toshiyasu; Okawa, Masakazu; Higashi, Toshio; Inoue, Tooru; Takano, Koichi; Minematsu, Noritoshi; Tashiro, Tadashi; Sakata, Noriyuki

2012-10-01

46

Atrial myxoma as a cause of stroke: case report and discussion  

Microsoft Academic Search

Cardiac myxoma is a source of emboli to the central nervous sys- tem and elsewhere in the vascular tree. However, nonspecific systemic symptoms and minor embolic phenomena may be over- looked in the absence of any history of cardiac problems. In this situation, cardiac investigations may not be performed, and diag- nosis of this rare condition may be delayed until

Fintan O'Rourke; Naeem Dean; Mikael S. Mouradian; Naveed Akhtar; Ashfaq Shuaib

2003-01-01

47

Early recurrent left atrial myxoma in a teenager with de novo mutation of Carney complex  

PubMed Central

We report a case of an extremely early recurrence of left atrial myxoma in a 13-year-old girl. On hospital admission, the clinical presentation was of cerebral embolism with noticeable spotty skin pigmentation and hypertelorism. The left atrial myxoma originated from the roof of the left atrium. The histology specimen showed typical finding of a myxoma. Six months later a new intracardial mass was evacuated, the postoperative result showing the same type of myxomatous tissue. Genetic investigations demonstrated Carney complex. The genetic analysis of the child's family was negative, demonstrating de novo mutation of this rare disorder.

Stajevic, Mila S.; Vukomanovic, Vladislav A.; Kuburovic, Vladimir D.; Djuricic, Slavisa M.

2011-01-01

48

Early recurrent left atrial myxoma in a teenager with de novo mutation of Carney complex.  

PubMed

We report a case of an extremely early recurrence of left atrial myxoma in a 13-year-old girl. On hospital admission, the clinical presentation was of cerebral embolism with noticeable spotty skin pigmentation and hypertelorism. The left atrial myxoma originated from the roof of the left atrium. The histology specimen showed typical finding of a myxoma. Six months later a new intracardial mass was evacuated, the postoperative result showing the same type of myxomatous tissue. Genetic investigations demonstrated Carney complex. The genetic analysis of the child's family was negative, demonstrating de novo mutation of this rare disorder. PMID:22090725

Stajevic, Mila S; Vukomanovic, Vladislav A; Kuburovic, Vladimir D; Djuricic, Slavisa M

2011-05-01

49

Fatal Disruption of a Left Atrial Myxoma Associated with Trauma  

PubMed Central

Cardiac myxomas are benign tumors composed of sparse stellate cells in an extensive mucoid stroma. The surface of these tumors is often friable and gelatinous. Their intracardiac location makes embolization a constant threat. We report a patient who had diffuse systemic embolization of a left atrial myxoma coincident with a low-velocity frontal motor vehicle crash.

Iacco, Anthony; Billimoria, Nazneen; Howells, Greg

2012-01-01

50

[A case of left atrial myxoma with ventricular septal defect and patent foramen ovale].  

PubMed

A 51-year-old female was referred to our institute because of chest oppressive feeling. Echocardiography and magnetic resonance imaging revealed a left atrial tumor with ventricular septal defect. At operation patent foramen ovale was recognized. After excision of the tumor including intraatrial septum, which defect was repaired using a Teflon patch, and the ventricular septal defect was closed directly. PMID:8258918

Satokawa, H; Iwaya, F; Igari, T; Watanabe, M; Sato, Y; Ogawa, T; Hoshino, S

1993-12-01

51

Perplexing imaging manifestations of multiple metastatic intracranial lesions associated with atrial myxoma.  

PubMed

Neurological manifestations of atrial myxomas may be encountered in different pathological circumstances: cerebral embolism, intracranial aneurysms, and metastatic mass lesions. We report a case of multiple metastatic intracranial lesions associated with atrial myxoma and discuss the potential mechanisms of its perplexing neuroimaging manifestations. Comparing with previous reports of myxoma-associated intracranial lesions, the most notable features of the present case were the multiple high-density "calcified" lesions accompanying the aneurysms on computed tomography scan and the significant contrast-enhanced mass in the left parietal lobe on magnetic resonance scan. This suggested an extremely rare case of coexistence of aneurysms and intracranial metastatic mass lesion associated with cardiac myxoma, although the pathological evidence was not available. PMID:23524767

Zhan, Renya; Ji, Tao; Fan, Zuoxu; Pan, Desheng

2013-03-01

52

Cardiac lipoma at unusual location -- mimicking atrial myxoma.  

PubMed

Cardiac lipomas are one of the rare primary benign neoplasms composed of mature fat cells. The tumor originates mostly in the subendocardium and subepicardium but very rarely within the myocardium. Clinically, this tumor is asymptomatic and found incidentally in the vast majority of cases. We report a 26-year-old female presenting with atypical chest pain. Transthoracic echocardiogram showed a mass in relation to interatrial septum suggestive of atrial myxoma, but was confirmed to be cardiac lipoma on magnetic resonance imaging. Owing to the asymptomatic character and the benign nature of the tumor, a decision for conservative management was made. PMID:23311305

Singh, Bhupinder; Bhairappa, Shivakumar; Shankar, Subramani Khamitkar; Prasad, N M; Manjunath, C N

2013-01-11

53

Right atrial myxoma as a possible cause of hemorrhagic stroke and sudden death  

PubMed Central

Right atrial myxomas are rare primary tumors of the heart. They may remain asymptomatic or eventually cause constitutional signs and symptoms. Less frequently, obstruction of the tricuspid valve occurs, resulting in exertional dyspnea, syncope, or sudden death. Neurological manifestation as initial presentation of atrial myxomas is rarely, if ever, associated with right atrial myxomas and may be secondary to cerebral infarction, cerebral hemorrhage and, more rarely subarachnoid hemorrhage. We review the case of a previously unknown, middle-aged Nigerian man who presented to hospital with severe headache and sudden loss of consciousness. A clinical diagnosis of hypertensive hemorrhagic cerebrovascular accident was made. The patient died suddenly a few hours after presentation. Post-mortem examination revealed a small intracerebral hemorrhage in the left superior temporal lobe as well as a large right atrial myxoma, a ventricular septal defect in the muscular septum, and right ventricular hypertrophy. The liver showed fatty change while the kidneys showed evidence of benign nephrosclerosis. Right atrial myxomas may, therefore, be remotely considered as a cause of intracranial hemorrhage, especially in the presence of predisposing cardiac anomalies such as a ventricular septal defect. Similarly, being a known cause of right heart failure, sudden death, and other constitutional derangements, it may contribute significantly to disease outcome. Hence, it should be given due consideration in the differential diagnosis of cerebrovascular accidents.

Sabageh, Donatus; Odujoko, Oluwole Olaniyi; Komolafe, Akinwumi Oluwole

2012-01-01

54

The early presentation of atrial myxoma with acute myocardial infarction.  

PubMed

Atrial myxoma as a rare benign heart tumor can cause acute coronary syndrome via coronary embolization. In this report, we present a 54-year-old woman who presented with acute inferior myocardial infarction. In further evaluation a 2.5 x 3 x 4 cm mass was found in the left atrium. The mass was excised surgically and its pathology was compatible with myxoma. After resection, the patient was discharged with a favorable outcome. PMID:18154429

Namazee, Mohammad-Hassan; Rohani-Sarvestani, Hamid-Reza; Serati, Ali-Reza

2008-01-01

55

Mitral valve annular bacterial vegetative mass masquerading as a left atrial myxoma.  

PubMed

A 49-year-old male with chronic kidney disease and history of renal transplantation in 2006 on chronic immunosuppressant therapy presented with a 1-week history of chills and generalized myalgia. He had a temperature of 101 degrees F. One set of blood cultures grew methicillin-sensitive Staphylococcus aureus. Transesophageal echo (TEE) revealed a mobile mass that was 2 cm in length attached by a thin stalk to the base of the anterior leaflet of the mitral valve. The surgical diagnosis was a left atrial myxoma. The echocardiographic as well as the surgical findings were consistent with an atrial myxoma. However, the histopathology of the specimen showed no evidence of myxoma as the characteristic stellate mesenchymal cells were absent. Instead the milieu of inflammatory cells, fibrin and multimicrobial colonization of both Gram-positive and Gram-negative cocci suggested a super infected vegetative mass. It is interesting that the mitral valve was intact as de novo vegetation being formed on a structurally normal native valve is rare. In some instances, the echocardiographic distinction between atrial masses such as vegetation, thrombus or an atrial myxoma may be ambiguous. Not only does surgical removal allow histological determination of the diagnosis that is critical for treatment, but in cases where an infected mass is mobile and greater than 15 mm, as in this case, there is high potential for embolization. Surgical removal significantly decreases the risk of an embolic event. PMID:20545987

Bullock-Palmer, Renee P; Tak, Vinay; Mitchell, Judith E

2010-06-09

56

Left Atrial Myxoma on FDG-PET/CT.  

PubMed

A 56-year-old woman with rheumatoid factor-positive rheumatoid arthritis underwent FDG-PET/CT because of fatigue, fever, coughing, and weight loss for several months. FDG-PET/CT solely revealed a mildly hypermetabolic hypodense area in the left atrium. Subsequently, transthoracic echocardiography and contrast-enhanced MRI showed a left atrial pedunculated soft tissue mass suggestive for myxoma, with histological confirmation. Myocardial involvement by tumors is rare, and FDG-PET/CT has been very useful for identifying cardiac metastases. However, very few cases have been reported using FDG-PET/CT for detecting primary cardiac tumors, but as shown here, abnormal focal myocardial uptake should trigger further morphological assessment. PMID:23510877

Gheysens, Olivier; Cornillie, Jasmien; Voigt, Jens-Uwe; Bogaert, Jan; Westhovens, Rene

2013-11-01

57

Incidental Epstein-Barr virus associated atypical lymphoid proliferation arising in a left atrial myxoma: a case of long survival without any postsurgical treatment and review of the literature.  

PubMed

We report a case of left atrial cardiac myxoma harbouring an incidental atypical B-cell lymphoid proliferation. Histology disclosed classic myxoma cells embedded in a mucopolysaccharide-rich matrix and a micronodular atypical lymphoid proliferation under the surface of the mass. Myxoma cells were immunoreactive for calretinin, while lymphoid cells expressed B lineage markers (CD 20+, CD79a), without evidence of clonality. Moreover, they were LMP1 positive; EBNA2 negative; KSHV/HHV8 negative; and, by in situ hybridization, EBER/Epstein-Barr virus (EBV) positive and Kappa and Lambda negative. According to the 2008 WHO schemes, the present case shares close similarities either with diffuse large B-cell lymphomas growing in the context of long-standing chronic inflammation or with primary effusion lymphomas, solid variant, both associated with EBV infection. This is the sixth case of incidental atypical lymphoid proliferation discovered in a cardiac myxoma reported so far. The optimal treatment of such lesions remains undefined, but their clinical course is indolent. After an accurate staging workup, without any postsurgical treatment, the patient we observed has been well with no recurrence of the disease at 6 years of follow-up. PMID:23022500

Bartoloni, Giovanni; Pucci, Angela; Giorlandino, Alexandra; Berretta, Massimiliano; Mignosa, Carmelo; Italia, Fabrizio; Carbone, Antonino; Canzonieri, Vincenzo

2012-09-28

58

Atrial myxoma: an unusual cause of myocardial infarction.  

PubMed

A 55-year-old woman had an inferior myocardial infarction due to a coronary artery embolus from a large, polypoid, left atrial mass. The mass had an irregular surface and was prolapsing into the mitral valve orifice during diastole. Coronary angiography revealed tumor vascularization next to the right coronary artery. The other coronary arteries were normal. The tumor was removed surgically; pathologic examination confirmed the diagnosis of myxoma. The patient did well after the procedure and was discharged on postoperative day 10. PMID:16392241

Demir, Mesut; Akpinar, Onur; Acarturk, Esmeray

2005-01-01

59

Cerebral Embolism Associated with Left Atrial Myxoma That Was Treated with Thrombolytic Therapy  

PubMed Central

We present a case of cerebral embolism associated with a left atrial myxoma that was treated with intravenous thrombolytic therapy. A 79-year-old right-handed man with no history of neurological or psychiatric illnesses was referred to our hospital because of confusion. He had been self-supported in the activity of daily living and could enjoy gardening until just before his admission. He had aphasia, left conjugate deviation, right hemiparesis, and right pathological reflexes. His NIHSS score was 24. Cranial DWI showed hyperintense lesions in the left middle cerebral artery territory, and MRA revealed left middle cerebral artery occlusion. We started treatment with the recombinant tissue plasminogen activator alteplase intravenously 3 h after the onset. However, the therapy was ineffective, and the NIHSS score was 25 on the second day. A transthoracic echocardiogram and heart MRI showed a left atrial myxoma. However, surgery was contraindicated because of the patient's poor general condition. Although intravenous recombinant tissue plasminogen activator is a reasonable treatment for stroke patients, even with a cardiac myxoma, we cannot always expect good effects, especially if the emboli are parts of the tumor itself. In this case, we could not perform an endovascular mechanical embolectomy; however, we speculate that mechanical embolus retrieval in cerebral ischemia might be effective in such cases.

Kohno, Naoto; Kawakami, Yuko; Hamada, Chizuko; Toyoda, Genya; Bokura, Hirokazu; Yamaguchi, Shuhei

2012-01-01

60

Unilateral anhidrosis: a rare presentation of atrial myxoma?  

PubMed

A 50-year-old Chinese woman, non-smoker, presented with a 6-month history of increased sweating on the right side of her face, exertional chest tightness and breathlessness. Although the patient presented with increased sweating on the right, further history and examination revealed unilateral, left-sided anhidrosis, left partial ptosis and miosis consistent with Horner's syndrome. The patient was subsequently investigated with thoracic CT to assess for an apical lung mass (Pancoast tumour). A CT chest ruled out a mediastinal tumour, however, it revealed a large 60×41 mm soft tissue mass arising from the left atrium, protruding across the mitral valve into the left ventricle, suspicious of an intracardiac tumour. The patient was referred urgently for cardiothoracic assessment at a tertiary referral centre and successful open resection was performed. Histology confirmed an atrial myxoma. The patient developed postoperative atrial fibrillation but otherwise made a full recovery. PMID:23230264

Gould, Justin

2012-12-10

61

[Acute myocardial infarction due to coronary embolisation as the first manifestation of left atrial myxoma].  

PubMed

This report describes a 52 year-old women with an inferior myocardial infarction due to a coronary artery embolus. Coronary angiography revealed occlusion of right coronary artery and echocardiographic findings showed a large left intraatrial tumour. The tumour was removed surgically and pathological findings confirmed the diagnosis of myxoma. Aetiology of the occlusion was closely related to the left atrial tumour. Myocardial infarction was the first manifestation of left atrial myxoma. PMID:23788348

Konstanty-Kalandyk, Janusz; Wierzbicki, Karol; Bartu?, Krzysztof; Sadowski, Jerzy

2013-01-01

62

Primary occipital myxoma: A rare case report  

PubMed Central

Myxomas are benign tumors arising from mesenchymal tissues throughout the body. These tumors are usually seen in the atrium of heart and the jaw bone. Only a few cases of primary intracranial myxomas have been described in the literature. A rare case of primary myxoma of the occipital region is presented. A 12-year-old boy had mild occipital headache for the past 2 months which was unnoticed. Local hairdresser noticed a bulge in the occipital region while doing haircut and informed the parents and medical opinion was taken. He was seen by a neurosurgeon and after investigations he underwent craniotomy. Near total resection of the tumor was achieved. Histopathology and immunohistochemistry confirmed it to be a myxoma with no underlying cardiac focus. Following surgery the patient had rapid recovery.

Kawatra, Mallika; Bhandari, Virendra; Phatak, Satish; Kulkarni, Deepak

2013-01-01

63

Giant left atrial myxoma causing drop attacks by prolapsing into the mitral valve  

PubMed Central

Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation varies greatly from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We herein describe the clinicopathological and imaging features of a huge left atrial myxoma protruding into the left ventricle during diastole and obstructing diastolic filling of the left ventricle thus causing drop attacks by prolapsing into the mitral valve. The patient (a 56-year-old female) underwent emergency surgery with complete removal of a 74 g weighing myxoma from the left atrium. She recovered without any complications. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention to avoid irreversible cardiovascular complications.

Strecker, Thomas; Agaimy, Abbas

2012-01-01

64

Right atrial myxoma and severe left ventricular dysfunction: which explanations? Which management?  

PubMed

A 57 year-old woman with a large right atrial myxoma underwent emergency surgical resection in our institute. It is known that surgical management of such tumours is difficult regarding venous cannulation and embolic risk, but in our patient, the surgery was more challenging because of the severe left ventricular dysfunction. Thus, we aim on the one hand, to discuss the association between the left ventricular dysfunction and the right atrial myxoma, and, on the other hand, to describe the on-pump beating heart technique we used to remove this mass. PMID:23098892

Boutayeb, Alaae; Marmade, Lahcen; Bensouda, Adil; Moughil, Said

2012-10-24

65

Pulmonary Embolism Caused by Right Atrial Myxoma on FDG PET/CT.  

PubMed

Pulmonary embolism derived from the right atrial myxoma is a rare event and can be difficult to recognize. A chest x-ray image from a 48-year-old woman with shortness of breath revealed multiple pulmonary nodules, which suggested lung metastases. An FDG PET/CT was performed for further evaluation. The images showed that the lung nodules had variable but mild FDG activity in general. There was 1 additional large FDG activity in the right atrium. The subsequent studies demonstrated that the patient experienced pulmonary embolism derived from the right atrial myxoma. PMID:24089067

Liu, Qinghua; Zuo, Changjing; Lv, Taozhen; Cui, Bin

2013-11-01

66

Left atrial myxoma in a child: a challenging diagnosis of a rare lesion.  

PubMed

An eight-year-old child presented with congestive heart failure, blurred vision, and unexplained constitutional symptoms. An echocardiogram demonstrated a giant left atrial mass that obstructed the mitral valve inflow. After excision of the myxoma, the patient had an uneventful recovery. PMID:23799741

Sernich, Steffan; Chauhan, Aman; Singh, Dhiraj; Fuchs, Hans; Caspi, Joseph

2013-04-01

67

Successful Liver, Kidney, and Pancreas Transplantation From a Donor With Cerebral Emboli From a Left Atrial Myxoma  

Microsoft Academic Search

Although transmission and engraftment of donor-derived malignancies is rare in recipients of solid organ transplants, it is associated with unfavorable allograft and patient survival. Therefore, a recent history of malignancy is considered a contraindication to organ donation. Although atrial myxomas are benign cardiac tumors of stromal origin, they can lead to systemic embolization with ectopic myxoma formation. We report successful

R. J. Canter; P. L. Abt; L. A. Litzky; A. Frank; A. B. Abt; M. T. Sellers; J. F. Markmann; K. M. Olthoff; A. Naji; A. Shaked

2005-01-01

68

[Juxta articular myxoma of the wrist: a case report].  

PubMed

Juxta articular myxomas are rare tumors. The treatment is surgical with a high recurrence rate. A location proximal to the wrist joint is exceptional. We report a case of juxta articular myxoma of the wrist in a 30-year-old patient, with no recurrence four months after surgical excision. PMID:20724197

Abkari, I; El Hassib, J; Latifi, M; Hazmiri, F-E; Belaabidia, B

2010-07-24

69

Myxomas  

MedlinePLUS

... left atrium often grows from a stalk and swings freely with the flow of blood. As it swings, the myxoma may move in and out of ... left atrium often grow from a stalk and swing freely with the flow of blood, as a ...

70

Giant left atrial myxoma mimicking severe mitral valve stenosis and severe pulmonary hypertension.  

PubMed

Myxoma is the most common primary tumor of the heart and can arise in any of the cardiac chambers. This paper reports A 50 -year-old woman without medical history and any cardiovascular risk factors was hospitalized for exertional dyspnea and palpitations from three months and signifiant weight loss. Transthoracic echocardiogram showed a giant left atrial myxoma mobile confined to the left atrium in systole, in diastole the tumor was seen prolapsing across the mitral valve into the left ventricle and partially obstructing it and causing severe functional mitral stenosis with a mean gradient of 21,3 mmHg. Severe pulmonary hypertension was confirmed by Doppler PAPs =137 mmHg. The patient was scheduled for cardiac surgery with good outcome. PMID:23601991

Mouine, Najat N; Asfalou, Ilyass I; Raissouni, Maha M; Benyass, Aatif A; Zbir, El Mehdi

2013-04-19

71

Giant myxoma causing heart failure symptoms  

PubMed Central

Summary Background: Myxomas arising from the eustachian valve are exceedingly rare. Case Report: A 72-year-old Jamaican-Chinese woman was evaluated for worsening dyspnea. The 2-dimensional and real time 3-dimensional transesophageal echocardiogram showed a 75 mm length × 44 mm width, multilobulated, mobile mass arising from the eustachian valve occupying the entire right atrial and right ventricular cavities extending into the coronary sinus, right ventricular outflow tract, and proximal inferior vena cava. The patient underwent successful resection of the mass and replacement of the tricuspid valve. Histopathologic examination confirmed the diagnosis of atrial myxoma. Conclusions: This is the largest myxoma found on a Eustachian valve.

Chhabra, Amit; McClung, John A.; Kalapatapu, Srirama; Lafaro, Rocco J.; Fallon, John T.; Aronow, Wilbert S.

2012-01-01

72

Brain metastasis of cardiac myxoma: case report and review of the literature.  

PubMed

Cardiac myxoma is the most common benign heart tumor. Cardiac myxoma can be a sporadic lesion (93% of cases) and usually occurs in women over 30 years. Complete surgical removal of the myxoma and its cardiac attachment is usually curative. The frequency of recurrences in cardiac myxomas varies between 3% for sporadic cases and 22% for cases of Carney complex. Recurrence has been related to incomplete excision, multifocality, and embolism of tumor fragments. We report a case with multiple brain metastases presumably due to tumor embolization from previously operated cardiac myxoma. PMID:16132507

Altundag, Muzaffer B; Ertas, Gulcin; Ucer, Ali R; Durmus, Sema; Abanuz, Hayati; Caliko?lu, Tamer; Ozbagi, Kenan; Demirkasimoglu, Atila; Kaya, Bektas; Bakkal, Bekir H; Altundag, Kadri

2005-11-01

73

A Rare Case of Aortic Valve Myxoma: Easy to Confuse With Papillary Fibroelastoma  

PubMed Central

Myxoma of the aortic valve is an exceedingly uncommon condition. In this article, we report the case of a 72-year-old man with myxoma arising from the aortic valve. We extirpated the mass and repaired the aortic valve with the patient under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination confirmed that the mass was a myxoma.

Kim, Hyung Yoon; Jang, Woo-Ik; Kim, Han-Seong; Kim, Jin Suk; Lee, Han Sang; Park, Min Yong; Kim, Taewan; Lee, Sung Yun; Doh, Joon Hyung; Namgung, June; Lee, Won Roo

2012-01-01

74

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma  

PubMed Central

This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs. Our findings showed the absence of MES on two consecutive TCD examinations, suggesting a spontaneous occurrence, rather than the permanent presence, of embolization, even in the most acute phase of stroke. Thus, the tendency of myxomas to spontaneously produce multiple emboli emphasizes the need for the surgical excision of myxomas.

Telman, Gregory; Mesica, Orit; Kouperberg, Efim; Cohen, Oved; Bolotin, Gil; Agmon, Yoram

2010-01-01

75

Atrial myxoma: a rare cause of cardioembolic stroke.  

PubMed

The authors present the case of a 45-year-old lady who presented to the emergency department with sudden onset of right hemiparesis, numbness, dysarthria, dysmetria, left upper motor neuron facial palsy and left extensor plantar. Initial laboratory investigations, ECG and MR angiography were normal. MRI brain revealed multiple ischaemic strokes in middle cerebral artery and posterior cerebral artery territory. Transthoracic echocardiography revealed large mobile mass in left atrium which was resected and the patient remained well postoperatively. Anticoagulants do not play any protective role making resection as the only effective treatment. PMID:22962389

Akhtar, Junaid; Wasay, Mohammad; Rauf, Javeria

2012-09-07

76

Sphenoid Sinus Myxoma: Case Report and Literature Review  

PubMed Central

Objectives: We present the first known case in the English-language literature of a myxoma arising in the sphenoid sinus. By describing the patient's clinical course and the salient features of this rare neoplasm, we seek to increase the awareness of the presentation, histological features, and treatment considerations for myxomas of the head and neck. In the process, we intend to describe the work-up of isolated sphenoid sinus lesions and focus on the varying and evolving techniques for surgical access to the sphenoid sinus. Study Design and Methods: Case report and literature review. Results: We describe the clinical course of a patient with a myxoma of the sphenoid sinus. The patient underwent an external sphenoethmoidectomy through a lateral rhinotomy approach with medial maxillectomy under MRI-guidance. He remains without evidence of recurrent disease after 8 months. Conclusions: Myxomas of the head and neck are rare neoplasms. Their infiltrative nature and tendency to recur demand an aggressive surgical approach that may be accomplished with minimal morbidity using currently available image-guided techniques.

Moore, Brian A.; Wine, Todd; Burkey, Brian B.; Amedee, Ronald G.; Butcher, R. Brent

2008-01-01

77

Pathology Case Study: Multiple Myxomas and Thyroid Cancer  

NSDL National Science Digital Library

This is a endocrine pathology case study presented by the University of Pittsburgh Department of Pathology in which a 36-year-old white female has multiple myxomas and thyroid cancer. Visitors are given examination and laboratory data and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with diagnosis. It is also a helpful site for educators to use to introduce or test student learning in endocrine pathology.

Virji, Mohamed; Wang, Jianzhou

2008-04-08

78

Condyloma acuminatum associated with odontogenic myxoma: a case report.  

PubMed

Condylomata acuminatum is a sexually transmitted infectious disease caused by human papiloma virus on the skin. The transmission is mainly by close contact with infected person and autoinoculation. In oral cavity the condition manifests as soft pink nodules which proliferate and coalesce rapidly to form diffuse papillomatous clusters of varying size. Odontogenic myxoma is a rare tumor of jaws which occurs in the tooth-bearing areas of the mandible and maxilla. It is an uncommon, benign, but locally aggressive neoplasm. This case report highlights a 17-year-old girl with two lesions in oral cavity with soft tissue growth on the palate which has been diagnosed as Condyloma Acuminatum, treated by surgical excision and a large swelling on the right side of the mandible in the same patient diagnosed as odontogenic myxoma where marginal resection was performed. PMID:23139551

Rajasekhar, G; Mushtaq, Mohammed; Vura, Nanda Gopal; Shekar, Ravi; Kumar, Sravan

2010-04-24

79

Brain metastases and multiple cerebral aneurysms from cardiac myxoma: case report and review of the literature.  

PubMed

Cardiac myxoma, the most common benign cardiac tumour, can determine brain metastases or multiple cerebral aneurysms, but very few cases of both complications have been reported. We discuss the therapeutic management in the case of a patient, operated for a cardiac myxoma, who presented three intracerebral tumours and five cerebral microaneurysms. PMID:22686128

Radoi, Mugurel Petrinel; Stefanescu, Florin; Arsene, Dorel

2012-06-11

80

Atrial myxoma as a cause of stroke: emboli detection and thrombolytic treatment.  

PubMed

It presents a case of a 42-year-old female patient who was admitted to the stroke unit for right-sided hemiplegia and global aphasia, without conventional stroke risk factors. As the patient presented within the therapeutic time window and had no contraindications for thrombolysis, intravenous thrombolytic treatment was initiated. Brain CT showed multiple hypodense partly confluent lesions in the territory of the left middle cerebral artery. For the purpose of determining the etiology of the stroke, TCD was performed and after cerebral microemboli were detected, transthoracic echocardiography was indicated, the finding of which showed the presence of a myxoma in the left atrium. The patient underwent surgery and thereafter her neurological deficits improved. PMID:22634921

Ruži?ka-Kaloci, Svetlana; Slankamenac, Petar; Viti?, Branka; Lu?i?-Prokin, Aleksandra; Jovi?evi?, Mirjana; Zivanovic, Zeljko; Hajder, Dragica

2012-02-01

81

A Rare Presentation of Conjunctival Myxoma with Pain and Redness: Case Report and Literature Review  

PubMed Central

Background Conjunctival myxoma is a type of rare, benign tumor of mesenchymal cells, with fewer than 30 reported cases in the English literature. It is mostly an isolated occurrence but can sometimes be associated with systemic diseases such as Carney complex or Zollinger-Ellison syndrome. It is necessary in clinical practice to differentiate it from other similar lesions, such as amelanotic nevus, lymphangioma, myxoid liposarcoma, spindle-cell lipoma, myxoid neurofibroma, and rhabdomyosarcoma. Case Presentation The usual presentation of conjunctival myxoma is a translucent, well-circumscribed, and painless conjunctival mass, but in this report we discuss an unusual case of conjunctival myxoma in a 47-year-old Taiwanese woman who presented initially with pain and redness. This atypical presentation complicated the diagnosis and the management at first. Surgical excision of the mass was performed. The mass was found to be a conjunctival myxoma. The patient subsequently underwent extensive evaluation but was found not to have any systemic diseases with known association with conjunctival myxoma. Conclusions In summary, we present a case of conjunctival myxoma in a 47-year-old Taiwanese woman. The initial presentation with pain and redness was atypical for conjunctival myxoma. The lesion was successfully managed with complete excisional biopsy.

Chen, Yu-Po; Tsung, Swei Hsiung; Yet-Min Lin, Tommy

2012-01-01

82

Neovascularized myxoma-causing abnormal blood flow in the left atrium diagnosed by transesophageal echocardiography.  

PubMed

Myxomas are the most common primary cardiac tumor, and neovascularization of cardiac myxoma has been shown in previous case reports. However, it is seldom reported that abnormal blood flow spurted from a neovascularized myxoma into the cardiac chamber. In this unusual case report, we present a left atrial myxoma in a 44-year-old woman with atypical angina. Transesophageal echocardiography (TEE) revealed several small blood streams spurting from the surface of massively vascularized myxoma into the left atrium. Coronary angiography showed a feeding artery which arose from the right coronary artery and supplied the left atrial myxoma, with no evidence of coronary artery stenosis. This case demonstrated that TTE might be helpful for confirming the neovascularization of myxoma in the left atrium and finding the abnormal blood flow that spurts from the neovascularized myxoma. We speculate that the abnormal blood flow spurting from the neovascularized myxoma into the left atrium may have caused a coronary steal phenomenon thus resulting in myocardial ischemia. PMID:23002715

Wang, Xiaobing; Ren, Weidong; Yang, Jun

2012-09-25

83

Cardiac myxoma diagnosed by signs of purpuric macules on both palms and soles.  

PubMed

Cardiac myxoma, the most prevalent primary cardiac tumor, is rare. The clinical features of this tumor are principally intracardiac obstruction, extracardiac embolism, and general symptoms including fever, myalgia, arthralgia. Although cutaneous manifestations in patients with cardiac myxoma are frequent, in rare cases, cutaneous signs have been clues to the correct diagnosis. We report a 42-year-old male who presented with recurrent multiple purpuric patches on both palms and soles for 4 months. Histopathological finding showed a myxomatous embolus in the arteriole in the lower dermis. Echocardiogram demonstrated the presence of a left atrial myxoma with a provisional diagnosis of left atrial myxoma. In our patient, skin examinations and histopathological finding led us to the diagnosis of cardiac myxoma. PMID:22879718

Lee, Hyo Jin; Park, Jeung Young; Kim, Young Sik; Shin, Dong Hoon; Choi, Jong Soo; Kim, Ki-Hong; Bae, Young Kyung

2012-07-25

84

MULTIPLE CALCIFIED RIGHT ATRIAL MYXOMAS ASSOCIATED WITH TRICUSPID INSUFFICIENCY IN A CHILD  

PubMed Central

Multiple calcified myxomas of the right atrium were discovered in a 12-year-old girl and were associated with a dysplastic tricuspid valve that was grossly insufficient. Surgical resection of three pedunculated masses was performed, and the tricuspid valve was replaced with a biologic prosthesis. Images

Martinez, Manuel Jimenez; Franco, Eliud Hernandez; Avalos, Luis Lasso; Perez, Alejandro Martinez

1979-01-01

85

Oncologic profile of maxillary odontogenic myxoma: A rare case.  

PubMed

Odontogenic myxoma (OM) is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis. PMID:24124309

Sarkar, Reena Radhikaprasad

2013-07-01

86

Oncologic profile of maxillary odontogenic myxoma: A rare case  

PubMed Central

Odontogenic myxoma (OM) is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis.

Sarkar, Reena Radhikaprasad

2013-01-01

87

[Recurrent cardiac myxoma that developed rapidly in a short period].  

PubMed

A 55-year-old woman, who had undergone extirpation of left atrial myxoma 3-years before, was admitted to our hospital with dyspnea. Chest computed tomography revealed a low density mass in the left atrium (LA) with a diameter of 54 mm. Transthoracic echocardiography showed that the mass was attached to the left atrial septal wall and had a pendulum-like movement. We urgently performed an operation for recurrent left atrial myxoma. Through atrial transseptal approach, a huge myxomatus tumor was observed in the LA. The stalk was on the endocardium at the cranial side of the previous autologous pericardial patch. The tumor was completely excised along with the patch. We repaired the disrupted endocardium and performed Dacron patch repair of the atrial septal defect. The patient recovered uneventfully and was discharged 14 days after surgery. The excised tumor was found to be myxoma on pathological examination similar to the previous tumor. We report a case of recurrent left atrial myxoma with rapid growth in a short time period. PMID:19202933

Okamoto, Y; Shimura, K; Mitsumori, Y; Katsu, M; Kaga, S; Inoue, H; Ogata, K; Suzuki, S; Shindo, S; Matsumoto, M

2009-02-01

88

Fibrous dysplasia of bone associated with soft-tissue myxomas as well as an intra-osseous myxoma in a woman with Mazabraud's syndrome: a case report  

PubMed Central

Introduction Mazabraud's syndrome is a rare but well-described disorder characterized by fibrous dysplasia in single or multiple bones associated with one or more soft-tissue myxomas. In this report, we describe what is, to the best of our knowledge, the first case involving an intra-osseous myxoma. This finding supports, and could provide new insight into, the pathological association between fibrous dysplasia and myxomas. Case presentation In this report, we describe the case of a 49-year-old Caucasian woman known for years to have fibrous dysplasia in the left femur and tibia who presented with progressive pain in her left leg and soft swelling in the left quadriceps region. After surgical intervention with excision of the soft-tissue mass, the diagnosis of Mazabraud's syndrome was confirmed. During follow-up, our patient presented with a painless mass located on the lateral side of the left knee, next to a second, intra-osseous lesion with the same characteristics in the left lateral tibial plateau. The histopathological examination was consistent with a soft-tissue intra-osseous myxoma. Conclusion In the international literature, 67 cases of Mazabraud's syndrome have been described so far. To our knowledge, the present case report is the first to describe the combination of polyostotic fibrous dysplasia and intra-muscular as well as intra-osseous myxoma.

2011-01-01

89

Myxoma of the small intestine complicated by ileo-ileal intussusception: Report of an extremely rare case  

PubMed Central

INTRODUCTION Myxomas of the small intestine are extremely rare types of primary bowel neoplasms. Their presence can trigger intestinal intussusception in the adults. We present the eighth case of intestinal myxoma reported in the English literature. PRESENTATION OF CASE Our patient is a 44-year-old Caucasian female who presented with clinical and imaging findings of intestinal intussusception. Laparotomy revealed ileo-ileal intussusception caused by an intramural mass of the middle-ileum which was resected. Histological and immunohistochemical studies pointed to the diagnosis of benign intestinal myxoma, while imaging studies of the heart excluded a synchronous cardiac myxoma. Twenty months after surgery she remains disease-free. DISCUSSION The myxoma is a benign, true neoplasm which resembles primitive mesenchyme. It occurs predominantly in the heart and is also found in several soft tissues and bones. Myxomas seem to grow at different rates of speed, they infiltrate adjacent structures and they do not metastasize, apart from cardiac variants. Intestinal myxomas share some clinical characteristics which are emphasized. CONCLUSION Myxomas of the small intestine should be included in the differential diagnosis of ileal tumors in middle-aged women manifesting as intestinal intussusception. Treatment should include wide resection of the affected intestinal segment with primary anastomosis. A close follow-up control of the patients along with cardiac imaging evaluation is recommended postoperatively, in order to detect and treat any possible recurrence of the tumor or a synchronous cardiac myxoma.

Varsamis, Nikolaos; Tavlaridis, Theodoros; Lostoridis, Eftychios; Tziastoudi, Eirini; Salveridis, Nikolaos; Chatzipourgani, Chrysanthi; Pouggouras, Constantinos; Pakataridis, Athanasios; Christodoulidis, Constantinos

2013-01-01

90

Carney Complex: case report and review  

PubMed Central

Carney complex is a very rare multiple neoplasia syndrome with cardiac, cutaneous, and neural tumours with a variety of pigmented lesion of skin. We are reporting a rare case of carney complex in which left atrial myxoma with superficial angiomyxoma, giant cell tumour of bone and lentigines showed a unique association. This patient underwent successful surgical excision of left atrial myxoma under cardiopulmonary bypass.

2011-01-01

91

Tricuspid Valvular Myxoma: Unusual Case of Tricuspid Valve Myxoma Mimicking Thrombus after Pulmonary Artery Embolectomy and Tricuspid Annuloplasty in Pulmonary Thromboembolism Patient  

PubMed Central

A 55-year-old man with massive pulmonary thromboembolism underwent thrombolysis, pulmonary artery embolectomy and tricuspid annuloplasty. Nine months later, a mobile echogenic intra-cardiac mass was found in the tricuspid valve. Because the patient had undergone annuloplasty, thrombosis was suspected as the most likely diagnosis and thrombolytic therapy was instituted. However, the size of the cardiac mass did not change and after surgical excision the mass was found to be a myxoma. Cardiac valvular tumors are uncommon and when they occur they are usually slow growing fibroelastomas. In this case, the rapid growing cardiac myxoma on the tricuspid valve was found after the occurrence of pulmonary thromboembolism. To our knowledge, this is first reported case of tricuspid valve myxoma in Korea.

Park, Min Yong; Lee, Sung Yun; Kang, Boram; Kim, Hyung Yoon; Cho, Yu Jung; Chang, Woo-Ik; Chang, Sun Hee

2011-01-01

92

Infiltrative odontogenic myxoma of the posterior maxilla: Report of a case  

PubMed Central

Myxomas of the head and neck are rare tumors of uncertain histogenesis. Odontogenic myxomas in maxilla are less common but behave more aggressively, as it spreads through maxillary antrum. It therefore reaches considerable size before being detected. The current case arouses particular interest due to the rapid growth and infiltrating nature of the lesion in a 25-year-old female patient, who denied any leading symptoms, even with the lesion involving extensively. Radiographic and microscopic similarities to a number of entities make diagnostic interpretation of odontogenic myxoma challenging. Therefore sound knowledge of clinical, radiographic and histopathologic features is important to establish an appropriate treatment aimed at a good clinical course and patient cure.

Arul, A. Sri Kennath J.; Verma, Sonika; Arul, A. Sri Sennath J.; Verma, Rashmika

2013-01-01

93

A new intracavitary lesion at echocardiography and MR: a case of mistaken identity.  

PubMed

Atrial myxomas often show contrast enhancement following administration of intravenous gadolinium, whereas thrombus appears as a hypointense structure, typically without any contrast enhancement. This case report presents a diagnostic challenge involving a recently developed left atrial mass in which echocardiography and cardiac MRI provided discordant results. While the morphological characteristics of the new left atrial lesion were suggestive of myxoma, the signal characteristics and behavior following intravenous gadolinium at MR, and, in particular, the rapid interval appearance of the lesion, prompted consideration for left atrial thrombus. Subsequent intra-operative and histopathologic evaluation proved the mass to be a left atrial myxoma. PMID:23712831

Pandit, Anil; Panse, Prasad M; Aryal, Aashrayata; Gruden, James F; Gotway, Mike

2013-05-26

94

Multiple Recurrences of Nonfamilial Cardiac Myxomas  

PubMed Central

Cardiac myxomas are the most common primary cardiac tumors. Surgical resection usually provides definitive treatment; however, postoperative tumor recurrence has been reported, especially when myxomas occur as part of a familial pattern. Only a few cases of 2nd recurrence of nonfamilial cardiac myxoma have been reported. We report 2 cases of nonfamilial cardiac myxoma, with multiple recurrences after surgical resection. The possibility of repeated recurrence of cardiac myxomas demonstrates the importance of regular echocardiography after surgical resection in order to detect such recurrence. Future studies, including genetic analysis of patients with recurrent cardiac myxomas, are warranted to investigate the nature of these tumors.

Mendoza, Cesar; Bernstein, Erik; Ferreira, Alexandre

2007-01-01

95

[Persistent atrial paralysis: reported of 2 cases].  

PubMed

Persistent atrial standstill is an uncommon clinical finding, this condition has no atrial electrical activity and do not respond to electrical stimulation. Electrophysiologic mapping of the heart, demonstrates two types of standstill: total and partial. There are three types of patients with this condition: patients with chronic cardiopathy, patients with muscular dystrophy and the third idiopathic group. In this article, we present two clinical cases, the fist one with dilated cardiomiopathy, in which we demonstrated total atrial standstill. The second patient with rheumatic heart disease, in which we demonstrated partial standstill that included the apical portion of the rigth atrium. We discuss the clinical and electrophysiological finding of both cases and we review the literature. PMID:9585833

Rodríguez Reyes, H; Cruz Cruz, F; Iturralde Torres, P; de Micheli, A; González Hermosillo, J A

96

Carney-Complex: multiple resections of recurrent cardiac myxoma.  

PubMed

We report a case of a female patient who was operated at the third relapse of an atrial myxoma caused by Carney complex. The difficult operation was performed without any complications despite extensive adhesions caused by the previous operations. The further inpatient course went without complications and the patient was discharged to the consecutive treatment on the 9th postoperative day. The echocardiographic finding postoperative showed no abnormalities. PMID:21291531

Bireta, Christian; Popov, Aron F; Schotola, Hanna; Trethowan, Brian; Friedrich, Martin; El-Mehsen, Mohamed; Schoendube, Friedrich A; Tirilomis, Theodor

2011-02-03

97

Carney-Complex: Multiple resections of recurrent cardiac myxoma  

PubMed Central

We report a case of a female patient who was operated at the third relapse of an atrial myxoma caused by Carney complex. The difficult operation was performed without any complications despite extensive adhesions caused by the previous operations. The further inpatient course went without complications and the patient was discharged to the consecutive treatment on the 9th postoperative day. The echocardiographic finding postoperative showed no abnormalities.

2011-01-01

98

Myxoma of the Vomer Bone  

PubMed Central

Myxomas of bone in the head and neck are rare tumors. We present a 68 year old female with pain and epistaxis who was found to have the first reported case of a myxoma arising within the vomer bone. Some atypical magnetic resonance imaging features are described, however, myxoma imaging features are often non-specific and typically evoke a benign differential diagnosis. Surgical excision is the treatment of choice.

Besachio, David; Quigley, Edward; Orlandi, Richard; Harnsberger, Hugh; Wiggins, Richard

2013-01-01

99

Cardiac Myxoma Originating from the Anterior Mitral Valve Leaflet  

PubMed Central

Primary cardiac tumors are rare and myxoma is the most common tumor among them. Cardiac myxoma usually occurs in the left atrium. Myxoma originating from mitral valve is extremely rare. We report a case of mitral valve myxoma. The tumor originated from the anterior mitral valve leaflet. The tumor was completely removed and replacement of the mitral valve was not done.

Yoon, Jung-Han; Kim, Ji-Hyun; Sung, Young-Jun; Lee, Min-Ho; Cha, Myung-Jin; Kang, Do-Yoon; Kim, Yong-Jin

2011-01-01

100

Peripheral odontogenic myxoma of maxillary gingiva: A rare clinical entity  

PubMed Central

Odontogenic myxoma comprises 3-6% of all odontogenic tumors. Odontogenic myxomas are relatively rare benign mesenchymal tumors found exclusively in the tooth-bearing areas of the jaw and are usually located centrally in the mandible. Soft-tissue localization is rarely seen and is classified as peripheral myxoma. Peripheral myxoma is slow growing and less aggressive, as compared to the central myxoma. It has a low recurrence rate. Till date, only few cases of maxillary gingival myxomas are reported in the literature. Here, we present an unusual case of primary peripheral odontogenic myxoma occurring in the gingiva of anterior maxilla in a 41-year-old female patient.

Jain, Vijay Kumar; Reddy, Soundarya Narayana

2013-01-01

101

Carney Complex: case report and review.  

PubMed

Carney complex is a very rare multiple neoplasia syndrome with cardiac, cutaneous, and neural tumours with a variety of pigmented lesion of skin. We are reporting a rare case of carney complex in which left atrial myxoma with superficial angiomyxoma, giant cell tumour of bone and lentigines showed a unique association. This patient underwent successful surgical excision of left atrial myxoma under cardiopulmonary bypass. PMID:21375769

Borkar, Shirish S; Kamath, Sevagur G; Kashyap, Nitin; Sagar, Sunil C V; Rao, Lakshmi; Warrier, Raj; Chauhan, Aman

2011-03-05

102

[Recurrent cerebrovascular accident: unusual and isolated manifestation of myxoma of the left atrium].  

PubMed

The authors report an unusual case of left atrial myxoma in a 30-year-old woman, discovered after a recurrent stroke. This tumor was misdiagnosed earlier because of an exclusive neurologic symptomatology, a normal cardiac exam without any sign of mitral obstruction (unusual high implantation of the myxoma within the roof of the left atrium), and the lack of doing an echocardiography which should be systematically done after an ischemic stroke, even if its etiology seems to be evident. Surgical resection of the tumor led to prevent further myxomatous emboli, but unfortunately, the patient keeps severe neurological sequelae. PMID:10641454

Kassab, R; Wehbe, L; Badaoui, G; el Asmar, B; Jebara, V; Ashoush, R

103

[Histopathological and immunohistochemical features of cardiac myxomas].  

PubMed

Mixomas are the most common primary cardiac tumors with an estimate incidence of 0,5-1 per 10(6) individuals per year. These tumors have generated interest due to their unique location (left side of the atrial septum near the fossa ovalis), variable clinical presentation and undefined histogenesis. Most cardiac myxomas occur sporadically while approximately 10% of diagnosed cases develop as part of Carney complex. This neoplasm is of uncertain histogenesis, however, endothelial, neurogenic, fibroblastic, and cardiac and smooth muscle cells differentiation has been proposed, and rarely glandular differentiation has been observed. Recently, due to the expression of certain cardiomyocyte-specific factors, an origin of mesenchymal cardiomyocytes progenitor cells has been suggested. Histologically cardiac myxomas are mainly composed of stellated, fusiform and polygonal cells, immersed in an amorphous myxoid matrix. Immunohistochemically some endothelial markers, such as CD31, CD34, FVIIIAg, are present. Positive staining has also been reported for S-100 protein, calretinin, vimentin, desmin, smooth muscle myosin, CD56, ?1 antitrypsin and ? 1antichymotrypsin. Surgical resection is currently the only treatment of choice. We present in this article a histopathological and immunohistochemical review of cardiac myxomas. PMID:23663893

Hernández-Bringas, Omar; Ortiz-Hidalgo, Carlos

104

Intra-atrial course of right coronary artery - case report  

PubMed Central

Summary Background: Intra-atrial course of the right coronary artery is a rare anomaly. The recognition of this entity is crucial to avoid potential hazards related to vessel injury during interventional procedures such as right heart catheterization, pacemaker implantation, invasive electrophysiology testing or atrial flutter ablation. Case Report: We present a case of a 62-year old female with paroxysmal atrial flutter and atrial fibrillation, whose cardiac computed tomography revealed an anomalous course of the right coronary artery through the right atrium. Conclusions: Cardiac computed tomography examination enables an accurate assessment of morphology and location of the anomalous vessel course.

Waniewska, Joanna; Michalowska, Ilona; Oleksiuk, Tomasz; Kwiatek, Pawel

2012-01-01

105

Myxoma developing after open heart surgery: is radiofrequency ablation responsible for the formation of the tumor?  

PubMed

34-year-old male with history of recurrent atrial fibrillation (AF) and mitral stenosis, status post radiofrequency ablation (RFA) and prosthetic mitral valve replacement two years earlier was admitted with prosthetic valve thrombosis for redo mitral valve surgery. During the surgery, a 2 x 1.5 x 1 cm mass was identified on the interatrial septum, attached to the edge of tricuspid valve's septal leaflet by a stalk. The mass was excised and histological evaluation revealed myxoma. It is accepted that myxomas can develop after cardiac trauma. It is known that RFA for AF increases the risk of thrombus or endocarditis in the atrium. Herein, we report a myxoma case where we think the heat energy caused by RFA might have triggered the development of the tumor. PMID:22571079

Sirin, G; Ozker, E; Fotbolcu, H; Ozden, K; Demirsoy, E

106

[Fever, asthenia, myalgia and murmur due to cardiac myxoma].  

PubMed

Cardiac tumours are rare, especially in children, and most of them are benign. Myxomas are unusual in children, being more common among adults. They are usually located in the left atrium, with 25% appearing in the right. The clinical signs and symptoms depend mainly on where the tumour is located. A feature of these tumours is that they can be accompanied by constitutional symptoms and laboratory abnormalities. Echocardiography is the study of choice, and a prompt resection is required to prevent serious complications. We present a case of a 10 year-old girl diagnosed with right atrial myxoma who presented with a fever, myalgia, asthenia and laboratory abnormalities. Diagnosis was made by echocardiography, and the early surgical resection of the tumour ran smoothly and showed a good postoperative recovery. PMID:23567656

Giménez Roca, C; Felipe Villalobos, A; Cambra Lasaosa, F J; Prada Martínez, F; Caffarena Calvar, J M; Jou Muñoz, C

2013-04-06

107

Right ventricular myxoma in a 12-year-old child: a case report.  

PubMed

Cardiac myxoma especially of the right ventricle, is rare in children. A 12-year-old boy with right ventricle myxoma is reported. His heart murmur was found incidentally when he visited the Outpatient Department (OPD) because of upper respiratory infection symptoms. There was no exertional dyspnea, no palpitation, no syncope and no skin lesion. The echocardiogram revealed a heart tumor of about 4 x 3 cm in the right ventricle (RV) extending to the right atrium (RA). The tumor grew from the interventricular septum, resulting in an RV outlet and inlet obstruction. Magnetic resonance image (MRI) revealed a well-defined mass in the RV ventricle, with good enhancement after injecting a contrast medium. The patient received right atriotomy and total excision of the tumor with repairing of the interventricular septum base. Pathology revealed myxoma with gelatinous whitish color and central hemorrhage. At post-operative follow-up, the patient's condition was good. PMID:7850689

Tsai, T S; Chen, Y J; Hsieh, K S; Lee, P C; Chi, C S

1994-12-01

108

Periocular Myxoma in a Child  

PubMed Central

Myxomas are locally invasive, benign mesenchymal neoplasms with odontogenic, osteogenic, or soft tissue origin. Facial myxomas probably account for less than 0.5% of all paranasal sinus and nasal tumors. We report a case of a left painless periocular mass in a 11-month-old girl. The lesion was resected with a clinical diagnosis of lacrimal sac tumor. Histopathology and immunohistochemistry proved the tumor to be a myxoma. There has been no recurrence after 4 years of followup. Midfacial myxomas should be differentiated from other benign and malignant tumors such as dermoid, hamartoma, neurofibroma, nasolacrimal duct cyst, and sarcomas in particular embryonal rhabdomyosarcoma. Because of the infiltrative nature of these tumors, a wide surgery is required to achieve clear resection margins and avoid recurrence.

Rios y Valles-Valles, Dolores; Vera-Torres, Ana Maria; Rodriguez-Martinez, Hector A.; Rodriguez-Reyes, Abelardo A.

2012-01-01

109

An exceptional case of atrial fibrillation arrhythmia induced by Etoposide.  

PubMed

Background: Arrhythmia induced by etoposide is exceedingly rare. There are only a very few individual case histories of arrhythmias during etoposide infusion, including atrial fibrillation. Objective: Through this uncommon case, we propose to study the pathophysiology, the diagnosis and the management of this entity. Case Report: We report a case of a 57-year-old man, without cardiac history, followed for endocrine tumor of the pancreas with liver metastases who had presented atrial fibrillation (AF) after etoposide infusion. Conclusion: It is important to consider cardiac monitoring during etoposide infusion in patients with known cardiac disease or at high risk of cardiac complications. PMID:23962185

Kridis, Wala Ben; Khanfir, Afef; Triki, Faten; Frikha, Mounir

2013-09-01

110

Emergency Excision of Cardiac Myxoma and Endovascular Coiling of Intracranial Aneurysm after Cerebral Infarction  

PubMed Central

Cardiac myxoma is the most common primary tumor of the heart, located mainly in the left atrium. Cerebral embolization or intracranial aneurysm formation as a consequence of left atrial myxomas has been well documented, whereas myxoma embolization causing the combination of cerebral infarction and intracranial myxomatous aneurysm is rare. We report herein, a 67-year-old female with a cardiac myxoma who experienced a left hemispheric embolic ischemic stroke and in addition was found to have right internal carotid artery aneurysm. The patient underwent emergency surgical excision of left atrial myxoma 2 hours after the stroke onset and endovascular coiling of the aneurysm a week later. Although the timing of cardiac surgery is controversial in patients who have had recent ischemic stroke, we recommend immediate resection of cardiac myxoma, if feasible, and early endovascular treatment of associated intracranial myxomatous aneurysms.

Al-Said, Youssef; Al-Rached, Heyam; Hassan, Ahmed

2013-01-01

111

Emergency excision of cardiac myxoma and endovascular coiling of intracranial aneurysm after cerebral infarction.  

PubMed

Cardiac myxoma is the most common primary tumor of the heart, located mainly in the left atrium. Cerebral embolization or intracranial aneurysm formation as a consequence of left atrial myxomas has been well documented, whereas myxoma embolization causing the combination of cerebral infarction and intracranial myxomatous aneurysm is rare. We report herein, a 67-year-old female with a cardiac myxoma who experienced a left hemispheric embolic ischemic stroke and in addition was found to have right internal carotid artery aneurysm. The patient underwent emergency surgical excision of left atrial myxoma 2 hours after the stroke onset and endovascular coiling of the aneurysm a week later. Although the timing of cardiac surgery is controversial in patients who have had recent ischemic stroke, we recommend immediate resection of cardiac myxoma, if feasible, and early endovascular treatment of associated intracranial myxomatous aneurysms. PMID:24109531

Al-Said, Youssef; Al-Rached, Heyam; Baeesa, Saleh; Kurdi, Khalil; Zabani, Ibrahim; Hassan, Ahmed

2013-09-16

112

[Intramuscular myxoma of the lower leg].  

PubMed

The intramuscular myxoma is a rare benign soft tissue tumor characterized by bland spindle-shaped and stellate cells embedded in hypovascular myxoid stroma. We report the isolated case of a 44-year-old female patient with an intramuscular myxoma in the anterior tibial muscle and report the clinical and radiographic findings. We performed an analysis of the GNAS gene mutation status with a positive finding. In difficult cases, recurrent tumors or small biopsies detection of a GNAS mutation can be useful to confirm the diagnosis of an intramuscular myxoma. PMID:23179208

Luebke, A M; Gocke, C; Priemel, M; Grob, T J; Zustin, J

2013-07-01

113

Infected left atrial mass within anatomically normal heart.  

PubMed Central

A case is presented with some features of subacute bacterial endocarditis and of left atrial myxoma. Operative removal of a 5x3 cm tumour lying above and attached to an anatomically normal mitral valve reversed a rapidly deteriorating clinical situation. Histologically the entire tumour appeared to be old thrombus, and Gram-positive cocci in its superficial strata corresponded with Streptococcus viridans previously isolated from blood cultures. Many features, including an eight-year history of intermittent neurological disturbances and recent increasing hypergammaglobulinaemia, accord with the diagnosis of atrial myxoma. However, the valvular attachment site, absence of any cardiac structural abnormality, and tumour histopathology with bacterial colonization of the tumour present a unique situation which is explored in the discussion. Images

Malcolm, A D; Chaput de Saintonge, D M

1975-01-01

114

A rare disappearing right atrial mass†  

PubMed Central

Cardiac tuberculosis is rare and usually involves the pericardium. Myocardial tuberculoma is a very rare occurrence and only a few cases have been reported. We describe a rare case of cardiac tuberculoma involving the whole of the lateral right atrial wall, extending from the superior vena cava/right atrial junction up to a tricuspid valve. The initial diagnosis of right atrial myxoma was made based on the echocardiography report and surgical excision was planned. Intraoperatively, the excision of the mass was deferred due to the extensive nature of the disease and a high suspicion of malignancy. Cardiac tuberculoma was confirmed by histopathological examination. The patient made a remarkable recovery with the complete disappearance of the mass after anti-tuberculous treatment, as viewed by a postoperative echocardiography during the follow-up.

Rao, Venugopal R.; Jagannath, Kolwalkar; Sunil, Putane K.; Madhusudana, Narayan

2012-01-01

115

A rare disappearing right atrial mass.  

PubMed

Cardiac tuberculosis is rare and usually involves the pericardium. Myocardial tuberculoma is a very rare occurrence and only a few cases have been reported. We describe a rare case of cardiac tuberculoma involving the whole of the lateral right atrial wall, extending from the superior vena cava/right atrial junction up to a tricuspid valve. The initial diagnosis of right atrial myxoma was made based on the echocardiography report and surgical excision was planned. Intraoperatively, the excision of the mass was deferred due to the extensive nature of the disease and a high suspicion of malignancy. Cardiac tuberculoma was confirmed by histopathological examination. The patient made a remarkable recovery with the complete disappearance of the mass after anti-tuberculous treatment, as viewed by a postoperative echocardiography during the follow-up. PMID:22535544

Rao, Venugopal R; Jagannath, Kolwalkar; Sunil, Putane K; Madhusudana, Narayan

2012-04-25

116

Cardiac Myxoma Presenting as Dyspnea after Cesarean Delivery  

PubMed Central

Introduction. Dyspnea during pregnancy and in the immediate postpartum or postoperative period is a relatively common symptom that can be an early sign of a life threatening condition. The differential diagnosis is broad and can represent a wide variety of underlying etiologies. Cardiac tumors are one of the rarest causes of dyspnea in a reproductive age women during the postpartum period. Case Presentation. 42-years old G7P1051 presented with acute dyspnea postoperatively after an elected uncomplicated repeat cesarean section and tubal ligation. The patient was diagnosed with a large left atrial cardiac myxoma and required urgent cardiothoracic surgery. Conclusion. The following case illustrates how a standard response to a common postpartum symptom, dyspnea, can divert and distract from less common exam findings. A careful, stepwise evaluation of symptoms and related findings will usually determine the underlying cause so that appropriate and timely treatment can be initiated.

Wyman, Allison; Hurd, William; Lappen, Justin

2012-01-01

117

[Cardiac myxoma--a rare cause of cerebral embolism].  

PubMed

Cardiac myxoma is the most common benign heart tumor. We report a case with multiple brain metastases, presumably due to tumor embolization. It is important to perform transthoracic echocardiography at a very early stage to exclude structural heart disease in patients with signs of multiple brain metastases. Though myxoma is a rare cause of cerebral embolism, detection of this tumor is relatively easy and surgical resection of myxoma is usually a permanent measure to prevent subsequent stroke. PMID:18761832

Thielke, Desirée; Thyssen, Jacob Pontoppidan; Sejersen, Holger Marquard

2008-08-11

118

Tricuspid valve myxoma in a patient with congestive heart failure  

PubMed Central

Myxomas are the most frequent benign primary cardiac tumours (50% of benign heart tumours). This kind of tumour is most likely to be localized in the left atrium, followed by the right atrium, right ventricle and left ventricle. Quite exceptional is the presence of a myxoma originating from the tricuspid valve or from the Eustachian valve. We describe the case of a woman with moderate dyspnoea of unknown origin and the presence of tricuspid myxoma who underwent tricuspid valve curettage.

2010-01-01

119

Anesthetic experiences of myxoma removal surgery in two patients with Carney complex -A report of two cases-  

PubMed Central

Carney complex is an autosomal dominant disorder that occurs due to a mutation in PRKAR1A, which encodes protein kinase A. The clinical features are multiple endocrine gland neoplasms, skin tumors, pigmented skin lesions, myxomas, and schwannomas. In Carney complex, the cardiac myxoma is a common co-morbidity. It occurs in multiples, during young age, regardless of gender and cardiac chamber and is known to recur frequently. Therefore there are high risks of adhesion and massive bleeding due to repeated surgeries. Such surgical risks account for over 50% of disease-specific mortality of Carney complex patients. Here, we present anesthetic experiences of myxoma removal surgery in two patients with Carney complex.

Kang, Young Mi

2011-01-01

120

Anesthetic experiences of myxoma removal surgery in two patients with Carney complex -A report of two cases-.  

PubMed

Carney complex is an autosomal dominant disorder that occurs due to a mutation in PRKAR1A, which encodes protein kinase A. The clinical features are multiple endocrine gland neoplasms, skin tumors, pigmented skin lesions, myxomas, and schwannomas. In Carney complex, the cardiac myxoma is a common co-morbidity. It occurs in multiples, during young age, regardless of gender and cardiac chamber and is known to recur frequently. Therefore there are high risks of adhesion and massive bleeding due to repeated surgeries. Such surgical risks account for over 50% of disease-specific mortality of Carney complex patients. Here, we present anesthetic experiences of myxoma removal surgery in two patients with Carney complex. PMID:22220234

Kang, Young Mi; Kim, Yoon Hee

2011-12-20

121

Right-sided myxomas with extramedullary hematopoiesis and ossification in Carney complex.  

PubMed

The authors report the case of multiple right-sided myxomas in a 42-year-old man with Carney complex. He had previously been diagnosed as Cushing's syndrome and undergone resection of pituitary adenoma at the age of 21. After 10 years, bilateral adrenalectomy had been performed with recurrence of Cushing's syndrome. Recently, he complained of palpitation and intracardiac masses were detected. On physical examination, he had nevi on the lips and in the oral cavity. A tiny eyelid nodule was noted and histopathological analysis confirmed the diagnosis of skin myxoma. Thyroid ultrasonography revealed multiple hypoechoic nodules, which were confirmed pathologically as follicular adenomas. Scrotal ultrasonography also revealed small multiple testicular tumors. Echocardiography demonstrated intracardiac masses in right atrium and right ventricle. Right atriotomy revealed a right atrial mass attached to the annulus of the tricuspid valve and another mass arising from the interatrial septum. In right ventricle, a polypoid mass arose from the anterior leaflet of the tricuspid valve. Also, there were multiple tiny to small masses on the interatrial septum. The masses were completely excised and the tricuspid valve was repaired with annuloplasty. Histopathological analysis confirmed myxomas with foci of extramedullary hematopoiesis and ossification. PMID:18230408

Lee, Bora; Sir, Jung-Ju; Park, Sung-Won; Kim, Seong-Beom; Nah, Jong-Chun; Kang, Yun Kyung; Lee, Hye-Kyung; Kim, Yong-In; Cho, Wook Hyun; Choi, Suk-Koo

2008-01-29

122

Biatrial myxomas with Carney complex.  

PubMed

A 30-year-old man presented with chest pain and was diagnosed with biatrial myxomas and pulmonary embolism. He underwent resection of the biatrial myxomas and tumor embolectomy from the pulmonary artery. The histological diagnosis was multiple cardiac myxomas. Further examination showed that this patient also had spotty pigmentations, cutaneous myxomas, and acromegaly. He was diagnosed with Carney complex. PMID:22879562

Yamada, Yukiko; Sasaki, Hideki; Tominaga, Takashi; Ishitoya, Hiroshi

2012-08-01

123

Atrial fibrillation-related cardiomyopathy: a case report.  

PubMed

Sustained chronic tachyarrhythmias often cause a deterioration of cardiac function known as tachycardia-induced cardiomyopathy or tachycardiomyopathy.The incidence of tachycardia-induced cardiomyopathy is unknown, but in selected studies of patients with atrial fibrillation, approximately 25% to 50% of those with left ventricular dysfunction had some degree of tachycardia-induced cardiomyopathy. It is an important clinical entity due to the high incidence and potential reversibility of the disease process.This case describes a cardiomyopathy induced by excess caffeine consumption. Six months following withdrawal of caffeine from the subject's diet, full resolution of symptoms occurred. PMID:17953770

Peake, Simon Tc; Mehta, Paresh A; Dubrey, Simon W

2007-10-22

124

Odontogenic myxoma with orbital involvement.  

PubMed

A 15-month-old female child presented with progressive right-sided facial swelling, nasal obstruction, and deviation of the nose to the left. Computed tomography revealed a cystic mass in the maxillary sinus with disruption of the medial orbital floor. Incisional biopsy of this mass was nondiagnostic and the mass continued to grow rapidly. The mass was removed by excisional biopsy and curettage with conservative margins via combined lateral rhinotomy and sublabial approaches. Intraoperatively, a large defect of the floor that extended to the orbital apex was noted. Histopathology revealed an odontogenic myxoma. Odontogenic myxomas are uncommon tumors that are usually seen in adults. Our case is unique because to the best of our knowledge, it is the first reported case with orbital involvement in the pediatric population. PMID:23034692

Chen, Henry H; Streubel, Sven-Olrik; Durairaj, Vikram D

125

[Cardiac damage due to scorpion envenomation: case involving atrial flutter].  

PubMed

The purpose of this report is to describe a case of scorpion envenomation observed in northern Chad in a 24-year-old-man with no medical history. The victim rapidly developed supraventricular arrhythmia due to catecholaminergic storm induced by the neurotoxic activity of the venom. Cardiomyopathy that can lead to fatal acute heart failure is a risk after scorpion envenomation. Heart damage is observed in 1% of scorpion envenomation cases and can result from several mechanisms, i.e., adrenergic myocarditis (as in the patient herein), toxic myocarditis or myocardial ischemia. Few articles describing supraventricular arrhythmia following scorpion envenomation have been published. It is paroxystic and regresses spontaneously in case of transient catecholaminergic storm. Occurrence of atrial flutter, even if not associated with heart failure, is an indication of severe scorpion envenomation and requires close patient monitoring and symptomatic treatment using betablocking drugs. The efficacy of specific treatment for scorpion envenomation, i.e., immunotherapy, remains controversial. PMID:19702162

Deman, A L; Lerecouvreux, M; Miandrisoa, M R; Klein, I; Romain, H; Dubourdieu, D; David, S; Deroche, J; Berbari, H; Heno, P

2009-06-01

126

Atrial paroxysmal tachycardia in dogs and its management with homeopathic Digitalis--two case reports.  

PubMed

Homeopathic Digitalis 6c was evaluated in two clinical cases of atrial paroxysmal tachycardia in dogs. Tachycardias are common cardiac problems in dogs, and atrial paroxysmal tachycardia is a serious cardiac arrhythmia that may lead to syncope. Both adult dogs (Labrador and German Shepherd) were treated with Digitalis 6c, 4 drops orally four times daily for 7 days. Following treatment with Digitalis 6c heart rate stabilised and synchronized atrial and ventricular electrical activity was restored in 7 days. PMID:17954385

Varshney, J P; Chaudhuri, S

2007-10-01

127

Pulmonary myxoma in a sheep.  

PubMed

Pulmonary myxomas are rare in domestic animals and only two cases have been reported previously in sheep. An 8 x 6 x 4 cm mass was detected in the diaphragmatic lobe of the right lung of a 4-year-old Persian Karakul ewe. The mass was well demarcated, multilobulated, soft in consistency and white in colour. The cut surface exuded a mucoid substance and a distinct capsule was evident. Microscopically, the tumour comprised a hypocellular myxomatous matrix, rich in acid mucopolysaccharides, with scattered spindle-shaped or stellate cells. These cells had uniform, oval-shaped nuclei without visible nucleoli and expressed vimentin and S100 on immunohistochemical examination. These gross, microscopical and immunohistochemical features are characteristics of myxoma. PMID:19406435

Oryan, A; Ahmadi, N; Ghane, M; Daneshbod, Y

2009-04-29

128

A rare case of giant congenital left atrial appendage aneurysm in a 4-month-old child.  

PubMed

Aneurysm of the left atrial appendage is a rare pathological condition, especially during infancy. We describe the case of a 4-month-old child with a giant congenital aneurysm of the left atrial appendage. PMID:23751599

Di Salvo, Giovanni; Al-Sehly, Abdullah; Al-Fadley, Fadel; Bulbul, Ziad Al; Fadel, Bahaa M; Al-Fayyadh, Majid; Al-Soufi, Bahaaldin

2013-06-01

129

Left Atrial Thrombus  

PubMed Central

Rationale:Echocardiography is essential in establishing the diagnosis in patients with cardiac masses. The differentiation between myxomas and thrombi is sometimes difficult, but is critical in making the right therapeutical decision. Objective: A 70–year–old female presented to the Emergency Department with palpitations, dyspnea and anterior epistaxis. She had a 3 years history of atrial fibrillation and chronic heart failure NYHA class III. Method and Result: Two-dimensional transthoracic echocardiography showed the thickening of the mitral valves with moderate mitral insufficiency and a mobile round mass in the left atrium, heterogeneous, inhomogeneous, 18 mm in size, attached with a narrow stalk to the interatrial septum, reaching mitral annular plane; tricuspid insufficiency with a maximum 30 mmHg gradient, intact interatrial septum, akinesia of two thirds of basal inferior wall, 42% ejection fraction. Discussion: The two–dimensional transesophageal echocardiography confirmed the intraatrial mass. Epistaxis was considered to be due to heart failure and the increased venous pressure. The patient was referred to the cardiovascular surgery clinic, but refused surgery. Anticoagulation with fraxiparine 0,6 ml/day was started and continued for 3 weeks, after cessation of epistaxis by nasal tamponament. Then echocardiography was repeated, with no remnant mass in the left atrium. The conclusion was that the mass must have been a thrombus that has melted away. In this particular case, the left intraatrial thrombus may have been due to the presence of atrial fibrillation.

2011-01-01

130

Robotic assisted excision of a left ventricular myxoma.  

PubMed

We present a rare case of left ventricular myxoma discovered incidentally in an asymptomatic 16-year old male. The patient underwent the appropriate work-up and a robotic-assisted excision of the mass. The patient had an uneventful recovery and was discharged home at postoperative day 3. To our knowledge, this is the first case of robotic-assisted left ventricular myxoma excision in the literature. Robotic-assisted surgery of left ventricular myxomas is a safe and feasible method of excision. PMID:22108931

Hassan, Mohammed; Smith, J Michael

2011-11-15

131

Robotic assisted excision of a left ventricular myxoma  

PubMed Central

We present a rare case of left ventricular myxoma discovered incidentally in an asymptomatic 16-year old male. The patient underwent the appropriate work-up and a robotic-assisted excision of the mass. The patient had an uneventful recovery and was discharged home at postoperative day 3. To our knowledge, this is the first case of robotic-assisted left ventricular myxoma excision in the literature. Robotic-assisted surgery of left ventricular myxomas is a safe and feasible method of excision.

Hassan, Mohammed; Smith, J. Michael

2012-01-01

132

Myxoma of the aortic valve  

PubMed Central

Myxomatous tumours can arise from different cardiac structures. They have a special predilection for the left atrium and are an exceedingly uncommon finding in cardiac valves. We report the case of a 28-year old man who presented with a stroke and was found to have a mass arising from his aortic valve. The patient underwent a successful surgical excision of the aortic valve with the implantation of a mechanical prosthesis. The histopathological examination of the aortic valve confirmed the diagnosis of myxoma. Some aspects related to the diagnosis and management of this entity are discussed in this article.

Fernandez, Angel L.; Vega, Marino; El-Diasty, Mohammad M.; Suarez, Jose M.

2012-01-01

133

Giant atrial thrombus presenting as a tumor  

PubMed Central

INTRODUCTION Right Atrial masses may represent tumors or thrombi of the heart and are potentially fatal if left untreated. PRESENTATION OF CASE A 45-year-old woman with a previous history of breast cancer who was found to have a right atrial mass diagnosed as a tumor by Echocardiography and Computed Tomography which ultimately proved to be a giant organized thrombus at surgery. DISCUSSION Metastatic tumors of the heart are 20 times more common than primary tumors and malignancies that often involve the heart include breast, lung, lymphoma, melanoma and sarcomas. Myxomas remain the most common cause of atrial tumors and are classically described arising on the left but a significant amount do occur on the right side. Presenting features with masses in the right atrium are similar to patients with tricuspid stenosis which may present with tiredeness, swelling of the feet, hepatomegaly and ascites. The clinical presentation and history may be of help in the diagnosis especially if the patient has a confirmed tumour. CONCLUSION Despite our current state of the art equipment these “masses” still pose a diagnostic challenge in distinguishing between solid thrombus and tumour as to determine the appropriate therapeutic approach. Surgical removal of Giant Atrial Thrombi appears to be the procedure of Choice.

Nicolaou, N.; Becker, A.; Mc Michael, G.; Nicolaou, V.

2012-01-01

134

Role of coronary angiography in myxoma patients: a 14-year experience in one medical center.  

PubMed

Cardiac myxoma is the most common form of primary heart tumor and often treated with surgical resection without a preoperative angiographic examination for fear of potential risk of sudden death. During the last 14 years, 24 of 38 patients with myxoma underwent coronary angiography. Coronary artery disease (CAD) and other abnormalities were found in 5. Our findings indicated that CAD is not uncommon among the myxoma patients, and coronary angiography should be performed preoperatively in all cases. PMID:10844382

Li, A H; Liau, C S; Wu, C C; Chien, K L; Ho, Y L; Huang, C H; Chen, M F; Lee, Y T

1999-01-01

135

A case of atrial tachycardia sensitive to increased caffeine intake.  

PubMed

A 33-year-old Japanese man with atrial tachycardia visited our clinic. He regularly consumed daily alcohol with cola, one cup of regular coffee, and a candy containing 0.7 mg of caffeine per tablet. After stopping his caffeine intake, his arrhythmia ameliorated. Since caffeine might be associated with his arrhythmia, a caffeine load test (equivalent to his daily intake of caffeine) was performed for 4 days. Atrial tachycardia time from a Holter recording was 44.2 minute/day before the caffeine load, compared with 215.2 minute/day during the caffeine load. Plasma caffeine concentration before and during caffeine loading was 3.1 mg/dL and 5.4 mg/dL, respectively. Caffeine use seemed to be an important factor for his atrial tachycardia, since his arrhythmia became worse during caffeine load testing and was ameliorated after the cessation of caffeine. PMID:22188716

Kinugawa, Toru; Kurita, Takashi; Nohara, Ryuji; Smith, Michael L

2011-01-01

136

Case report: Atrial fibrillation following exposure to ambient air pollution particles  

EPA Science Inventory

CONTEXT: Exposure to air pollution can result in the onset of atrial fibrillation. CASE PRESENTATION: We present a case of a 58 year old woman who volunteered to participate in a controlled exposure to concentrated ambient particles (CAPs). Twenty minutes into the exposure, there...

137

Endobronchial Lipomatous Hamartoma: An Incidental Finding in a Patient with Atrial Fibrillation--A Case Report  

PubMed Central

Introduction. Lung hamartomas are the most common benign tumors of the lung. Typically, they are located in the peripheral lung, while an endobronchial localisation is rare. Case Presentation. We present a case with the rare diagnosis of an endobronchial hamartoma as incidental finding in a 69-year-old male, caucasian patient with atrial fibrillation. At first admission, the patient's exertional dyspnea was caused by atrial fibrillation. Relapse of exertional dyspnea in the absence of arrhythmia was due to postobstructive pneumonia caused by an endobronchial hamartoma. Conclusion. Endobronchial tumors such as endobronchial lipoma or hamartoma should be considered as potential causes of exertional dyspnea and thus as differential diagnosis of atrial fibrillation. Although endobronchial hamartomas are benign, resection is recommended to prevent postobstructive lung damage.

Schneider, Friederike; Winter, Hauke; Schwarz, Florian; Niederhagen, Manuel; Arias-Herrera, Vivian; Martens, Eimo; Kaab, Stefan; Theiss, Hans

2012-01-01

138

Peri-ictal prolonged atrial fibrillation after generalized seizures: description of a case and etiopathological considerations.  

PubMed

Cardiac rhythm changes are not uncommon in connection with seizures and should be considered and recognized given their potentially harmful consequences including Sudden Unexpected Death in Epilepsy (SUDEP). The most well known are ictal tachycardia and bradycardia. However, other potentially dangerous peri-ictal arrhythmias have been reported. Brief atrial fibrillation episodes, never longer than 2 min, have rarely been described in connection with seizures. We report the case of a patient who presented with two generalized tonic-clonic seizures associated with prolonged atrial fibrillation. Extensive non-invasive cardiac investigations failed to disclose cardiac abnormalities, and after proper antiepileptic drug treatment the patient had neither further seizures nor cardiac events in an 18-month follow-up. Our case, to our knowledge, is the first report of prolonged (more than 1 h) peri-ictal atrial fibrillation. PMID:22341957

Vedovello, Marcella; Baldacci, Filippo; Nuti, Angelo; Cipriani, Gabriele; Ulivi, Martina; Vergallo, Andrea; Borelli, Paolo

2012-02-16

139

Surgical repair of atrial septal defect with severe pulmonary hypertension during pregnancy: a case report with literature review.  

PubMed

We are reporting a case of a 37-year-old pregnant woman with a large secundum atrial septal defect with left-to-right shunt and severe pulmonary hypertension. Her atrial septal defect was undiagnosed before this pregnancy. After carefully considering all the options, we repaired her atrial septal defect with an open heart surgical closure at 20 weeks of gestation. A substantial and consistent reduction in pulmonary arterial pressure after the surgery and subsequent uneventful delivery indicate that surgical repair of atrial septal defects is a viable option that should be considered for such patients. PMID:22717278

Manivannan, Suganya; Dadlani, Gul; Parsons, Michael; Crisan, Luminita; Belogolovkin, Victoria; Sastry, Narendra; Guglin, Maya

2012-04-16

140

Extragnathic odontogenic sinonasal myxoma with mitotic features  

PubMed Central

We present the first-ever documented evidence of mitotic figures in a case of sinonasal myxoma diagnosed in a 37 year-old gentleman. A 37 year-old gentleman was referred to the Otolaryngology clinic with left nasal discharge for six months. Preoperative images demonstrated obstruction of the left nasal airway with complete opacification of the left maxillary sinus, obscuration of the osteomeatal complex, as well as expansion and thinning of the medial wall of the maxillary antrum. The patient underwent diagnostic Funtional Endoscopic Sinus Surgery (FESS), therapeutic left Caldwell-Luc antrostomy, and revision FESS following recurrence. The patient was symptom-free at routine follow-up post-op. There has been much debate as to whether the absence of mitotic features in a specimen is absolutely necessary in order to confirm the diagnosis. We postulate that the presence of mitoses is an unusual diagnostic feature in extensive sinonasal myxoma.

Onyekwelu, O; DeZoysa, O; Watts, S

2012-01-01

141

Sequential malignant transformation of cardiac myxoma.  

PubMed

We describe a case of cardiac myxoma in a 44-year-old Japanese man, who died after developing metastases in the skin, brain and muscle. A satellite tumor which was attached to the wall of the abdominal aorta induced marked hypertension due to obstruction of the renal arteries. Although the primary heart tumor had typical histological features of benign cardiac myxoma, the recurrent heart tumor, which was partly resected three months before the patient's death, showed apparently malignant characteristics resembling malignant fibrous histiocytoma (MFH). Since the histological features of the initial and recurrent tumors were different, the grade of malignancy was investigated using the cellularity of the tumor as an arbitrary criterion. A gradual but significant increase in the cellularity was observed over the course of five years. Immunohistochemically, tumor cells in the muscle metastasis contained vimentin and factor VIII-related antigen, and multinucleated giant cells in the recurrent heart tumor contained desmin, which is rarely detectable in MFH. Therefore, we considered that the present case represented malignant transformation of benign cardiac myxoma. PMID:2260476

Kasugai, T; Sakurai, M; Yutani, C; Hirota, S; Waki, N; Adachi, S; Kitamura, Y

1990-09-01

142

High-resolution esophageal long-term ECG allows detailed atrial wave morphology analysis in case of atrial ectopic beats.  

PubMed

Detection of arrhythmic atrial beats in surface ECGs can be challenging when they are masked by the R or T wave, or do not affect the RR-interval. Here, we present a solution using a high-resolution esophageal long-term ECG that offers a detailed view on the atrial electrical activity. The recorded ECG shows atrial ectopic beats with long coupling intervals, which can only be successfully classified using additional morphology criteria. Esophageal high-resolution ECGs provide this information, whereas surface long-term ECGs show poor atrial signal quality. This new method is a promising tool for the long-term rhythm monitoring with software-based automatic classification of atrial beats. PMID:22610727

Niederhauser, Thomas; Marisa, Thanks; Haeberlin, Andreas; Goette, Josef; Jacoment, Marcel; Vogel, Rolf

2012-05-18

143

Isomeric arrangement of the left atrial appendages and visceral heterotaxy: two atypical cases.  

PubMed

We present two cases in which there was isomeric arrangement of the left atrial appendages in association with multiple spleens and complete heart block. In both of these, the venous connections were normal. In one case the arrangement of the bronchial tree and the lungs was normal, the liver was left-sided, and the stomach was right-sided. In the other case, there was left isomeric broncho-pulmonary morphology, and both liver and stomach were right-sided. These unusual combinations show the need for full description of the morphology of other organs, and the venoatrial connections, in cases with isomeric arrangement of the atrial appendages. They also demonstrate that connection of the inferior caval vein cannot be taken as a reliable marker of an atrium having a morphologically right appendage. PMID:10817298

Gerlis, L M; Durà-Vilà, G; Ho, S Y

2000-03-01

144

Intrapericardial Hemangioma: A Case Report  

PubMed Central

Hemangiomas of the pericardium are very rare primary pericardial tumours. Very few cases of pericardial hemangioma have been reported in the literature till date. We are reporting a case of a 40 years old male who presented with the complaints of chest discomfort and palpitation on exertion, of 3 months duration. ECHO and Colour Doppler ECHO which were done, revealed a large heterogeneous mass which measured 7.6 × 7.1cms, which was possibly attached to the roof and the anterior surface of the left atria, which was possibly a myxoma. Based on the radiological findings, a diagnosis of left atrial myxoma was considered. However, intra operatively, an encapsulated mass was seen within the pericardium, which was successfully excised and sent for histopathology. The histopathological examination revealed an intrapericardial hemangioma. This case has been reported on account of its extreme rarity.

Gupta, Nalini

2013-01-01

145

Intrapericardial hemangioma: a case report.  

PubMed

Hemangiomas of the pericardium are very rare primary pericardial tumours. Very few cases of pericardial hemangioma have been reported in the literature till date. We are reporting a case of a 40 years old male who presented with the complaints of chest discomfort and palpitation on exertion, of 3 months duration. ECHO and Colour Doppler ECHO which were done, revealed a large heterogeneous mass which measured 7.6 × 7.1cms, which was possibly attached to the roof and the anterior surface of the left atria, which was possibly a myxoma. Based on the radiological findings, a diagnosis of left atrial myxoma was considered. However, intra operatively, an encapsulated mass was seen within the pericardium, which was successfully excised and sent for histopathology. The histopathological examination revealed an intrapericardial hemangioma. This case has been reported on account of its extreme rarity. PMID:23449754

Gupta, Nalini

2013-01-01

146

Endoscopic transnasal transpterygoid approach for parasphenoidal myxoma.  

PubMed

The parasphenoidal region is a difficult location to gain access to and contains a lot of vital neurovascular structures that have risk of injury during surgery. The transnasal endoscopic approach for this region has been described in several cadaveric studies in recent years. Herein we present a case of parasphenoidal myxoma, extending to the anteroinferior border of the cavernous sinus in a 48-year-old woman. The tumor was completely removed by the endoscopic transnasal transpterygoid approach. No postoperative complication was seen. The endoscopic transnasal transpterygoid approach may be a good alternative to external approaches in selective skull base tumors. PMID:20190945

Tosun, Fuat; Durmaz, Abdullah; Deveci, M Salih; Hidir, Yusuf

2009-09-01

147

Genetic alterations of Carney complex are not present in sporadic cardiac myxomas.  

PubMed

Cardiac myxomas are the most frequent cardiac tumors and cause for significant morbidity and mortality. Recent evidence indicates that cardiac myxomas are, in fact, neoplasms rather than organized thrombi. Cardiac myxomas may present as solitary lesions or in association with the Carney complex. Carney complex has been linked to chromosome 2p16 and the PRKAR1A gene at 17q22-24. In this study, we analyzed sporadic cardiac myxomas to evaluate whether the genetic alterations seen in Carney complex are present in non Carney complex associated cardiac myxomas as well. We analyzed microdissected material from 13 patients with cardiac myxomas for the markers PRKAR1 9CA, D2S2153, D2S2251 and D2S123. None of the cases demonstrated loss of heterozygosity or definite band changes suggestive of microsatellite instability for any of the markers used. We conclude that sporadic cardiac myxomas are genetically not related to Carney complex and most likely do not represent an incomplete form of Carney complex. PMID:11744997

Fogt, Franz; Zimmerman, Robert L; Hartmann, Christopher J; Brown, Charlotte A; Narula, Navneet

2002-01-01

148

Atrial fibrillation.  

PubMed

In 2000, some 2.3 million Americans were affected by atrial fibrillation, and that number is expected to rise as our population ages. Atrial fibrillation is both a reflection of active physiologic stressors on the body and a marker of future cardiac disease progression. The disorganized atrial activity that characterizes atrial fibrillation affects cardiac function, metabolic demand, and quality of life. However, our understanding of the etiology and treatment of this condition continues to advance with the result of recent large-scale clinical trials. Diabetes, hypertension, congestive heart failure, valvular disease, and myocardial infarction are all risk factors in the development of atrial fibrillation. And the diagnosis confers a five-fold increase in the incidence of stroke. (Patients at increased risk for stroke include those with congestive heart failure, hypertension, age greater than 75, diabetes, and previous stroke.) Anticoagulation is a critical action in most cases of atrial fibrillation, as data show a 68% relative risk reduction of stroke when patients are treated with warfarin. Prior to recent trials, achieving sinus rhythm was thought to invariably improve symptoms, cardiac function, and mortality. The adverse effects of antiarrhythmic medications are now being recognized, and treatment strategies emphasizing ventricular rate control have been recommended in recent clinical practice guidelines. This shift in thinking is influencing both outpatient and emergency department management. Controlling the ventricular rate in atrial fibrillation increases cardiac output, decreases the metabolic demand of the heart, and avoids the potentially dangerous side effects of rhythm-control drugs. Rate-control agents should be selected based on the clinical profile of individual patients. A well-chosen subset of patients may benefit from either chemical or electrical cardioversion; this appears to be a reasonably safe procedure and can be accomplished on an outpatient basis. Understanding causal etiologies, managing risk for stroke (and need for anticoagulation), addressing rate, and assessing the risks of cardioversion are key elements in a comprehensive approach to atrial fibrillation. PMID:16470327

Andrews, Marc; Nelson, Bret P

2006-01-01

149

Coronary artery fistula and atrial septal defect: a case report and brief review of the literature.  

PubMed

We present a case of a 25-year-old male with a large secondum atrial septal defect (ASD) associated with a coronary artery fistula (CAF) between the right coronary artery and the right atrium. The ASD was diagnosed preoperatively by transesophageal echocardio-graphy (TEE). The fistula was found at surgery. The ASD and fistula were closed successfully without any complication. The case highlights the common presenting features of the two conditions as well as the low sensitivity of pre-operative TEE in diagnosing CAF in the setting of an ASD. PMID:9828289

Hijazi, A; Mazhar, R; Hajar, R

1998-10-01

150

Natural history of atrial septal defect in the sixth decade : Study of 5 cases.  

PubMed

aim: Atrial septal defect (ASD) is one of the most common causes of congenital heart disease manifested in adulthood. Aim: To describe clinical and likelihood picture of adults over 60 years born with an ASD type II. methods: We performed a retrospective study of adult'sASD referred toourinstitutionfrom 1985 through 2010. Clinical, electrocardiographic, echocardiographic and hemodynamic data were reviewed. On follow up study, patients were investigated by echocardiography, ECG and assessed for quality of life by a questionnaire results: Among forty ASD type II manifested in adulthood which were referred to our department of cardiology five cases of ASD manifested in the sixth decades (2 men and 3 women). Complaints were dyspnea and palpitations in 4 cases and chest pain in only one patient. Slight anterior chest deformity was present in the older patient. Systolic murmur was found in the 3rd left intercostals space and the pulmonary second heart sound was accentuated in all patients. Complete right bundle branch block and right ventricular hypertrophy were found in all cases. Three patients presented atrial fibrillation. There was marked cardiomegaly in four patients. The pulmonary arteries were markedly enlarged and the peripheral vascular markings were increased. Echocardiographic data revealed large secundum ASD (mean 20 mm, ranged between 10 and 30mm), severe systolic pulmonary pressure in two cases (>5O mmhg). MeanQP/QS was 2.2 and contrast revealed bidirectional shunt in one patient. All patients were studied by venous cardiac catheterization. They showed a significant increase in the oxygen content of right atrial blood. Three patients underwent surgical atrial septal defect closure under general anesthesia. There were no operative or peri operative deaths. At mean follow up of 50±75 months, there was one late death from heart failure in a patient with advanced preoperative heart failure. The oldest patient is in the medical group and he is 75years old. Most survival patients remain in good clinical condition. Some of them were symptomatic at the last follow up and complained of shortness of breath on effort and palpitations in two cases. Two patients were in chronic atrial fibrillation developed during follow up. However, chest RX showed reduction in cardiothoracic ratio postoperatively. Echocardiographic examination confirmed that there was no residual shunt in across the atrial septum in any patient. Systolic pulmonary pressure felled only in 2 patients in the surgery group. Conclusion: To our knowledge, thesepatients havealongue life span, although survivors with ASD described in the world. There is a lack of evidence regarding treatment options for adults with an ASD aged more than 60years. Given the higher risks of surgery in advanced age, the defect should be repaired as early as possible to prevent hemodynamic complications. PMID:23673702

Lakhdhar, R; Drissa, M; Drissa, H

2013-04-01

151

Cellular myxoma of the lumbar spine  

PubMed Central

Background: Cellular myxoma is a histopathologically distinctive benign neoplasm, which has often been categorized among the broad category of benign mesenchymal tumors with myxoid stroma and fibroblast- and/or myofibroblast-like cells. These tumors can arise in any of the large muscles and are usually found in the thigh, shoulder, buttocks, and upper arm, and more rarely in the head and neck or in small muscles of the hand. Case Description: Here we illustrate the case of a 57-year-old female with a spinal lesion, who initially presented with complaints of vague pelvic discomfort but no focal neurological deficits. Imaging revealed a sharply demarcated paraspinal lesion concerning for a tumorous growth. The lesion was excised in toto and a detailed immuno-histopathological analysis was performed revealing the diagnosis of a cellular myxoma. Postoperative imaging showed a gross total resection and the patient is under clinical surveillance since, with no signs of recurrence after 42 months. Conclusion: Although very rare, this entity should be considered in the differential diagnosis of any spinal and paraspinal mass to allow for adequate treatment, which requires wide excision with clean margins to avoid any local recurrence.

Ohla, Victoria; Ciarlini, Pedro D.S.C; Goldsmith, Jeffrey D.; Kasper, Ekkehard M.

2013-01-01

152

Supraventricular tachycardia and atrial flutter associated with a coronary sinus diverticulum: A case report  

PubMed Central

The case of a patient with narrow QRS-complex supraventricular tachycardia and atrial flutter is described. The 12-lead surface electrocardiogram (ECG) revealed sinus rhythm with ventricular pre-excitation and negative ? waves in leads II, III and aVF, indicating Wolff-Parkinson-White syndrome with a posteroseptal accessory pathway (AP). Coronary sinus angiography revealed the presence of a diverticulum near the coronary sinus ostium. The AP was successfully ablated using radiofrequency energy applied in the neck of the diverticulum, following several failed attempts at catheter ablation from the endocardial surface of the posteroseptal space.

WU, XIAOLIN; ZHU, RUI; JIANG, HONG; LIU, WENWEI

2013-01-01

153

Cryptogenic Stroke and the Left Atrial Septal Pouch: A Case Report.  

PubMed

The left atrial septal pouch (LASP) is an anatomic variant of the interatrial septum and may be a nidus for thromboembolism. We present the case of a 49 year-old man without known vascular risk factors who experienced bi-hemispheric strokes over the course of 10 days, suggestive of multiple emboli. Transesophageal echocardiography revealed a prominent LASP. We suggest that presence of LASP was a likely cause of stroke in this patient and that further study of a possible association between LASP and ischemic stroke in younger individuals may be warranted. PMID:23680685

Wong, Jonathan M; Lombardo, Dawn; Handwerker, Jason; Fisher, Mark

2013-05-13

154

Atrial fibrillation in healthy adolescents after highly caffeinated beverage consumption: two case reports  

PubMed Central

Introduction Energy drinks and highly caffeinated drinks comprise some of the fastest growing products of the beverage industry, often targeting teenagers and young adults. Cardiac arrhythmias in children related to high caffeine consumption have not been well described in the literature. This case series describes the possible association between the consumption of highly caffeinated drinks and the subsequent development of atrial fibrillation in the adolescent population. Case presentations We report the cases of two Caucasian adolescent boys of 14 and 16 years of age at the time of presentation, each without a significant cardiac history, who presented with palpitations or vague chest discomfort or both after a recent history of excessive caffeine consumption. Both were found to have atrial fibrillation on electrocardiogram; one patient required digoxin to restore a normal sinus rhythm, and the other self-converted after intravenous fluid administration. Conclusion With the increasing popularity of energy drinks in the pediatric and adolescent population, physicians should be aware of the arrhythmogenic potential associated with highly caffeinated beverage consumption. It is important for pediatricians to understand the lack of regulation in the caffeine content and other ingredients of these high-energy beverages and their complications so that parents and children can be educated about the risk of cardiac arrhythmias with excessive energy drink consumption.

2011-01-01

155

Increased Expression and Activity of Matrix Metalloproteinases Characterize Embolic Cardiac Myxomas  

PubMed Central

Tumor embolism occurs in 30 to 50% of all cases of cardiac myxoma, but the causes are still uncertain. Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade the extracellular matrix (ECM) and play a crucial role in plaque instability and aortic aneurysm development, in addition to cancer and heart failure. To determine whether MMP activity contributes to tumor embolism, we examined 27 left atrium-sided myxomas, 10 of which showed clinical signs of peripheral embolism. Immunohistochemistry (in all cases) and Western blotting, and in situ and in-gel zymography (in four embolic and six nonembolic consecutive tumors) demonstrated higher expression and activity of MT1-MMP, pro-MMP-2, and pro-MMP-9 in embolic myxomas, whereas pro-MMP-1, MMP-3, and TIMP-1 levels were similar to those of nonembolic tumors. Reverse transcriptase-polymerase chain reaction demonstrated that increased MMP activity was due, at least in part, to increased transcription and that TIMP-2 transcripts increased in embolic myxomas. In vitro, embolic tumor cells retained higher MT1-MMP and pro-MMP-2 levels in basal conditions and after stimulation with interleukin-1? and interleukin-6. Increased MMP synthesis and release correlated with enhanced ECM degradation products containing glycosaminoglycan chains in embolic myxoma tissue. Our results strongly suggest that MMP overexpression may contribute to an excessive degradation of tumor ECM and increase the risk of embolism in cardiac myxomas.

Orlandi, Augusto; Ciucci, Alessandro; Ferlosio, Amedeo; Pellegrino, Antonio; Chiariello, Luigi; Spagnoli, Luigi Giusto

2005-01-01

156

Paroxysmal atrial fibrillation in a young female patient following marijuana intoxication--a case report of possible association.  

PubMed

Marijuana is one of the most popular drugs legally admitted for general sale in many countries. To consider it safe and unlikely to develop drug dependence is abusive. The use of marijuana as a herbal medication is being widely discussed in literature. The most promising effect of delta-9-etrahydrocannabinol seems to be observed in the case of nausea, following cancer chemotherapy. Despite its positive action on the human organism, marijuana smoking has been shown to exert adverse effects on the cardiovascular system causing well-tolerated tachycardia and/or hypotension. We also observed that marijuana abuse was associated with an increased risk of paroxysmal atrial fibrillation. The report presents a case of young healthy white subject suffering from paroxysmal atrial fibrillation following marijuana intoxication. The abuse of this substance was the most possible and identifiable risk factor for observed paroxysmal atrial fibrillation. PMID:11208344

Kosior, D A; Filipiak, K J; Stolarz, P; Opolski, G

157

A case of sustained atrial fibrillation in a cat with a normal sized left atrium at the time of diagnosis.  

PubMed

This case illustrates an unusual presentation of atrial fibrillation in a 10-year-old male neutered Maine coon. At the time of diagnosis of the arrhythmia the size of the left atrium determined by echocardiography was within normal limits and no structural or functional heart or other systemic disease was identified. Traditionally it has been suggested that the atria must be of a sufficient size in order to sustain atrial fibrillation (multiple wavelet theory) and therefore only cats with significant cardiac disease can attain sufficiently large atria to sustain this arrhythmia. To the author's knowledge this is the first detailed case report of sustained atrial fibrillation in a cat with a normal sized left atrium and no obvious structural heart disease seen on cardiac ultrasound. PMID:19083329

Connolly, David J

2005-10-14

158

A case of sustained atrial fibrillation in a cat with a normal sized left atrium at the time of diagnosis  

Microsoft Academic Search

This case illustrates an unusual presentation of atrial fibrillation in a 10-year-old male neutered Maine coon. At the time of diagnosis of the arrhythmia the size of the left atrium determined by echocardiography was within normal limits and no structural or functional heart or other systemic disease was identified. Traditionally it has been suggested that the atria must be of

David J. Connolly

2005-01-01

159

Presentation of intramuscular myxoma as an unusual neck lump.  

PubMed

Intramuscular myxoma (IM) has a distinct diagnostic identity among soft tissue myxomas. IMs have an approximate incidence of 1 per million of the population per year, with a female-to-male ratio of 14:3. The age range for presentation is 40 to 70 years, and the thigh is affected most frequently. IMs most commonly affect larger muscle groups, making the head and neck a rare site. To the authors' knowledge, there is 1 previous report of an IM presenting in the sternocleidomastoid muscle. In addition, IMs usually present as slow-growing asymptomatic swellings. Although abnormal gag reflexes have been reported in cases of glossopharyngeal schwannoma and neurofibroma in patients with neurofibromatosis-1, a gag reflex has not been reported previously as a complication of IM in the head and neck. A case of IM in the left sternocleidomastoid muscle, presenting with an intense gag reflex on palpation, in a 70-year-old woman is presented. PMID:23351479

Kalsi, Jagdip Singh; Pring, Miranda; Hughes, Ceri; Fasanmade, Adekunmi

2013-01-23

160

Statin Use and Risk of Atrial Fibrillation or Flutter: A Population-based Case-Control Study.  

PubMed

The pleiotropic effects of statins have been suggested to prevent atrial fibrillation onset. We conducted a population-based case-control study using medical databases from Northern Denmark (population: 1.8 million) to examine the association between statin use and atrial fibrillation or flutter. We identified 51,374 patients with atrial fibrillation or flutter between 1999 and 2010 and 513,670 matched population controls. We collected data on statin prescriptions redeemed within 90 days (current users) or longer (former users) before the diagnosis date of atrial fibrillation or flutter. We stratified statin users by duration of exposure, determined by the number of days between first and last redeemed prescription before the diagnosis date (<365, 365-1094, and ?1095 days). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs), controlling for potential confounders. We defined people without previous statin use as never users (reference). A total of 7360 (14.3%) cases and 55,699 (10.8%) controls were current statin users. Among current users (adjusted OR: 0.96, 95% CI, 0.93-0.99), the preventive effect of statins on atrial fibrillation or flutter was related to duration of use: adjusted ORs decreased from 1.35 (95% CI, 1.28-1.42) for users who were prescribed statins for <365 days to 0.85 (95% CI, 0.81-0.89) for users who were prescribed statins for ?1095 days compared with never users. For former users (adjusted OR: 0.94, 95% CI. 0.90-0.98), the ORs did not change with varying lengths of exposure. In conclusion, long-term statin use may reduce the risk of atrial fibrillation or flutter compared with never use. PMID:23567792

Veronese, Giacomo; Montomoli, Jonathan; Schmidt, Morten; Horváth-Puhó, Erzsébet; Sørensen, Henrik Toft

2013-04-01

161

[A case of mitral stenosis with left atrial thrombus arose and reduced in a short-term].  

PubMed

A case of mitral stenosis with left atrial thrombus which rapidly arose and reduced within a month was reported. A 61-year-old female was admitted to our hospital on November 14, 1986 because of a syncopal attack due to ventricular tachycardia. On admission she had typical auscultatory signs of mitral stenosis, mild hepatomegaly and no neurological abnormality. Laboratory findings included coagulation studies were normal, and atrial fibrillation was noted on ECG. Heart catheterization revealed low cardiac output, the mitral orifice area to be 2.4 cm2 and left ventriculography showed mild mitral regurgitation. Ventricular tachycardia was controlled following improvement of heart failure. On two-dimensional echocardiography performed on December 24, left atrial thrombus was revealed which was not detected on December 3. Through the continuous administration of warfarin and aspirin to prevent the thrombus' growth, it markedly reduced in size, from 3 x 2 x 4.5 cm on December 24, 1986 to 1.5 x 1 x 2.5 cm on January 30, 1987 without systemic embolism. Then a mitral valve replacement and a left atrial thrombectomy were performed on February 3, with the removal of a red thrombus, partially organized, measuring 1 x 0.7 x 2.5 cm. This case is unique in its clinical outcome and further investigation is necessary for the management of patients as our case. PMID:2664932

Ueda, M; Shibata, N; Miyazaki, Y; Miura, M; Miyazawa, Y; Komatsu, Y

1989-05-01

162

Development of multifocal atrial tachycardia in a patient using aminophylline -A case report-  

PubMed Central

An 82-year-old female, with left femoral neck fracture was scheduled for left hip hemiarthroplasty, under spinal anaesthesia. She had been suffering from diabetes, hypertension, lung cancer and was previously treated with IV aminophylline for respiratory insufficiency. She was given spinal anaesthesia with 10 mg of 0.5% hyperbaric bupivacaine, and T6 sensory block level was established. After 10 minutes, her blood pressure dropped to 80/60 mmHg, so intravenous ephedrine was given. At that moment, multifocal atrial tachycardia (MAT) appeared on electrocardiogram (ECG). Intravenous infusion of phenylephrine and procainamide was given and conversion of MAT to sinus rhythm was successfully achieved. We report a case of MAT after spinal anaesthesia, in a patient with respiratory insufficiency previously treated with IV aminophylline, which was successfully treated by intravenous infusion of phenylephrine and procainamide.

Kim, Lee Kyoung; Jeun, Jun Gong

2010-01-01

163

Development of multifocal atrial tachycardia in a patient using aminophylline -A case report-.  

PubMed

An 82-year-old female, with left femoral neck fracture was scheduled for left hip hemiarthroplasty, under spinal anaesthesia. She had been suffering from diabetes, hypertension, lung cancer and was previously treated with IV aminophylline for respiratory insufficiency. She was given spinal anaesthesia with 10 mg of 0.5% hyperbaric bupivacaine, and T6 sensory block level was established. After 10 minutes, her blood pressure dropped to 80/60 mmHg, so intravenous ephedrine was given. At that moment, multifocal atrial tachycardia (MAT) appeared on electrocardiogram (ECG). Intravenous infusion of phenylephrine and procainamide was given and conversion of MAT to sinus rhythm was successfully achieved. We report a case of MAT after spinal anaesthesia, in a patient with respiratory insufficiency previously treated with IV aminophylline, which was successfully treated by intravenous infusion of phenylephrine and procainamide. PMID:21286467

Kim, Lee Kyoung; Lee, Chul Seung; Jeun, Jun Gong

2010-12-31

164

Clinicopathologic analysis of cardiac myxomas: Seven years' experience with 61 patients  

PubMed Central

Objective Cardiac myxomas are the most common primary neoplasms of heart. The present study was performed on the 61 cases of patients with cardiac myxoma, in order to investigate the tumors’ clinical and pathological features, and to identify the relationship between the pathological characteristics and clinical behaviors. Methods A total of 61 cardiac myxoma cases were analyzed and reviewed retrospectively, including the clinical presentations, physical examinations, and echocardiography, electrocardiography, and pathology documents. Results The total patient cohort was made up of 37 women and 24 men. The average age at diagnosis was 48.8 years in males and 51.9 years in females. The most common complaint was dyspnea (37 cases, 60.7%) and the most common sign was systolic murmur (30 cases, 49.2%). Two surface structures and three tumor cell arrangement patterns were observed, and statistical analysis revealed the surface structure was related to the cell arrangement pattern. However, neither the cell arrangement pattern nor the tumor surface structure showed a significant correlation with the clinical presentation. Conclusions The present study showed the pathological profiles of cardiac myxomas were not related to the clinical presentations. The results of our study indicate morphologic classifications of cardiac myxomas may not be significant for clinical practice.

Li, Yu-Jun; Liu, Hui; Li, Ning-Ning; Zhao, Jie; Xing, Xiao-Ming

2012-01-01

165

Oral Bisphosphonates and Risk of Atrial Fibrillation and Flutter in Women: A Self-Controlled Case-Series Safety Analysis  

PubMed Central

Background A recent trial unexpectedly reported that atrial fibrillation, when defined as serious, occurred more often in participants randomized to an annual infusion of the relatively new parenteral bisphosphonate, zoledronic acid, than among those given placebo, but had limited power. Two subsequent population-based case-control studies of patients receiving a more established oral bisphosphonate, alendronic acid, reported conflicting results, possibly due to uncontrolled confounding factors. Methodology/Principal Findings We used the United Kingdom General Practice Research Database to assess the risk of atrial fibrillation and flutter in women exposed to the oral bisphosphonates, alendronic acid and risedronate sodium. The self-controlled case-series method was used to minimise the potential for confounding. The age-adjusted incidence rate ratio for atrial fibrillation or flutter in individuals during their exposure to these oral bisphosphonates (n?=?2195) was 1.07 (95% CI 0.94–1.21). The age-adjusted incidence rate ratio for alendronic acid (n?=?1489) and risedronate sodium (n?=?649) exposed individuals were 1.09 (95% CI 0.93–1.26) and 0.99 (95% CI 0.78–1.26) respectively. In post-hoc analyses, an increased risk of incident atrial fibrillation or flutter was detected for patients during their first few months of alendronic acid therapy. Conclusions/Significance We found no robust evidence of an overall long-term increased risk of atrial fibrillation or flutter associated with continued exposure to the oral bisphosphonates, alendronic acid and risedronate sodium. A possible signal for an increase in risk during the first few months of therapy with alendronic acid needs to be re-assessed in additional studies.

Grosso, Anthony; Douglas, Ian; Hingorani, Aroon; MacAllister, Raymond; Smeeth, Liam

2009-01-01

166

Initial description of radiofrequency catheter ablation as treatment for atrial flutter in Marfan’s syndrome: A case report and literature review  

Microsoft Academic Search

Marfan’s syndrome is a common connective tissue disease with different musculoskeletal, ophthalmic and cardiac manifestations.\\u000a Marfan’s patients carry increased risk for cardiac arrhythmias. Only three cases of atrial flutter in Marfan’s patients are\\u000a described in the literature. We report a fourth case of a young Marfan’s patient who presents with typical atrial flutter\\u000a after motor vehicle accident. After electrical cardioversion,

Ahmad Halawa; Vipul Brahmbhatt; Stephen A. Fahrig

2007-01-01

167

Mutations in the protein kinase A R1? regulatory subunit cause familial cardiac myxomas and Carney complex  

PubMed Central

Cardiac myxomas are benign mesenchymal tumors that can present as components of the human autosomal dominant disorder Carney complex. Syndromic cardiac myxomas are associated with spotty pigmentation of the skin and endocrinopathy. Our linkage analysis mapped a Carney complex gene defect to chromosome 17q24. We now demonstrate that the PRKAR1? gene encoding the R1? regulatory subunit of cAMP-dependent protein kinase A (PKA) maps to this chromosome 17q24 locus. Furthermore, we show that PRKAR1? frameshift mutations in three unrelated families result in haploinsufficiency of R1? and cause Carney complex. We did not detect any truncated R1? protein encoded by mutant PRKAR1?. Although cardiac tumorigenesis may require a second somatic mutation, DNA and protein analyses of an atrial myxoma resected from a Carney complex patient with a PRKAR1? deletion revealed that the myxoma cells retain both the wild-type and the mutant PRKAR1? alleles and that wild-type R1? protein is stably expressed. However, in this atrial myxoma, we did observe a reversal of the ratio of R1? to R2? regulatory subunit protein, which may contribute to tumorigenesis. Further investigation will elucidate the cell-specific effects of PRKAR1? haploinsufficiency on PKA activity and the role of PKA in cardiac growth and differentiation. This article may have been published online in advance of the print edition. The date of publication is available from the JCI website, http://www.jci.org. J. Clin. Invest. 106:R31–R38 (2000).

Casey, Mairead; Vaughan, Carl J.; He, Jie; Hatcher, Cathy J.; Winter, Jordan M.; Weremowicz, Stanislawa; Montgomery, Kate; Kucherlapati, Raju; Morton, Cynthia C.; Basson, Craig T.

2000-01-01

168

A Case of Aorta-Right Atrial Tunnel Presented with an Asymptomatic Murmur  

PubMed Central

Aorta-right atrial tunnel is a rare and distinct congenital anomaly. It is a vascular channel that originates from one of the sinuses of Valsalva with a tortuous course anterior or posterior to the ascending aorta, and terminates either in the superior vena cava or in the right atrium (RA). We report a 42-year-old female briefly with aorta-right atrial tunnel in which the left coronary artery arose from the tunnel and terminated into the RA.

Kim, Kyoung-Nyoun; Kim, Jae-Joon; Kang, Ji-Hoon; Goo, Ja-Jun; Lee, Ja-Young; Kim, Seong-Man

2013-01-01

169

[Cauliflower-like giant left atrial thrombus successfully treated by anticoagulants without systemic complication: a case report].  

PubMed

A 64-year-old woman with hypertension presented with a left atrial giant mass during the treatment of congestive heart failure. She was admitted to our hospital for intensive treatment. Transesophageal echocardiography demonstrated a cauliflower-like, large (3 x 2 cm), mobile echogenic mass attached to the left atrial wall. There were no signs of systemic embolism. Anticoagulant therapy was started. Repeated echocardiography showed the mass was reduced gradually and had diminished on the 10th day. She remained asymptomatic during the anticoagulant therapy. The diagnosis was thrombus based on the response to treatment. Surgical removal should be considered for such a large thrombus, but the present case of giant thrombus was successfully treated by anticoagulants without systemic complication. PMID:12845882

Ogata, Chinami; Nakatani, Satoshi; Yasumura, Yoshio; Kitakaze, Masafumi; Yamagishi, Masakazu

2003-06-01

170

[Multifocal (chaotic) atrial tachycardia in infancy].  

PubMed

A newborn baby shows atrial tachycardia and gets into cardiac failure by atrial fibrillation at 12 weeks of age. With digoxin and chinidin spontaneous conversion to multifocal atrial tachycardia occurs. Treatment with additional propranolol leads to atrial fibrillation and paroxysmal atrial tachycardia with block. When chinidin was discontinued atrial flutter occurred. With a maintenance therapy with digoxin and chinidin the baby remained asymptomatic, and sinusrhythm occurred at 6 months of age. At 9 months chinidin was discontinued. At 14 months of age, the child is well and in sinusrhythm with a maintenance digoxin therapy. This seems to be the third described case of multifocal atrial tachycardia in infancy. PMID:521298

Beitzke, A

1979-09-01

171

Coexistent congenital aortic defects, aneurysm of sinus of valsalva, atrial septal defect and infective endocarditis: a case report.  

PubMed

Coarctation of the Aorta is frequently associated with bicuspid aortic valve. This is a risk factor for infective endocarditis. Aneurysm of a sinus of Valsalva is a rare defect with a prevalence of 0.09%. They are associated in 10% of cases with a bicuspid aortic valve and less frequently with coarctation of the aorta and atrial septal defect. It is extremely rare the association of coarctation of the aorta with an atrial septal defect. This is one of the first cases reported in Puerto Rico of an adult patient with coarctation of the aorta in association with a bicuspid aortic valve, a ruptured aneurysm of a sinus of Valsalva and an atrial septal defect. The patient is a 22 year old male with coarctation of the aorta diagnosed since childhood who was admitted at the Cardiovascular Center of Puerto Rico with signs of heart failure due to infective endocarditis secondary to a teeth infection. Upon evaluation with transthoracic and transesophageal echos, he was found to have a coarctation at the aortic isthmus, aortic root dilatation, bicuspid aortic valve with vegetation, severe aortic and tricuspid regurgitation, aneurysm of the non coronary sinus of Valsalva with perforation to the right atrium, biatrial enlargement and a dilated right ventricle. Successful antibiotic treatment of endocarditis was achieved followed by surgical replacement of the aortic valve and ascending aorta with closure of the non coronary sinus of Valsalva was done. An secundum atrial septal defect was found and was also closed. Surgical correction of the coarctation of the aorta was postponed for a future time. The patient had a successful postsurgical recovery and was discharged home with anticoagulation treatment. PMID:17203799

Mundo-Sagardía, Jorge A; Johnson, Charles; Calderón, Rafael; Quintana, Cid

2006-09-01

172

Non-steroidal anti-inflammatory drug use and risk of atrial fibrillation or flutter: population based case-control study  

Microsoft Academic Search

Objectives To examine the risk of atrial fibrillation or flutter associated with use of non-selective non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclo-oxygenase (COX) 2 inhibitors.Design Population based case-control study using data from medical databases.Setting Northern Denmark (population 1.7 million).Participants 32 602 patients with a first inpatient or outpatient hospital diagnosis of atrial fibrillation or flutter between 1999 and 2008; 325

Morten Schmidt; Christian F Christiansen; Frank Mehnert; Kenneth J Rothman; Henrik Toft Sørensen

2011-01-01

173

Multifocal atrial tachycardia.  

PubMed

Multifocal atrial tachycardia (MAT) was observed in 41 patients, 35 of whom were in acute respiratory distress. A hospital mortality of 37% reflected the seriousness of their underlying conditions. In no patient was the arrhythmia the primary cause of death. The MAT preceded and/or followed atrial fibrillation (AF) or atrial flutter (Af) in 19 patients (46%). The MAT simulated AF in several cases in which P-waves were inconspicuous. Our cases suggest that MAT is not a manifestation of digitalis intoxication. Quinidine sulfate, procainamide hydrochloride, lidocaine, and phenytoin (diphenythydantoin) did not affect the rhythm. Digitalis was usually not effective in slowing the ventricular response in patients with MAT. Propranolol hydrochloride was given to seven patients and was effective in slowing the atrial rate in all cases. An attempt at electrocardioversion was unsuccessful in one patient. PMID:836113

Wang, K; Goldfarb, B L; Gobel, F L; Richman, H G

1977-02-01

174

Atrial septal aneurysm mimicking a cor triatriatum sinister: a case report and review of the literature.  

PubMed

An atrial septal aneurysm (ASA) is a rare but well-recognized abnormality of uncertain clinical relevance. It is a localized bulging of the inter-atrial septum into either or both atria during the cardiac cycle. ASA has been reported as an unexpected finding during autopsy but may also be diagnosed in living patients by echocardiographic techniques.We present a 37-year-old woman with a recurrent atypical chest pain of one-year duration. She was found to have a congenital atrial septal aneurysm on evaluation. The echocardiographic images mimicked a left sided cor triatriatum sinister. She had no other symptoms and had no co-morbidities. There was no audible murmur.ASA can mimic cor-triatriatum and echocardiographic examination should be performed from multiple views before any echocardiographic diagnosis is made. PMID:23133316

Oyedeji, Adebayo Tolulope; Okunola, Oluyomi; Umar Sani, Mahmoud

2012-10-29

175

Atrial Septal Aneurysm Mimicking a Cor Triatriatum Sinister: A Case Report and Review of the Literature  

PubMed Central

An atrial septal aneurysm (ASA) is a rare but well-recognized abnormality of uncertain clinical relevance. It is a localized bulging of the inter-atrial septum into either or both atria during the cardiac cycle. ASA has been reported as an unexpected finding during autopsy but may also be diagnosed in living patients by echocardiographic techniques. We present a 37-year-old woman with a recurrent atypical chest pain of one-year duration. She was found to have a congenital atrial septal aneurysm on evaluation. The echocardiographic images mimicked a left sided cor triatriatum sinister. She had no other symptoms and had no co-morbidities. There was no audible murmur. ASA can mimic cor-triatriatum and echocardiographic examination should be performed from multiple views before any echocardiographic diagnosis is made.

Oyedeji, Adebayo Tolulope; Okunola, Oluyomi; Umar Sani, Mahmoud

2012-01-01

176

Rare right ventricular myxoma detected incidentally on a FAST examination.  

PubMed

A young man underwent Focused Assessment with Sonography in Trauma (FAST) scan for blunt abdominal trauma. An incidental finding on the pericardial view was the presence of a tumor in the right ventricle. Detailed cardiac imaging and subsequent excision revealed the presence of a myxoma. The patient had no obvious cardiac symptoms, but the awareness and experience of the examiner during the FAST examination detected this rare heart tumor at a latent stage, preventing serious, irreversible complications. This case demonstrates the potential importance of looking above the diaphragm during routine abdominal sonography, especially in patients who are critically ill. PMID:15756670

Brestas, Paraskevas S; Malagari, Katerina S; Kelekis, Dimitrios A

177

Atrial fibrillation after ondansetron for the prevention and treatment of postoperative nausea and vomiting: a case report  

Microsoft Academic Search

Purpose  Even though clinical safety has been established in large studies, ondansetron has been reported to cause adverse cardiovascular\\u000a events. We present a case of atrial fibrillation in association with ondansetron in the postoperative period.\\u000a \\u000a \\u000a \\u000a Clinical features  A 47-yr-old, 81 kg female presented with a benign lump in her left breast for lumpectomy. Her past medical history was unremarkable.\\u000a Physically she was

Nagesha S. Kasinath; Osama Malak; John Tetzlaff

2003-01-01

178

Termination of persistent atrial fibrillation during left atrial mapping.  

PubMed

Termination of Persistent AF During Mapping.?Complex fractionated atrial electrograms (CFAEs) may represent critical areas for the maintenance of atrial fibrillation (AF). While AF organization and termination have been reported with CFAE ablation, no reports of arrhythmia termination during left atrial mapping exist. We report a case of reproducible AF termination with catheter pressure at a site of CFAE remote from the site of AF.? PMID:21539640

Tzou, Wendy S; Sághy, László; Lin, David

2011-05-03

179

Aggregation of BioGlue(®) presenting as a right atrial mass: a case report.  

PubMed

Use of biological glue during cardiovascular surgery is a common practice, rarely associated with immediate or long-term complications. We present a patient with a right atrial mass as a long-term complication associated with the use of biological glue. Surgical exploration revealed the mass to be an unabsorbed and infected aggregate of biological glue used to stop bleeding from a friable right atrium during previous surgery. PMID:22607106

Ramineni, Rajesh; Mandalapu, Tapasya; Chernobelsky, Alexander

2012-05-20

180

Right atrial angiosarcoma and electrocardiogram-gated cardiac computed tomography: a case report  

Microsoft Academic Search

Primary cardiac tumors are quite rare and most of these tumors are benign. In this report, a patient presented with chest\\u000a distress and shortness of breath after activity. Echocardiography of other hospital showed a hyperechoic right atrial mass.\\u000a Electrocardiogram-gated cardiac computed tomography (ECG-Gated CT) of our hospital provided accurate information about the\\u000a site and extent of the tumor, and the

Jing Gong; Jianming Tian; Yi Xiao

2009-01-01

181

Atrial fibrillation in the elderly  

PubMed Central

This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted.

Franken, Roberto A.; Rosa, Ronaldo F.; Santos, Silvio CM

2012-01-01

182

Giant right atrial thrombus in premature newborn.  

PubMed

Pediatric guidelines for treatment options of right atrial thrombosis in newborn are quite limited. Herein we present a case with giant atrial thrombosis resulting from umbilical venous catheter and intend to discuss the therapy in the area of current literature on right atrial thrombus in newborn and children. PMID:23689956

Baykan, Ali; Ozyurt, Abdullah; Korkmaz, Levent; Pamukcu, Ozge; Argun, Mustafa; Ozturk, Adnan; Kurtoglu, Selim; Narin, Nazmi

2013-05-21

183

Atrial Laceration Caused by Removal of a Transjugular Intrahepatic Portosystemic Shunt Necessitates Emergent Cardiopulmonary Bypass during Liver Transplant: A Case Report  

Microsoft Academic Search

In situ transjugular intrahepatic portosystemic shunting (TIPS) can complicate liver transplantation. We present a case where an intraoperative attempt to remove a malpositioned TIPS resulted in atrial laceration. Massive transfusion and emergent institution of cardiopulmonary bypass allowed patient resuscitation and completion of surgery. We describe our surgical and anesthesiologic management, and discuss the absence of criteria to predict when TIPS

D. Tivener; A. Vannucci; R. E. Fagley; M. Doyle; S. Shenoy; W. Chapman; I. Kangrga

2011-01-01

184

Accessory pathway potential recording in a case of permanent junctional reciprocating tachycardia with decremental conduction localized on the atrial site.  

PubMed

Permanent junctional reciprocating tachycardia (PJRT) is an uncommon form of atrioventricular reentrant tachycardia due to the presence of an accessory pathway characterized by slow and decremental retrograde conduction. We report a case of PJRT where we demonstrated the possibility of recording a distinct accessory pathway potential. Decremental retrograde conduction was evident using ventricular extrastimuli and it was also adenosine-sensitive. Delivering ventricular extrastimuli a prolongation of the accessory pathway potential-atrium interval was seen demonstrating that decremental conduction was located at the atrial insertion of the pathway. The accessory pathway was successfully ablated using the potential as the target of radiofrequency delivery. These electrophysiological findings seem to support the hypothesis that a nodal-like structure may be responsible for this arrhythmia. PMID:11256544

Scaglione, M; Caponi, D; Riccardi, R; Di Donna, P; Solano, A; Licciardello, G; Gaita, F

2001-02-01

185

Lack of Association between Stroke and Left Atrial Out-Pouching Structures: Results of a Case-Control Study  

PubMed Central

Background and Purpose Clinical significance of out-pouching structures of the left atrium (LA) as potential embolic sources remains unclear. We sought to evaluate the association between stroke and LA out-pouching structures. Methods A case-control study was conducted to assess the prevalence of LA out-pouching structures in subjects with and without stroke. Case subjects were 270 stroke patients who had undergone cardiac CT. Control subjects were 270 age- and sex-matched patients without a history of stroke and who had undergone cardiac CT. Presence of LA out-pouching structures was determined by ECG-gated cardiac CT. The location of out-pouching structures was categorized as near Bachmann bundle, anterior, inferoseptal, inferior, and lateral. The prevalence, number and location of out-pouching structures and clinical characteristics were compared between the two groups. Results One hundred sixty eight out-pouching structures were identified in 139 stroke patients (51%), while a total of 169 out-pouching structures were found in 155 control patients (57%) (p=0.1949). The prevalence of LA out-pouching structures with different locations was not significantly different between the stroke group and control group. In the stroke group, the prevalence of out-pouching structures was not significantly different by subtypes of ischemic stroke and the prevalence of LA out-pouching structures was not different between patients with atrial fibrillation (AF) and without AF. Conclusion The left atrial out-pouching structures are commonly seen in a population with and without stroke with similar prevalence. Our study suggests that LA out-pouching structures are not significant risk factors of stroke.

Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Heo, Ji Hoe; Kim, Young Jin

2013-01-01

186

Unusually located left ventricular outflow myxoma: a brief review of the literature.  

PubMed

Among all myxomas, left ventricular outflow tract (LVOT) myxomas are very rare. This article reports an LVOT myxoma in a 67-year-old woman presenting with palpitations and weight loss. Surgical excision of the LVOT myxoma was performed. PMID:23761565

Cetin, Mustafa; Cakici, Musa; Ercisli, Murat; Polat, Mustafa

2013-06-11

187

Atrial Septal Defect, Ostium Secundum Variety--A Review of 117 Cases  

PubMed Central

Atrial septal defect is one of the most common congenital cardiac lesions seen at most centers. Typically one notes on physical examination a pulmonic lift with associated right ventricular lift. Wide splitting of the second sound is assocated with a Grade II to III systolic pulmonary ejection murmur. Characteristically, the electrocardiograph discloses an incomplete or complete right bundle branch block. This lesion is often well tolerated into the third and fourth decades of life. Subsequently one notes progressive cardiac symptomatology and eventual inoperability due to fixed pulmonary vascular changes. Our experience would indicate this entity to be readily correctable with an extremely low morbidity and mortality. Good result can be anticipated in all age groups.

Rodriguez, Rafael; Kuzman, William J.

1968-01-01

188

Atrial Fibrillation  

MedlinePLUS

... of catheters that can freeze the heart tissue (cryotherapy) are used. Surgical maze procedure. The maze procedure ... electrical impulses that cause atrial fibrillation. Radiofrequency or cryotherapy also can be used to create the scars, ...

189

Paroxysmal atrial fibrillation in racehorses.  

PubMed

The paper describes five cases of atrial fibrillation detected after racing. In four of them, the arrhythmia disappeared spontaneously within 24 h and they were regarded as paroxysmal in type. In the fifth case, which won its race, the arrhythmia persisted for at least 45 h after racing. It was therefore regarded as an example of persistent atrial fibrillation. It was then treated with quinidine sulphate which restored sinus rhythm. It would seem that paroxysmal atrial fibrillation may be a cause of sudden decrease in racing performance. PMID:3948829

Holmes, J R; Henigan, M; Williams, R B; Witherington, D H

1986-01-01

190

Trends in hospital activity, morbidity and case fatality related to atrial fibrillation in Scotland, 1986–1996  

Microsoft Academic Search

Aims Atrial fibrillation is a common and important cause of cardiovascular morbidity and mortality that may become more prevalent due to an ageing population and more prolonged exposure to predisposing cardiovascular disease states. This study examines recent trends in hospitalizations related to atrial fibrillation in Scotland. Methods and Results Scotland (population 5·1 million) has a well described system for recording

S. Stewart; K. MacIntyre; M. M. C. MacLeod; A. E. M. Bailey; S. Capewell; J. J. V. McMurray

2001-01-01

191

Atrial fibrillation after vardenafil therapy.  

PubMed

Vardenafil is a new oral phosphodiesterase inhibitor used for erectile dysfunction. We report a case admitted with a first-detected, symptomatic paroxysmal atrial fibrillation in a healthy patient after self-medication with vardenafil. PMID:16244351

Veloso, H H; de Paola, A A V

2005-11-01

192

Calcified right atrial mass  

PubMed Central

This is the report of a case of a grossly calcified right atrial mass in a woman of 40 who also suffered from systemic hypertension, pyelonephritis, and hepatic cirrhosis. The differential diagnosis, surgical treatment, and necropsy findings are described along with a review of the literature. Images

Fleming, H. A.; Stovin, P. G. I.

1972-01-01

193

Post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect: a case report and review of the literature  

PubMed Central

Introduction Fat embolism syndrome with respiratory failure after intramedullary nailing of a femur fracture is a rare but serious complication in trauma patients. Case presentation We present the case of a 20-year-old Caucasian man who experienced paradoxical cerebral fat embolism syndrome with fulminant progression after intramedullary nailing of a femur fracture, in conjunction with a clinically asymptomatic atrial septal defect in a high position resulting in a right-to-left shunt. Conclusion Fat embolism syndrome may occur as a fulminant complication following femoral fracture repair in the presence of a concomitant atrial septal defect with right-to-left shunt. Thus, in patients with cardiac right-to-left shunts, femurs should not be nailed intramedullary, not even in cases of isolated injuries.

2011-01-01

194

Atrial fibrillation.  

PubMed

The incidence and prevalence of atrial fibrillation are increasing because of both population ageing and an age-adjusted increase in incidence of atrial fibrillation. Deciding between a rate control or rhythm control approach depends on patient age and comorbidities, symptoms and haemodynamic consequences of the arrhythmia, but either approach is acceptable. Digoxin is no longer a first-line drug for rate control: beta-blockers and verapamil and diltiazem control heart rate better during exercise. Anti-arrhythmic drugs have only a 40%-60% success rate of maintaining sinus rhythm at 1 year, and have significant side effects. The selection of optimal antithrombotic prophylaxis depends on the patient's risk of ischaemic stroke and the benefits and risks of long-term warfarin versus aspirin, but is independent of rate or rhythm control strategy. Ischaemic stroke risk is best estimated with the CHADS2 score (Congestive heart failure, Hypertension, Age > or = 75 years, Diabetes, 1 point each; prior Stroke or transient ischaemic attack, 2 points). For patients with valvular atrial fibrillation or a CHADS(2) score > or = 2, anticoagulation with warfarin is recommended (INR 2-3, higher for mechanical valves) unless contraindicated or annual major bleeding risk > 3%. Aspirin or warfarin may be used when the CHADS(2) score = 1. Aspirin, 81-325 mg daily, is recommended in patients with a CHADS(2) score of 0 or if warfarin is contraindicated. Stroke rate is similar for paroxysmal, persistent, and permanent atrial fibrillation, and probably for atrial flutter. PMID:17309423

Medi, Caroline; Hankey, Graeme J; Freedman, Saul B

2007-02-19

195

A case with catecholaminergic polymorphic ventricular tachycardia unmasked after successful ablation of atrial tachycardias from pulmonary veins.  

PubMed

Catecholaminergic polymorphic ventricular tachycardia (VT) is characterized by polymorphic VT during exercise, and the association of atrial fibrillation (AF) has been reported. However, the mechanism of AF in this disease and the relationship between VT and AF has been obscured. We described a 13-year-old girl who referred for catheter ablation of exercise-induced paroxysmal AF. Multifocal atrial tachycardia mimicking AF on the surface electrocardiogram originated from multiple pulmonary veins (PVs). While AT became non-inducible after the isolation of four PVs, polymorphic VT was initiated by isoproterenol infusion. Polymorphic VT was suppressed during rapid atrial pacing. PMID:19712071

Sugiyasu, Aiko; Oginosawa, Yasushi; Nogami, Akihiko; Hata, Yoshito

2009-08-27

196

The importance of atrial contribution: a case study of dual-chamber pacing in hypertrophic obstructive cardiomyopathy.  

PubMed

Beta blockers and calcium channel blockers are the mainstay of therapy for hypertrophic obstructive cardiomyopathy. Recent evidence suggests that dual-chamber pacing may also relieve symptoms in a subset of patients. Proper interval programming is critical to the success of this intervention-as well as maintenance of the atrial contribution to preserve left ventricular diastolic filling. This report illustrates the importance of atrial contribution, as well as the loss of atrial capture, which can lead to hemodynamic deterioration and recurrence of symptoms. PMID:9315462

Schactman, M; Cote, P M; Ramza, B

197

Atrial laceration caused by removal of a transjugular intrahepatic portosystemic shunt necessitates emergent cardiopulmonary bypass during liver transplant: a case report.  

PubMed

In situ transjugular intrahepatic portosystemic shunting (TIPS) can complicate liver transplantation. We present a case where an intraoperative attempt to remove a malpositioned TIPS resulted in atrial laceration. Massive transfusion and emergent institution of cardiopulmonary bypass allowed patient resuscitation and completion of surgery. We describe our surgical and anesthesiologic management, and discuss the absence of criteria to predict when TIPS may become adherent to the inferior vena cava or the right atrium and difficult to remove. PMID:21911169

Tivener, D; Vannucci, A; Fagley, R E; Doyle, M; Shenoy, S; Chapman, W; Kangrga, I

2011-09-01

198

Cor triatriatum dexter, atrial septal defect, and Ebstein's anomaly in an adult given a diagnosis by transthoracic and transesophageal echocardiography: a case report.  

PubMed

Cor triatriatum dexter is a very rare congenital abnormality in which the right atrium is divided into two chambers by a membrane. In this abnormality, there is a high incidence of associated congenital abnormalities, particularly of the right heart. In this case study, a 67-year-old man with Ebstein's anomaly, atrial septal defect, and cor triatriatum dexter is presented and echocardiography is discussed as a noninvasive diagnostic tool. PMID:15220906

Eroglu, Serpil Taymaz; Yildirir, Aylin; Simsek, Vahide; Bozbas, Huseyin; Bilgi, Muhammet; Ozin, Bulent; Muderrisoglu, Haldun

2004-07-01

199

Left atrial inflow and outflow obstruction as a complication of retrograde approach for chronic total occlusion: Report of a case and literature review of left atrial hematoma after percutaneous coronary intervention.  

PubMed

Retrograde recanalization of a chronic coronary total occlusion has become an increasingly utilized method to increase success from percutaneous coronary intervention (PCI). Retrograde wire passage using a septal collateral is the preferred route as the consequences of vessel perforation are more benign than epicardial collateral perforation which may produce cardiac tamponade. Tamponade risk is thought to be lessened by previous coronary bypass surgery due to adhesions preventing free flow of blood throughout the pericardial space. We report the first case of the retrograde approach producing epicardial collateral perforation resulting in a localized epicardial hematoma, which in turn, produced left atrial (LA) inflow and outflow obstruction, with the former producing localized pulmonary edema and pleural effusion. We review reported cases of LA hematoma as a consequence of the antegrade PCI approach and describe a unified explanation for the development of this phenomenon. © 2012 Wiley Periodicals, Inc. PMID:23239608

Aggarwal, Chhaya; Varghese, Joji; Uretsky, Barry F

2013-03-22

200

Cryoballoon ablation for iatrogenic left atrial tachycardia  

PubMed Central

Percutaneous and surgical left atrial ablation has been widely used to treat paroxysmal and persistent atrial fibrillation. However, left atrial ablation may result in left atrial tachycardia due to an iatrogenic substrate created by the ablation lesion sets. Ablation of these iatrogenic arrhythmias can be technically challenging, requiring prolonged procedures and the use of three-dimensional electroanatomical mapping systems. In some cases, the atrial tachycardia may terminate during mapping, or may degenerate into atrial fibrillation during the procedure before adequate mapping. Some patients also have several arrhythmia circuits, each requiring separate mapping, which may be time consuming. The present article reports the cases of three patients in whom a large cryoballoon was used to empirically ablate the pulmonary vein antral region, which is important for the initiation and maintenance of these arrhythmias.

Dhillon, Paramdeep S; Chen, Zhong; Sunni, Nadia; Norman, Mark; Ward, David E

2012-01-01

201

A role for CETP TaqIB polymorphism in determining susceptibility to atrial fibrillation: a nested case control study  

PubMed Central

Background Studies investigating the genetic and environmental characteristics of atrial fibrillation (AF) may provide new insights in the complex development of AF. We aimed to investigate the association between several environmental factors and loci of candidate genes, which might be related to the presence of AF. Methods A nested case-control study within the PREVEND cohort was conducted. Standard 12 lead electrocardiograms were recorded and AF was defined according to Minnesota codes. For every case, an age and gender matched control was selected from the same population (n = 194). In addition to logistic regression analyses, the multifactor-dimensionality reduction (MDR) method and interaction entropy graphs were used for the evaluation of gene-gene and gene-environment interactions. Polymorphisms in genes from the Renin-angiotensin, Bradykinin and CETP systems were included. Results Subjects with AF had a higher prevalence of electrocardiographic left ventricular hypertrophy, ischemic heart disease, hypertension, renal dysfunction, elevated levels of C-reactive protein (CRP) and increased urinary albumin excretion as compared to controls. The polymorphisms of the Renin-angiotensin system and Bradykinin gene did not show a significant association with AF (p > 0.05). The TaqIB polymorphism of the CETP gene was significantly associated with the presence of AF (p < 0.05). Using the MDR method, the best genotype-phenotype models included the combination of micro- or macroalbuminuria and CETP TaqIB polymorphism, CRP >3 mg/L and CETP TaqIB polymorphism, renal dysfunction and the CETP TaqIB polymorphism, and ischemic heart disease and CETP TaqIB polymorphism (1000 fold permutation testing, P < 0.05). Interaction entropy graph showed that the combination of albuminuria and CETP TaqIB polymorphism removed the most entropy. Conclusion CETP TaqIB polymorphism is significantly associated with the presence of AF in the context of micro- or macroalbuminuria, elevated C-reactive protein, renal dysfunction, and ischemic heart disease.

Asselbergs, Folkert W; Moore, Jason H; van den Berg, Maarten P; Rimm, Eric B; de Boer, Rudolf A; Dullaart, Robin P; Navis, Gerjan; van Gilst, Wiek H

2006-01-01

202

Bi-atrial mapping of atrial arrhythmias.  

PubMed

Cardiac mapping of atrial activation was originally performed in animals during open chest preparations, using epicardial electrodes. The development of endocardial egg-shaped multiple electrodes provided detailed assessment of the minimum number of wavelengths required to sustain atrial fibrillation (AF), as well as the role of interatrial connections during AF. Subsequently, several studies on bi-atrial epicardial high-density mapping in animals and humans also reported on the importance of interatrial connections, as well as the specific characteristics of the left atrium as compared with the right atrium during chronic AF. Endocardial bi-atrial mapping studies using electrode catheters were reported using basket-shaped catheters carrying 64 electrodes. Animal studies suggested that septal activation was asynchronous and discordant, while a human study outlined the multiple origins of atrial ectopic beats following DC cardioversion in patients with chronic atrial fibrillation. The advent of non-fluoroscopic mapping systems significantly changed our approach to percutaneous endocardial mapping. Simultaneous bi-atrial studies using electroanatomic mapping were performed in sinus rhythm as well as in atrial flutter. These studies demonstrated the predominance of interatrial conduction over Bachmann's Bundle and the coronary sinus-left atrial connection during respectively, sinus rhythm and atrial flutter. Simultaneous bi-atrial non-contact mapping was initially performed during porcine studies and later in humans, demonstrating asynchronous and discordant septal activation both during sinus rhythm or left lateral atrial pacing. Preliminary studies from simultaneous bi-atrial non-contact mapping in humans in whom AF occurred spontaneously or was induced suggests three main types of atrial activation, consisting of left atrial drivers causing the right atrium to fibrillate following conduction over interatrial connections, the right atrium independently sustaining AF, even after pulmonary vein disconnection, and both atria fibrillating independently without activation over interatrial connections. Bi-atrial mapping has been essential for our understanding of normal and abnormal atrial activation, and ultimately may provide new approaches for ablation of atrial fibrillation. PMID:12438816

Lemery, Robert

2002-12-01

203

PRKAR1A gene mutation in patients with cardiac myxoma  

Microsoft Academic Search

BackgroundPRKAR1A gene encodes the type 1A regulatory subunit of protein kinase A. The mutation of this gene causes Carney complex which is an autosomal dominant multiple neoplasia syndrome characterized by spotty pigmentations, endocrine overactivity and cardiac myxoma. We hypothesized that cardiac myxoma may be associated with PRKAR1A gene mutation and determined whether mutation in the PRKAR1A gene is the cause

T. Mabuchi; M. Shimizu; H. Ino; M. Yamguchi; H. Terai; N. Fujino; M. Nagata; K. Sakata; M. Inoue; T. Yoneda; H. Mabuchi

2005-01-01

204

Atrial fibrillation in healthy adolescents after highly caffeinated beverage consumption: two case reports  

Microsoft Academic Search

INTRODUCTION: Energy drinks and highly caffeinated drinks comprise some of the fastest growing products of the beverage industry, often targeting teenagers and young adults. Cardiac arrhythmias in children related to high caffeine consumption have not been well described in the literature. This case series describes the possible association between the consumption of highly caffeinated drinks and the subsequent development of

Jennifer R Di Rocco; Peter J Morelli; Marybeth Heyden; Thomas A Biancaniello

2011-01-01

205

Surgical treatment of odontogenic myxoma and facial deformity in the same procedure.  

PubMed

Odontogenic myxoma (OM) is an uncommon benign tumor with aggressive and invasive behavior. Predominant symptoms are usually slow and painless swelling, sometimes resulting in perforation of the cortical borders of the affected bone. In this paper, a case report of a patient with an OM on the right maxillary sinus and a vertical excess of maxilla will be presented. The treatment chosen was tumor resection in association with orthognathic surgery with biomodels assessment for surgical planning. A 3-year follow-up showed disease free and stability of the new position of maxilla. The international literature is evaluated to discuss this case report. PMID:24124313

Mayrink, Gabriela; Luna, Anibal Henrique Barbosa; Olate, Sergio; Asprino, Luciana; De Moraes, Marcio

2013-07-01

206

Surgical treatment of odontogenic myxoma and facial deformity in the same procedure  

PubMed Central

Odontogenic myxoma (OM) is an uncommon benign tumor with aggressive and invasive behavior. Predominant symptoms are usually slow and painless swelling, sometimes resulting in perforation of the cortical borders of the affected bone. In this paper, a case report of a patient with an OM on the right maxillary sinus and a vertical excess of maxilla will be presented. The treatment chosen was tumor resection in association with orthognathic surgery with biomodels assessment for surgical planning. A 3-year follow-up showed disease free and stability of the new position of maxilla. The international literature is evaluated to discuss this case report.

Mayrink, Gabriela; Luna, Anibal Henrique Barbosa; Olate, Sergio; Asprino, Luciana; De Moraes, Marcio

2013-01-01

207

Recurrent cardiac myxoma in a 25 year old male: a DNA study  

PubMed Central

We present a 25 year old Caucasian male patient with multiple recurrences of cardiac myxomas after surgical removal of the original tumor. His mother was operated on for right ventricular myxoma. The genetic analyses disclosed an aneuploid DNA content by flow cytometry analysis. The familial form of the cardiac myxomas must be distinguished from Carney complex syndrome. A long- term echocardiographic follow up is recommended to patients and their first degree relatives with cardiac myxomas.

2013-01-01

208

A giant, free-floating mass in the left atrium in a patient with atrial fibrillation.  

PubMed

A large intracardiac mass is a rare condition and one with an extremely high risk of haemodynamic and embolic complications. Urgent surgical excision is the treatment of choice, and the histological examination reveals the exact nature of the mass, usually a myxoma or a thrombus. We present the case of an 80-year-old woman, with a history of atrial fibrillation, who was admitted because of a seriously impaired level of consciousness, and fever. A large cerebral infarct and a urinary tract infarction were diagnosed. On the transthoracic echocardiogram a giant, free-floating mass was detected in the left atrium, transiently obstructing the mitral valve orifice. Based on the features of the mass and patient's history, it was considered more likely to be a thrombus rather than a tumour. Given the patient's extremely unfavourable neurological status, cardiac surgery was considered to be contraindicated and the patient was administered unfractionated heparin intravenously. Unfortunately, after a few hours the patient suffered a cardiac arrest and died. PMID:21940296

Kakkavas, Apostolos T; Fosteris, Michalis K; Stougiannos, Pavlos N; Paschalis, Athanasios K; Damelou, Anastasia N; Trikas, Athanasios G

209

Right atrial angiosarcoma with severe biventricular dysfunction and massive pericardial effusion.  

PubMed

This paper presents the case of a 35 year-old woman with symptoms of heart failure from the last month. A physical examination at admission showed paleness, dyspnea, peripheral edema and fatigue. In a two-dimensional echocardiography and transesophageal echocardiography, normal thickness but severe left and right ventricular dysfunction with severe pericardial effusion and thickened pericardium were found. In the enlarged right atrium, an oval-shaped structure was found with features of continuity with lateral right atrial wall and also a bulging of the structure through the orifice of the tricuspid valve to the right ventricle. In the echocardiography, we did not saw any blocking of the tricuspid valve or the inflow from inferior vena cava (IVC) or superior vena cava (SVC) or coronary sinus. On the basis of the echocardiography examination and clinical presentation, tentative diagnosis of the right atrium myxoma was made. A coronary angiography revealed normal coronary arteries and no feeding of tumor by branch of right coronary artery (RCA). Surgical removal of the tumor was performed without complication. The histopathological examination confirmed the diagnosis of angiosarcoma. In the follow-up echocardiography carried out after three months, severe left ventricular (LV) and right ventricular (RV) dysfunction continued and was demonstrated. Magnetic resonance imaging revealed no lymphadenopathy or re-growth of the tumor in the mediastinum or pericardium. PMID:23585321

Sabzi, Feridoun; Dadkhah, Heidar; Shojaei, Sharam; Mahdavi, Masoume; Poormotaabed, Alireza; Javid, Nasrin; Dabiri, Samsam

2013-03-16

210

Implementation of antithrombotic management in atrial fibrillation  

Microsoft Academic Search

The aim of the study was to assess the extent to which published recommendations on the antithrombotic management of atrial fibrillation had been adopted into clinical practice in a busy district general hospital, and the impact of clinical audit on subsequent management. In the initial audit, 185 consecutive patients with atrial fibrillation were studied using their case notes to identify

S J McNulty; D Hutchinson; K J Hardy

2000-01-01

211

Targeting Human Medulloblastoma: Oncolytic Virotherapy with Myxoma Virus Is Enhanced by Rapamycin  

Microsoft Academic Search

We have shown previously the oncolytic potential of myxoma virus in a murine xenograft model of human glioma. Here, we show that myxoma virus used alone or in combination with rapamycin is effective and safe when used in experimental models of medulloblastoma in vitro and in vivo. Nine of 10 medulloblastoma cell lines tested were susceptible to lethal myxoma virus

Xue Qing Lun; Hongyuan Zhou; Tommy Alain; Beichen Sun; Limei Wang; John W. Barrett; Marianne M. Stanford; Grant McFadden; John Bell; Donna L. Senger; Peter A. Forsyth

212

Identification of a Novel Genetic Locus for Familial Cardiac Myxomas and Carney Complex  

Microsoft Academic Search

Background—Intracardiac myxomas are significant causes of cardiovascular morbidity and mortality through embolic stroke and heart failure. In the autosomal dominant syndrome Carney complex, intracardiac myxomas arise in the setting of lentiginosis and other lesions associated with cutaneous hyperpigmentation, extracardiac myxomas, and nonmyxo- matous tumors. Genetic factors that regulate cardiac tumor growth remain unknown. Methods and Results—We used the molecular genetic

Mairead Casey; Caroline Mah; Andrew D. Merliss; Lawrence S. Kirschner; Susan E. Taymans; Alfred E. Denio; Bruce Korf; Alan D. Irvine; Anne Hughes; J. Aidan Carney; Constantine A. Stratakis; Craig T. Basson

213

Disruption of Erk-dependent type I interferon induction breaks the myxoma virus species barrier  

Microsoft Academic Search

Myxoma virus, a member of the poxvirus family, causes lethal infection only in rabbits, but the mechanism underlying the strict myxoma virus species barrier is not known. Here we show that myxoma virus infection of primary mouse embryo fibroblasts elicited extracellular signal–regulated kinase (Erk) signaling, which was integrated to interferon regulatory factor 3 activation and type I interferon induction. We

Fuan Wang; Yiyue Ma; John W Barrett; Xiujuan Gao; Joy Loh; Erik Barton; Herbert W Virgin; Grant McFadden

2004-01-01

214

Atrial tachycardia originating from the atrial septum in a patient with dextrocardia and complex structural heart disease.  

PubMed

We report a case with dextrocardia, corrected transposition of the great arteries. He also had an atrial septum defect (ASD) with patch repair. Activation map showed a centrifugal activation from a focal origin on the systemic lower left atrial ASD patch. Ablation of the origin can terminate the atrial tachycardia. PMID:22734926

Niu, Ya-Lei; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Lee, Pi-Chang; Chen, Shih-Ann

2012-06-26

215

The importance of atrial contribution: A case study of dual-chamber pacing in hypertrophic obstructive cardiomyopathy  

Microsoft Academic Search

Beta blockers and calcium channel blockers are the mainstay of therapy for hypertrophic obstructive cardiomyopathy. Recent evidence suggests that dual-chamber pacing may also relieve symptoms in a subset of patients. Proper interval programming is critical to the success of this intervention—as well as maintenance of the atrial contribution to preserve left ventricular diastolic filling. This report illustrates the importance of

Marylin Schactman; Piera M. Cote; Brian Ramza

1997-01-01

216

Chronic atrial fibrillation in patients with paroxysmal atrial fibrillation, atrioventricular node ablation and pacemakers  

Microsoft Academic Search

AimsThis study examined the factors associated with the development of chronic (or permanent) atrial fibrillation (AF) in patients who had undergone atrioventricular (AV) node ablation with permanent pacing because of paroxysmal AF.MethodsA retrospective review of case notes of all 65 consecutive patients identified as having had paroxysmal atrial arrhythmias, AV node ablation and permanent pacemaker implantation was performed. Atrial rhythm

J. M. McComb; G. M. Gribbin

1999-01-01

217

Atrial Flutter.  

PubMed

Atrial flutter (AFl) is an arrhythmia resulting from reentry in a macroreentrant circuit, most commonly in the right atrium. Typical AFl uses the narrow isthmus of right atrial tissue between the tricuspid valve annulus and the inferior vena cava orifice as part of the macroreentrant circuit. The treatment of AFl is directed toward achieving the following four goals. 1) In the presence of AFl, adequate rate control is required, which can be achieved in most but not all patients by oral or intravenous digoxin, calcium channel blockers, or beta-blockers, alone or in combination. 2) Anticoagulation with warfarin should be considered in patients with recurrent AFl, especially those over 70 years of age, and those with a history of atrial fibrillation, stroke, or structural heart disease. 3) Conversion to sinus rhythm can be achieved in up to 70% of patients with intravenous ibutilide, but this should be reserved for patients with either normal hearts or only mild left ventricular dysfunction. Direct-current cardioversion is nearly 100% effective and is ideal for patients with left ventricular dysfunction. 4) Long-term maintenance of sinus rhythm may be achieved in up to 50% to 60% of patients by using antiarrhythmic drugs, including sotalol, amiodarone, dofetilide, propafenone, and flecainide, but with the potential for causing significant proarrhythmia and side effects. Radiofrequency catheter ablation may cure over 90% of patients with type 1 AFl (using the tricuspid valve to inferior vena cava isthmus), and from 70% to 90% of patients with atypical AFl. Newer mapping techniques, such as electroanatomic mapping, are likely to further reduce procedure time and improve success rates. PMID:11445058

Garg, Ashok; Feld, Gregory K.

2001-08-01

218

[Phospholipase A2, group IIa, as an earlier unknown immunohistological marker of cardiac myxoma].  

PubMed

Phospholipase A2, group IIA, gene expression has been analyzed in primary heart tumors. High expression has been demonstrated through several ways: reverse-transcriptase chain polymerase chain, Northern blotting hybridization at the RNA level and immunoblotting, immunohistochemical assay at the protein level. Human cardiac myxoma exhibits highly positive phospholipase A2, group IIA, immunophenotype (100% positive cases). The immunophenotype is unique among human primary cardiac tumors. Phospholipase A2, group IIA, can be proposed as a tissue marker for pathological examination after heart tumor resection. PMID:18540439

Khaspekov, G L; Sheremet'eva, G F; Skamrov, A V; Nechaenko, M A; Vinnitski?, L I; Vlasik, T N; Goriunova, L E; Rutkevich, N M; Peklo, M M; Bibilashvili, R Sh

219

Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study  

PubMed Central

Advanced hepatocellular carcinoma (HCC) with invasion into the heart through the hepatic vein is a recognized rare occurrence with an extremely poor prognosis. Patients who present with right heart tumor thrombus have generally been considered inoperable. Although aggressive resection and liver transplantation treatment have previously been performed, the results remain unsatisfactory. However, HCC with extension into the heart usually indicates a contraindication for transcatheter arterial chemoembolization (TACE). In this study, a rare case of HCC with metastatic inferior vena cava (IVC) and right atrial (RA) tumor thrombus was reported. The young patient was admitted to our department due to Budd-Chiari syndrome. Following diagnosis according to CT image findings and laboratory data, the patient underwent TACE therapy. This treatment resulted in a marked reduction in the liver tumor and the right atrial tumor thrombus. Following TACE therapy, the patient survived for 3 years and 10 months and remains alive without any signs of recurrence. This case indicates that TACE therapy can be used successfully for the treatment of advanced HCC with heart tumor thrombus and may result in long-term survival.

SUN, JUN-HUI; ZHANG, YUE-LIN; NIE, CHUN-HUI; CHEN, LI-MING; HE, JIAN-DI; WANG, WEI-LIN; ZHENG, SHU-SEN

2012-01-01

220

Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study.  

PubMed

Advanced hepatocellular carcinoma (HCC) with invasion into the heart through the hepatic vein is a recognized rare occurrence with an extremely poor prognosis. Patients who present with right heart tumor thrombus have generally been considered inoperable. Although aggressive resection and liver transplantation treatment have previously been performed, the results remain unsatisfactory. However, HCC with extension into the heart usually indicates a contraindication for transcatheter arterial chemoembolization (TACE). In this study, a rare case of HCC with metastatic inferior vena cava (IVC) and right atrial (RA) tumor thrombus was reported. The young patient was admitted to our department due to Budd-Chiari syndrome. Following diagnosis according to CT image findings and laboratory data, the patient underwent TACE therapy. This treatment resulted in a marked reduction in the liver tumor and the right atrial tumor thrombus. Following TACE therapy, the patient survived for 3 years and 10 months and remains alive without any signs of recurrence. This case indicates that TACE therapy can be used successfully for the treatment of advanced HCC with heart tumor thrombus and may result in long-term survival. PMID:22783375

Sun, Jun-Hui; Zhang, Yue-Lin; Nie, Chun-Hui; Chen, Li-Ming; He, Jian-DI; Wang, Wei-Lin; Zheng, Shu-Sen

2012-02-28

221

A left atrial mass in a patient with atrial fibrillation and previous renal cancer.  

PubMed

A 73-year-old man underwent a surveillance CT following a laparoscopic radical nephrectomy for left-sided renal cell carcinoma 3 years earlier. He had atrial fibrillation. CT identified a large left atrial mass. The differential diagnosis of this mass was thrombus, primary cardiac tumour or cardiac metastasis secondary to his previous renal cell carcinoma. Location, size and appearance of the mass on echocardiogram were unusual for a left atrial thrombus; however, following surgical removal pathological examination confirmed this as an organised thrombus. A brief discussion on diagnostic evaluation of a left atrial mass follows the case report. PMID:23904420

Mahmood, Muhammad Muzaffar; Wynn, Nu Nu; Sanderson, Steven; Junejo, Shahid

2013-07-31

222

Multifocal atrial tachycardia: a complication of pneumomediastinum.  

PubMed

We report here an interesting case of multifocal atrial tachycardia (MAT) occurring as a complication of surgical emphysema with pneumomediastinum. The MAT reverted to sinus rhythm following aspiration of air from mediastinum. PMID:8340335

Sharma, S N; Iyengar, S S; Verma, M

1993-01-01

223

Clinical and electrophysiological characteristics of atrial standstill.  

PubMed

To clarify the clinical and electrophysiological characteristics of atrial standstill (AS) we studied 11 patients (7 males and 4 females), whose average age was 62 years and who were followed over a period of 4-179 months. Underlying heart disease was present in nine patients and two cases were idiopathic. Major clinical symptoms in the 11 cases included Adams-Stokes attacks, and dyspnea on exertion. In the standard 12-lead ECGs obtained on admission, the P wave was absent in six cases. Atrial flutter (AF) was noted in 3, atrial fibrillation (Af) in 1, and multifocal atrial tachycardia in 1. In some cases, the ECG initially showed AF or Af, and was transformed after several years into ectopic atrial tachycardia or an ectopic atrial rhythm with a markedly decreased amplitude of the P wave. Finally, the P wave disappeared over a prolonged period. When intracardiac mapping was performed, the atrial electrograms tended to diminish at the site of high, mid-lateral right atrium (RA). Electrograms were remained present in the vicinity of the tricuspid valve (TV) annulus. A repeated mapping and pacing study conducted in two patients revealed that the "silent" area spread toward the lower site of RA. During the average follow-up period of 64 months, four patients died. The interval until death in one patient with myocarditis was 6 months, and in another with dilated cardiomyopathy (DCM) it was 8 months. It appears that the atrial muscular lesion starts in the high lateral RA and progresses toward the lower RA, then to the vicinity of the TV annulus. A diffuse and progressive disturbance may occur not only in the atrial muscle, but also in the atrioventricular conduction system in patients with AS who had progressive myocarditis or DCM. PMID:7659578

Nakazato, Y; Nakata, Y; Hisaoka, T; Sumiyoshi, M; Ogura, S; Yamaguchi, H

1995-06-01

224

Oncolytic myxoma virus: the path to clinic.  

PubMed

Many common neoplasms are still noncurative with current standards of cancer therapy. More therapeutic modalities need to be developed to significantly prolong the lives of patients and eventually cure a wider spectrum of cancers. Oncolytic virotherapy is one of the promising new additions to clinical cancer therapeutics. Successful oncolytic virotherapy in the clinic will be those strategies that best combine tumor cell oncolysis with enhanced immune responses against tumor antigens. The current candidate oncolytic viruses all share the common property that they are relatively nonpathogenic to humans, yet they have the ability to replicate selectively in human cancer cells and induce cancer regression by direct oncolysis and/or induction of improved anti-tumor immune responses. Many candidate oncolytic viruses are in various stages of clinical and preclinical development. One such preclinical candidate is myxoma virus (MYXV), a member of the Poxviridae family that, in its natural setting, exhibits a very restricted host range and is only pathogenic to European rabbits. Despite its narrow host range in nature, MYXV has been shown to productively infect various classes of human cancer cells. Several preclinical in vivo modeling studies have demonstrated that MYXV is an attractive and safe candidate oncolytic virus, and hence, MYXV is currently being developed as a potential therapeutic for several cancers, such as pancreatic cancer, glioblastoma, ovarian cancer, melanoma, and hematologic malignancies. This review highlights the preclinical cancer models that have shown the most promise for translation of MYXV into human clinical trials. PMID:23726825

Chan, Winnie M; Rahman, Masmudur M; McFadden, Grant

2013-05-29

225

Myxoma virus: propagation, purification, quantification, and storage.  

PubMed

Myxoma virus (MYXV) is a member of the Poxviridae family and prototype for the genus Leporipoxvirus. It is pathogenic only for European rabbits, in which it causes the lethal disease myxomatosis, and two North American species, in which it causes a less severe disease. MYXV replicates exclusively in the cytoplasm of the host cell. Although not infectious in humans, its genome encodes proteins that can interfere with or modulate host defense mechanisms; it is able to productively infect a number of human cancer cell lines, but not normal human cells, and has also been shown to increase survival time in mouse models of human glioma. These characteristics suggest that MYXV could be a viable therapeutic agent, e.g., in anti-inflammatory or anti-immune therapy, or as an oncolytic agent. MYXV is also an excellent model for poxvirus biology, pathogenesis, and host tropism studies. It is easily propagated in a number of cell lines, including adherent cells and suspension cultures, and minimal purification is required to provide a stock for in vivo and in vitro studies. PMID:20440681

Smallwood, Sherin E; Rahman, Masmudur M; Smith, Dorothy W; McFadden, Grant

2010-05-01

226

Atrial Fibrillation and Stroke  

MedlinePLUS

NINDS Atrial Fibrillation and Stroke Information Page Table of Contents (click to jump to sections) What is Atrial Fibrillation and Stroke? Is there any treatment? What is the prognosis? What research ...

227

Multifocal atrial tachycardia  

MedlinePLUS

Multifocal atrial tachycardia is a rapid heart rate that occurs when too many signals (electrical impulses) are sent from ... normal heart rate is faster in children. In multifocal atrial tachycardia (MAT), multiple locations in the atria fire signals ...

228

Dronedarone and Atrial Fibrillation  

Center for Biologics Evaluation and Research (CBER)

Text Version... Page 10. Delay in time to recurrence of atrial fibrillation: •DAFNE- Phase 2 dose-ranging ... Nearly all effect due to atrial fibrillation hospitalizations ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

229

[Atrial fibrillation].  

PubMed

Atrial fibrillation (AF) is the most common sustained arrhythmia. AF has now been exhaustively studied: more is known about its mechanism and research is moving towards new forms of treatment. For chronic AF, basically the control of ventricular rate and the brain protection are the main issues. It is well known that with the identification of high risk group for embolism, oral anticoagulation should be administered. Ventricular rate control can be achieved by using betablockers or calcium channel blockers, unless these are contraindicated for the elderly. Oral anticoagulation prevents the stroke. The main mechanism of AF is the re-entry of multiple wavelets, but now it is more frequently found on patients with focal AF. Therapies are employed to bring the patient to a sinusal rhythm as soon as possible with antiarryhthmics or electric cardioversion externally or internally. The internal procedure includes 1 to 15 J and the success rate is of 91% vs 67% in relation to the external one. The introduction of the catheter ablation has opened new frontiers for the treatment of AF, first as the ablate-and-pace technique and now trying to mimic the maze procedure or with the ablation of the focal tachycardia. The stimulation for prevention of AF under research, as well as the implantable dysfibrillation for selected patients. On going studies will show the possible benefit of this type of benefits. PMID:11565343

Colín Lizalde, L J

230

Surgical treatment of right atrial focal tachycardia in adults.  

PubMed

Although successful operative treatment of atrial focal tachycardia has been reported in children, there are only isolated reports of surgical treatment of this arrhythmia in adults. In this case series of eight patients (aged 10 to 53 years) with drug-resistant right atrial focal tachycardia, results of electrophysiologic studies, surgical techniques and long-term follow-up are described. Atrial focal tachycardia was reproduced during electrophysiologic study, and endocardial mapping localized the earliest onset of atrial activation in the right atrium in all patients. Epicardial mapping confirmed the location of atrial tachycardia foci in seven of eight patients whose tachycardia was inducible intraoperatively. Of four patients treated with epicardial cryoablation alone, two had recurrent tachycardia and required a second procedure. None have had arrhythmia recurrence. In all four patients after right atrial excision (two of whom had intraoperative recurrence of atrial focal tachycardia after epicardial cryoablation alone), there has been no recurrence during a clinical follow-up period of 11 to 67 months (mean 30). It is concluded that in adult patients 1) electrophysiologic study with endocardial and epicardial mapping permits successful surgical treatment of atrial focal tachycardia; 2) epicardial cryoablation alone may be associated with recurrence of atrial focal tachycardia either intraoperatively or postoperatively; and 3) subtotal right atrial resection appears to be a well tolerated procedure with no long-term recurrence of atrial focal tachycardia. PMID:3356830

Seals, A A; Lawrie, G M; Magro, S; Lin, H T; Pacifico, A; Roberts, R; Wyndham, C R

1988-05-01

231

[Multifocal atrial tachycardia in infancy].  

PubMed

Four infants with multifocal atrial tachycardia are presented. They all displayed the typical ECG-findings of this particular form of supraventricular tachycardia: at least 3 different P-waves; varying atrial rate over 100 beats per minute; an isoelectric baseline between P-waves and a permanent variation of PP-, PR- and RR-intervals. One baby had a truncus arteriosus communis, the other 3 were healthy except for their rhythm disorder. In 2 of our patients, the multifocal atrial tachycardia was already present at birth, in the other 2 infants it became apparent at age 2 and 4 months respectively. Two children were asymptomatic, the other 2 had a slightly enlarged heart and some evidence of pulmonary venous congestion on chest roentgenogram. All 4 patients received digoxin. The tachycardia disappeared in 2 cases under but without definite causal relation to that treatment. In the 2 other cases the tachycardia persists in spite of treatment. Multifocal atrial tachycardia is a rare form of rhythm disturbance in infancy; it is difficult to treat but frequently resolves spontaneously within the first year of life. PMID:6737948

Toussaint, R; Hofstetter, R; von Bernuth, G

232

Gene expression analysis to identify mRNA markers of cardiac myxoma  

Microsoft Academic Search

cDNA expression arrays were used to identify mRNA expression markers for cardiac myxoma. The RNA profile analysis suggests that cardiac myxoma should be considered as a stand-alone tissue rather than a pathological modification of particular normal tissue. The analysis reveals a set of genes which are highly and steadily expressed in cardiac myxomas and can serve as an mRNA expression

A. V. Skamrov; M. A. Nechaenko; L. E. Goryunova; E. S. Feoktistova; G. L. Khaspekov; D. A. Kovalevsky; L. I. Vinnitsky; G. F. Sheremeteva; R. Sh. Beabealashvilli

2004-01-01

233

Atrial Thrombosis in Cardiac Amyloidosis: Diagnostic Contribution of Transesophageal Echocardiography  

Microsoft Academic Search

Few cases of atrial thrombosis detected by transesophageal echocardiography (TEE) in cardiac amyloidosis have been reported recently. We present the cases of 3 consecutive patients affected by AL-type cardiac amyloidosis, symptomatic for heart failure and in sinus rhythm. All patients had a cardiac restrictive pattern at Doppler examination. TEE showed left atrial thrombus in 2 patients and biatrial thrombi in

Mauro Santarone; Giovanni Corrado; Luca Mario Tagliagambe; Giovanni Foglia Manzillo; Giorgio Tadeo; Manuela Spata; Matteo Longhi

1999-01-01

234

[Heart failure due to atrial standstill in a cat].  

PubMed

A 7.5-year-old male Persian cat with a history of asymptomatic hypertrophic cardiomyopathy was examined for severe lethargy and dyspnoea. Physical examination revealed bradycardia (60 beats/ minute), and ECG investigation revealed persistent atrial standstill that was most likely caused by atrial fibrosis. Persistent atrial standstill is a very rare cardiac condition in cats and is characterized by a complete lack of mechanical, electrical, and possibly endocrine function of the atria. Several pathophysiological mechanisms can cause atrial standstill and include hyperkalaemia, intoxication, and atrialfibrosis. On the basis of the clinical findings, atrial fibrosis was the most likely cause of atrial standstill in this cat. Treatment depends on the underlying cause, but pacemaker implantation can be considered if there are structural abnormalities. The prognosis is guarded in such cases. In this particular case, the cat was euthanized at the owner's request. PMID:21939015

Wienesen, R C; Szatmári, V

2011-09-01

235

When the Body and Appendage of the Left Atrium Disagree: “Focal” Atrial Fibrillation—Implications for Atrial Thrombus Formation and Risk of Thromboembolism  

Microsoft Academic Search

A case is presented of a man who had 5 hours of atrial fibrillation followed by spontaneous conversion and maintained sinus rhythm that persisted as shown by surface electrocardiography. Transesophageal echocardiography performed 24 hours after electrocardiographic conversion documented an atrial fibrillation pattern within the left atrial appendage, with a normal sinus Doppler pattern in the body of the left atrium.

Todd B. Seto; W. Andrew Buchholz; Pamela S. Douglas; Warren J. Manning

1999-01-01

236

Total Occlusion of the Abdominal Aorta Caused by Detachment of Cardiac Myxoma  

PubMed Central

Abdominal aortic occlusion (AAO) caused by detachment of cardiac myxoma (CM) is a very rare complication in patients with CM. Although the nature of CMs has been well established, detachment of CM may cause unexpected serious complications such as vicious embolic events. Actually, in several cases of AAO caused by detachment of CM, it has been reported that CM fragments easily migrated to the brain, heart, and lungs, and caused lifelong neurological complications despite appropriate surgical therapy. Herein, we report a case of a patient with AAO caused by detachment of CM who underwent CM excision and abdominal aortic thromboembolectomy. Additionally, we have presented the preoperative and postoperative images using 64-multidetector computed tomography.

Hong, Sungyong; Choe, Hyunmin

2012-01-01

237

Catheter ablation of atrial arrhythmias: state of the art.  

PubMed

Catheter ablation is at the forefront of the management of a range of atrial arrhythmias. In this Series paper, we discuss the underlying mechanisms and the current role of catheter ablation for the three most common atrial arrhythmias encountered in clinical practice: focal atrial tachycardia, atrial flutter, and atrial fibrillation. The mechanisms of focal atrial tachycardia and atrial flutter are well understood, and these arrhythmias are amenable to curative catheter ablation with high success rates. In most cases, paroxysmal atrial fibrillation is initiated by triggers located within pulmonary vein musculature. Circumferential ablation to isolate this musculature is associated with high success rates for elimination of paroxysmal atrial fibrillation in selected populations. Because of the problem of recurrent pulmonary vein connection, more than one procedure will be needed in about 30% of patients, and new technologies are being developed to reduce this occurrence. The mechanisms that sustain persistent atrial fibrillation are not well understood and are the subject of continuing investigation. As such, ablation approaches and technologies for this arrhythmia are still evolving. PMID:23101718

Lee, Geoffrey; Sanders, Prashanthan; Kalman, Jonathan M

2012-10-27

238

The Relationship Between Chronic Atrial Fibrillation and Reduced Pulmonary Function in Cases of Preserved Left Ventricular Systolic Function  

PubMed Central

Background and Objectives The purpose of this study was to investigate the relationship between chronic atrial fibrillation (AF) and reduced pulmonary function. Subjects and Methods Eighty-six chronic AF patients who were enrolled from annual health examination programs were studied using echocardiography and pulmonary function tests (PFT). Echocardiography and PFT matched for age, gender, and year performed were selected by the control group who had normal sinus rhythms. Patients with ejection fractions <50%, valvular heart disease, or ischemic heart disease were excluded. Results In the chronic AF patients, the forced expiratory volume at one second (FEV1), FEV1%, and FEV1/forced vital capacity (FVC) were significantly reduced, and the right ventricular systolic pressure was significantly increased. Episodes of heart failure were more frequently associated with the chronic AF patients than the controls. In particular, the FEV1% had the most meaningful relationship to chronic AF after an adjustment for cardiovascular risk factors {p=0.003, Exp (B)=0.978, 95% confidence interval (CI):0.963-0.993}. Conclusion Reduced FEV1%, which represents the severity of airway obstruction, was associated with chronic AF, and the greater the pulmonary function impairment, the greater the co-existence with AF and congestive heart failure in those with preserved left ventricular systolic function.

Kang, Hyunjae; Bae, Byung Seok; Kim, Jae Hoon; Jang, Hee Sang; Lee, Bong-Ryeol

2009-01-01

239

Surgical pathology of atrial appendages removed during the cox-maze procedure: a review of 86 cases (2004 to 2005) with implications for prognosis.  

PubMed

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Some patients are managed surgically (Cox-maze procedure) with removal of 1 or both atrial appendages. A retrospective review was performed on surgically excised atrial appendages from 86 consecutive patients with AF (2004 to 2005), at Mayo Clinic in Rochester, MN. These were compared with atrial appendages removed from 2 autopsy control groups without a history of AF (26 without heart disease, and 20 with heart disease). Compared with the 2 control groups, appendages from patients with AF contained more myocyte vacuolization, fatty infiltration, and myocardial inflammation. Among the AF patients, left atrial appendages (LAA) were larger and more likely to show fatty infiltration, endocardial fibroelastosis, and mural thrombus than were right atrial appendages (RAA); in contrast, RAA were more likely to show myocyte hypertrophy and interstitial fibrosis than were LAA. In the LAA, myocyte hypertrophy and interstitial fibrosis were more often seen in patients with long-term AF recurrence than were those who remained in normal sinus rhythm postoperatively (P=0.045 and 0.036, respectively). Given the potential clinical relevance of these findings, it is recommended that the presence or absence of hypertrophy and fibrosis, and their extent, be incorporated into the surgical pathology report of all patients undergoing resection of an atrial appendage. PMID:23629441

Castonguay, Mathieu C; Wang, Yinong; Gerhart, Jacqueline L; Miller, Dylan V; Stulak, John M; Edwards, William D; Maleszewski, Joseph J

2013-06-01

240

Multifocal atrial tachycardia.  

PubMed

Multifocal atrial tachycardia is typically seen in elderly patients with severe illnesses, most commonly COPD. The mechanism of the arrhythmia may be delayed afterdepolarizations leading to triggered activity, but this has not been firmly established. The initial treatment of multifocal atrial tachycardia should include supportive measures and aggressive reversal of precipitating causes. Since multifocal atrial tachycardia is commonly a secondary phenomenon, the role for antiarrhythmic therapy is unclear. Metoprolol, magnesium, and verapamil have been evaluated in a few treatment studies, and may have a role in the treatment of multifocal atrial tachycardia. PMID:9440591

McCord, J; Borzak, S

1998-01-01

241

Free floating left atrial ball thrombus: a rare cause of stroke.  

PubMed

In the setting of mitral valve stenosis and atrial fibrillation, left atrial ball thrombus is a rare but recognized cause of stroke and can occur even in the presence of therapeutic anticoagulation. This case report highlights the need for echocardiography to rule out treatable cardioembolic substrates for stroke. We report a case of cardioembolic stroke as a result of free floating left atrial ball thrombus presenting as a complication of rheumatic mitral valve disease. This case highlights that, in all patients with a history of structural heart disease, atrial fibrillation, or rheumatic fever, prompt cardiac ultrasound to exclude free floating atrial thrombus is essential. PMID:22959106

Rider, Oliver J; Malhotra, Aneil; Newton, James D

2012-09-06

242

Severe Cyanosis Due to Atrial Septal Defect and an Anomalous Inferior Vena Caval Valve  

Microsoft Academic Search

Uncomplicated atrial septal defect is often associated with mild arterial de saturation. A case is reported with severe cyanosis and life-threatening hypoxemia due to an atrial septal defect. Cardiac catheterization revealed normal right heart pressures and an atrial septal de fect with shunting of inferior vena caval blood into the left atrium. At surgery an anomalous inferior vena caval valve

Hillel Laks; Nasseer Ahmad; J. Gerald Mudd

1978-01-01

243

Induction of atrial fibrillation with rapid high voltage ventricular pacing for ventricular fibrillation conversion testing  

PubMed Central

OBJECTIVE—To assess whether rapid high voltage ventricular pacing can also induce atrial fibrillation, and whether the induction of atrial fibrillation during ventricular fibrillation conversion testing is related to the patient's heart disease.?DESIGN—Prospective study of 50 patients who received the dual chamber implantable cardioverter-defibrillator (ICD) Ventak AV II DR (Guidant) as a first implant. This device can record atrial activity even during a ventricular fibrillation episode and can induce atrial fibrillation by rapid atrial bursts.?MAIN OUTCOME MEASURES—Frequency of atrial fibrillation after induction of ventricular fibrillation; clinical characteristics of patients with and without induced atrial fibrillation; frequency of atrial fibrillation induced by rapid atrial bursts during predischarge testing.?RESULTS—Atrial fibrillation was observed in 40 of the 217 ventricular fibrillation episodes (18%) that could be detected immediately after delivery of high voltage pacing. The biphasic ICD shock for termination of ventricular fibrillation also terminated the atrial fibrillation in all cases. The 40 episodes of simultaneous atrial and ventricular fibrillation occurred in 18 patients (36%). The distribution of the clinical characteristics of the patients and the inducibility of atrial fibrillation during predischarge testing were similar in those with and without induced atrial fibrillation.?CONCLUSIONS—Rapid high voltage ventricular pacing frequently induces atrial fibrillation, which was terminated by the subsequent biphasic ICD shock. The induction of atrial fibrillation seems to be a non-specific phenomenon, unrelated to the clinical status of the patient.???Keywords: dual chamber implantable cardioverter-defibrillator; atrial fibrillation induction; ventricular fibrillation conversion test; high voltage ventricular pacing; atrial burst pacing

Schuchert, A; Kuhl, M; Ruppel, R; Meinertz, T

2000-01-01

244

Insights into atrial fibrillation.  

PubMed

Atrial fibrillation is the most common clinically relevant heart rhythm disorder and is associated with increased morbidity and mortality. Most important risk factors for atrial fibrillation are high age, arterial hypertension, diabetes mellitus, heart failure and rheumatic heart disease. Chronic atrial fibrillation is classified as paroxysmal, persistent, long-standing persistent and permanent atrial fibrillation. Spontaneous conversion to sinus rhythm is observed in paroxysmal atrial fibrillation, whereas in persistent atrial fibrillation, pharmacological or electrical cardioversion is required in order to restore sinus rhythm. In permanent atrial fibrillation, the arrythmia is accepted by patient and physician and cardioversion is not attempted. Rate control only is thus applied in permanent atrial fibrillation, whereas in paroxysmal and persistent atrial fibrillation, addition rhythm control with anti-arrhythmic drugs and/or ablation is attempted if symptoms persist and age and co-morbidities do not pose contra-indications. Besides rhythm management, oral anticoagulation is the mainstay of therapy for most patients with atrial fibrillation. Risk scores such as the CHA2DS2-VASc score help to identify patients with a high risk of stroke and need for oral anticoagulation. The underuse of vitamin K antagonists in clinical practise is partly due to considerable disadvantages: an increased bleeding risk, a narrow therapeutic window and multiple drug interactions prompting frequent laboratory controls to assess an individual dosage. New oral anticoagulants targeting thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban and edoxaban) may replace warfarin in many patients with atrial fibrillation due to convincing data both on efficacy and safety as well as convenience. However, challenges remain with respect to lack of specific antidotes and high costs. PMID:23514988

Mischke, K; Knackstedt, C; Marx, N; Vollmann, D

2013-04-01

245

Calcified right atrial thrombus in HIV infected patient.  

PubMed

Calcified right atrial thrombi are rare cardiac masses that may be complicated by pulmonary embolism. Although they can be discovered by a transthoracic echocardiography, they may need histological examination to differentiate them from other cardiac masses. We report a case of a 44-year-old woman who presented with a calcified right atrial thrombus and progressive dyspnoea. PMID:23819008

Mwita, Julius Chacha; Goepamang, Monkgogi; Mkubwa, Jack Joseph; Gunness, Teeluck Kumar; Reebye, Deshmukh; Motumise, Kelebogile

2013-04-30

246

Multiple external electrical cardioversions for refractory neonatal atrial flutter.  

PubMed

This report describes a case of atrial flutter in a fetal/neonatal patient who did not respond to adenosine, a propafenone bolus, and three electrical external cardioversions. A fourth direct current cardioversion after propafenone premedication resolved the atrial flutter. The arrhythmia did not recur with propafenone therapy during a 12-month follow-up period. PMID:21965089

Gulletta, Simone; Rovelli, Rosanna; Fiori, Rossana; Bella, Paolo Della

2011-10-01

247

Dedifferentiation of atrial cardiomyocytes as a result of chronic atrial fibrillation.  

PubMed Central

Chronic atrial fibrillation was induced in goats by electrical pacing. After 9 to 23 weeks of sustained atrial fibrillation, the morphology of the atrial structures was examined. The majority of the cardiomyocytes exhibited marked changes in their cellular substructures, with the replacement of sarcomeres by glycogen as the main characteristic. Using immuno-histochemical staining procedures, we assessed the expression and organization of contractile and cytoskeletal proteins in these cases and compared them with the expression and organization of these proteins in normal atria. Part of the atrial cardiomyocytes acquired a dedifferentiated phenotype, as deduced from the re-expression of alpha-smooth muscle actin, the disappearance of cardiotin, and the staining patterns of titin, which resembled those of embryonic cardiomyocytes. From these results we conclude that chronic atrial fibrillation induces myocardial dedifferentiation. This model of chronic atrial fibrillation in goats offers the possibility to study the time course of changes in cardiac structure during sustained atrial fibrillation and after cardioversion. Images Figure 1 Figure 2 Figure 3 Figure 5 Figure 6 Figure 7

Ausma, J.; Wijffels, M.; van Eys, G.; Koide, M.; Ramaekers, F.; Allessie, M.; Borgers, M.

1997-01-01

248

Blind atrial pacing for patients with sinus node disease who develop atrial fibrillation during permanent pacemaker implantation  

Microsoft Academic Search

During a 6-year period, six of 110 patients implanted with AAI pacemakers for sick sinus syndrome developed atrial fibrillation at the time of pacemaker implantation (5.5%). In all cases a passive fixation lead was sited in the right atrial appendage, its stability being ensured by rotation of the lead and phrenic nerve stimulation excluded by pacing at 10 V. One

T Fyfe; P. D MacIntyre; J. F Robinson; A. L Clark

1997-01-01

249

Transcatheter closure of secundum atrial septal defect with atrial septal defect occlusion system (ASDOS): initial experience and short-term follow-up.  

PubMed

Transcatheter closure of secundum atrial septal defect is a well known alternative to surgery. It was attempted in seven patients (age range 7-34 years, mean 20.1 +/- 6.5 years) with the double umbrella nitinol device (ASDOS, Dr. Ing Osypka, Germany). The interatrial septal anatomy and blood flow were examined by transthoracic and multiplane transoesophageal echocardiography. The size of atrial septal defect varied from 1.25-2.4 cm (mean 1.75 +/- 0.3 cm), minimal septal rim 0.5-1.0 cm (mean 0.75 +/- 0.20 cm), and Qp/Qs 1.6-3.2:1 (mean 2.4 +/- 0.6). One patient had an atrial septal defect following surgery for left atrial myxoma. The procedure which involved the use of monorail system for deployment of device under transoesophageal echocardiography guidance, was successful in six (86%) of the seven patients. The size of the implanted device ranged from 30-45 mm. In two patients, the right atrial umbrella had to be oversized in comparison to the left atrial umbrella for stability and adequate occlusion of the defect. The patient in whom the procedure failed had a defect size of 1.7 cm, with minimal septal rim (anterosuperior) of 5 mm; however, the device could be easily retrieved. Immediately after and at follow-up of one year, transoesophageal echocardiography-guided colour flow mapping revealed complete abolition of left-to-right shunt in five (83%) of the six patients. One patient had a small residual flow at the posterior rim of the defect; none had atrioventricular valve regurgitation. Although the procedure is complex, it is safe with the advantage of excellent control on the monorail system for proper positioning, repositioning and, if required, retrieval of the device. PMID:9835200

Kalra, G S; Verma, P K; Dhall, A; Singh, S; Bhardwaj, S; Arora, R

250

[Atrial fibrillation and stroke].  

PubMed

BACKGROUND More than 70 000 Norwegians have atrial fibrillation, which is a major risk factor for ischemic stroke. A large proportion of ischemic strokes caused by atrial fibrillation could be prevented if patients receive optimal prophylactic treatment. This article describes the risk for ischemic stroke in patients with atrial fibrillation, and discusses who should receive prophylactic treatment and which therapy provides the best prevention.METHOD The article is based on recently published European, American and Canadian guidelines, a search in PubMed and the authors' own clinical experience.RESULTS The new risk score CHA2DS2-VASc is better than the CHADS2 score for identifying patients with atrial fibrillation who have a truly low risk of ischemic stroke and are not in need of antithrombotic treatment. Oral anticoagulation therapy is recommended for patients with two or more risk factors for thromboembolism in addition to atrial fibrillation (CHA2DS2-VASc ? 2). Patients with atrial fibrillation and a single additional risk factor (CHA2DS2-VASc =1) an individual assessment should be made as to who should receive oral anticoagulants, and for patients with CHA2DS2-VASc = 0 antithrombotic treatment is not recommended. New oral anticoagulants are at least as effective as warfarin for preventing ischemic stroke in patients with nonvalvular atrial fibrillation, they carry a lower risk of cerebral haemorrhage, especially intracranial haemorrhage and are more practical in use. Platelet inhibitors have a minimal role in stroke prevention in patients with atrial fibrillation.INTERPRETATION Risks stratifying patients using the CHA2DS2-VASc score is a better method for assessing which patients with atrial fibrillation who should receive oral anticoagulation. The introduction of new oral anticoagulants will simplify preventive treatment and hopefully lead to a more efficient anticoagulation treatment in a larger number of patients with atrial fibrillation. PMID:23929293

Aamodt, Anne Hege; Sandset, Per Morten; Atar, Dan; Tveit, Arnljot; Russell, David

2013-08-01

251

Cardiac tumour masquerades as mid-life (menopause) event.  

PubMed

Atrial myxomas are the most common primary cardiac tumours encountered. Their detection may be incidental, owing to embolic events, intracardiac obstructive features or in some cases, non-specific constitutional symptoms. We describe a middle-aged woman attributing constitutional symptoms to menopause, but later determined to be due to an atrial myxoma. PMID:23362067

Rosser, Gareth J; Goode, Emily F; Godazgar, Faezah; Dubrey, Simon William

2013-01-28

252

Video-assisted cardiac myxoma resection: basket technique for complete and safe removal from the heart.  

PubMed

Video assistance can replace sternotomy in cardiac operations with excellent results. Because myxomas are very friable tumors, their removal from the heart and chest cavity through a working port in video-assisted or robotic procedures may be challenging. We used a laparoscopic basket to safely catch and remove these friable tumors in 10 patients undergoing video-assisted myxoma resection between December 2008 and June 2011. Complete excision and removal was achieved in all patients. No neurologic, vascular, or wound complications were observed. This minimally invasive myxoma technique gives excellent and reproducible results without a higher risk for the patient. PMID:22450108

Panos, Aristotelis; Myers, Patrick O

2012-04-01

253

Cigarette smoking induces atrial fibrosis in humans via nicotine  

PubMed Central

Background Cigarette smoking (CS) promotes endothelial dysfunction and atherosclerosis in the vascular bed. The impact of smoking on atrial myocardium is not defined in humans. Objective To determine the effect of CS on the development of interstitial fibrosis in atrial myocardium. Design Case–control study. Patients 95 patients (46 smokers and 49 non?smokers) undergoing coronary artery bypass grafting (CABG). Main outcome measures Amount of atrial fibrosis, collagen I, III and IV expression pattern, and quantitative reverse transcriptase?PCR. Occurrence of postoperative atrial fibrillation (AF). Results In the study population, patient age correlated significantly with the amount of atrial fibrosis (r?=?0.18; p<0.05). Nicotine misuse (pack years) was identified as the only factor related to atrial fibrosis in smokers (r?=?0.311; p<0.05). The amount of fibrosis was higher in patients with postoperative AF (22.9% (6.2%) vs. 27.0% (8.2%); p<0.05). To show a causal relationship between CS and atrial fibrosis, atrial tissue slices from non?smokers (n?=?8) were cultured in the presence of nicotine base (185 and 740?nmol/l). Nicotine base induced mRNA expression of collagen III (up to 10?fold) in a concentration?dependent manner resembling the immunohistological collagen expression pattern observed in CS. Conclusion CS contributes to the development of atrial fibrosis via nicotine. Atrial fibrosis by itself has been shown to provide an arrhythmogenic substrate, which may increase the likelihood of the occurrence of atrial arrhythmias, including postoperative AF.

Goette, Andreas; Lendeckel, Uwe; Kuchenbecker, Anja; Bukowska, Alicja; Peters, Brigitte; Klein, Helmut U; Huth, Christof; Rocken, Christoph

2007-01-01

254

A woman with cystic fibrosis, severe hypoxaemia, an atrial thrombus and a patent foramen ovale: a case report  

Microsoft Academic Search

INTRODUCTION: Cystic fibrosis is usually associated with chronic pulmonary sepsis and frequent infective exacerbations. We report a very unusual cause of severe hypoxaemia in a woman with cystic fibrosis caused by thrombus formation in the right atrium. CASE PRESENTATION: A 21-year-old Caucasian woman with cystic fibrosis and a totally implantable venous access device presented with severe hypoxaemia. This was initially

Nicholas J Simmonds; Hilary Wyatt; Raj Patel; Margaret E Hodson; Khin M Gyi

2009-01-01

255

Atrial fibrillation or flutter  

MedlinePLUS

... Cardiol . 2011;57:e101-198. Morady F, Zipes DP. Atrial fibrillation: clinical featuers, mechanisms, and management. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook ...

256

Atrial fibrillation in athletes.  

PubMed

Many studies have shown a relationship between long-term endurance sport practice and atrial fibrillation. Inflammation, anatomic remodelling, alterations in the autonomic system and neurohormonal activation are all possible explanations for the increased prevalence of this arrhythmia in athletes. Atrial fibrillation may determine disabling symptoms like palpitations and impaired physical performance, compromising eligibility for competitive activities, but exclusion from sport is not necessary for all athletes. Limited data are available on drug therapy and recently ablation resulted to be a particularly attractive option for young athletes with paroxysmal atrial fibrillation. The purpose of this review is to discuss mechanisms, clinical features, management of atrial fibrillation in competitive athletes, including criteria for eligibility and disqualification in sport practice. PMID:23041967

Mascia, G; Perrotta, L; Galanti, G; Padeletti, L

2012-10-05

257

Focal ablation of chaotic atrial rhythm in an infant with cardiomyopathy.  

PubMed

Chaotic atrial rhythm in infants has been defined similar to multifocal atrial tachycardia in adults, implying a multifocal etiology. However, its ECG appearance resembles atrial fibrillation, which sometimes has a unifocal ectopic mechanism amenable to catheter ablation. Curative focal radiofrequency ablation was performed in a 4-month-old infant with chaotic atrial rhythm and dilated cardiomyopathy. Left ventricular function subsequently returned to normal. Reversibility of associated cardiomyopathy supports aggressive rhythm management of chaotic atrial rhythm. In this patient, the unifocal origin allows insight into the pathophysiology of the rhythm and demonstrates the potential utility of catheter ablation for refractory cases. PMID:10826938

Bevilacqua, L M; Rhee, E K; Epstein, M R; Triedman, J K

2000-05-01

258

[Prevention of thrombolitic compications with atrial fibrillation].  

PubMed

This study presents the modern principles of prevention and treatment of thrombolitic complications in patients with atrial fibrillation. The adequate tactics and algorithm of antithrombotic therapy in the case of variety versions of this disease is considered in this study. It described the efficiency and safety of oral anticoagulants (antagonist Vit K) varfarin with the purpose to inform the practical doctors with principals of prevention and treatment of hemorrhagic complications. This publication appears as a fragment from the series of atrial fibrillation management and destinated for physicians and cardiologist. PMID:18997251

Abuladze, G; Jinjolia, N; Narsia, E; Abashidze, R; Kajaia, T

2008-10-01

259

[Anticoagulation with atrial fibrillation].  

PubMed

Atrial fibrillation is associated with a relevant risk for ischemic stroke: Observational studies suggest that one in four to five strokes is due to atrial fibrillation. Depending on the risk profile of an individual patient, the yearly risk for a stroke is between 2% and 14%. Continuous oral anticoagulation is indicated if atrial fibrillation is accompanied by at least one additional risk factor for thromboembolic complications. This recommendation is supported by several large randomized trials. Due to their low therapeutic range, vitamin K antagonists (phenprocoumon, warfarin, and others), the most commonly used oral anticoagulants, require regular anticoagulation monitoring. If well-controlled (international normalized ratio 2-3, in elderly patients preferably 2-2.5), oral anticoagulation prevents more than half of ischemic strokes related to atrial fibrillation, while bleeding complications are rare. In the follow-up of low risk patients (CHADS2-Score 0), oral anticoagulation becomes necessary when risk factors for thromboembolic complications develop. If a stroke occurs during oral anticoagulation and an INR>2 in a patient with atrial fibrillation, other causes than thromboembolic events should be considered. New anticoagulants--especially direct thrombin antagonists--are currently evaluated in clinical trials and may in the future facilitate anticoagulation in patients with atrial fibrillation. PMID:16786467

Zellerhoff, S; Goette, A; Kirchhof, P

2006-06-01

260

[Multifocal atrial tachycardia in the newborn infant--obstetrical implications].  

PubMed

The present discussion deals with the rare multifocal atrial tachycardia in the neonate, initiated by a recent case in our clinic. The difficulties in prenatally diagnosing the disease by cardiotocography are as well discussed as the obstetric management. PMID:4072318

Haenel, A F; Olafsson, A

261

Recurrent left atrial and left ventricular thrombosis due to heparin-induced thrombocytopenia: case report and short review.  

PubMed

The combination of heparin-induced thrombocytopenia (HIT) II, left ventricular failure with extracorporeal membrane oxygenation (ECMO) therapy, and recurrent left ventricular thrombosis is rare and predicts a poor outcome. In this case, HIT II occurred after an ischemic cardiogenic shock. We initiated ECMO and intra-aortic balloon pump therapy during coronary artery bypass grafting and ventricular thrombectomy. Despite continued therapeutic therapy with heparin and later argatroban, the patient developed solid and recurrent thrombotic masses in the left atrium and left ventricle. PMID:23424064

Kuhl, Thomas; Wendt, Stefanie; Langebartels, Georg; Kröner, Axel; Wahlers, Thorsten

2013-02-19

262

Myxoma valvulae arteriae pulmonalis described by Rokitansky: medicohistorical and clinicopathological aspects  

Microsoft Academic Search

Summary The bicentenary of the birth of Rokitansky, the first true descriptive pathologist, was celebrated in February 2004. Rokitansky gathered many and important specimens that are now displayed in the Federal Museum of Pathological Anatomy in Vienna. On examining Rokitansky’s collection we found a myxoma of the pulmonary valve of a 70-year-old woman who died in 1833. Cardiac myxomas are

Sandra Kandutsch; Andrija Javor; Roland Sedivy

2004-01-01

263

Targeting human medulloblastoma: oncolytic virotherapy with myxoma virus is enhanced by rapamycin.  

PubMed

We have shown previously the oncolytic potential of myxoma virus in a murine xenograft model of human glioma. Here, we show that myxoma virus used alone or in combination with rapamycin is effective and safe when used in experimental models of medulloblastoma in vitro and in vivo. Nine of 10 medulloblastoma cell lines tested were susceptible to lethal myxoma virus infection, and pretreatment of cells with rapamycin increased the extent of in vitro oncolysis. Intratumoral injection of live myxoma virus when compared with control inactivated virus prolonged survival in D341 and Daoy orthotopic human medulloblastoma xenograft mouse models [D341 median survival: 21 versus 12.5 days; P = 0.0008; Daoy median survival: not reached (three of five mice apparently "cured" after 223 days) versus 75 days; P = 0.0021]. Rapamycin increased the extent of viral oncolysis, "curing" most Daoy tumor-bearing mice and reducing or eliminating spinal cord and ventricle metastases. Rapamycin enhanced tumor-specific myxoma virus replication in vivo and prolonged survival of D341 tumor-bearing mice (median survival of mice treated with live virus (LV) and rapamycin, versus LV alone, versus rapamycin alone, versus inactivated virus: 25 days versus 19, 13, and 11 days, respectively; P < 0.0001). Rapamycin increased the levels of constitutively activated Akt in Daoy and D341 cells, which may explain its ability to enhance myxoma virus oncolysis. These observations suggest that myxoma virus may be an effective oncolytic agent against medulloblastoma and that combination therapy with signaling inhibitors that modulate activity of the phosphatidylinositol 3-kinase/Akt pathway will further enhance the oncolytic potential of myxoma virus. PMID:17875723

Lun, Xue Qing; Zhou, Hongyuan; Alain, Tommy; Sun, Beichen; Wang, Limei; Barrett, John W; Stanford, Marianne M; McFadden, Grant; Bell, John; Senger, Donna L; Forsyth, Peter A

2007-09-15

264

A MYXOMA VIRUS EPlZOOTlC IN A BRUSH RABBIT POPULATION  

Microsoft Academic Search

During the spring and summer months of 1964 more than 95% of a population of brush rabbits (Sy11~ilagu.s bacl~trlat~i) became infected with Californian myxoma virus. The characteristics of the epizootic and its effect on this species reinforce the assumption that the brush rabbit is an endemic reservoir of the Californian myxoma virus. Several lines of evidence suggest that the brush

DAVID C. REGNERYO

265

Prolonged PR interval despite a programmed short sensed AV delay: the role of intra-atrial conduction time  

Microsoft Academic Search

Intracavitary electrogram (IEGM) is a useful tool in the interpretation of difficult pacemaker electrograms. A case of 320ms P–V spike interval on the surface ECG despite a 110ms programmed sensed AV delay is presented. Atrial IEGM revealed atrial tachycardia with a significant atrial conduction delay. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

A. Bohm; A. Pintér; G. Dudás; I. Préda

2002-01-01

266

Isolated atrial infarction in a patients with single vessel disease of the sinus node artery.  

PubMed

Atrial infarction is found in approximately 17 percent of autopsy-proven cases of myocardial infarction, but is a frequently missed clinical diagnosis. The antemortem diagnosis of atrial infarction occurring in the absence of ventricular infarction has not been previously reported. We present a patient with ischemic chest discomfort associated with paroxysmal atrial fibrillation. Electrocardiographic and enzymatic changes were consistent with atrial infarction. Cardiac catheterization demonstrated single vessel critical stenosis at the origin of the sinus node artery. Combined atrial and ventricular infarction occurs frequently and should be considered in the setting of paroxysmal supraventricular arrhythmias occurring early in the course of ventricular myocardial infarction. Lone atrial infarction is a rare but distinct clinical entity. The tetrad of typical ischemic chest discomfort, paroxysmal supraventricular arrhythmia, P-Ta segment shifts, and elevated cardiac enzyme levels without evidence for ventricular infarction strongly suggests isolated atrial infarction. PMID:2060356

Wong, A K; Marais, H J; Jutzy, K; Capestany, G A; Marais, G E

1991-07-01

267

Management of Atrial Tachycardia in the Newborn With Enterovirus Myocarditis  

PubMed Central

Neonatal enterovirus myocarditis is a rare but serious infection that is often an underrecognized cause of cardiovascular collapse. Enterovirus myocarditis in patients with such collapse should be suspected when signs of congestive heart failure and tachyarrhythmia are present. The majority of reported electrical disturbances associated with enterovirus myocarditis are ventricular in origin, but the infection can present as atrial tachyarrhythmia. Atrial tachyarrhythmias associated with enterovirus myocarditis are difficult to manage because of their resistance to conventional antiarrhythmic therapy. We present 2 cases of neonates with atrial tachycardia associated with enterovirus myocarditis who responded to a combination of amiodarone and flecainide.

Petroni, Daniel H.; Yang, Song G.; Kattash, Mudar M.; Snyder, Christopher S.

2012-01-01

268

Serial evaluation of left atrial dimension after cardioversion for atrial fibrillation and relation to atrial function  

Microsoft Academic Search

The size of the left atrium is usually increased during atrial fibrillation (AF). The aim of the present study was to evaluate changes in left atrial (LA) dimension after cardioversion for AF, and the relation between LA dimension and atrial function. The initial study population included 171 consecutive patients. Patients who had spontaneous cardioversion to sinus rhythm (56 patients) were

Anna Vittoria Mattioli; Stefania Sansoni; Giulia Ricci Lucchi; Giorgio Mattioli

2000-01-01

269

Cardioversion of atrial fibrillation.  

PubMed Central

Cardioversion to sinus rhythm should be considered for all patients in atrial fibrillation in order to improve cardiac performance and perhaps to reduce the long-term risk of thromboembolic complications. Different methods of cardioversion, whether electrical or pharmacological, exist and there is often uncertainty about performing the procedure. In particular, there is often confusion about the use of anti-arrhythmic drugs and the suitable length of anticoagulant therapy required pre- and post-cardioversion. This review discusses the current understanding of electrical and pharmacological cardioversion of atrial fibrillation, the clinical effects and the role of prophylactic anti-arrhythmic and anticoagulant therapy in this procedure. Images Figure 1

Lip, G. Y.

1995-01-01

270

Distribution of atrial electrogram types during atrial fibrillation: Effect of rapid atrial pacing and intercaval junction ablation  

Microsoft Academic Search

Objectives. This study examined the anatomic distribution types and possible determinant of atrial electrogram types during atrial fibrillation.Background. Different types of atrial electrograms during atrial fibrillation have been observed and classified, but their anatomic distribution patterns, determinants and potential usefulness in guiding future catheter ablation are unknown.Methods. Two animal models of atrial fibrillation were used: the sterile pericarditis model (n

Huagui Li; John Hare; Kashef Mughal; David Krum; Michael Biehl; Sanjay Deshpande; Anwer Dhala; Zalmen Blanck; Jasbir Sra; Mohammad Jazayeri; Masood Akhtar

1996-01-01

271

[Electrophysiological study in atrial fibrillation].  

PubMed

Electrophysiological study should be done in patients who suppose to undergo the treatment including pulmonary vein isolation using catheter ablation for atrial fibrillation. The purpose of the electrophysiological study consist with confirmation of the induction and the origin of atrial fibrillation, and with recognition of electrical potential and arrhythmogenic substrate for maintenance of atrial fibrillation. The shortening and irregularity of the refractory periods and prolongation of conduction time are important factor in occurrence of atrial fibrillation. Moreover, the complex fractionated atrial electrograms(CFAE) and ganglionated plexus(GP) play an important role in maintenance of atrial fibrillation. As it is indispensable to record and distinguish the electrical potential of atrium and pulmonary vein for the ablation of atrial fibrillation, every physician who is concerned in the catheter ablation requires accustoming to these potentials. PMID:23631172

Sugi, Kaoru; Itoh, Naoshi; Enomoto, Yoshinari; Kujime, Shingo; Noro, Mahito

2013-01-01

272

Incidence and predictors of atrial flutter in the general population  

Microsoft Academic Search

OBJECTIVESThe goal of our study was to determine the incidence and predictors of atrial flutter in the general population.BACKGROUNDAlthough atrial flutter can now be cured, there are no reports on its epidemiology in unselected patients.METHODSThe Marshfield Epidemiological Study Area (MESA), a database that captures nearly all medical care among its 58,820 residents was used to ascertain all new cases of

Juan Granada; William Uribe; Po-Huang Chyou; Karen Maassen; Robert Vierkant; Peter N Smith; John Hayes; Elaine Eaker; Humberto Vidaillet

2000-01-01

273

Surgical ablation for atrial fibrillation.  

PubMed

This paper reviews the history of surgical procedures developed for eradication of atrial fibrillation (AF) during cardiac surgery for structural heart disease, and in patients with AF without other indication for cardiac surgery. Current evidence indicates that, despite their proven efficacy, the Cox-Maze procedure and its modifications require cardiopulmonary bypass and cannot be easily justified in the case of AF without other indication for cardiac surgery. In patients undergoing cardiac surgery for mitral valve disease, concomitant ablation techniques using modifications of the Maze and alternative energy sources appear to be safe and effective in treating AF, especially in non-rheumatic disease. Minimally invasive epicardial ablation has been recently developed and can be performed on a beating heart through small access incision ports. Various techniques combining pulmonary vein isolation, ganglionated plexi ablation, and left atrial lines have been tried. Initial results are promising but further clinical experience is required to establish ideal lesion sets, appropriate energy sources, and the benefit-risk ratio of such an approach in patients without other indication for cardiac surgery. The role of surgical ablation in the current management of AF is under investigation. PMID:22490369

Fragakis, Nikolaos; Pantos, Ioannis; Younis, Jenan; Hadjipavlou, Marios; Katritsis, Demosthenes G

2012-04-05

274

Multifocal atrial tachycardia (MAT). The misdiagnosed atrial arrhythmia of old age.  

PubMed

The clinical and electrocardiographic features of multifocal atrial tachycardia are described and illustrated by nine examples. It is almost entirely seen in later life and is often misdiagnosed as atrial fibrillation. It is associated with a high mortality and the majority of the cases described here reverted to sinus rhythm. Little attention has been so far paid to this important arrhythmia in the elderly in standard textbooks of cardiology. The literature is reviewed and management discussed. It is not a rare supreventricular tachycardia in the aged and many examples may be not diagnosed. It merits further study in relation to unanswered questions. PMID:892451

Clark, A N

1977-01-01

275

Atrial Compartment Operation for Atrial Fibrillation: To Isolate the Left Atrium or Not?  

Microsoft Academic Search

Background. The atrial compartment operation was designed to convert atrial fibrillation (AF) to sinus rhythm with intentional preservation of the electrical connection between adjacent atrial compartments. How- ever, incidental left atrial isolation was observed in some patients. This study compared the long-term clinical outcomes of left atrial isolation for AF with those with right and left atrial connection. Methods. Twenty

Huey-Ming Lo; Fang-Yue Lin; Yung Zu Tseng

2010-01-01

276

Electrophysiology and endocardial mapping of induced atrial fibrillation in patients with spontaneous atrial fibrillation  

Microsoft Academic Search

We analyzed the patterns of atrial activation and characterized the electrophysiologic properties of regional atrial sites in the right atrium and left atrium at the onset of atrial fibrillation (AF) induced with programmed right atrial (RA) stimulation. Intraatrial conduction, atrial electrogram return cycle lengths for the first AF cycle, RA and left atrial (LA) activation maps during AF, and the

Sanjeev Saksena; Irakli Giorgberidze; Rahul Mehra; Michael Hill; Atul Prakash; Ryszard B Krol; Philip Mathew

1999-01-01

277

Exploiting periodicity to extract the atrial activity in atrial arrhythmias  

NASA Astrophysics Data System (ADS)

Atrial fibrillation disorders are one of the main arrhythmias of the elderly. The atrial and ventricular activities are decoupled during an atrial fibrillation episode, and very rapid and irregular waves replace the usual atrial P-wave in a normal sinus rhythm electrocardiogram (ECG). The estimation of these wavelets is a must for clinical analysis. We propose a new approach to this problem focused on the quasiperiodicity of these wavelets. Atrial activity is characterized by a main atrial rhythm in the interval 3-12 Hz. It enables us to establish the problem as the separation of the original sources from the instantaneous linear combination of them recorded in the ECG or the extraction of only the atrial component exploiting the quasiperiodic feature of the atrial signal. This methodology implies the previous estimation of such main atrial period. We present two algorithms that separate and extract the atrial rhythm starting from a prior estimation of the main atrial frequency. The first one is an algebraic method based on the maximization of a cost function that measures the periodicity. The other one is an adaptive algorithm that exploits the decorrelation of the atrial and other signals diagonalizing the correlation matrices at multiple lags of the period of atrial activity. The algorithms are applied successfully to synthetic and real data. In simulated ECGs, the average correlation index obtained was 0.811 and 0.847, respectively. In real ECGs, the accuracy of the results was validated using spectral and temporal parameters. The average peak frequency and spectral concentration obtained were 5.550 and 5.554 Hz and 56.3 and 54.4%, respectively, and the kurtosis was 0.266 and 0.695. For validation purposes, we compared the proposed algorithms with established methods, obtaining better results for simulated and real registers.

Llinares, Raul; Igual, Jorge

2011-12-01

278

Iatrogenic intra-atrial macro-reenterant tachycardia following transcatheter closure of atrial septal defect treated by radiofrequency ablation.  

PubMed

Percutaneous closure of an atrial septal defect (ASD) has been established as a safe and effective alternative to surgical management. We describe a case of a 41-year-old patient in whom an Amplatzer septal occluder device was used to close a moderately large ASD and who subsequently developed incessant intra-atrial macro-reenterant tachycardia. The tachycardia was terminated by radiofrequency ablation guided by electroanatomical mapping. PMID:21976886

Marai, Ibrahim; Suleiman, Mahmoud; Lorber, Abraham; Boulos, Monther

2011-07-01

279

Iatrogenic intra-atrial macro-reenterant tachycardia following transcatheter closure of atrial septal defect treated by radiofrequency ablation  

PubMed Central

Percutaneous closure of an atrial septal defect (ASD) has been established as a safe and effective alternative to surgical management. We describe a case of a 41-year-old patient in whom an Amplatzer septal occluder device was used to close a moderately large ASD and who subsequently developed incessant intra-atrial macro-reenterant tachycardia. The tachycardia was terminated by radiofrequency ablation guided by electroanatomical mapping.

Marai, Ibrahim; Suleiman, Mahmoud; Lorber, Abraham; Boulos, Monther

2011-01-01

280

Obesity and atrial fibrillation.  

PubMed

Atrial fibrillation (AF) is an increasing public health problem, often described as the epidemic of the new millennium. The rising health economic impact of AF, its association with poor quality of life and independent probability of increased mortality, has recently been highlighted. Although population ageing is regarded as an important contributor to this epidemic, obesity and its associated cardiometabolic comorbidities may represent the principal driving factor behind the current and projected AF epidemic. Obesity-related risk factors, such as hypertension, vascular disease, obstructive sleep apnea and pericardial fat, are thought to result in atrial electro-structural dysfunction. In addition, insulin resistance, its associated abnormalities in nutrient utilization and intermediary metabolic by-products are associated with structural and functional abnormalities, ultimately promoting AF. Recent elucidation of molecular pathways, including those responsible for atrial fibrosis, have provided mechanistic insights and the potential for targeted pharmacotherapy. In this article, we review the evidence for an obesity-related atrial electromechanical dysfunction, the mechanisms behind this and its impact on AF therapeutic outcomes. In light of the recently described mechanisms, we illustrate proposed management approaches and avenues for further investigations. PMID:23879190

Abed, H S; Wittert, G A

2013-07-24

281

INTRACARDIAC ATRIAL DEFIBRILLATION  

PubMed Central

Intravascular ventricular defibrillation and intravascular atrial defibrillation have many similarities, some of which are as follows. An important factor influencing the outcome of the shock is the potential gradient field created throughout the ventricles or the atria by the shock. A minimum potential gradient is required throughout the ventricles and probably the atria to defibrillate. The value of this minimum potential gradient is affected by several factors including the duration, tilt, and number of phases of the waveform. For shock strengths near the defibrillation threshold, earliest activation following failed shocks arises in a region in which the potential gradient is low. The defibrillation threshold energy can be decreased by adding a third and even a fourth defibrillation electrode in regions where the shock potential gradient is low for the shock field created by the first two defibrillation electrodes and giving two sequential shocks, each through a different set of electrodes. However, the addition of more electrodes and sequential shocks complicates both the device and its implantation. Since patients are conscious when the atrial defibrillation shock is given, they experience pain during the shock, which is one of the main drawbacks of intravascular atrial defibrillation. Unfortunately, the pain threshold for defibrillation shocks is so low that a shock of less than 1 Joule is uncomfortable and is not much less painful than shocks several times stronger. Therefore, even though electrode configurations exist that have lower atrial defibrillation threshold energy requirements than the atrial defibrillation threshold with standard defibrillation electrode configurations used in implantable cardioverter/defibrillators (ICDs) for ventricular defibrillation, they are not clinically practical because their shocks are almost as painful as with the standard ICD electrode configurations and they would cause the ICD to be more complicated and to take longer and be more difficult to implant.

Dosdall, Derek J.; Ideker, Raymond E.

2007-01-01

282

Detection of Herplex Simplex Virus-1 and -2 in Cardiac Myxomas  

PubMed Central

The etiology of sporadic cardiac myxomas remains elusive. The tendency for these lesions to recur following resection, their immunopathological characteristics, along with their histological and molecular profile, may implicate the presence of an infective agent in this type of tumor. In this study, we investigated the presence of herpes simplex virus (HSV) DNA in a cohort of cardiac myxomas in a tertiary referral centre. Twenty-nine formalin-fixed paraffin-embedded (FFPE) sporadic cardiac myxomas were obtained, 17 of which were shown to be informative. These were compared to 19 macroscopically and microscopically normal heart tissue specimens. The detection of HSV-1 and -2 genomic sequences was achieved with the use of a combined nested PCR-Restriction Fragment Length Polymorphism methodology. The presence of HSV-1 and/or -2 DNA was demonstrated in 6 of 17 (35%) informative sporadic cardiac myxomas, whereas no HSV DNA was detected in normal heart tissues (P < 0.01). The existence of HSV-1/2 DNA in sporadic cardiac myxomas, along with its absence from normal heart tissues, reinforces the possibility that HSV infection might be involved in the development of these lesions. Our findings raise the point of anti-HSV medication postsurgically with a potential benefit in reducing the rate of recurrences.

Pateras, Ioannis S.; Evangelou, Konstantinos; Tsimaratou, Katerina; Liontos, Michalis; Sakellariou, Stratigoula; Barlogiannis, Theodoros; Karakitsos, Petros; Papalois, Apostolos; Kotsinas, Athanassios; Gorgoulis, Vassilis G.

2012-01-01

283

Atrial activity selection for atrial fibrillation ECG recordings.  

PubMed

In this paper we apply independent component analysis (ICA) followed by second order blind identification (SOBI) to an atrial fibrillation (AF) 12-lead electrocardiogram (ECG) recording in order to extract the source that represents atrial activity (AA) (ICA-SOBI method). Still, there is no assurance that only one source obtained from this method will contain AA, and thus we aim to select the most representative source of AA. The novelty in this paper is the proposal of three parameters to select the most representative source of AA. These parameters are correlation coefficient with lead V1 (CV1), peak factor (PF) and spectral concentration (SC). The first two parameters are introduced as new indicators, addressing features overlooked by the SC even when they are present in AA during AF. For synthesized data, at least two of the three parameters select the same representation of AA in 93.3% of the cases. For real data (218 ECG recordings), we observe that PF presents, in 89.5% of the cases, values between 2 and 4.5 for the selected sources, ensuring a well-defined range of values for AA. The actual values of CV1 and SC were scattered throughout their possible ranges (0-1 for CV1 and 0.08-0.7 for SC), and the correlation coefficient between these variables was found to be ?=0.58. We compared our results with three known algorithms: QRST cancellation, principal components analysis (PCA) and ICA-SOBI. The results obtained from this comparison show that our proposed methods to select the best representation of AA in general outperform the three above-mentioned algorithms. PMID:24034755

Donoso, Felipe I; Figueroa, Rosa L; Lecannelier, Eduardo A; Pino, Esteban J; Rojas, Alejandro J

2013-08-14

284

Carney complex: a case report.  

PubMed

Cardiac myxoma is the most common benign cardiac tumor, and 10% of cases are familial forms. The authors present a review of the literature on the Carney complex, and a case report of a 68-year-old man with a cardiac mass, associated with a significant family history and a diagnosis of coronary embolism. PMID:19438156

Teixeira, Rogério; Lourenço, Carolina; Coelho, Lourenço; Vieira, Henrique; Ramos, Domingos; Castro, Graça; Monteiro, Pedro; Donato, Paulo; Ferreira, Maria J; Providência, Luís A

2009-02-01

285

Acute atrial fibrillation during dengue hemorrhagic fever.  

PubMed

Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease. PMID:14636482

Horta Veloso, Henrique; Ferreira Júnior, João Anísio; Braga de Paiva, Joyce Morgana; Faria Honório, Júlio; Junqueira Bellei, Nancy C; Vicenzo de Paola, Angelo Amato

2003-12-01

286

Myxoma of the ear lobe in a 23-month-old girl with Carney complex.  

PubMed

Myxomas of the ear are extremely uncommon, especially in young children. A 23-month-old girl born to a family with known Carney complex, a condition that predisposes to multiple myxomas, presented with a large, cauliflower-like mass located on the back of her right ear. Histopathologically, the lesion was composed of scattered spindle-shaped or stellate cells with abundant associated mucin and a very sparse inflammatory infiltrate containing lymphocytes and neutrophils. The patient was a carrier of a protein kinase A regulatory subunit 1A (PRKAR1A) mutation; PRKAR1A mutations cause Carney complex in most patients with this rare disorder. This is the earliest presentation of an ear lobe myxoma reported in the literature. PMID:21880053

Briassoulis, George; Quezado, Martha; Lee, Chyi-Chia Richard; Xekouki, Paraskevi; Keil, Meg; Stratakis, Constantine A

2011-09-01

287

Myxoma of the ear lobe in a 23 month-old girl with Carney complex  

PubMed Central

Myxomas of the ear are extremely uncommon, especially in young children. A 23-month-old girl born to a family with known Carney complex, a condition that predisposes to multiple myxomas, presented with a large, cauliflower-like mass located on the back of her right ear. Histopathologically, the lesion was composed of scattered spindle-shaped or stellate cells with abundant associated mucin and a very sparse inflammatory infiltrate containing lymphocytes and neutrophils. The patient was a carrier of a protein kinase A regulatory subunit 1A (PRKAR1A) mutation; PRKAR1A mutations cause Carney complex in most patients with this rare disorder. This is the earliest presentation of an ear lobe myxoma reported in the literature.

Briassoulis, George; Quezado, Martha; Lee, Chyi-Chia Richard; Xekouki, Paraskevi; Keil, Meg; Stratakis, Constantine A.

2011-01-01

288

Management of atrial fibrillation  

Microsoft Academic Search

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. It is common in the elderly and those with structural heart disease. Clinical classification can be helpful in treatment decisions and the most widely accepted classification scheme (first episode, recurrent paroxysmal, recurrent persistent, permanent) is found in the ACC\\/AHA\\/ESC guidelines.The pathophysiology of AF remains unclear at this time.

A. Hersi; D. G. Wyse

2005-01-01

289

Cryoablation of atrial fibrillation  

Microsoft Academic Search

Atrial fibrillation (AF) is a significant burden to the public health. AF is associated with increased morbidity and mortality,\\u000a including an increased risk of heart failure, stroke, cognitive impairment, and diminished quality of life. Catheter ablation\\u000a is an effective therapy for recurrent, symptomatic, drug-refractory AF. To date, radiofrequency ablation has been the most\\u000a common catheter-based method of pulmonary vein isolation;

Jonathan P. Piccini; James P. Daubert

290

Atrial fibrillation: catheter ablation.  

PubMed

Catheter ablation of atrial fibrillation (AF) has evolved dramatically over the last several years. The initial efforts in the catheter-based management of AF targeted the atrial substrate in an effort to mimic the maze procedure. After the pulmonary veins (PV) were shown to be critical in the initiation and perpetuation of AF, the focus then shifted to a trigger approach in which the PVs and other foci were targeted for ablation. The pendulum then appeared to swing back toward the substrate approach after it was shown that left atrial circumferential ablation afforded improved outcomes in patients with paroxysmal and persistent AF. It has become clear that there are several possible approaches in the catheter ablation of AF, each with its strengths and limitations. It is also becoming evident that not all patients will respond to a single ablation technique and that the ablation protocol is best tailored to suit the individual patient. This article strives to present an evidence-based review of the many techniques, and then offer a practical guide to the catheter ablation of AF. PMID:17053976

Chugh, Aman; Morady, Fred

2006-10-20

291

Myxoma virus induces extensive CD4 downregulation and dissociation of p56lck in infected rabbit CD4+ T lymphocytes.  

PubMed Central

Myxoma virus is a pathogenic poxvirus that induces extensive dysregulation of cellular immunity in infected European rabbits. Infection of a rabbit CD4+ T-cell line (RL-5) with myxoma virus results in dramatic reductions of cell surface levels of CD4 as monitored by flow cytometry. The virus-induced downregulation of CD4 requires early but not late viral gene expression and could not be inhibited by staurosporine, an inhibitor of protein kinase C, which effectively blocks phorbol 12-myristate-13-acetate-induced downregulation of CD4. The decrease in total cellular levels of CD4 during myxoma virus infection could be inhibited by the lysosomotrophic agent NH4Cl, suggesting a lysosomal fate for CD4 during myxoma virus infection. Steady-state levels of the CD4-associated protein tyrosine kinase p56lck remained unchanged during myxoma virus infection, suggesting that p56lck dissociates from CD4 prior to CD4 degradation in virus infected cells. Total p56lck kinase activity was unaffected during myxoma virus infection, although the amount of p56lck physically associated with CD4 declined in parallel with the loss of CD4. Thus, myxoma virus infection of CD4+ T lymphocytes triggers CD4 downregulation via a protein kinase C-independent pathway, causing the dissociation of p56lck and the degradation of CD4 in lysosomal vesicles.

Barry, M; Lee, S F; Boshkov, L; McFadden, G

1995-01-01

292

[Catheter ablation of atrial flutter and paroxysmal atrial fibrillation].  

PubMed

Radiofrequency catheter ablation has emerged as a curative therapy for atrial flutter based on studies demonstrating the role of the cavotricuspid isthmus. With a high rate of success and minimal complications, catheter ablation is the therapy of choice for patients with the common type of atrial flutter. Left atrial flutter, non-cavotricuspid isthmus dependent, and those associated with heart disease have a worst outcome with catheter ablation. Radiofrequency catheter ablation has also emerged as a curative therapy for paroxysmal atrial fibrillation based on studies demonstrating the role of triggering foci in the pulmonary veins for the initiation of atrial fibrillation. Catheter ablation is performed by a transseptal approach using radiofrequency energy at the ostium of each pulmonary vein. Mapping is guided by special catheters. Sequential radiofrequency applications eliminates or dissociates pulmonary vein muscle activity. Although complications exists, this is the only curative method for these patients. PMID:12966653

Márquez, Manlio F

293

Radiofrequency catheter ablation of atrial flutter after orthotopic heart transplantation: insights into the redefined critical isthmus  

Microsoft Academic Search

We report a case of successful radiofrequency catheter ablation of recurrent atrial flutter in a heart transplant recipient and discuss technical aspects of the procedure. A counterclockwise flutter circuit was defined during endocardial mapping of the donor atrium. Termination of atrial flutter was achieved by creating lines of radiofrequency lesions from the tricuspid ring to the suture line between donor

Sergio L Pinski; Audrius J Bredikis; Elaine Winkel; Richard G Trohman

1999-01-01

294

Severely reduced left atrial appendage function: A cause of embolic stroke in patients in sinus rhythm?  

Microsoft Academic Search

Recently, attention has been focused on transesophageal echocardiographic detection of left atrial appendage function to assess of risk of thrombus formation because of potential benefit of anticoagulation therapy. However, most of these studies have been conducted in patients with atrial fibrillation or mitral valve disease. In this article we review cases of 2 patients without valvular disease who had embolic

Masoor Kamalesh; T. Burton Copeland; Stephen Sawada

1998-01-01

295

Isomerism of the atrial appendages associated with 22q11 deletion in a fetus.  

PubMed Central

There is a strong association between prenatally diagnosed structural heart disease and fetal chromosomal abnormalities. Isomerism of the atrial appendages is an exception to this because the fetal karyotype is usually normal in this condition. A case of atrial isomerism diagnosed antenatally with a normal female karyotype but with a microdeletion of chromosome 22q11 is reported. Images

Yates, R. W.; Raymond, F. L.; Cook, A.; Sharland, G. K.

1996-01-01

296

Mobile Right Atrial Thrombi in a Patient with the Hemoglobin SC Disease  

PubMed Central

The formation of Intracardiac thrombi is rare in the absence of structural heart disease or atrial fibrillation. We describe a case of spontaneous right atrial thrombus formation that occurred in a patient with a hypercoagulable condition who had been sub optimally anticoagulated.

Savage, H. O.; Ding, N.; Eso, O.; Sachdev, B.; Lefroy, D. L.

2011-01-01

297

The clinical pathology of heart failure and atrial fibrillation in old age  

Microsoft Academic Search

The factors associated with the development of heart failure and of atrial fibrillation in elderly patients were studied in a prospective clinico-pathological series of 171 cases. Multiple logistic analyses allowed the contributions of multiple factors to be assessed simultaneously. Senile cardiac amyloidosis, ischaemic heart disease and atrial fibrillation were significantly associated with heart failure and had additive effects. Senile cardiac

H. M. Hodkinson; A. Pomerance

1979-01-01

298

A fatal complication due to radiofrequency ablation for atrial fibrillation: atrio-esophageal fistula.  

PubMed

Treatment of chronic atrial fibrillation with intraoperative radiofrequency ablation is gaining more acceptance in patients with rheumatic valve disease. This article reports a case of fatal atrio-esophageal fistula after radiofrequency ablation in a patient with rheumatic mitral and aortic valve disease with chronic atrial fibrillation. PMID:12842562

Sonmez, Bingur; Demirsoy, Ergun; Yagan, Naci; Unal, Mehmet; Arbatli, Harun; Sener, Deniz; Baran, Turker; Ilkova, Feryal

2003-07-01

299

Deletion analysis of two tandemly arranged virulence genes in myxoma virus, M11L and myxoma growth factor.  

PubMed Central

Myxoma virus (MYX) is a leporipoxvirus of rabbits that induces a lethal syndrome characterized by disseminated tumorlike lesions, generalized immunosuppression, and secondary gram-negative bacterial infection. A MYX deletion mutant (vMYX-GF- delta M11L) was constructed to remove the entire myxoma growth factor (MGF) coding sequence and that for the C-terminal five amino acids of the partially overlapping upstream gene, M11L. Unexpectedly, this deletion completely abrogates the capacity of MYX to cause the characteristic disease symptoms of myxomatosis. Upon inoculation of rabbits with vMYX-GF- delta M11L, recipient animals developed only a benign, localized nodule reminiscent of a Shope fibroma virus-induced tumor in which a single primary lesion appeared at the site of injection and then completely regressed within 14 days, leaving the animals resistant to challenge with wild-type MYX. No evidence of the purulent conjunctivitis and rhinitis that always accompany wild-type MYX infection was observed. To ascertain whether the attenuation observed in vMYX-GF- delta M11L was due to a combined effect of the MGF deletion and alteration of the upstream M11L gene, two additional MYX recombinants were constructed: an MGF- virus (vMYX-GF-) containing an intact M11L gene and an M11L- virus (vMYX-M11L-) containing an intact MGF gene. Infection with vMYX-GF- resulted in moderated symptoms of myxomatosis, but all clinical stages of the disease were still detectable. In contrast, disruption of M11L alone dramatically reduced the virus virulence, resulting in a nonlethal syndrome whose clinical course was nevertheless distinct from that of vMYX-GF- delta M11L. Upon inoculation with vMYX-M11L-, rabbits developed primary and secondary tumors which were larger and more circumscribed than those of wild-type MYX recipients. Whereas wild-type MYX infection always includes severe, purulent conjunctivitis and rhinitis, vMYX-M11L- recipients remained healthy and displayed only minimal signs of respiratory distress. By about 30 days after infection, the tumors induced by vMYX-M11L- had completely regressed and these animals were immune to challenge with wild-type MYX. Histological analysis indicated that tumors induced by vMYX-M11L- are much more heavily infiltrated with macrophages and heterophils and that the sites of viral replication are more edematous and necrotic than those of wild-type infection, suggesting that the host was able to mount a more vigorous inflammatory response to vMYX-M11L- infection.(ABSTRACT TRUNCATED AT 400 WORDS) Images

Opgenorth, A; Graham, K; Nation, N; Strayer, D; McFadden, G

1992-01-01

300

Atrial cardiomyocyte tachycardia alters cardiac fibroblast function: A novel consideration in atrial remodeling  

Microsoft Academic Search

Objective: Atrial fibrillation (AF) causes tachycardia-induced atrial electrical remodeling, contributing to the progressive nature of the arrhythmia. Ventricular dysfunction due to a rapid response to AF can cause structural remodeling, but whether AF itself directly promotes atrial fibrosis is controversial. This study investigated the hypothesis that rapid atrial cardiomyocyte activation produces factors that influence atrial fibroblast proliferation and secretory functions.

Brett Burstein; Xiao-Yan Qi; Yung-Hsin Yeh; Angelino Calderone

2007-01-01

301

The hypoplastic left heart syndrome with intact atrial septum: atrial morphology, pulmonary vascular histopathology and outcome  

Microsoft Academic Search

OBJECTIVESThe purpose of this study was to investigate the outcome in infants with hypoplastic left heart syndrome and intact atrial septum and to evaluate the relationship of atrial morphology, left atrial decompression pathway and lung histopathology to outcome.BACKGROUNDIn the hypoplastic left heart syndrome, severe restriction at the atrial level results in marked systemic hypoxemia after birth. Infants with intact atrial

Jack Rychik; Jonathan J Rome; Margaret H Collins; William M DeCampli; Thomas L Spray

1999-01-01

302

Multifocal atrial tachycardia and Ibutilide.  

PubMed

Multifocal atrial tachycardia is an electrocardiographic phenomenon seen primarily in the elderly. The hemodynamic consequences of multifocal atrial tachycardia in an elderly woman are presented. Successful treatment with Ibutilide is demonstrated. Treatment with a class III antiarrhythmic agent opposes the frequently accepted mechanism of triggered activity in causing this arrhythmia. PMID:11455238

Pierce, W J; McGroary, K

303

Atypical right atrial flutter patterns  

Microsoft Academic Search

Background—The purpose of our study was to define the incidence and mechanisms of atypical right atrial flutter. Methods and Results—A total of 28 (8%) of 372 consecutive patients with atrial flutter (AFL) had 36 episodes of sustained atypical right AFL. Among 24 (67%) of 36 episodes of lower loop reentry (LLR), 13 (54%) of 24 episodes had early breakthrough at

Yanfei Yang; Jie Cheng; Andy Bochoeyer

2001-01-01

304

The management of atrial fibrillation  

Microsoft Academic Search

Atrial fibrillation affects approximately one million persons in the United States, making it the most common cardiac arrhythmia seen in clinical practice. Its prevalence increases with age, and occurs in up to 10% of the population in the eighth decade of life. Unlike coronary heart disease, atrial fibrillation affects men and women approximately equally and, in an increasingly elderly population,

David M. Gilligan; Kenneth A. Ellenbogen; Andrew E. Epstein

1996-01-01

305

Ablation for Atrial Fibrillation  

PubMed Central

Executive Summary Objective To review the effectiveness, safety, and costing of ablation methods to manage atrial fibrillation (AF). The ablation methods reviewed were catheter ablation and surgical ablation. Clinical Need Atrial fibrillation is characterized by an irregular, usually rapid, heart rate that limits the ability of the atria to pump blood effectively to the ventricles. Atrial fibrillation can be a primary diagnosis or it may be associated with other diseases, such as high blood pressure, abnormal heart muscle function, chronic lung diseases, and coronary heart disease. The most common symptom of AF is palpitations. Symptoms caused by decreased blood flow include dizziness, fatigue, and shortness of breath. Some patients with AF do not experience any symptoms. According to United States data, the incidence of AF increases with age, with a prevalence of 1 per 200 people aged between 50 and 60 years, and 1 per 10 people aged over 80 years. In 2004, the Institute for Clinical Evaluative Sciences (ICES) estimated that the rate of hospitalization for AF in Canada was 582.7 per 100,000 population. They also reported that of the patients discharged alive, 2.7% were readmitted within 1 year for stroke. One United States prevalence study of AF indicated that the overall prevalence of AF was 0.95%. When the results of this study were extrapolated to the population of Ontario, the prevalence of AF in Ontario is 98,758 for residents aged over 20 years. Currently, the first-line therapy for AF is medical therapy with antiarrhythmic drugs (AADs). There are several AADs available, because there is no one AAD that is effective for all patients. The AADs have critical adverse effects that can aggravate existing arrhythmias. The drug selection process frequently involves trial and error until the patient’s symptoms subside. The Technology Ablation has been frequently described as a “cure” for AF, compared with drug therapy, which controls AF but does not cure it. Ablation involves directing an energy source at cardiac tissue. For instance, radiofrequency energy uses heat to burn tissue near the source of the arrhythmia. The purpose is to create a series of scar tissue, so that the aberrant electrical pathways can no longer exist. Because the pulmonary veins are the predominant source of AF initiation, the primary goal of ablation is to isolate the pulmonary veins from the left atria through the creation of a conduction block. There are 2 methods of ablation: catheter ablation and surgical (operative) ablation. Radiofrequency energy is most commonly used for ablation. Catheter ablation involves inserting a catheter through the femoral vein to access the heart and burn abnormal foci of electrical activity by direct contact or by isolating them from the rest of the atrium. The surgical ablation is performed minimally invasively via direct visualization or with the assistance of a special scope for patients with lone AF. Review Strategy In March 2006, the following databases were searched: Cochrane Library International Agency for Health Technology Assessment (first quarter 2006), Cochrane Database of Systematic Reviews (first quarter 2006), Cochrane Central Register of Controlled Trials (first quarter 2006), MEDLINE (1966 to February 2006), MEDLINE In-Process and Other Non-indexed Citations (1966 to March 1, 2006), and EMBASE (1980 to 2006 week 9). The Medical Advisory Secretariat also searched Medscape on the Internet for recent reports on trials that were unpublished but that were presented at international conferences. In addition, the Web site Current Controlled Trials (www.controlled-trials.com) was searched for ongoing trials investigating ablation for atrial fibrillation. Search terms included: radiofrequency ablation, catheter ablation and atrial fibrillation. Summary of Findings Sixteen RCTs were identified that compared ablation methods in patients with AF. Two studies were identified that investigated first-line therapy for AF or atrial flutter. Seven other studies examined patients with drug-refra

2006-01-01

306

Role of the Serine-Threonine Kinase PAK1 in Myxoma Virus Replication  

Microsoft Academic Search

Subversion or appropriation of cellular signal transduction pathways is a common strategy employed by viruses to promote an environment within infected cells that supports the viral replicative cycle. Using subsets of 3T3 murine fibroblasts previously shown to differ in their ability to support myxoma virus (MV) replication, we investigated the role of host serine-threonine kinases (STKs) as potential mediators of

J. B. Johnston; John W. Barrett; Wen Chang; Che-Sheng Chung; Wei Zeng; Jennefer Masters; Melissa Mann; Fuan Wang; Jingxin Cao; Grant McFadden

2003-01-01

307

Myxoma on anterior mitral leaflet presenting with symptoms of cerebellar artery infarction.  

PubMed

This report describes a patient who had dizziness and loss of balance. During routine investigation, a mass located on the anterior mitral valve leaflet was detected on transthoracic echocardiography. The patient underwent surgery for a mass located on the mitral valve, and histopathologic examination determined the mass was a myxoma. PMID:10849519

Ozer, N; Aksöyek, S; Aytemir, K; Güvener, M; Böke, E; Kes, S

2000-06-01

308

Horizontal Transmissible Protection against Myxomatosis and Rabbit Hemorrhagic Disease by Using a Recombinant Myxoma Virus  

Microsoft Academic Search

We have developed a new strategy for immunization of wild rabbit populations against myxomatosis and rabbit hemorrhagic disease (RHD) that uses recombinant viruses based on a naturally attenuated field strain of myxoma virus (MV). The recombinant viruses expressed the RHDV major capsid protein (VP60) including a linear epitope tag from the transmissible gastroenteritis virus (TGEV) nucleoprotein. Following inoculation, the recombinant

JUAN BARCENA; MONICA MORALES; B. Vazquez; J. A. Boga; F. Parra; J. Lucientes; A. Pages-Mante; J. M. Sanchez-Vizcaino; R. Blasco; J. M. Torres

2000-01-01

309

Mandibular odontogenic myxoma. Reconstructive considerations by means of the vascularized fibular free flap  

Microsoft Academic Search

The odontogenic myxoma is a rare entity located in mandible and upper maxilla. Due to its local aggressiveness, wide surgical excision is mandatory. Several surgical techniques have been described for the reconstruction of segmental mandibular defects. In comparison with other free flaps, the vascularized free fibular flap (VFFF) supports the lon- gest amount of bone and, due to the nature

Raúl González García; Francisco J. Rodríguez Campo; Mario F. Muñoz Guerra; Jesús Sastre Pérez; J. Díaz González

310

Benchmarking electrophysiological models of human atrial myocytes  

PubMed Central

Mathematical modeling of cardiac electrophysiology is an insightful method to investigate the underlying mechanisms responsible for arrhythmias such as atrial fibrillation (AF). In past years, five models of human atrial electrophysiology with different formulations of ionic currents, and consequently diverging properties, have been published. The aim of this work is to give an overview of strengths and weaknesses of these models depending on the purpose and the general requirements of simulations. Therefore, these models were systematically benchmarked with respect to general mathematical properties and their ability to reproduce certain electrophysiological phenomena, such as action potential (AP) alternans. To assess the models' ability to replicate modified properties of human myocytes and tissue in cardiac disease, electrical remodeling in chronic atrial fibrillation (cAF) was chosen as test case. The healthy and remodeled model variants were compared with experimental results in single-cell, 1D and 2D tissue simulations to investigate AP and restitution properties, as well as the initiation of reentrant circuits.

Wilhelms, Mathias; Hettmann, Hanne; Maleckar, Mary M.; Koivumaki, Jussi T.; Dossel, Olaf; Seemann, Gunnar

2013-01-01

311

Myxoma and Vaccinia Viruses Bind Differentially to Human Leukocytes  

PubMed Central

Myxoma virus (MYXV) and vaccinia virus (VACV), two distinct members of the family Poxviridae, are both currently being developed as oncolytic virotherapeutic agents. Recent studies have demonstrated that ex vivo treatment with MYXV can selectively recognize and kill contaminating cancerous cells from autologous bone marrow transplants without perturbing the engraftment of normal CD34+ hematopoietic stem and progenitor cells. However, the mechanism(s) by which MYXV specifically recognizes and eliminates the cancer cells in the autografts is not understood. While little is known about the cellular attachment factor(s) exploited by MYXV for entry into any target cells, VACV has been shown to utilize cell surface glycosaminoglycans such as heparan sulfate (HS), the extracellular matrix protein laminin, and/or integrin ?1. We have constructed MYXV and VACV virions tagged with the Venus fluorescent protein and compared their characteristics of binding to various human cancer cell lines as well as to primary human leukocytes. We report that the binding of MYXV or VACV to some adherent cell lines could be partially inhibited by heparin, but laminin blocked only VACV binding. In contrast to cultured fibroblasts, the binding of MYXV and VACV to a wide spectrum of primary human leukocytes could not be competed by either HS or laminin. Additionally, MYXV and VACV exhibited very different binding characteristics against certain select human leukocytes, suggesting that the two poxviruses utilize different cell surface determinants for the attachment to these cells. These results indicate that VACV and MYXV can exhibit very different oncolytic tropisms against some cancerous human leukocytes.

Chan, Winnie M.; Bartee, Eric C.; Moreb, Jan S.; Dower, Ken; Connor, John H.

2013-01-01

312

Assessment of Left Atrial Ejection Force in Mildly Asphyxiated Newborns  

PubMed Central

Objective Asphyxia-induced cardiac insult is one of the major causes of mortality and morbidity in the course of perinatal asphyxia. Nowadays, a remarkable trend of interest is sensed introducing a plausible modality for early detection of cardiac insults at the beginning stages of asphyxia. In this study we aimed to evaluate diagnostic utility of transmitral Doppler–derived parameters as well as left atrial ejection force index as a marker of left atrial contractile function in these patients. Methods In a prospective study selected cases of 26 asphyxiated newborns with preserved systolic function underwent conventional transmitral Doppler flow echocardiographic assessment. Left atrial ejection force index was further calculated for all patients. Data was compared with normal ranges of healthy newborns in order to clarify the diagnostic utility of these parameters for determining minor cardiac insults in this age group. Findings We found that mildly asphyxiated newborns showed an increase in the values of left atrial ejection force index (5.44±2.12 kilodyne vs. 6.66±2.17 kilodyne, P= 0.02) and left atrial filling fraction (39%±10% vs. 45%±8%, P= 0.01). Furthermore, the acceleration and deceleration rate of early filling flow peak velocity were decreased in this group of asphyxiated newborns. Conclusion Assessment of left atrial ejection force in mildly asphyxiated newborns reveals that newborns with even mild asphyxia, although could not be categorized in conventional grading system, suffer to some extent from a ventricular filling abnormality. This type of latent ventricular filling abnormality could simply be unmasked by calculation of atrial ejection force index.

Kiani, Abdolrazagh; Shabanian, Reza; Rekabi, Mahsa; Kocharian, Armen; Heidari-Bateni, Giv

2012-01-01

313

Human atrial fibrillation substrate: towards a specific fibrotic atrial cardiomyopathy.  

PubMed

The atrial structure/substrate of patients with atrial fibrillation (AF) and clinically similar characteristics can present very differently, and also the 'phenotype' (i.e. paroxysmal, persistent, and long standing persistent) of the arrhythmia cannot comprehensively explain these differences. It was unclear why some patients stay in paroxysmal AF for decades, whereas other patients with the same characteristics progress to persistent AF within a few months. In this review, evidence is described that AF patients without apparent structural heart disease have a chronic fibrotic bi-atrial substrate. There is also evidence from intraoperatively obtained specimen analysis, post-mortem autopsy findings, electroanatomic mapping studies, and delayed enhancement-MRI investigations that a higher mean value of fibrosis is detected in patients with persistent vs. paroxysmal AF but that the variability in the extend of fibrosis is always very high with part of paroxysmal AF patients having massive fibrosis and part of persistent AF patients showing mild fibrosis. In addition, patients undergoing ablation very early after the first AF episodes show already significant fibrosis. These data do not support a causal relationship that AF (significantly) produces fibrosis in the sense of 'AF begets AF' instead of being a consequence of the fibrotic process. In patients with mitral stenosis, evidence for reverse atrial remodelling after commissurotomy was reported, however, in patients with 'lone' AF, the atrial substrate progressed after successful AF elimination indicating towards the independent/progressive disease process of an underlying structural atrial disease called fibrotic atrial cardiomyopathy. Other 'conventional wisdoms' also need to be re-considered including the aetiological role of age and arterial hypertension for human structural atrial remodelling. PMID:23761394

Kottkamp, Hans

2013-06-11

314

Atrial and ventricular function after cardioversion of atrial fibrillation.  

PubMed Central

OBJECTIVE--Previous studies on atrial recovery after cardioversion of atrial fibrillation have not taken into account new knowledge about the pathophysiology of transmitral and transtricuspid flow velocity patterns. It is possible to shed further light on this problem if atrioventricular inflow velocity, venous filling pattern, and atrioventricular annulus motion are recorded and interpreted together. DESIGN--Prospective examinations of mitral and tricuspid transvalvar flow velocities, superior caval and pulmonary venous filling, and mitral and tricuspid annulus motion were recorded using Doppler echocardiography. Examinations were performed before and 24 hours, 1 month, and 20 months after cardioversion. SETTING--Tertiary referral centre for cardiac disease with facilities for invasive and non-invasive investigation. PATIENTS--16 patients undergoing cardioversion of atrial fibrillation in whom sinus rhythm had persisted for 24 hours or more. RESULTS--Before conversion there was no identifiable A wave in transvalvar flow recordings. The total motion of the tricuspid and mitral annulus was subnormal and there was no identifiable atrial component. Venous flow patterns in general showed a low systolic velocity. After conversion, A waves and atrial components were seen in all patients and increased significantly (P < 0.01) with time. There was a similar time course for the amplitude of annulus atrial components, an increased systolic component of venous inflow, an increased A wave velocity, and a decreased E/A ratio of the transvalvar velocity curves. The ventricular component of annulus motion was unchanged. Changes in general occurred earlier on the right side than the left. CONCLUSIONS--This study indicates that, in addition to the previously known electromechanical dissociation of atrial recovery that exists after cardioversion of atrial fibrillation, there may also be a transient deterioration of ventricular function modulating the transvalvar inflow velocity recordings. Function on the right side generally becomes normal earlier than on the left. Integration of information from transvalvar inflow curves, annulus motion, and venous filling patterns gives additional insight into cardiac function.

Xiong, C.; Sonnhag, C.; Nylander, E.; Wranne, B.

1995-01-01

315

Severe aortic stenosis, bicuspid aortic valve and atrial septal defect in a child with Joubert Syndrome and Related Disorders (JSRD) - a case report and review of congenital heart defects reported in the human ciliopathies.  

PubMed

We report a case of a 2 year-old boy with Joubert Syndrome and Related Disorders (JSRD), severe congenital aortic stenosis, bicuspid aortic valve and an atrial septal defect. JSRD is one of a group of conditions known as 'ciliopathies', whose multi-organ involvement results from primary cilia dysfunction. To date, there have been no other reported cases of aortic stenosis and bicuspid aortic valve associated with JSRD. Cardiac screening is not currently recommended in the management guidelines for individuals suspected of having JSRD. We speculate that while the presence of congenital aortic stenosis in this child could be caused by an unrelated genetic mechanism, it could also represent a phenotypic overlap with another ciliopathy, Bardet Biedl syndrome, in which aortic stenosis is more commonly reported. We also review the range of cardiac malformations reported to be present in all human diseases known to be ciliopathies, in order to assist with the investigation and management of individuals with a suspected or proven ciliopathy. PMID:22910529

Karp, Natalya; Grosse-Wortmann, Lars; Bowdin, Sarah

2012-08-03

316

Stroke Prevention in Atrial Fibrillation  

MedlinePLUS

Stroke Prevention in Atrial Fibrillation Christian T. Ruff , MD, MPH From the TIMI Study Group, Brigham and ... block an artery in the brain, causing a stroke ( Figure 2 ). People with AF are at a ...

317

Magnetic field of atrial depolarization.  

PubMed

The isomagnetic maps of normal subjects and patients with right and left atrial overloading were recorded to determine the characteristic features of the magnetic field of atrial depolarization. The isomagnetic maps examined in this study indicated the instantaneous current source, which specifically localizes the current sources due to the right and left atria, respectively. The magnetic field recorded with a second derivative gradiometer clearly detected the cardiac current source from the right atrium, which is located close to the anterior chest wall, thus this method improved the diagnostic sensitivity for right atrial overloading. In patients with left atrial overloading, the isomagnetic map showed multiple dipoles due to the right and left atria, respectively, which are difficult to be detected by the electrocardiogram or isopotential map. These results suggest that the magnetocardiogram provides useful information on the current source to supplement information obtained by the conventional electrocardiogram. PMID:2978585

Takeuchi, A; Watanabe, K; Katayama, M; Nomura, M; Nakaya, Y; Mori, H

318

Focal Left Atrial Tachycardia in a Patient with Left Ventricular Noncompaction  

PubMed Central

Left ventricular noncompaction (LVNC) is a rare disease caused by intrauterine failure of the myocardium to compact. The major clinical manifestations of LVNC include heart failure, ventricular tachyarrhythmia, thromboembolic event, and sudden deaths. Atrial arrhythmia usually seen is atrial fibrillation. We report a rare case of focal left atrial tachycardia in an 18-year-old patient who presented for evaluation of persistent tachycardia. Transthoracic echocardiogram showed severe systolic dysfunction and evidence of noncompaction of the left ventricle. A detailed review of ECG revealed the possibility of ectopic atrial tachycardia, most likely originating from the left side. Electrophysiology study showed sustained atrial tachycardia originating on the ridge anterior to the left sided pulmonary veins. A successful radiofrequency catheter ablation was performed at this site without any complications.

Singh, Shailendra; Parihar, Gulam; Rao, Rohit; Goyal, Vishal

2013-01-01

319

Spontaneous Conversion of Atrial Fibrillation to Normal Sinus Rhythm Following Recurrent Cerebral Infarctions  

PubMed Central

Post-stroke atrial fibrillation has been frequently reported especially in the patients with right insular infarct as an evidence of cerebrogenic mechanism affecting on cardiac rhythm. However, conversion to normal sinus rhythm after stroke in patients who had atrial fibrillation has not been reported. A 88-year-old men who had untreated atrial fibrillation was admitted to hospital due to left middle cerebral artery territory infarction. During admission, second ischemic attack occurred in right middle cerebral artery territory. At that time, his atrial fibrillation converted spontaneously to normal sinus rhythm. Restored sinus rhythm sustained until he died due to sepsis. This case is evidence supporting a theory that brain is associated with control of cardiac rhythm. If no risk factor is revealed by intensive investigation in patients with acute cerebral infarctions that cardioembolism is strongly suspected as a cause, physicians should concern transformation of atrial fibrillation to normal sinus rhythm after stroke.

Oh, Kyungmi; Choi, Jeong-Yoon

2013-01-01

320

[Antithrombotic drugs in atrial fibrillation].  

PubMed

Stroke and peripheral thrombo-embolism are common in all forms of atrial fibrillation which is responsible for a hypercoagulable state. Clinical and echocardiographic risk stratification allow therapeutic recommendations among the different antithrombotic strategies used in randomized studies (adjusted-dose oral anticoagulant, aspirin or a combination of aspirin and low-dose oral anticoagulant) in agreement with recent guidelines from the European and American associations of cardiology for the managMent of patients with atrial fibrillation. PMID:12187896

Hidden-Lucet, Françoise

2002-06-15

321

[Vectorcardiographic manifestations of atrial enlargements].  

PubMed

Rational interpretation of changes of the P loop due to atrial enlargements must to rely on the magnitude and spatial orientation of main resultant vectors of the activation sequence of the atria. Under normal conditions, these vectors give rise to a mean vector oriented to the left downward and discretely forward with respect to their point of origin. In the presence of right atrial enlargement, the manifestation of the first vector of atrial depolarization, oriented downward and forward, is increased. This one moves in the same direction as the mean vector of atrial depolarization, originating an elongated P loop of more than 100 mcv in the three planes. Nevertheless, in the horizontal plane, increase of the P loop voltage predominates when hypertrophy exists, while augmentation of its area predominates when dilatation exists. In left atrial enlargement, the manifestation of the second vector of atrial depolarization, oriented to the left and backward, is augmented, and it moves in the same direction as the mean vector of atrial depolarization. For this, the PF loop acquires a characteristic aspect of a boxing glove, an the PH loop becomes diphasic, with its posterior area more or less prominent, or with a typical figure-eight conformation. If a biatrial enlargement is present, the manifestation of both the main resultant vectors of atrial depolarization is accentuated. Therefore the voltage of the diphasic P loop increases. Moreover the Ps loop has a triangular configuration, with its base of 30 msc or more, located below its point of origin. Generally disturbances of interatrial and intraatrial conduction coexist owing to myocardial damage. PMID:2146934

de Micheli, A; Medrano, G A

322

Clinical observation on the treatment of atrial fibrillation with amiodarone combined with Shenmai Injection (?????)  

Microsoft Academic Search

Objective  To observe the therapeutic efficacy and safety of amiodarone combined with Shenmai Injection (?????) on atrial fibrillation.\\u000a \\u000a \\u000a \\u000a Methods  A total of 351 patients with atrial fibrillation caused by cardiovascular diseases and idiopathic atrial fibrillation were\\u000a assigned to amiodarone group (control group, 128 cases) and amiodarone combined with Shenmai Injection group (treatment group,\\u000a 223 cases). The patients in the control group received

Min Deng; Xiang-qian Sui; Shi-bing Zhu; Wei Ma; Ying Xu; Zhi-ming Chen

2010-01-01

323

[Atrial tachycardia ablated from the non-coronary aortic cusp].  

PubMed

We present a case of a patient with drug resistant atrial tachycardia which was ablated from the noncoronary aortic cusp. Tachycardia was adenosine-sensitive and was characterized by a long RP' interval and low amplitude P waves (biphasic in II, III, aVF and V1-V2 leads, and positive in aVL). The earliest atrial activation during tachycardia was recorded at His region and from non-coronary aortic sinus of Valsalva. RF ablation at this area terminated tachycardia and did not impair atrio-ventricular conduction. PMID:17366369

Baszko, Artur; Krzyzanowski, Krzysztof; Zinka, Elzbieta; Grajek, Stefan

2007-02-01

324

Mass in the left atrial appendage: a therapeutic dilemma.  

PubMed

This is a case of a persistent mobile mass in the left atrial appendage in which 3-dimensional transesophageal echocardiography provided excellent definition of the contour of the mass and helped in comparison during follow-up. The mass was incidentally found before atrial fibrillation ablation and initially thought to be a thrombus. As it persisted almost unchanged despite adequate anticoagulation, a tumour such as a fibroelastoma became the leading possibility, presenting us with a management dilemma. Ablation was cancelled, and, because the mass was stable with no embolic sequelae, a conservative approach was adopted. The patient was discharged on long-term anticoagulation. PMID:22906804

Natarajan, Arun; Tan, Stuart; Patel, Hetal N; Chukwu, Chukwuma; Harkness, Allan; Harris, Stuart

2012-08-17

325

Left atrial rhabdomyosarcoma and the use of digital gated computed tomography in its diagnosis  

Microsoft Academic Search

A case of left atrial rhabdomyosarcoma presenting in a patient with known mitral stenosis is described. Computed tomography of the left atrium, gated to the electrocardiogram cycle, was used to visualise the site and extension of the tumour.

C M Jack; J Cleland; J S Geddes

1986-01-01

326

Ventricular fibrillation following successful DC cardioversion for atrial fibrillation.  

PubMed

Cardioversion remains an important therapy in the management of atrial fibrillation. Here, we report a case where direct current cardioversion resulted in a sudden dramatic change of heart rate that was associated with multiple ventricular fibrillation arrests in a manner akin to that previously observed post-atrioventricular node ablation. PMID:21251025

Caldwell, Jane C; Woolfson, Peter; Clarke, Bernard; Garratt, Clifford J

2011-01-20

327

Right giant atrial thrombosis and pulmonary embolism complicating pacemaker leads.  

PubMed

We describe a case of a patient with bilateral pulmonary embolism because of a giant intracardiac thrombus anchored on a right atrial pacemaker lead treated with unfractionated heparin and the consecutively complete thrombus resolution after 5-6 days. PMID:23997072

D'Aloia, Antonio; Bonadei, Ivano; Vizzardi, Enrico; Curnis, Antonio

2013-08-30

328

Massive Left Atrial Calcification Associated with Mitral Valve Replacement  

PubMed Central

Calcification of the left atrium can be observed in patients with a long-lasting rheumatic heart disease. However, massive calcification of the atrial wall, so called porcelain or coconut atrium is very rare and has been generally reported only as incidental radiographic findings. We report a case of massive and firm calcifications at the left atrium in patient who underwent mitral valve replacement.

Lee, Won Jae; Son, Chang Woo; Yoon, Jun Cheol; Jo, Hyun Su; Son, Jang Won; Park, Kyu Hwan; Lee, Sang Hee; Shin, Dong Gu; Park, Jong Seon; Kim, Young Jo

2010-01-01

329

Chemical Cardioversion of Atrial Fibrillation with Calcium Gluconate  

PubMed Central

Background Calcium infusion is used as a pre-treatment before calcium channel blockers to prevent hypotension. Occasional cardioversion with calcium gluconate infusion is seen in patients with paroxysmal supraventricular tachycardia. Several mechanisms have been suggested for mechanism. Herein we report a case presenting with atrial fibrillation but cardioverted with calcium gluconate infusion, which is unreported in the literature before.

Serhat, A; Gonullu, Hayriye; Huriye, A

2012-01-01

330

Massive hiatus hernia mimicking a left atrial mass.  

PubMed

Echocardiography is the investigational tool of choice for identifying cardiac masses. However, extracardiac masses may lead to a misdiagnosis. We present a unique case of a massive hiatus hernia in a 93 year-old woman, compressing on the left atrium, mimicking a left atrial mass. Echocardiographic features suggestive of a hiatus hernia are discussed. PMID:23369345

Lim, Han S; Leong, Darryl P; Alasady, Muayad

2013-01-28

331

Right atrial hemangioma in the newborn: Utility of fetal imaging  

PubMed Central

We present a rare primary right atrial tumor diagnosed in-utero with fetal echocardiography, and further characterized as a congenital hemangioma with magnetic resonance imaging. Surgical resection was done six days after birth. This case illustrates the complementary roles of evolving advanced imaging techniques for fetuses and infants with congenital heart disease that allows for surgery early in the neonatal period.

Baird, Christopher; Blalock, Shannon; Bengur, Resai; Ikemba, Catherine

2012-01-01

332

Does Rapid Atrial Pacing Terminate Atrial Fibrillation? A Comparison of Laboratory and Device Termination Studies  

Microsoft Academic Search

Atrial fibrillation is understood to be a re-entrant arrhythmia and for many years electrophysiologists have attempted to pace-terminate the rhythm. Several studies have demonstrated that an excitable gap is present during atrial fibrillation and that the capture of small amounts of atrial tissue is possible. Early attempts to terminate atrial fibrillation however were unsuccessful. The rapid development of pacemaker and

Andrew R. J. Mitchell; Neil Sulke

2003-01-01

333

The Effects of Atrial Fibrillation on Atrial Pressure Volume and Flow Relationships  

Microsoft Academic Search

SUMMARY. To study whether atrial fibrillation might produce local changes in the atrium which could facilitate the tendency of this arrhythmia to become chronic and self-perpetuating, we compared the effect of atrial fibrillation, atrial pacing, and acute volume loading on the perfusion and oxygen consumption of the atrium in anesthetized dogs. Measurement of atrial perfusion with microspheres indicates that during

Carl W. White; Richard E. Kerber; Harvey R. Weiss; Melvin L. Marcus

334

Characterization of left atrial appendage Doppler flow in atrial fibrillation and flutter by Fourier analysis  

Microsoft Academic Search

The aim of this study was to characterize left atrial appendage mechanical function in atrial fibrillation and flutter by Fourier analysis to analyze frequency and regularity of flow. Left atrial appendage function is central to a patient's risk for thromboembolism. Although the function of the appendage can be analyzed by Doppler echocardiography in sinus rhythm, its mechanical function in atrial

Richard A. Grimm; Shalabh Chandra; Allan L. Klein; William J. Stewart; Ian W. Black; Gregory A. Kidwell; James D. Thomas

1996-01-01

335

Simple Left Atrial Procedure for Chronic Atrial Fibrillation Associated With Mitral Valve Disease  

Microsoft Academic Search

Background. A computerized 48-channel mapping system was used to investigate the characteristics of an atrial epicardial electrogram during chronic atrial fibrillation (AF) in patients with solitary mitral valve disease. We have devised a simple left atrial procedure to eliminate the chronic AF during a mitral valve operation.Methods. Using this mapping system, we performed intraoperative atrial mapping in 11 patients with

Taijiro Sueda; Hideyuki Nagata; Hiroo Shikata; Kazumasa Orihashi; Satoru Morita; Masafumi Sueshiro; Kenji Okada; Yuichiro Matsuura

1996-01-01

336

Self-expandable device for percutaneous closing of left atrial appendage with organized thrombus in a patient with permanent atrial fibrillation.  

PubMed

While a left atrial appendage (LAA) occlusion device may reduce the risk of cardioembolic stroke in patients with nonvalvular atrial fibrillation, an antithromboembolic strategy for patients with an organized thrombus in the LAA is still unclear. The present case is the first report of percutaneous closing of an LAA and organized thrombus with a self-expandable LAA occlusion device without complication. This minimally invasive intervention is a potential treatment option in a patient with significant risk of recurrent thromboembolism. PMID:23228490

Pak, Hui-Nam; Shim, Chi-Young; Kim, Jung Sun; Park, Jai-Wun; Jang, Yangsoo

2012-12-07

337

Assessment of the dynamics of atrial signals and local atrial period series during atrial fibrillation: effects of isoproterenol administration  

Microsoft Academic Search

BACKGROUND: The autonomic nervous system (ANS) plays an important role in the genesis and maintenance of atrial fibrillation (AF), but quantification of its electrophysiologic effects is extremely complex and difficult. Aim of the study was to evaluate the capability of linear and non-linear indexes to capture the fine changing dynamics of atrial signals and local atrial period (LAP) series during

Luca T Mainardi; Valentina DA Corino; Leonida Lombardi; Claudio Tondo; Massimo Mantica; Federico Lombardi; Sergio Cerutti

2004-01-01

338

Atrial fibrillation in endurance athletes.  

PubMed

There is a growing population of veteran endurance athletes, regularly participating in training and competition. Although the graded benefit of exercise on cardiovascular health and mortality is well established, recent studies have raised concern that prolonged and strenuous endurance exercise may predispose to atrial and ventricular arrhythmias. Atrial fibrillation (AF) and atrial flutter are facilitated by atrial remodelling, atrial ectopy, and an imbalance of the autonomic nervous system. Endurance sports practice has an impact on all of these factors and may therefore act as a promoter of these arrhythmias. In an animal model, long-term intensive exercise training induced fibrosis in both atria and increased susceptibility to AF. While the prevalence of AF is low in young competitive athletes, it increases substantially in the aging athlete, which is possibly associated with an accumulation of lifetime training hours and participation in competitions. A recent meta-analysis revealed a 5-fold increased risk of AF in middle-aged endurance athletes with a striking male predominance. Beside physical activity, height and absolute left atrial size are independent risk factors for lone AF and the stature of men per se may explain part of their higher risk of AF. Furthermore, for a comparable amount of training volume and performance, male non-elite athletes exhibit a higher blood pressure at rest and peak exercise, a more concentric type of left ventricular remodelling, and an altered diastolic function, possibly contributing to a more pronounced atrial remodelling. The sports cardiologist should be aware of the distinctive features of AF in athletes. Therapeutic recommendations should be given in close cooperation with an electrophysiologist. Reduction of training volume is often not desired and drug therapy not well tolerated. An early ablation strategy may be appropriate for some athletes with an impaired physical performance, especially when continuation of competitive activity is intended. This review focuses on the prevalence, risk factors, and mechanisms of AF in endurance athletes, and possible therapeutic options. PMID:23610454

Wilhelm, Matthias

2013-01-30

339

Atrial Fibrillation Begets Atrial Fibrillation: Autonomic Mechanism for Atrial Electrical Remodeling Induced by Short-term Rapid Atrial Pacing  

PubMed Central

Background The mechanism(s) for acute changes in electrophysiological properties of the atria during rapid pacing induced atrial fibrillation (AF) is not completely understood. We sought to evaluate the contribution of the intrinsic cardiac autonomic nervous system (ICANS) in acute atrial electrical remodeling and AF induced by six-hour rapid atrial pacing. Methods and Results Continuous rapid pacing (1200 bpm, 2× threshold, TH) was performed at the left atrial appendage. Group 1 (N=7): 6-hour pacing immediately followed by ganglionated plexi (GP) ablation; Group 2 (N=7): GP ablation immediately followed by 6-hour pacing; Group 3 (N=4): administration of autonomic blockers, atropine (1 mg/kg) and propranolol (0.6 mg/kg) immediately followed by 6-hour pacing. The effective refractory period (ERP) and window of vulnerability (WOV, in milliseconds), i.e., the difference between the longest and the shortest coupling interval of the premature stimulus which induced AF, were measured at 2×TH and 10×TH at the left atrium, right atrium and pulmonary veins every hour before and after GP ablation or autonomic blockade. In Group 1, ERP was markedly shortened in the first two hours and then stabilized both at 2×TH and 10×TH; however, WOV was progressively widened throughout the 6-hour period. After GP ablation, ERP was significantly longer than before ablation and AF could not be induced (WOV=0) at either 2×TH or 10×TH. In Group 2 and 3, rapid atrial pacing failed to shorten the ERP. AF could not be induced in 6/7 dogs in Group 2 and 4/4 dogs in Group 3 during the 6-hour pacing period. Conclusion The ICANS plays a crucial role in the acute stages of atrial electrical remodeling induced by rapid atrial pacing.

Lu, Zhibing; Scherlag, Benjamin J.; Lin, Jiaxiong; Niu, Guodong; Fung, Kar-Ming; Zhao, Lichao; Ghias, Muhammad; Jackman, Warren M.; Lazzara, Ralph; Jiang, Hong; Po, Sunny S.

2009-01-01

340

Emergency surgery for left atrial metastatic alveolar rhabdomyosarcoma manifesting as a right atrial mass.  

PubMed

We report the case of a 43-year-old woman with a history of alveolar rhabdomyosarcoma of the forearm, scalp, and paraspinal region who developed acute shortness of breath owing to a tumor arising from the left atrium and extending through the coronary sinus. This was causing partial obstruction across the tricuspid valve as a result of the ball-valve effect. Emergency resection of the atrial mass was performed, and histologic analysis confirmed the presence of metastatic rhabdomyosarcoma. To our knowledge, this is the first reported case of emergency surgical resection of intracardiac metastatic alveolar rhabdomyosarcoma. PMID:18721606

Javangula, Kalyana C; O'Regan, David J

2008-09-01

341

Multifocal atrial tachycardia in two neonates.  

PubMed

Two neonates with rapid and irregular pulse rate had an uncommon form of atrial tachycardia. The irregular heart rate was first detected during fetal monitoring. Postnatal electrocardiograms were compatible with the diagnosis of multifocal atrial tachycardia or chaotic atrial rhythm. Both patients were treated with digoxin and the rhythm gradually reverted to sinus. This may represent the first description of multifocal atrial tachycardia in the newborn. PMID:901681

Farooki, Z Q; Green, E W

1977-08-01

342

Multifocal atrial tachycardia in two neonates.  

PubMed Central

Two neonates with rapid and irregular pulse rate had an uncommon form of atrial tachycardia. The irregular heart rate was first detected during fetal monitoring. Postnatal electrocardiograms were compatible with the diagnosis of multifocal atrial tachycardia or chaotic atrial rhythm. Both patients were treated with digoxin and the rhythm gradually reverted to sinus. This may represent the first description of multifocal atrial tachycardia in the newborn. Images

Farooki, Z Q; Green, E W

1977-01-01

343

Iatrogenic atrial septum defect and aortoatrial fistula in a patient with endovascular prosthesis in the inferior vena cava  

Microsoft Academic Search

Percutaneous procedures and endovascular prostheses are becoming increasingly frequent, replacing classic interventions, and new complications are now appearing. We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto–right atrial fistula and an atrial septum defect. Open heart surgery was

María Teresa Barrio-López; Alejandro Martín-Trenor; Stefano Mastrobuoni; Juan José Gavira-Gómez

344

Identification of host range mutants of myxoma virus with altered oncolytic potential in human glioma cells  

Microsoft Academic Search

The authors have recently demonstrated that wild-type myxoma virus (MV) tagged with gfp (vMyxgfp) can generate a tumor-specific\\u000a infection that productively infects and clears human tumor-derived xenografts when injected intratumorly into human gliomas\\u000a transplanted into immunodeficient mice (Lun et al, 2005). To expand the understanding of MV tropism in cancer cells from a specific tissue lineage, the authors have screened

John W. Barrett; Lindsay R. Alston; Fuan Wang; Marianne M. Stanford; Philippe-Alexandre Gilbert; Xiujuan Gao; June Jimenez; Danielle Villeneuve; Peter Forsyth; Grant McFadden

2007-01-01

345

The effect of buprenorphine on the course of disease in laboratory rabbits infected with myxoma virus.  

PubMed

The only method of assessing the virulence of myxoma virus is to record survival times of rabbits inoculated with the virus. This raises ethical concerns about using animals in experiments where death is the end point. We investigated whether or not the opioid analgesic buprenorphine could be used in rabbits without compromising the myxoma virus virulence assay and on the presumption that animals may suffer pain during the course of the disease. Thirty, 5-month-old New Zealand White rabbits were divided into two groups stratified for weight and gender, and inoculated intradermally with 100 pfu of the Standard Laboratory Strain (SLS) of myxoma virus. At day 6 post infection (p.i.), when eyelid swelling was first seen, each animal in one group was treated with 0.03 mg/kg buprenorphine, subcutaneously, morning and evening until death. Animals in the other group were untreated. Animals were weighed daily and rectal temperatures taken morning and evening. Intake of food and water was assessed as was general demeanor including respiratory effort. There was no significant difference in mean survival time, weight change, or demeanor between the two groups. Increased respiratory effort was seen from day 10 p.i. in animals surviving up to and beyond that time but again there was no difference between groups. Animals treated with buprenorphine refused food and water a day earlier than untreated animals, and had lower temperatures immediately prior to death. It was concluded that the opiate analgesic buprenorphine can be used without compromising the current virulence assay for the SLS of myxoma virus in New Zealand White rabbits but that the clinical signs of myxomatosis that could be attributed to pain were not abrogated. PMID:10780844

Robinson, A J; Müller, W J; Braid, A L; Kerr, P J

1999-07-01

346

Nerve-sheath myxoma on a chicken-pox vaccination site  

Microsoft Academic Search

A nerve-sheath myxoma beneath the dermis in the arm of a 5-year-old boy is reported. The tumor had developed on the site of chicken-pox vaccination the patient had received 2 years previously, and a foreign-body granuloma involving a nerve-fiber bundle was seen adjavent to the tumor. On the basis of previous reports, it is doubtful whether the varicella-zoster virus is

M. Nokubi; S. Makino; T. Kawai; T. Fujii; K. Saito

1994-01-01

347

Dynamic morphology of the secundum atrial septal defect evaluated by three dimensional transoesophageal echocardiography  

PubMed Central

OBJECTIVE—To define by three dimensional echocardiography the pattern and potential determinants of contraction of a secundum atrial septal defect through the cardiac cycle, and to evaluate the possibility of using cross sectional transthoracic and transoesophageal imaging to assess the dynamic nature of the defect.?DESIGN—Three dimensional echocardiography was performed using a multiplane transoesophageal probe on 50 patients with a secundum atrial septal defect (median age 9.8 years). Nine patients were excluded because of poor images or morphological features that precluded defect measurement. In 41 cases, defect area, long and short axis length, and distance of the attenuated anterior rim were measured in their largest and smallest dimensions.?RESULTS—Defect area changed significantly through the cardiac cycle (mean change 61%, p < 0.0001; range 17% to 86%). The defect contracted symmetrically and was not related to patient age, defect size, heart rate, Qp/Qs ratio, the presence of an aneurysmal atrial septum, or attenuated anterior rim. In all cases with an attenuated anterior rim (n = 13), the length of the rim significantly decreased (p = 0.001) during atrial systole. Dynamic changes measured by either transthoracic or transoesophageal cross sectional images did not correlate with those obtained by three dimensional imaging.?CONCLUSIONS—Three dimensional echocardiography shows dynamic features of defects in the atrial septum. This information may lead to an improved understanding of the pathophysiology of atrial shunting.???Keywords: echocardiography; atrial septal defect; congenital heart disease

Maeno, Y; Benson, L; McLaughlin, P; Boutin, C

2000-01-01

348

Predictors of atrial fibrillation recurrence in patients with long-lasting atrial fibrillation  

PubMed Central

BACKGROUND: Limited data are available on the predictors of atrial fibrillation (AF) recurrence in patients with chronic AF. OBJECTIVES: To evaluate potential clinical, echocardiographic and electrophysiological predictors of AF recurrence after internal cardioversion for long-lasting AF. METHODS: A total of 99 consecutive patients (63 men and 36 women, mean age 63.33±9.27 years) with long-standing AF (52.42±72.02 months) underwent internal cardioversion with a catheter that consisted of two defibrillating coils. Shocks were delivered according to a step-up protocol. Clinical follow-up and electrocardiographic recordings were performed on a monthly basis for a 12-month period or whenever patients experienced symptoms suggestive of recurrent AF. RESULTS: Ninety-three patients (93.94%) underwent a successful uncomplicated cardioversion, with a mean atrial defibrillation threshold of 10.69±6.76 J. Immediate reinitiation of AF was observed in 15 patients (15.78%) of whom a repeated cardioversion restored sinus rhythm in 13 cases. Early recurrence of AF (within one week) was observed in 12 of 93 patients (12.90%). At the end of the 12-month follow-up period, during which seven patients were lost, 42 of the 86 remaining patients (48.84%) were still in sinus rhythm. Multivariate regression analysis showed that left atrial diameter (OR 1.126, 95% CI 1.015 to 1.249; P=0.025) and mitral A wave velocity (OR 0.972, 95% CI 0.945 to 0.999; P=0.044) were significant and independent predictors of AF recurrence, whereas age, left ventricular ejection fraction and AF cycle length were not predictive of arrhythmia recurrence. CONCLUSION: The present study showed that the left atrial diameter and mitral A wave velocity are the only variables associated with AF recurrence after successful cardioversion.

Efremidis, Michalis; Alexanian, Ioannis P; Oikonomou, Dimitrios; Manolatos, Dimitrios; Letsas, Konstantinos P; Pappas, Loukas K; Gavrielatos, Gerasimos; Vadiaka, Maria; Mihas, Constantinos C; Filippatos, Gerasimos S; Sideris, Antonios; Kardaras, Fotios

2009-01-01

349

The Modern Surgical Management of Atrial Fibrillation  

Microsoft Academic Search

Atrial fibrillation is the most common arrhythmia disorder. Its incidence is especially high among patients with valvular heart dis- ease. Patients with atrial fibrillation are at a six-fold increased risk of stroke and a two-fold increased risk of mortality. Medical management for rhythm control of patients with atrial fibrillation is suboptimal and no better than simple rate management. How -

ANIL K. GEHI; DAVID H. ADAMS; FARZAN FILSOUFI

350

Molecular Genetic Studies in Atrial Fibrillation  

Microsoft Academic Search

Atrial fibrillation is a complex disease. Its etiologies are diverse and genetic factors may also contribute to this disease. With the advent of modern molecular biology technology, it is now possible to explore the genetic components in the pathogenesis of atrial fibrillation. Past molecular genetic studies on atrial fibrillation in the literature can be divided into linkage analysis studies and

Ling-Ping Lai; Jiunn-Lee Lin; Shoei K. Stephen Huang

2003-01-01

351

Ablation of atrial tachycardia and atrial flutter in heart failure.  

PubMed

Atrial tachycardia and atrial flutter are common tachyarrhythmias in the heart failure population. They commonly lead to, exacerbate, and increase the morbidity and mortality associated with heart failure and, thereby, warrant urgent and early definitive therapy in the form of catheter ablation. Catheter ablation requires careful patient stabilization and extensive preprocedural planning, particularly with regards to anesthesia, strategy, catheter choice, mapping system, and fluid balance, to increase efficacy and limit adverse effects. Heart failure may limit the success of catheter ablation with higher reported recurrence rates, and in selected patients, a hybrid epicardial-endocardial ablation can be considered. PMID:24054482

Bamimore, Ayotunde; Mounsey, Paul

2013-08-01

352

Coronary air embolism associated with atrioesophageal fistula after ablation of atrial fibrillation.  

PubMed

A 68-year-old man presented with multiple embolic strokes and sepsis 50 days after catheter ablation of atrial fibrillation. Cardiac computed tomography scan demonstrated an atrioesophageal fistula at the left atrial posterior wall and hypermobile materials with hypoattenuating lesions in the left atrium. On the 12th hospital day, he presented with acute ST-elevation in the inferior leads. A bedside echocardiogram revealed unusually high myocardial echogenecity and akinesia on the right coronary artery territory. These findings disappeared within a few minutes. This case shows characteristic images of coronary air embolism in gas-containing endocarditis caused by atrioesophageal fistula after catheter ablation of atrial fibrillation. PMID:23932328

Shim, Chi Young; Lee, Seung-Yul; Pak, Hui-Nam

2013-08-09

353

Identification and analysis of left atrial isomerism.  

PubMed

The veno-atrial connections, atrial morphology, atrioventricular (AV) junction, ventricular mass, ventriculoarterial (VA) connection and great arteries in 22 autopsied hearts, diagnosed as having bilateral left-sidedness because of the morphology of the atrial appendages, were studied. The findings were correlated with the arrangement of the thoracic-abdominal organs. A solitary spleen was found in 3 and double spleens in 2 hearts (the remaining 17 hearts had multiple spleens) but left bronchial isomerism existed in all hearts in which bronchial arrangement could be determined. The heart was in the left chest in 14 cases, in the right chest in 5 and midline in 3. The apex pointed to the left in 18 hearts while in 4 hearts it pointed to the right. Fifteen hearts had a biventricular and ambiguous AV connection, 3 hearts had an absent left AV connection and 4 had double-inlet connection via a common valve (to the left ventricle in 3 and the right ventricle in 1). The VA connection was concordant in 14 hearts, discordant in 1, double outlet from the right ventricle in 4, double outlet from a solitary indeterminate ventricle in 1 and single outlet from the right ventricle through a pulmonary trunk with aortic atresia in 2 hearts. Superior caval veins were present bilaterally in 13 hearts. There was interruption of the infrahepatic inferior caval vein with azygos or hemiazygos continuation in 19 hearts while in 3 hearts the inferior caval vein continued upwards to drain into the right-sided morphologically left atrium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3687746

Sharma, S; Devine, W; Anderson, R H; Zuberbuhler, J R

1987-11-15

354

Cryoballoon Ablation for Atrial Fibrillation  

PubMed Central

Focal point-by-point radiofrequency catheter ablation has shown considerable success in the treatment of paroxysmal atrial fibrillation. However, it is not without limitations. Recent clinical and preclinical studies have demonstrated that cryothermal ablation using a balloon catheter (Artic Front©, Medtronic CryoCath LP) provides an effective alternative strategy to treating atrial fibrillation. The objective of this article is to review efficacy and safety data surrounding cryoballoon ablation for paroxysmal and persistent atrial fibrillation. In addition, a practical step-by-step approach to cryoballoon ablation is presented, while highlighting relevant literature regarding: 1) the rationale for adjunctive imaging, 2) selection of an appropriate cryoballoon size, 3) predictors of efficacy, 4) advanced trouble-shooting techniques, and 5) strategies to reduce procedural complications, such as phrenic nerve palsy.

Andrade, Jason G; Dubuc, Marc; Guerra, Peter G; Macle, Laurent; Rivard, Lena; Roy, Denis; Talajic, Mario; Thibault, Bernard; Khairy, Paul

2012-01-01

355

Oral contrast echocardiography for the diagnosis of left atrial encroachment.  

PubMed

The differential diagnosis of masses encroaching on the left atrium may be challenging. We describe a case in which contrast echocardiography using a carbonated drink provided a rapid and simple way to clarify the diagnosis of an incidental mass causing extrinsic compression of the left atrium. Given its simplicity and availability, we believe that it should be considered as a first line tool for clarifying the diagnosis in cases of echocardiographic evidence of left atrial encroachment of unknown origin. PMID:19017321

Bouzas-Mosquera, Alberto; Alvarez-García, Nemesio; Peteiro, Jesús; García-Bueno, Lourdes; Castro-Beiras, Alfonso

2008-11-01

356

Physician variation in the management of patients with atrial fibrillation.  

PubMed Central

OBJECTIVE: To investigate variations in the management of patients with atrial fibrillation among consultant physicians. DESIGN: Questionnaire survey. SUBJECTS: Consultant physicians in England, Wales, and Scotland. RESULTS: 214 consultant physicians (88 cardiologists and 126 non-cardiologists) were surveyed between May and July 1994. Most physicians (47.7%) reported that they saw one to five patients with atrial fibrillation weekly. Some 52% of cardiologists and 40% of non-cardiologists considered that the main factor influencing their decision of whether or not to anticoagulate was the clinical history--that is, heart failure, valve disease, or stroke. When encountering a patient admitted acutely with new onset atrial fibrillation, significantly more cardiologists (66% v 52%, chi 2 = 6.89, P = 0.03) would immediately start anticoagulant treatment, most favouring intravenous heparin. Most physicians would also introduce antiarrhythmic treatment or digoxin, but more cardiologists would attempt immediate pharmacological (39% v 18% of non-cardiologists, P < 0.001) or later electrical (86% v 69%, chi 2 = 11.7, P = 0.003) cardioversion to sinus rhythm, while non-cardiologists tended to prefer "rate control" with digoxin. Although many physicians would not continue antiarrhythmic treatment post-cardioversion, more cardiologists than non-cardiologists would do so (the commonest choice being class III agents) (31% v 17%, P = 0.04). Fewer non-cardiologists would continue anticoagulant treatment post-cardioversion (27% v 69% of cardiologists, chi 2 = 39.8, P < 0.0001). When treating patients with atrial fibrillation, decisions about anticoagulation were usually related to the perceived relative risk of thromboembolism versus haemorrhage derived for each of six case management scenarios in the questionnaire. There was, however, general agreement between cardiologists and non-cardiologists in the use of antithrombotic treatment in the management of lone atrial fibrillation, paroxysmal atrial fibrillation, and patients with atrial fibrillation and mitral valve disease or thyrotoxicosis. CONCLUSION: There is considerable variation in the management of atrial fibrillation, with more cardiologists than non-cardiologists considering cardioversion to sinus rhythm (and the use of antiarrhythmic and anticoagulant treatment post-cardioversion) and thrombo-prophylaxis with anticoagulation. Guidelines on the management of this common arrhythmia are clearly required.

Lip, G. Y.; Zarifis, J.; Watson, R. D.; Beevers, D. G.

1996-01-01

357

Repetitive 4Week Periods of Atrial Electrical Remodeling Promote Stability of Atrial Fibrillation Time Course of a Second Factor Involved in the Self-Perpetuation of Atrial Fibrillation  

Microsoft Academic Search

Background—Episodes of atrial fibrillation (AF) are known to cause both a rapid reduction in atrial refractoriness (atrial electrical remodeling) and a more delayed increase in AF stability thought to be due to a so-called \\

Derick M. Todd; Simon P. Fynn; Andrew P. Walden; W. Julian Hobbs; Sanjay Arya; Clifford J. Garratt

2010-01-01

358

[Panic disorder and atrial fibrillation].  

PubMed

This paper studies the relationship between atrial fibrillation and panic disorder. There are often doubts on the differential diagnosis in emergency services and general medical settings. Panic disorder prevalence rates have been found to be high in patients suffering from atrial fibrillation. Various studies have observed that patients diagnosed with anxiety disorders frequently have higher cardiovascular disease rates compared to the general population. Usually, patients suffering from panic disorder exhibit somatic complaints suggesting coronary disease, such as chest pain or palpitations. The aim is to make the correct diagnosis and treatment for these different illnesses, and to decrease the costs due to misdiagnosis. PMID:24011716

Olazabal Eizaguirre, N; Chavez, R; González-Torres, M A; Gaviria, M

2013-09-05

359

A review of atrial fibrillation.  

PubMed Central

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and accounts for more physician visits and hospital days than any other cardiac rhythm disturbance. Atrial filbrillation is incresing in frequency as the population ages, and therefore, a knowledge of the clinical spectrum and available treatment regimen is essential. Here, we review the pathophysiology, clinical presentation, and current status of management. Experience is being rapidly accumulated in all of the areas discussed in the management of this important clinical entity. Images Figure 1 Figure 2

Dang, David; Arimie, Raluca; Haywood, L. Julian

2002-01-01

360

Atrial Fibrillation and Delayed Gastric Emptying  

PubMed Central

Background Atrial fibrillation and delayed gastric emptying (DGE) are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7th postoperative day. Methods We performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables. Results Approximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p?=?0.0005). Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p?=?0.03). 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p?=?0.0007). This association held true when controlling for age. Conclusion Patients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.

Botwinick, Isadora C.; Shonkwiler, R. Joseph; Steele, John; Yu, Gary; Chabot, John A.

2011-01-01

361

Atrial natriuretic peptide in spontaneous tachycardias.  

PubMed Central

Because anecdotal reports suggest that concentrations of atrial natriuretic peptide are raised during tachycardias, plasma immunoreactive atrial natriuretic peptide concentrations were measured in 34 consecutive patients when tachycardia was diagnosed and again five and 15 minutes after conversion to sinus rhythm. Plasma atrial natriuretic peptide concentrations were raised in all but four patients, and were higher in patients with known heart disease than in those without. The concentrations were higher with ventricular tachycardia than with atrial fibrillation or supraventricular tachycardia, and in acute versus chronic tachycardia. There was only a weak positive relation between ventricular rate and atrial natriuretic peptide (r = 0.31); but there was a closer inverse correlation between atrial natriuretic peptide and systolic arterial pressure (r = -0.60). Conversion to sinus rhythm was associated with a definite fall in plasma atrial natriuretic peptide concentrations. Despite very high baseline concentrations of atrial natriuretic peptide only two patients reported polyuria. It is likely that atrial pressure rather than ventricular rate determines atrial natriuretic peptide release during tachycardia. Despite the absence of polyuria in all but two patients in this study atrial peptides could still contribute to, or cause, the polyuria of tachycardias.

Crozier, I G; Ikram, H; Nicholls, M G; Espiner, E A; Yandle, T G

1987-01-01

362

Atrial structure and fibres: morphologic bases of atrial conduction  

Microsoft Academic Search

Abstract The relationship between anatomy and function has long been recognised. Understanding the gross structure, and the myoarchitecture, of the atriums is fundamental,to investigations into the substrates and therapy of atrial fibrillation. Based primarily on our experience with normal human hearts, this review provides, firstly, a basis of comparison of gross structures as seen in the clinical situation, and in

Siew Yen Ho; Robert H. Anderson; Damian Sanchez-quintana

363

The determination of atrial arrangement by examination of appendage morphology in 1842 heart specimens.  

PubMed Central

The morphology of the atrial appendages was examined in 1842 specimen hearts from patients with congenital lesions. The external and internal features that permitted the identification of the right and left appendages were studied in detail in one tenth of the hearts. These results were compared with a similar analysis of 25 normal hearts. This study showed that criteria for identification of right and left appendages were reliable. Application of these criteria to the overall collection identified the usual arrangement in 1776 (97%) hearts, a mirror image arrangement in eight (0.4%); left atrial isomerism in 22 (1.2%); and right atrial isomerism in 36 (1.9%). Fourteen (0.81%) had juxtaposed atrial appendages (13 with usual arrangement and one with left isomerism). This did not interfere with identification of the left and right atria on the basis of appendage morphology. In only two cases did the determination by atrial morphology produce a result that was inconsistent with the arrangement of the other thoracoabdominal organs. Further examination of the atria in these showed a mistake had been made in the initial assessment. The atrial arrangement can be accurately determined by the morphology of the atrial appendages. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5

Sharma, S; Devine, W; Anderson, R H; Zuberbuhler, J R

1988-01-01

364

Congenital absence of the left atrial appendage: a rare anatomical variation with clinical significance.  

PubMed

Congenital absence of the left atrial appendage (LAA) is extremely rare.We describe a case of congenial absence of the LAA in a patient scheduled for atrial fibrillation (AF) ablation. Absence of the LAA was found pre-procedurally by transoesophageal echocardiography (TEE) and cardiac computer tomography (CT). During the ablation procedure, the absence was confirmed by contrast injection at the usual location of the LAA. PMID:23882880

Zhang, Zhi-Jun; Dong, Jian-Zeng; Ma, Chang-Sheng

2013-06-01

365

Total endoscopic robotic atrial septal defect repair in a patient with dextrocardia and situs inversus totalis.  

PubMed

Situs inversus with mirror-image of the heart is a rare condition. The present report describes a case of a patient with dextrocardia with situs inversus who had atrial septal defect with multiple holes in the fossa ovalis. The patient underwent total endoscopic atrial septal defect repair using the da Vinci surgical system. This procedure was achieved safely with good clinical and excellent cosmetic results. PMID:22200951

Iino, Kenji; Watanabe, Go; Ishikawa, Norihiko; Tomita, Shigeyuki

2011-12-26

366

Lack of prevention of heart failure by serial electrical cardioversion in patients with persistent atrial fibrillation  

Microsoft Academic Search

OBJECTIVETo investigate the occurrence of heart failure complications, and to identify variables that predict heart failure in patients with (recurrent) persistent atrial fibrillation, treated aggressively with serial electrical cardioversion and antiarrhythmic drugs to maintain sinus rhythm.DESIGNNon-randomised controlled trial; cohort; case series; mean (SD) follow up duration 3.4 (1.6) years.SETTINGTertiary care centre.SUBJECTSConsecutive sampling of 342 patients with persistent atrial fibrillation (defined

A E Tuinenburg; I C Van Gelder; M P Van Den Berg; J Brügemann; P J De Kam; H J G M Crijns

1999-01-01

367

Dissimilar atrial rhythms. A patient with interatrial block.  

PubMed Central

A patient with type A Wolff-Parkinson-White syndrome and prolonged interatrial conduction intervals developed atrial flutter during the course of an electrophysiological study. The atrial flutter blocked along the left-to-right conduction pathways in a Wenckebach pattern. The dissimilar atrial rhythms of right atrial tachycardia and left atrial flutter evolved as the interatrial block increased to 2:1 conduction.

Leier, C V; Schaal, S F

1977-01-01

368

Anatomical basis of minimally invasive epicardial ablation of atrial fibrillation.  

PubMed

Minimally invasive atrial fibrillation surgery (MIAFS) has become a well established and increasingly used option for managing patients with stand-alone arrhythmia. Pulmonary veins (PVs) isolation continues to be the cornerstone of ablation strategies. Indeed, in most cases, atrial fibrillation (AF) is triggered in or near the PVs. Nevertheless, ectopic beats initiating AF may occasionally arise from non-PV foci. The knowledge of the anatomy and underlying morphology of PVs and non-PV foci is essential for cardiac surgeons treating AF patients with epicardial minimally invasive procedures. The anatomical structures relevant to the pathogenesis and the epicardial treatment of AF include the PVs, the pericardial space, the pericardial sinuses, the phrenic nerve, the left atrium, the retro-atrial and caval ganglionated plexuses, the ligament of Marshall, the caval veins and the left atrial appendage. In this review, we briefly describe the basic anatomy of these structures and discuss their specific correlations for cardiac surgeons interested in performing MIAFS. PMID:23111561

Gelsomino, Sandro; Corradi, Domenico; Lorusso, Roberto; Parise, Orlando; Callegari, Sergio; Macchi, Emilio; Maessen, Jos; La Meir, Mark

2012-10-30

369

Amiodarone for refractory atrial fibrillation  

Microsoft Academic Search

Atrial fibrillation (AF) is a difficult arrhythmia to manage with antiarrhythmic agents. Amiodarone is highly effective in restoring and maintaining normal sinus rhythm in patients with AF. However, the mechanism and predictors of efficacy for amiodarone in treating AF have not been adequately addressed. Various measures of success or failure of amiodarone therapy were examined in 68 patients who had

Robert L. Gold; Charles I. Haffajee; George Charos; Kathy Sloan; Stephen P. Baker; Joseph S. Alpert

1986-01-01

370

Acute Treatment of Atrial Fibrillation  

Microsoft Academic Search

Atrial fibrillation (AFib) is a common clinical entity, responsible for significant morbidity and mortality, but it also accounts for a large percentage of healthcare dollar expenditures. Efforts to treat this arrhythmia in the past have focused on subacute antithrombotic therapy and eventually use of antiarrhythmic drugs for maintenance of sinus rhythm. However, there has been a growing interest in the

Peter R Kowey; Roger A Marinchak; Seth J Rials; Roland A Filart

1998-01-01

371

Surgical Therapy of Atrial Fibrillation  

PubMed Central

Atrial fibrillation (AF) can be found in an increasing number of cardiac surgical patients due to a higher patient's age and comorbidities. Atrial fibrillation is known, however, to be a risk factor for a greater mortality, and one aim of intraoperative AF treatment is to approximate early and long-term survival of AF patients to survival of patients with preoperative sinus rhythm. Today, surgeons are more and more able to perform less complex, that is, minimally invasive cardiac surgical procedures. The evolution of alternative ablation technologies using different energy sources has revolutionized the surgical therapy of atrial fibrillation and allows adding the ablation therapy without adding significant risk. Thus, the surgical treatment of atrial fibrillation in combination with the cardiac surgery procedure allows to improve the postoperative long-term survival and to reduce permanent anticoagulation in these patients. This paper focuses on the variety of incisions, lesion sets, and surgical techniques, as well as energy modalities and results of AF ablation and also summarizes future trends and current devices in use.

Haensig, Martin; Rastan, Ardawan Julian; Holzhey, David Michael; Mohr, Friedrich-Wilhelm; Garbade, Jens

2012-01-01

372

Unexpected low prevalence of atrial fibrillation in cryptogenic ischemic stroke: a prospective study  

PubMed Central

Purpose Ischemic stroke is a frequent pathology with high rate of recurrence and significant morbidity and mortality. There are several causes of stroke, affecting prognosis, outcomes, and management, but in many cases, the etiology remains undetermined. We hypothesized that atrial fibrillation was involved in this pathology but underdiagnosed by standard methods. The aim of the study was to determine the incidence of atrial fibrillation in cryptogenic ischemic stroke by using continuous monitoring of the heart rate over several months. The secondary objective was to test the value of atrial vulnerability assessment in predicting spontaneous atrial fibrillation. Methods and results We prospectively enrolled 24 patients under 75 years of age, 15 men and 9 women of mean age 49 years, who within the last 4 months had experienced cryptogenic stroke diagnosed by clinical presentation and brain imaging and presumed to be of cardioembolic mechanism. All causes of stroke were excluded by normal 12-lead ECG, 24-h Holter monitoring, echocardiography, cervical Doppler, hematological, and inflammatory tests. All patients underwent electrophysiological study. Of the patients, 37.5% had latent atrial vulnerability, and 33.3% had inducible sustained arrhythmia. Patients were secondarily implanted with an implantable loop recorder to look for spontaneous atrial fibrillation over a mean follow-up interval of 14.5 months. No sustained arrhythmia was found. Only one patient had non-significant episodes of atrial fibrillation. Conclusion In this study, symptomatic atrial fibrillation or AF with fast ventricular rate has not been demonstrated by the implantable loop recorder in patients under 75 years with unexplained cerebral ischemia. The use of this device should not be generalized in the systematic evaluation of these patients. In addition, this study attests that the assessment of atrial vulnerability is poor at predicting spontaneous arrhythmia in such patients.

Dion, Fanny; Saudeau, Denis; Bonnaud, Isabelle; Friocourt, Patrick; Bonneau, Armel; Poret, Philippe; Giraudeau, Bruno; Regina, Sandra; Fauchier, Laurent

2010-01-01

373

Clinical implications of left atrial spontaneous echo contrast in mitral valve disease.  

PubMed

The aim of this study was to investigate the factors related to the presence of left atrial spontaneous echo contrast in mitral valve disease, and to ascertain whether it is a predictor of thromboembolism. One hundred and one patients (47 men, 54 women) with a mean age of 57.04 +/- 10.6 years who underwent transthoracic and transesophageal echocardiography were included in the study. Forty-five (44.5%) had isolated or predominant mitral valve stenosis, 12 (11.9%) predominant mitral insufficiency and 44 (43.6%) had had previous mitral valve replacement. Left atrial spontaneous echo contrast was detected by transesophageal echocardiography in 58 patients, while the transthoracic approach detected it in only 15 (14.9%) (P < 0.0001). An atrial thrombus was found in six cases, with a history of recent systemic embolism in three of them. There was no thrombus in the left atria of a further nine patients, despite definitive histories of recent systemic embolism. The finding of left atrial spontaneous echo contrast was related to the presence of atrial fibrillation or enlarged left atrium, the severity of mitral stenosis and the absence of significant mitral insufficiency. Anticoagulant therapy was not significantly associated with spontaneous left atrial echo contrast, but a stepwise linear regression analysis showed that its presence was the only independent predictor of thromboembolism (p < 0.0001). We conclude that left atrial spontaneous echo contrast in mitral valve disease can be discovered mainly by transesophageal echocardiography, and is correlated with factors which are associated with low left atrial blood flow velocity such as atrial fibrillation, enlarged left atrium, mitral stenosis of increased severity and the absence of significant mitral insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8269118

Kranidis, A; Koulouris, S; Anthopoulos, L

1993-05-01

374

Action of adenine derivatives on experimental atrial flutter in the canine heart.  

PubMed

We have studied the effects of adenosine (Ado) and adenosine derivatives on an experimental atrial flutter (AFL) in the canine heart. Moreover, we have assessed these adenine derivatives on some electrophysiological parameters (the conduction time and functional refractory period) of the posterior internodal pathway (PIP) and of the ordinary atrial myocardium (OAM). The adenosine derivatives assessed were adenosine 5'-monophosphate (AMP), adenosine 3' 5'-monophosphate (cAMP) and adenosine 5'-triphosphate (ATP). Ado, AMP, and cAMP transformed the atrial flutter into a short episode of atrial fibrillation that terminated spontaneously to sinus rhythm. This effect was prevented by previous blockade of A1 purinergic receptors with aminophylline, but not by parasympathectomy (vagotomy and atropine). ATP also suppressed the AFL, but in this case, sinus rhythm was achieved without an intermediate episode of atrial fibrillation, and the effect of ATP was not prevented by A1 purinergic blockade. Ado, AMP and cAMP extended the functional refractory period measured in the PIP, but reduced this parameter in the OAM (p < 0.01). The different response of atrial tissues to the adenosine and its monophosphate derivatives was not elicited by ATP. This derivative caused a prolongation of FRP on both atrial tissues PIP and OAM (p < 0.05). The changes produced by Ado and its monophosphate derivatives on FRP was blocked by aminophylline. The effect of adenine derivatives on AFL may be explained by the dispersion of refractoriness created as a result of the heterogeneous response of atrial tissues to these agents. Our results support the hypothesis of an agonistic action of adenine derivatives on atrial purinergic receptors. PMID:9291626

Alvarado, J L; Pastelín, G

1997-01-01

375

Large free-floating left atrial thrombus with normal mitral valve.  

PubMed

Left atrial thrombus in the presence of diseased mitral valve and atrial fibrillation is a well known entity. But it is very rare to occur in the presence of normal mitral valve apparatus. We report the case of a 36 year old female who presented with left atrial ball valve thrombus and normal mitral valve apparatus and underwent surgery. This patient with gangrene of right lower limb came for cardiac evaluation. She had infarct in left middle cerebral artery territory- ten months prior to this admission and was on treatment for infertility. She had atrial fibrillation. Emergency surgery to remove the thrombus should be considered given its potential life threatening embolic nature. PMID:23438617

Chidambaram, Sundar; Rajkumar, Arunkumar; Ganesan, Gnanavelu; Sangareddi, Venkatesan; Ramasamy, Alagesan; Dhandapani, V E; Ravi, M S

2012-12-26

376

Atrial fibrillation after taser exposure in a previously healthy adolescent.  

PubMed

We are reporting a previously healthy adolescent who developed atrial fibrillation after being tased. He has a structurally normal heart on echocardiogram, normal electrolyte level and thyroid function test results, and a urine toxicology screen positive for marijuana. The patient ultimately required external defibrillation to convert his cardiac rhythm to normal sinus rhythm and has had no recurrent arrhythmias since hospital discharge (approximately 1 year). This is the first reported case of atrial fibrillation developing after a Taser shot, occurring in an adolescent without other risk factors. This case illustrates the arrhythmogenic potential of a Taser in otherwise healthy young individuals, and further study of occurrence of Taser-induced arrhythmias is warranted. PMID:20016356

Multerer, Sara; Berkenbosch, John W; Das, Bibhuti; Johnsrude, Christopher

2009-12-01

377

Resuming electroconvulsive therapy (ECT) after emergence of asymptomatic atrial fibrillation during a course of right unilateral ECT.  

PubMed

Atrial fibrillation induced by electroconvulsive therapy (ECT) is rare, with only 3 reported cases. None of those cases involved either young healthy patients or right unilateral ECT. We report a 46-year-old healthy male observed to be in atrial fibrillation immediately after electrical induction of the 25th administration of right unilateral ECT. Diltiazem was administered, and he spontaneously cardioverted. After a negative cardiology workup, he safely resumed ECT. Atrial fibrillation was most likely triggered by autonomic imbalance due to the combination of electrical induction, seizure, and medication. PMID:22343588

Loeffler, George; Capobianco, Marc

2012-03-01

378

Prevention of recurrent atrial fibrillation with chronic dual-site right atrial pacing  

Microsoft Academic Search

Objectives. We investigated 1) the feasibility, safety and efficacy of multisite right atrial pacing for prevention of atrial fibrillation (AF); and 2) the ability of atrial pacing in single- and dual-site modes to increase arrhythmia-free intervals in patients with drug-refractory AF.Background. We recently developed and applied a novel technique of dual-site right atrial pacing in an unselected group of consecutive

Sanjeev Saksena; Atul Prakash; Michael Hill; Ryszard B. Krol; Anand N. Munsif; Philip P. Mathew; Rahul Mehra

1996-01-01

379

Present treatment options for atrial fibrillation  

PubMed Central

Atrial fibrillation is the commonest sustained cardiac arrhythmia. It accounts for >35% of all hospital admissions for cardiac arrhythmias in the United States. The presence of atrial fibrillation increases the mortality of a population by up to twofold. The risk of stroke increases from 1.5% in patients with atrial fibrillation from 50–59 years of age to up to 23.5% for such patients aged 80–89 years. Although the diagnosis of atrial fibrillation is usually straightforward, effective treatment is not. This article will discuss how rhythm control of atrial fibrillation can best be achieved, the controversy over the rhythm versus rate control, the maintenance of sinus rhythm with antiarrhythmic drugs after cardioversion, and prevention of thromboembolism. Finally, the recent advances in various non-pharmacological approaches for the treatment of atrial fibrillation will be highlighted.

Lairikyengbam, S; Anderson, M; Davies, A

2003-01-01

380

Slow ventricular response atrial fibrillation related to mad honey poisoning.  

PubMed

Mad honey poisoning which is induced by Grayanotoxin (Andromedotoxin), is also known to have adverse effects in the cardiovascular system leading to different clinical entities. This toxin is produced by a member of the Rhododendron genus of plants of two R. Luteum and R. Panticum. In this article, we presented a case of slow ventricular response atrial fibrillation complaints with nausea, vomiting, dizziness and chest pain about an hour after eating honey produced in the Black Sea Region. PMID:22923947

Osken, A; Yaylac?, S; Ayd?n, E; Kocayigit, I; Cakar, M A; Tamer, A; Gündüz, H

2012-07-01

381

Successful surgical excision of primary right atrial angiosarcoma  

Microsoft Academic Search

Primary cardiac angiosarcoma is a rare and aggressive tumor with a high incidence of metastatic spread (up to 89%) at the\\u000a time of diagnosis, which restricts the indication for surgical resection to a small number of patients. We report the case\\u000a of a 50-year old Caucasian woman with non-metastatic primary right atrial angiosarcoma, who underwent successful surgical\\u000a excision of the

Wobbe Bouma; Chris PH Lexis; Tineke P Willems; Albert JH Suurmeijer; Iwan CC van der Horst; Tjark Ebels; Massimo A Mariani

2011-01-01

382

Transverse conduction capabilities of the crista terminalis in patients with atrial flutter and atrial fibrillation  

Microsoft Academic Search

OBJECTIVESIn this study, the transverse conduction capabilities of the crista terminalis (CT) were determined during pacing in sinus rhythm in patients with atrial flutter and atrial fibrillation.BACKGROUNDIt has been demonstrated that the CT is a barrier to transverse conduction during typical atrial flutter. Mapping studies in animal models provide evidence that this is functional. The influence of transverse conduction capabilities

Burghard Schumacher; Werner Jung; Harald Schmidt; Christoph Fischenbeck; Thorsten Lewalter; Andreas Hagendorff; Heyder Omran; Christian Wolpert; Berndt Lüderitz

1999-01-01

383

Restoration of Atrial Function after Atrial Fibrillation of Different Etiological Origins  

Microsoft Academic Search

In order to evaluate atrial function after the restoration of normal sinus rhythm in patients with atrial fibrillation, an echocardiographic study was performed in 60 patients hospitalized for atrial fibrillation that was subsequently converted to sinus rhythm. The study population consisted of 60 patients, 41 males and 19 females, with a mean age of 67 ± 8 years. In etiological

A. V. Mattioli; Tarabini Castellani; D. Vivoli; R. Molinari; G. Mattioli

1996-01-01

384

Multisite Atrial Pacing for Atrial Fibrillation Prevention: Where to Go from Here?  

Microsoft Academic Search

Atrial fibrillation (AF) is a common arrhythmia associated with stroke, increased mortality and with a negative impact on quality of life. Pharmacologic treatments for AF have not provided long-term relief from arrhythmia recurrence. Multi-site atrial pacing was introduced by Daubert and colleagues about 10 years ago for the treatment of severe atrial conduction delays in patients with sick sinus syndrome.

AnandRamdat Misier; Willem P. Beukema; Roger Willems

2003-01-01

385

Giant pedunculated thrombus with normal left ventricular systolic function mimicking myxoma.  

PubMed

A 74-year-old woman with a history of essential thrombocythemia was admitted to the Coronary Care Unit because of atypical chest pain. The transthoracic echocardiogram showed normal left ventricular (LV) diameter and preserved regional and global systolic function. A pedunculated mobile mass measuring 25 mm × 14 mm was visualized in the LV cavity, attached to the midanterior wall. Because of the typical echocardiographic appearance, a myxoma was suspected. The patient evolved with left hemiparesis and negative T-waves in the electrocardiogram. Left ventriculotomy with excision of the ventricular mass was performed. Histopathological examination revealed an organized thrombus. PMID:21198822

Allende, Norberto G; Sokn, Fernando; Borracci, Raúl; Milani, Arnaldo; Kusselevski, Ana; Camilletti, Jesus; Trongé, Jorge; Hector, Perelmuter

2010-12-27

386

Acute Effects of Dual-Site Right Atrial Pacing in Patients With Spontaneous and Inducible Atrial Flutter and Fibrillation  

Microsoft Academic Search

Objectives. We tested the ability of dual-site right atrial pacing to prevent atrial fibrillation (AF) or atrial flutter induced by eingle-site atrial pacing and correlated its efficacy with clinical patient characteristics, atrial activation times and refractory periods.Background. Prevention of recurrent AF with long-term dual-site right atrial pacing has been demonstrated in our previous studies. However, the mechanism of antiarrhythmic benefit

Atul Prakash; Sanjeev Saksena; Ryszard B Krol; Anand N Munsif; Irakli Giorgberidze; Philip Mathew; Rahul Mehra

1997-01-01

387

Ablation of sarcolipin results in atrial remodeling  

PubMed Central

Sarcolipin (SLN) is a key regulator of sarco(endo)plasmic reticulum (SR) Ca2+-ATPase (SERCA), and its expression is altered in diseased atrial myocardium. To determine the precise role of SLN in atrial Ca2+ homeostasis, we developed a SLN knockout (sln?/?) mouse model and demonstrated that ablation of SLN enhances atrial SERCA pump activity. The present study is designed to determine the long-term effects of enhanced SERCA activity on atrial remodeling in the sln?/? mice. Calcium transient measurements show an increase in atrial SR Ca2+ load and twitch Ca2+ transients. Patch-clamping experiments demonstrate activation of the forward mode of sodium/calcium exchanger, increased L-type Ca2+ channel activity, and prolongation of action potential duration at 90% repolarization in the atrial myocytes of sln?/? mice. Spontaneous Ca2+ waves, delayed afterdepolarization, and triggered activities are frequent in the atrial myocytes of sln?/? mice. Furthermore, loss of SLN in atria is associated with increased interstitial fibrosis and altered expression of genes encoding collagen and other extracellular matrix proteins. Our results also show that the sln?/? mice are susceptible to atrial arrhythmias upon aging. Together, these findings indicate that ablation of SLN results in increased SERCA activity and SR Ca2+ load, which, in turn, could cause abnormal intracellular Ca2+ handling and atrial remodeling.

Xie, Lai-Hua; Shanmugam, Mayilvahanan; Park, Ji Yeon; Zhao, Zhenghang; Wen, Hairuo; Tian, Bin; Periasamy, Muthu

2012-01-01

388

Comparative Analysis of the Complete Genome Sequence of the California MSW Strain of Myxoma Virus Reveals Potential Host Adaptations.  

PubMed

Myxomatosis is a rapidly lethal disease of European rabbits that is caused by myxoma virus (MYXV). The introduction of a South American strain of MYXV into the European rabbit population of Australia is the classic case of host-pathogen coevolution following cross-species transmission. The most virulent strains of MYXV for European rabbits are the Californian viruses, found in the Pacific states of the United States and the Baja Peninsula, Mexico. The natural host of Californian MYXV is the brush rabbit, Sylvilagus bachmani. We determined the complete sequence of the MSW strain of Californian MYXV and performed a comparative analysis with other MYXV genomes. The MSW genome is larger than that of the South American Lausanne (type) strain of MYXV due to an expansion of the terminal inverted repeats (TIRs) of the genome, with duplication of the M156R, M154L, M153R, M152R, and M151R genes and part of the M150R gene from the right-hand (RH) end of the genome at the left-hand (LH) TIR. Despite the extreme virulence of MSW, no novel genes were identified; five genes were disrupted by multiple indels or mutations to the ATG start codon, including two genes, M008.1L/R and M152R, with major virulence functions in European rabbits, and a sixth gene, M000.5L/R, was absent. The loss of these gene functions suggests that S. bachmani is a relatively recent host for MYXV and that duplication of virulence genes in the TIRs, gene loss, or sequence variation in other genes can compensate for the loss of M008.1L/R and M152R in infections of European rabbits. PMID:23986601

Kerr, Peter J; Rogers, Matthew B; Fitch, Adam; Depasse, Jay V; Cattadori, Isabella M; Hudson, Peter J; Tscharke, David C; Holmes, Edward C; Ghedin, Elodie

2013-08-28

389

[Multifocal atrial tachycardia].  

PubMed

The multifocal auricular tachycardia is one ectopic rhythm anomaly, conditioned by a constellation of biochemical and mechanic factors. The presence of four basic ECG-criteria, characterizing the origination of heterotropic impulses from different auricular foci are necessary in order to admit that anomaly. The author has followed up seven cases, presenting characteristic ECG-records and clinical states, when multifocal auricular tachycardia arises. The considerable resistance of the applied antiarrhythmic therapy was stressed upon as well as the high mortality in case of that rhythm disorder, usually occurring in patients with advanced heart diseases. PMID:7395185

Georgiev, N

1980-01-01

390

The complex of myxomas, spotty skin pigmentation and endocrine overactivity (Carney complex): imaging findings with clinical and pathological correlation.  

PubMed

The complex of myxomas, spotty skin pigmentation and endocrine overactivity, or Carney complex (CNC), is a familial multiple endocrine neoplasia and lentiginosis syndrome. CNC is inherited in an autosomal dominant manner and is genetically heterogeneous. Its features overlap those of McCune-Albright syndrome and other multiple endocrine neoplasia (MEN) syndromes. Spotty skin pigmentation is the major clinical manifestation of the syndrome, followed by multicentric heart myxomas, which occur at a young age and are the lethal component of the disease. Myxomas may also occur on the skin (eyelid, external ear canal and nipple) and the breast. Breast myxomas, when present, are multiple and bilateral among female CNC patients, an entity which is also described as "breast-myxomatosis" and is a characteristic feature of the syndrome. Affected CNC patients often have tumours of two or more endocrine glands, including primary pigmented nodular adrenocortical disease (PPNAD), an adrenocorticotropin hormone (ACTH)-independent cause of Cushing's syndrome, growth hormone (GH)-secreting and prolactin (PRL)-secreting pituitary adenomas, thyroid adenomas or carcinomas, testicular neoplasms (large-cell calcifying Sertoli cell tumours [LCCSCT]) and ovarian lesions (cysts and cancinomas). Additional infrequent but characteristic manifestations of CNC are psammomatous melanotic schwannomas (PMS), breast ductal adenomas (DAs) with tubular features, and osteochondromyxomas or "Carney bone tumour". Teaching Points • Almost 60 % of the known CNC kindreds have a germline inactivating mutations in the PRKAR1A gene. • Spotty skin pigmentation is the major clinical manifestation of CNC, followed by heart myxomas. • Indicative imaging signs of PPNAD are contour abnormality and hypodense spots within the gland. • Two breast tumours may present in CNC: myxoid fibroadenomas (breast myxomatosis) and ductal adenomas. • Additional findings of CNC are psammomatous melanotic schwannomas (PMSs) and osteochondromyxomas. PMID:23315333

Courcoutsakis, Nikos A; Tatsi, Christina; Patronas, Nicholas J; Lee, Chiy-Chia Richard; Prassopoulos, Panos K; Stratakis, Constantine A

2013-01-12

391

Morphological study of defects of the atrial septum within the oval fossa: implications for transcatheter closure of left-to-right shunt  

Microsoft Academic Search

OBJECTIVE--To determine the anatomical variability of the oval fossa in cases of atrial septal defect and to find out which factors might make such defects suitable or unsuitable for closure by umbrella or clamshell devices. DESIGN--100 specimens with defects of the atrial septum within the oval fossa were studied, especially the position of the defects within the fossa; the area

S M Ferreira; S Y Ho; R H Anderson

1992-01-01

392

Clinical and echocardiographic features of aorto-atrial fistulas  

PubMed Central

Aorto-atrial fistulas (AAF) are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the fistula formation. With increasing survival of patients, particularly following complex aortic reconstructive surgeries and redo valve surgeries, recognition of this complication, its clinical features and echocardiographic diagnosis is important. Since physical exam in this condition may be misleading, echocardiography serves as the cornerstone for diagnosis. The case below illustrates aorto-left atrial fistula formation following redo aortic valve surgery with slowly progressive symptoms of heart failure. A brief review of the existing literature of this entity is presented including emphasis on echocardiographic diagnosis and treatment.

Ananthasubramaniam, Karthik

2005-01-01

393

“Stunning” of the left atrium after spontaneous conversion of atrial fibrillation to sinus rhythm  

Microsoft Academic Search

Objectives. This study compared left atrial and left atrial appendage contraction velocities in sinus rhythm before and after a brief period of atrial fibrillation in a canine model.Background. In patients, left atrial appendage contraction velocities measured during sinus rhythm after cardioversion from atrial fibrillation are depressed relative to left atrial appendage emptying velocities measured during atrial fibrillation, suggesting that the

Eric K Louie; Dong Liu; Sandra I Reynertson; Henry S Loeb; Thomas L McKiernan; Patrick J Scanlon; Robert J Hariman

1998-01-01

394

Myxoma virus M128L is expressed as a cell surface CD47-like virulence factor that contributes to the downregulation of macrophage activation in vivo  

Microsoft Academic Search

The M128L myxoma virus gene expresses a five-membrane spanning cell surface protein with significant amino acid homology to the cellular CD47 proteins. CD47, also called integrin-associated protein (IAP), is associated with the modulation of leukocyte adhesion, motility, activation, and phagocytosis. Creation of an M128L-deletion mutant myxoma virus strain and subsequent infection of the European rabbit demonstrated that M128L is necessary

C. M. Cameron; J. W. Barrett; M. Mann; A. Lucas; Grant McFadden

2005-01-01

395

Determinants of recurrent atrial flutter after cardioversion.  

PubMed Central

Eighteen male patients (mean age 59 years) who were electrically cardioverted for pure atrial flutter were retrospectively studied to determine those factors influencing the maintenance of regular sinus rhythm or reversion to atrial flutter. Six months after successful cardioversion, 10 patients (55%) had recurrent atrial flutter and eight patients (45%) were still in sinus rhythm. The two groups were not significantly different with respect to age, symptomatology, abnormalities on the 12 lead electrocardiogram (during sinus rhythm), or the administration of digoxin and a class Ia antiarrhythmic agent (after cardioversion). There was a trend for those patients with recurrent atrial flutter to have a higher incidence of underlying heart disease and previous episodes of atrial flutter than the non-recurrent group. There were statistically significant differences between the recurrent and non-recurrent groups with respect to echocardiographically determined left atrial size and left ventricular ejection fraction. Patients with a left atrial size greater than 45 mm or with an ejection fraction less than 45% were all at high risk for recurrent atrial flutter after successful cardioversion.

Pozen, R G; Pastoriza, J; Rozanski, J J; Kessler, K M; Myerburg, R J

1983-01-01

396

ICA APPLIED TO ATRIAL FIBRILLATION ANALYSIS  

Microsoft Academic Search

In this work we present a new biomedical application of independent component analysis (ICA) to solve the problem of atrial activity (AA) extraction from real electrocardiogram (ECG) recordings of atrial fibrillation (AF). The proper analysis and characterization of AA from ECG recordings requires, as a first step, the cancellation of ventricular activity (VA). The present contribution demonstrates the appropriateness of

José Joaquín Rieta; Francisco Castells; César Sánchez; Jorge Igual

2003-01-01

397

Electrophysiological and genetic insights into atrial fibrillation  

Microsoft Academic Search

In this PhD thesis we evaluated the role of the autonomic nervous system (ANS) and the genetic background on atrial substrates required for the initiation and perpetuation of atrial fibrillation (AF), one of the most common arrhythmia. It was shown that dispersion of refractoriness, an electrophysiological substrate for the initiation and perpetuation of AF, is not influenced by the electrical

S. M. Chaldoupi

2011-01-01

398

MEDICAL TREATMENT OF RECURRENT ATRIAL TACHYARRHYTHMIAS  

Microsoft Academic Search

Summary. Recurrent and symptomatic atrial tachyarrhythmias require the necessity of an efficient and low risk medical therapy. The relation between dose, ECG surface parameters, left atrium size and clinical efficiency of Propafenone, Quinidine and Amiodarone has been studied on 215 patients with recurrent atrial arrhythmias. The average age was 62.7±11.3 years and as a fundamental disease they have: valvular disease

Rodica Avram; Radu Cristodorescu; Florica Pascu; Simona Voinea; Ioana Domide; Jecu Avram

399

LEFT JUXTAPOSED ATRIAL APPENDAGES IN A PATIENT WITH DEXTROCARDIA AND TRICUSPID ATRESIA - SURGICAL IMPLICATIONS  

Microsoft Academic Search

The frequent association of complex congenital heart defects and left juxtaposition of atrial appendages (LJAA) is well known. The incidence of LJAA is seen in approximately 10% of those with tricuspid atresia, and in up to 30% of those with tricuspid atresia with ventriculo-arterial discordance. We report a case of LJAA in a patient with tricuspid atresia and dextrocardia. Case

Karthik Vaidyanathan; Madhu N Sankar; K M Cherian

400

Catheter closure of secundum atrial septal defects.  

PubMed Central

Catheter occlusion of atrial septal defects has its roots in the 1950s, with early devices being implanted during closed-heart surgery without cardiopulmonary bypass. For the past 20 years, various catheter-delivered devices have undergone testing and refinement. Designs have included single- and double-disk prostheses, with a variety of materials, delivery systems, and techniques. In this monograph, the history of atrial septal defect occluders and their evaluation, results, and prognoses will be outlined. The early work of King and Mills has been advanced in the forms of the Rashkind and Lock-USCI Clamshell occluders (USCI; Billerica, Mass), the "buttoned" device (custom made by E.B. Sideris), the Babic atrial septal defect occlusion system (Osypka, GmbH; Grenzach-Wyhlen, Germany), the Das-Angel Wings atrial septal defect occlusion device (Microvena Corporation; White Bear Lake, Minn), and others. The future holds promise for approved devices in the treatment of selected secundum atrial septal defects. Images

O'Laughlin, M P

1997-01-01

401

Risk of thromboembolic events in patients with atrial flutter  

Microsoft Academic Search

Based on multiple studies, clear, guided anticoagulation therapy is recommended for patients with atrial fibrillation. The value of anticoagulation therapy in patients with atrial flutter, however, is less well established. Little is known about the incidence of thromboembolism in patients with atrial flutter. We evaluated the risk of thromboembolism in 191 consecutive unselected patients referred for treatment of atrial flutter.

Karlheinz Seidl; Bernd Hauer; Nicola G Schwick; Dietmar Zellner; Ralf Zahn; Jochen Senges

1998-01-01

402

[Atrial flutter with 1/1 nodo-ventricular conduction with amiodarone. From physiopathology to diagnosis].  

PubMed

Atrial flutter with 1/1 nodo-ventricular conduction is a classical complication of Vaughan-Williams's Class I antiarrhythmic drugs. The increase of the flutter cycle and weak action of the antiarrhythmic on the atrioventricular node leads to 1/1 conduction of atrial depolarisation to the ventricles. In view of their marked action on the atrioventricular node, this type of pro-arrhythmic effect is very unexpected with Class III antiarrhythmics. The authors report 7 cases of 1/1 atrial flutter with oral amiodarone observed between 1994 and 2001. The patients were 6 men and 1 woman with an average age of 58 +/- 14 years. Four of them had underlying cardiac disease; none were hyperthyroid. The initial arrhythmia was 2/1 atrial flutter (n = 4), 1/1 atrial flutter (n = 2) and atrial fibrillation (n = 1). Treatment was preventive with doses of 400 mg/day associated with carvedilol in one patient and 200 mg/day in another. The other five patients all received loading doses of 9200 +/- 2400 mg over 10 +/- 4 days. The symptoms were palpitations (n = 2) associated in one patient with hypotension, one syncope, one near syncope and one cardiogenic shock. The ventricular cycle of the 1/1 flutter was 287 +/- 33 ms. The QRS duration was 136 +/- 35 ms with ventricular tachycardia-like appearances in 3 cases. An adrenergic trigger factor was noted in 5 patients. One patient required emergency cardioversion. The authors discuss the physiopathology of 1/1 flutter and theoretical diagnostic methods are proposed. In conclusion, amiodarone does not always prevent the occurrence of 1/1 nodo-ventricular conduction in atrial flutter. PMID:12611038

Aouate, P; Elbaz, N; Klug, D; Lacotte, J; Raguin, D; Frank, R; Lelouche, D; Dubois-Randé, J L; Tonet, J; Fontaine, G

2002-12-01

403

Atrial-Selective Sodium Channel Block as a Strategy for Suppression of Atrial Fibrillation  

PubMed Central

Antiarrhythmic drug therapy remains the principal approach for suppression of atrial fibrillation (AF) and flutter (AFl) and prevention of their recurrence. Among the current strategies for suppression of AF/AFl is the development of antiarrhythmic agents that preferentially affect atrial, rather than ventricular electrical parameters. Inhibition of the ultrarapid delayed rectifier potassium current (IKur), present in the atria, but not in the ventricles, is an example of an atrial-selective approach. Our recent study examined the hypothesis that sodium channel characteristics differ between atrial and ventricular cells and that atrial-selective sodium channel block is another effective strategy for the management of AF. We have demonstrated very significant differences in the inactivation characteristics of atrial versus ventricular sodium channels and a striking atrial selectivity for the action of ranolazine, an inactivated-state sodium channel blocker, to produce use-dependent block of the sodium channels, leading to depression of excitability, development of post-repolarization refractoriness (PRR), and suppression of AF. Lidocaine and chronic amiodarone, both predominantly inactivated-state sodium channel blockers, also produced a preferential depression of sodium channel–dependent parameters (VMax conduction velocity, diastolic threshold of excitation, and PRR) in the atria. Propafenone, a predominantly open-state sodium channel blocker, produced similar changes of electrophysiological parameters, which were was not atrial-selective. The ability of ranolazine, chronic amiodarone, and propafenone to prolong the atrial action potential potentiated their ability to suppress AF in coronary-perfused canine atrial preparations. In conclusion: Our data demonstrate important differences in the inactivation characteristics of atrial versus ventricular sodium channels and a striking atrial selectivity for the action of agents like ranolazine to produce use-dependent block of sodium channels leading to suppression of AF. Our findings suggest that atrial-selective sodium channel block may be a valuable strategy to combat AF.

Burashnikov, Alexander; di Diego, Jose M.; Zygmunt, Andrew C.; Belardinelli, Luiz; Antzelevitch, Charles

2008-01-01

404

Left Atrial Appendage Exclusion for Stroke Prevention in Atrial Fibrillation  

PubMed Central

The public health burden of atrial fibrillation (AF) and associated thromboembolic stroke continues to grow at alarming rates. AF leads to a fivefold increase in the risk of stroke. Therefore, stroke prevention remains the most critical aspect of AF management. Current standard of care focuses on oral systemic anticoagulation, most commonly with warfarin and now with newer agents such as dabigatran, rivaroxaban, and apixaban. However, the challenges and limitations of oral anticoagulation have been well documented. Given the critical role of the left atrial appendage (LAA) in the genesis of AF-related thromboembolism, recent efforts have targeted removal or occlusion of the LAA as an alternative strategy for stroke prevention, particularly in patients deemed unsuitable for oral anticoagulation. This paper highlights recent advances in mechanical exclusion of the LAA. The problem of AF and stroke is briefly summarized, followed by an explanation for the rationale behind LAA exclusion for stroke prevention. After briefly reviewing the history of LAA exclusion, we highlight the most promising LAA exclusion devices currently available. Finally, we discuss future challenges and opportunities in this growing field.

Patel, Taral K.; Yancy, Clyde W.; Knight, Bradley P.

2012-01-01

405

Current Issues in Atrial Fibrillation  

PubMed Central

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It places an enormous burden on the patients, caregivers, and the society at large. While the main themes in the care of an AF patient have not changed over the years and continue to focus on stroke prevention, control of the ventricular, rate and rhythm maintenance, there have been a number of new developments in each of these realms. This paper will discuss the “hot” topics in AF in 2012 including new and upcoming medical and invasive management strategies for this condition.

Khaykin, Yaariv; Shamiss, Yana

2012-01-01

406

Ablating Persistent Atrial Fibrillation Successfully  

PubMed Central

The ablation of persistent atrial fibrillation (AF) poses many challenges compared to ablation for paroxysmal AF, including greater procedural complexity, longer procedural time, unclear endpoints, increased patient comorbidity with a greater risk of procedural complications, and lower success rate. Nevertheless, using a combination of patient selection, careful procedural planning of both ablation strategy and endpoints, and by setting realistic patient expectations, successful ablation may be achieved. Further improvements will come from continued technical advances as well as from greater mechanistic understanding of persistent AF, including the physiologically-targeted ablation of localized rotors and focal sources that have recently been shown to maintain human AF.

Krummen, David E.; Narayan, Sanjiv M.

2012-01-01

407

Atrial Fibrillation After Radiofrequency Ablation of Type I Atrial Flutter Time to Onset, Determinants, and Clinical Course  

Microsoft Academic Search

Background—The occurrence of atrial fibrillation after ablation of type I atrial flutter remains an important clinical problem. To gain further insight into the pathogenesis and significance of postablation atrial fibrillation, we examined the time to onset, determinants, and clinical course of atrial fibrillation after ablation of type I flutter in a large patient cohort. Methods and Results—Of 110 consecutive patients

Hakan Paydak; John G. Kall; Martin C. Burke; Donald Rubenstein; Douglas E. Kopp; Ralph J. Verdino; David J. Wilber

2010-01-01

408

Factors associated with early atrial fibrillation after ablation of common atrial flutter. A single centre prospective study  

Microsoft Academic Search

Background The occurrence of early atrial fibrillation (6 months) after ablation of common atrial flutter is of clinical significance. Variables predicting this evolution in ablated patients without a previous atrial fibrillation history have not been fully investigated. Objectives The aim of the present study was: (1) to identify predictive factors of early atrial fibrillation (6 months) in the overall population

A. Da Costa; C. Romeyer; S. Mourot; M. Messier; A. Cerisier; E. Faure; K. Isaaz

2002-01-01

409

Isolated atrial amyloidosis and the importance of molecular classification.  

PubMed

Amyloid is identified microscopically as an amorphous extracellular hyaline material that exhibits "apple-green" birefringence with Congo red stains. Amyloid is not a chemically distinct entity, and currently available molecular methods are capable of identifying over 20 amyloidogenic precursor proteins. Some of the more common diseases associated with amyloidosis include plasma cell dyscrasias, chronic inflammatory disorders, hereditary-familial mutations involving transthyretin, Alzheimer's disease, and so-called "senile" or age-related amyloidosis. The amyloid deposits in these various diseases may be isolated to a single organ such as the heart or brain, or the amyloidosis may be systemic. The senile types of cardiac amyloidosis can result from overproduction of atrial natriuretic factor or from accumulation of otherwise normal or wild-type transthyretin. We present the case of an 83-year-old hospitalized woman with known atrial fibrillation and previous pacemaker implantation who had cardiac arrest unresponsive to attempted resuscitation. Autopsy disclosed prominent amyloidosis involving the left atrium, and subsequent molecular studies identified the amyloidogenic material as alpha atrial natriuretic factor. Since the clinical management and genetic implications of the various diseases associated with amyloidosis are markedly different, we stress the importance of molecular classification whenever possible. PMID:24082415

Podduturi, Varsha; Armstrong, Danielle R; Hitchcock, Michael A; Roberts, William C; Guileyardo, Joseph M

2013-10-01

410

Isolated atrial amyloidosis and the importance of molecular classification  

PubMed Central

Amyloid is identified microscopically as an amorphous extracellular hyaline material that exhibits “apple-green” birefringence with Congo red stains. Amyloid is not a chemically distinct entity, and currently available molecular methods are capable of identifying over 20 amyloidogenic precursor proteins. Some of the more common diseases associated with amyloidosis include plasma cell dyscrasias, chronic inflammatory disorders, hereditary-familial mutations involving transthyretin, Alzheimer's disease, and so-called “senile” or age-related amyloidosis. The amyloid deposits in these various diseases may be isolated to a single organ such as the heart or brain, or the amyloidosis may be systemic. The senile types of cardiac amyloidosis can result from overproduction of atrial natriuretic factor or from accumulation of otherwise normal or wild-type transthyretin. We present the case of an 83-year-old hospitalized woman with known atrial fibrillation and previous pacemaker implantation who had cardiac arrest unresponsive to attempted resuscitation. Autopsy disclosed prominent amyloidosis involving the left atrium, and subsequent molecular studies identified the amyloidogenic material as alpha atrial natriuretic factor. Since the clinical management and genetic implications of the various diseases associated with amyloidosis are markedly different, we stress the importance of molecular classification whenever possible.

Podduturi, Varsha; Armstrong, Danielle R.; Hitchcock, Michael A.; Roberts, William C.

2013-01-01

411

Inheritance of persistent foramen ovale and atrial septal defects and the relation to familial migraine with aura  

PubMed Central

Objective: To determine whether smaller atrial shunts (large persistent foramen ovale (PFO) and small atrial septal defect (ASD)) are inherited and whether this has a role in the inheritance of migraine with aura. Methods: Contrast echocardiography was used to detect atrial shunts in 71 relatives of 20 probands with a significantly sized atrial shunt (large PFO or ASD). Four families with three generations, 14 families with two generations, and two sibships were studied. The contrast echocardiograms were performed blind to history of migraine. A consultant neurologist, who was blinded to cardiac findings, categorised migraine symptoms in subjects. Results: The occurrence of atrial shunts was consistent with autosomal dominant inheritance. Usually shunts were large PFOs, but in some cases they were ASDs. There was also evidence that inheritance of more complex congenital heart disease may be related to the inheritance of PFOs. When the proband had migraine with aura and an atrial shunt, 15 of the 21(71.4%) first degree relatives with a significant right to left shunt also had migraine with aura compared with three of 14 (21.4%) without a significant shunt (p atrial shunts. This is linked to inheritance of migraine with aura in some families.

Wilmshurst, P T; Pearson, M J; Nightingale, S; Walsh, K P; Morrison, W L

2004-01-01

412

Successful closure of a previously unsuspected atrial septal defect by an implantable Clamshell device and subsequent transvenous pacemaker implantation.  

PubMed Central

Implantation of transvenous leads for a permanent cardiac pacing system usually requires the absence of intracardiac shunts. We report the case of an asymptomatic atrial septal defect in an 11-year-old boy who required permanent pacing. We implanted an atrial septal defect closure (Clamshell) device prior to implantation of transvenous leads. This new device makes transvenous implantation possible and may reduce the risk of stroke in patients with these anomalies. Images

Friedman, R A; O'Laughlin, M P; Moak, J P; Perry, J C; Mullins, C E; Garson, A; Feltes, T F

1994-01-01

413

Intra and Extracardiac Markers of Inflammation During Atrial Fibrillation  

PubMed Central

BACKGROUND A decrease in inflammation after cure of atrial arrhythmias suggests that such arrhythmias are pro-inflammatory, and lower inflammatory marker levels in the coronary sinus suggest that atrial arrhythmias result in the intracardiac appropriation of inflammatory cytokines. OBJECTIVE To investigate the effect of atrial fibrillation on inflammatory markers drawn from intra and extracardiac chambers. METHODS We performed a case control study of 167 AF patients and 207 controls. Blood from intra and extracardiac sites was obtained from a subset of patients undergoing curative AF ablation (n=46). RESULTS There were no significant differences in C-Reactive Protein (CRP) or interleukin-6 (IL-6) between those with and without a history of AF. Both were significantly higher when blood was drawn during AF compared to in sinus rhythm: median CRP 3.1 mg/dL (interquartile range [IQR] 1.0–6.0) versus 1.7 mg/dL (IQR 0.7 – 3.9, p=0.0005); median IL-6 2.3 ng/ml (IQR 1.5–3.9) versus 1.5 ng/ml (IQR 0.7–2.5; p=0.007). This finding persisted after adjusting for potential confounders. AF ablation patients in AF exhibited a positive median left atrial minus coronary sinus (LA-CS gradient) CRP (0.3 mg/dL , IQR ?0.03–1.1), whereas those in sinus rhythm had a negative median LA-CS gradient CRP (?0.2, IQR ?0.8-[?0.02], p=0.01); femoral artery minus femoral vein gradients in AF versus sinus rhythm failed to show any differences. CONCLUSIONS AF at the time of the blood draw, rather than a history of AF, was independently associated with inflammation. Differences in trans-cardiac gradients suggest that AF results in sequestration of inflammatory cytokines in the heart.

Marcus, Gregory M; Smith, Lisa M; Ordovas, Karen; Scheinman, Melvin M; Kim, Albert M; Badhwar, Nitish; Lee, Randall J; Tseng, Zian H; Lee, Byron K; Olgin, Jeffrey E

2009-01-01

414

Atrial fibrillation associated with chocolate intake abuse and chronic salbutamol inhalation abuse.  

PubMed

The use of substances as the substrate for atrial fibrillation is not frequently recognized. Chocolate is derived from the roasted seeds of the plant theobroma cacao and its components are the methylxanthine alkaloids theobromine and caffeine. Caffeine is a methylxanthine whose primary biological effect is the competitive antagonism of the adenosine receptor. Normal consumption of caffeine was not associated with risk of atrial fibrillation or flutter. Sympathomimetic effects, due to circulating catecholamines cause the cardiac manifestations of caffeine overdose toxicity, produce tachyarrhythmias such as supraventricular tachycardia, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation.The commonly used doses of inhaled or nebulized salbutamol induced no acute myocardial ischaemia, arrhythmias or changes in heart rate variability in patients with coronary artery disease and clinically stable asthma or chronic obstructive pulmonary disease. Two-week salbutamol treatment shifts the cardiovascular autonomic regulation to a new level characterized by greater sympathetic responsiveness and slight beta2-receptor tolerance. We present a case of atrial fibrillation associated with chocolate intake abuse in a 19-year-old Italian woman with chronic salbutamol inhalation abuse. This case focuses attention on chocolate intake abuse associated with chronic salbutamol abuse as the substrate for atrial fibrillation. PMID:19171401

Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

2009-01-26

415

Anticoagulation therapy for atrial fibrillation.  

PubMed

Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder, and its prevalence is increasing worldwide. Atrial fibrillation confers a fivefold increased risk of stroke, and these strokes are associated with significant mortality and disability. The vitamin K antagonist, warfarin, has been the mainstay of anticoagulant therapy for patients with AF, reducing the risk of stroke by 65%. Despite its efficacy, warfarin remains underused in clinical practice because of its variable dose response, diet and medication interactions, and need for frequent monitoring. Stroke prevention in AF has entered an exciting therapeutic era with new classes of targeted anticoagulants that avoid the many pitfalls of the vitamin K antagonists. Dabigatran, an oral thrombin inhibitor, and the factor Xa inhibitors, rivaroxaban and apixaban, have demonstrated efficacy for stroke prevention and a reduced risk of intracranial hemorrhage relative to warfarin. Translating the efficacy of clinical trials into effective use of these novel agents in clinical practice will require an understanding of their pharmacokinetic profiles, dose selection, and management in select clinical situations. PMID:23397554

Hylek, Elaine M

2013-02-08

416

Arrhythmias Complicating Acute Myocardial Infarction: Atrial Tachyarrhythmias Including Atrial Fibrillation and Atrial Flutter  

Microsoft Academic Search

In patients presenting with acute coronary syndrome (ACS), supraventricular tachyarrhythmias (SVTs) are relatively common\\u000a in the peri-infarction period. Their occurrence often heralds signifi cant myocardial ischemia with ventricular dysfunction\\u000a or cardiogenic shock and may, in themselves, cause congestive heart failure and exacerbate ongoing myocardial ischemia. They\\u000a also are a predictor of short- and long-term complications and prognosis [1–4].\\u000a \\u000a Atrial tachyarrhythmias

Dan L. Musat; Jonathan S. Steinberg; Delia Cotiga; Eyal Herzog

417

Multicenter Low Energy Transvenous Atrial Defibrillation (XAD) Trial Results in Different Subsets of Atrial Fibrillation  

Microsoft Academic Search

Objectives. This prospective, multicenter trial was aimed at defining efficacy and safety of low energy shocks during atrial fibrillation in a diverse cohort of patients.Background. Experimental studies in sheep and preliminary data in humans have suggested that low energy internal shocks delivered between right atrial and coronary sinus electrode catheters may terminate atrial fibrillation.Methods. Biphasic 3\\/3-ms R wave synchronous shocks

Samuel Lévy; Philippe Ricard; Chu-Pak Lau; Ngai-Sang Lok; A. John Camm; Francis D Murgatroyd; Luc J Jordaens; Lukas J Kappenberger; Pedro Brugada; Kenneth L Ripley

1997-01-01

418

Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes  

Microsoft Academic Search

BACKGROUND: Percutaneous closure of atrial septal defects (ASDs) should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure. Cardiovascular magnetic resonance (CMR) is

Karen SL Teo; Benjamin K Dundon; Payman Molaee; Kerry F Williams; Angelo Carbone; Michael A Brown; Matthew I Worthley; Patrick J Disney; Prashanthan Sanders; Stephen G Worthley

2008-01-01

419

Genome Comparison of a Nonpathogenic Myxoma Virus Field Strain with Its Ancestor, the Virulent Lausanne Strain ? †  

PubMed Central

One of the best-studied examples of host-virus coevolution is the release of myxoma virus (MV) for biological control of European rabbits in Australia and Europe. To investigate the genetic basis of MV adaptation to its new host, we sequenced the genome of 6918, an attenuated Spanish field strain, and compared it with that of Lausanne, the strain originally released in Europe in 1952. Although isolated 43 years apart, the genomes were highly conserved (99.95% identical). Only 32 of the 159 MV predicted proteins revealed amino acid changes. Four genes (M009L, M036L, M135R, and M148R) in 6918 were disrupted by frameshift mutations.

Morales, Monica; Ramirez, Miguel A.; Cano, Maria J.; Parraga, Mario; Castilla, Joaquin; Perez-Ordoyo, Luis I.; Torres, Juan M.; Barcena, Juan

2009-01-01

420

Atrial Fibrillation in Congestive Heart Failure  

PubMed Central

Synopsis Atrial fibrillation and congestive heart failure are morbid conditions that share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two identifies individuals at increased risk for mortality. Recent data have emerged which help elucidate the complex genetic and non-genetic pathophysiological mechanisms that contribute to the development of atrial fibrillation in individuals with congestive heart failure. Clinical trial results offer insights into the noninvasive prevention and management of these conditions, though the emergence of newer technologies, such as catheter ablation for atrial fibrillation, have yet to be studied extensively in patients with congestive heart failure.

Lubitz, Steven A.; Benjamin, Emelia J.; Ellinor, Patrick T.

2010-01-01

421

ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT).  

PubMed

Asymptomatic atrial fibrillation (AF) is common and may have the same prognostic implications as symptomatic AF. Among patients receiving dual-chamber pacemakers, it is now possible to quantify asymptomatic AF accurately. Most of these episodes are of short duration, often lasting only seconds to minutes and are called atrial high-rate episodes (AHRE) to distinguish them from the longer episodes of overt AF. To understand properly the clinical importance of asymptomatic AF, a large study of pacemaker patients without clinically overt AF is required. ASSERT is a multicenter, cohort follow-up, and single-blinded randomized trial in elderly hypertensive patients with a pacemaker recently implanted for sinus or atrioventricular node disease. The goals of this trial are to evaluate whether the detection of AHRE with pacemaker telemetry predicts an increased risk of stroke and other vascular events and to evaluate if atrial overdrive pacing reduces symptomatic AF. ASSERT is evaluating the hypothesis that among pacemaker patients without a previous history of AF, detection of AHRE predicts an increased risk of stroke and systemic embolism. The second hypothesis to be tested is that overdrive atrial pacing will reduce the risk of symptomatic AF in pacemaker patients without a previous history of AF. Finally, a 400-patient substudy will use the noninvasive testing capabilities of the patients' pacemaker to evaluate changes in atrial electrophysiology over 2 years. This substudy will determine if atrial electrical remodeling is detectable in pacemaker patients and if it is associated with the development of AF. PMID:16923410

Hohnloser, Stefan H; Capucci, Alessandro; Fain, Eric; Gold, Michael R; van Gelder, Isabelle C; Healey, Jeff; Israel, Carsten W; Lau, Chu P; Morillo, Carlos; Connolly, Stuart J

2006-09-01

422

Selective purging of human multiple myeloma cells from autologous stem cell transplant grafts using oncolytic myxoma virus  

PubMed Central

Autologous stem cell transplantation (ASCT) and novel therapies have improved overall survival of patients with multiple myeloma; however, most patients relapse and eventually succumb to their disease. Evidence indicates that residual cancer cells contaminate autologous grafts and may contribute to early relapses after ASCT. Here, we demonstrate that ex vivo treatment with an oncolytic poxvirus called myxoma virus results in specific elimination of human myeloma cells by inducing rapid cellular apoptosis while fully sparing normal hematopoietic stem and progenitor cells (HSPCs). The specificity of this elimination is based on strong binding of the virus to myeloma cells coupled with an inability of the virus to bind or infect CD34+ HSPCs. These two features allow myxoma to readily identify and distinguish even low levels of myeloma cells in complex mixtures. This ex vivo MYXV treatment also effectively inhibits systemic in vivo engraftment of human myeloma cells into immunodeficient mice and results in efficient elimination of primary CD138+ myeloma cells contaminating patient hematopoietic cell products. We conclude that ex vivo myxoma treatment represents a safe and effective method to selectively eliminate myeloma cells from hematopoietic autografts prior to reinfusion.

Bartee, Eric; Chan, Winnie S.; Moreb, Jan S.; Cogle, Christopher R.; McFadden, Grant

2012-01-01

423

[No Hodgkin Linfoma diagnosis with intra-atrial infiltration].  

PubMed

Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission. PMID:23248972

Alcocer Gamba, Marco Antonio; León González, Salvador; Castro Montes, Eliodoro; Loarca Piña, Luis Martín; Lugo Gavidia, Leslie Marisol; García Hernández, Enrique; González Galindo, Ulises; Paredes Serrano, Miguel Isaías

2012-09-01

424

Odontogenic tumours in Istanbul: 527 cases  

Microsoft Academic Search

We retrieved and analysed the records of 527 odontogenic tumours from a total of 62,565 cases in the department of tumour pathology in the Institute of Oncology, University of Istanbul, from 1971 to 2003. Of these 527 tumours, 521 were benign and 6 were malignant. The most common lesions were ameloblastomas (n=133) followed by odontomas (n=109), odontogenic myxomas (n=83) and

V. Olgac; B. G. Koseoglu; N. Aksakall?

2006-01-01

425

Cardiac Cycle Dependent Left Atrial Dynamics: Implications for Catheter Ablation of Atrial Fibrillation  

PubMed Central

Background Left atrial volume (LAV) determines prognosis and response to therapy in atrial fibrillation. Integration of electro-anatomical maps with 3D-images rendered from CT and MRI is used to facilitate atrial fibrillation ablation. Objectives We measured LAV changes and regional motion during the cardiac cycle that might affect the accuracy of image integration and determined their relationship to standard LAV measurements. Methods MRI was performed in thirty patients with paroxysmal atrial fibrillation. Left atrial time-volume curves were generated and used to divide the left atrial function (LAEF) into pumping (PEF) and conduit (CEF) fractions and to determine the maximum LAV (LAMAX) and the pre-atrial contraction volume (PACV). LAV was measured using an MRI angiogram and traditional geometric models from echocardiography (area-length and ellipsoid). The in-plane displacement of the pulmonary veins, anterior left atrium, mitral annulus, and left atrial appendage was measured. Results LAMAX was 107±36ml and occurred at 42±5% of the RR interval. PACV was 86 ±34ml and occurred at 81±4% of the RR interval. LAEF was 45±10% and PEF was 31±10%. LAV measurements made from the MRI angiogram, area-length and ellipsoid models underestimated LAMAX by 21±25ml, 16±26ml, and 35±22ml, respectively. The anterior LA, mitral annulus, and left atrial appendage were significantly displaced during the cardiac cycle (8.8±2.0mm, 13.2±3.8mm, and 10.2±3.4mm, respectively); the pulmonary veins were not. Conclusions LAV changes significantly during the cardiac cycle and substantial regional variation in left atrial motion exists. Standard measurements of left atrial volume significantly underestimate LAMAX when compared to the gold standard measure of 3D-volumetrics.

Patel, Amit R.; Fatemi, Omid; Norton, Patrick T.; West, J. Jason; Helms, Adam S.; Kramer, Christopher M.; Ferguson, John D.

2008-01-01

426

Atrial fibrillation, sleep apnea and obesity  

Microsoft Academic Search

Background A 60-year-old male with obesity (body-mass index 43 kg\\/m2) presented with recurrent symptomatic atrial fibrillation (AF), which he had had since age 41 years. The AF was refractory to treatment with antiarrhythmic drugs. Pacemaker implantation for tachycardia–bradycardia syndrome was required as well as ablation for atrial flutter, and the patient underwent a total of four DC cardioversions. Sleep studies

Nancy Foldvary-Schaefer; Virend K Somers; Paul A Friedman; Paul J Wang; Mina K Chung

2004-01-01

427

Echocardiographic pattern of right atrial tumour motion.  

PubMed Central

Propagation of Wilm's tumour to the right atrium was diagnosed by echocardiography. The tumour prolapsed into the right ventricle during each atrial systole. The presence of the tumour and its motion were confirmed by cardiac catheterization, cineangiography, and surgical exploration. Successful resection of the tumour was accomplished. Echocardiography was helpful in detecting the presence of the right atrial tumour and accurately reflected the pattern of its atrioventricular motion. Images

Farooki, Z Q; Green, E W; Arciniegas, E

1976-01-01

428

[Evidence-based treatment of atrial fibrillation].  

PubMed

Radiofrequency catheter ablation has emerged as a curative therapy for paroxysmal atrial fibrillation based on studies demonstrating the role of triggering foci in the pulmonary veins for the initiation of atrial fibrillation. Catheter ablation is performed by a trans-septal approach using radiofrequency energy at the ostium of each pulmonary vein. Mapping is guided by special catheters. Sequential radiofrequency applications eliminates or dissociates pulmonary vein muscle activity. Although complications exists, this procedure can be curative for these patients. PMID:17017102

Máquez, Manlio F; Gómez Flores, Jorge

429

Arterial embolism in thyrotoxicosis with atrial fibrillation.  

PubMed Central

In 262 patients with thyrotoxicosis and atrial fibrillation there were 26 episodes of arterial embolism (17 cerebral and nine elsewhere) in 21 patients. Twelve incidents occurred with active thyrotoxicosis, three on reversion to sinus rhythm, and 11 after the patients were euthyroid. This important complication is more common than is realised, and most patients should be put on prophylactic anticoagulants when first seen with atrial fibrillation.

Staffurth, J S; Gibberd, M C; Fui, S N

1977-01-01

430

Adjuvant therapy for atrial fibrillation.  

PubMed

Atrial fibrillation (AF) is the most common heart rhythm disorder, with increasing prevalence in the aging US population and affecting more than 2.3 million people. Current approaches for managing AF are rate- or rhythm-control strategies, both using anti-thrombotic therapy to prevent thromboembolism. While great advances have been made in understanding the pathophysiology of AF, few new strategies have shown promise in prevention or treatment of AF. Recent data suggest that non-antiarrhythmic medication may be useful in modifying the substrate that allows AF precipitation and perpetuation. This article reviews the data on the role of these agents in the prevention and management of AF as an adjunct to standard therapy. PMID:20014988

Mohammed, Khaja S; Kowey, Peter R; Musco, Simone

2010-01-01

431

Spontaneous onset of atrial fibrillation  

NASA Astrophysics Data System (ADS)

Most commonly, atrial fibrillation is triggered by rapid bursts of electrical impulses originating in the myocardial sleeves of pulmonary veins (PVs). However, the nature of such bursts remains poorly understood. Here, we propose a mechanism of bursting consistent with the extensive empirical information about the electrophysiology of the PVs. The mechanism is essentially non-local and involves the spontaneous initiation of non-sustained spiral waves in the distal end of the muscle sleeves of the PVs. It reproduces the experimentally observed dynamics of the bursts, including their frequency, their intermittent character, and the unusual shape of the electrical signals in the pulmonary veins that are reminiscent of so-called early afterdepolarizations (EADs).

Zemlin, Christian W.; Mitrea, Bogdan G.; Pertsov, Arkady M.

2009-06-01

432

Drug therapy for atrial fibrillation.  

PubMed

Although the maintenance of sinus rhythm would be the ideal scenario for patients with atrial fibrillation (AF), recent randomised trials have questioned the value of this approach. A careful interpretation of their results showed the limited efficacy of currently available antiarrhythmic drugs in maintaining sinus rhythm, as well as their potentially serious side effects. Therefore, it is imperative to develop safer and more effective drugs for AF. Based on our improved understanding of the pathophysiology of AF and the mechanism of action of antiarrhythmic drugs, significant efforts are being made to develop new antiarrhythmic agents that would prevent electrophysiological remodelling, would be selective for the atria and, therefore, would not prolong ventricular repolarisation, thus lacking any proarrhythmic effect. PMID:16732699

Vardas, Panos E; Kallergis, Eleftherios M

2006-06-01

433

The Net Clinical Benefit of Warfarin Anticoagulation in Atrial Fibrillation  

PubMed Central

Background Guidelines recommend warfarin use in patients with atrial fibrillation solely on the basis of risk for ischemic stroke without antithrombotic therapy. These guidelines rely on ischemic stroke rates observed in older trials and do not explicitly account for increased risk for hemorrhage. Objective To quantify the net clinical benefit of warfarin therapy in a cohort of patients with atrial fibrillation. Design Mixed retrospective and prospective cohort study of patients with atrial fibrillation between 1996 and 2003. Setting An integrated health care delivery system. Patients 13559 adults with nonvalvular atrial fibrillation. Measurements Warfarin exposure, patient characteristics, and outcome events were ascertained from health plan records and databases. Outcome events were validated by formal physician review. Net clinical benefit was defined as the annual rate of (ischemic strokes and systemic emboli prevented by warfarin) minus (intracranial hemorrhages attributable to warfarin multiplied by an impact weight). For the base case, the impact weight was 1.5, reflecting the greater clinical impact of intracranial hemorrhage versus thromboembolism. Results Patients accumulated more than 66000 person-years of follow-up. The adjusted net clinical benefit of warfarin for the cohort overall was 0.68% per year (95% CI, 0.34% to 0.87%). Adjusted net clinical benefit was greatest for patients with a history of ischemic stroke (2.48% per year [CI, 0.75% to 4.22%]) and for those 85 years or older (2.34% per year [CI, 1.29% to 3.30%]). The net clinical benefit of warfarin increased from essentially zero in CHADS2 (congestive heart failure/hypertension/age/diabetes/prior stroke2) stroke risk categories 0 and 1, to 2.22% per year (CI, 0.58% to 3.75%) in CHADS2 categories 4 to 6. The patterns of results were preserved using weighting factors for intracranial hemorrhage of 1.0 and 2.0. Limitations Residual confounding is a possibility. Some outcome events were probably missed by the screening algorithm or when medical records were unavailable. Conclusion Expected net clinical benefit of warfarin therapy is highest among patients with the highest untreated risk for stroke, which includes the oldest age category. Risk assessment that incorporates both risk for thromboembolism and risk for intracranial hemorrhage provides a more quantitatively informed basis for the decision on antithrombotic therapy in patients with atrial fibrillation. Primary Funding Source National Institute on Aging; National Heart, Lung, and Blood Institute; and Massachusetts General Hospital.

Singer, Daniel E.; Chang, Yuchiao; Fang, Margaret C.; Borowsky, Leila H.; Pomernacki, Niela K.; Udaltsova, Natalia; Go, Alan S.

2009-01-01

434

Electrocardiographic artefacts mimicking atrial tachycardia resulted in unnecessary diagnostic and therapeutic measures.  

PubMed

Electrocardiographic (ECG) artefacts may closely simulate both supraventricular and ventricular tachycardias. We describe a case initially diagnosed as rapid atrial fibrillation, based on 12-lead surface ECG (especially the limb leads) and monitor tracing. The arrhythmia was resistant to beta blockers. Because of the at times apparently regular rhythm, an esophageal ECG recording was performed, and adenosine was administered. When the presumed atrial fibrillation terminated after sodium pentothal was administered while preparing for electrical cardioversion, the oesophageal ECG recordings and the ECGs during adenosine administration were reviewed. An ECG artefact diagnosis was suspected, and then confirmed, during relapse of the "arrhythmia," with simple palpation of the radial pulse and cardiac auscultation. PMID:23526333

Y-Hassan, Shams; Sylvén, Christer

2013-02-27

435

Intracardiac echocardiography (ICE)--guided biopsy of a right atrial mass.  

PubMed

Although performing a biopsy of the right ventricular septum is a routine procedure in many cardiac catheterization laboratories, the ability to direct a bioptome to a mass within the right or left side of the heart is extremely difficult with fluoroscopic or echocardiographic guidance. The first intracardiac echo (ICE) was performed in the early 1970s. Since that time, the use of ICE in the cardiac catheterization laboratory has aided in transseptal puncture, ablation of cardiac arrhythmias, mitral valvuloplasty, and the closure of atrial septal defects and patent foramen ovale. This case report describes the use of ICE to facilitate intracardiac biopsy of a right atrial mass. PMID:21562362

Poommipanit, Paul; Tobis, Jonathan

2011-05-01

436

Delayed pericarditis associated with an implantable cardioverter defibrillator implantation using an active-fixation atrial lead.  

PubMed

A 57-year-old man with nonischemic dilated cardiomyopathy and ventricular tachycardia underwent routine dual chamber implantable cardioverter defibrillator (ICD) implantation. An active-fixation atrial lead was positioned at the lateral wall of the right atrium. He subsequently developed chronic severe pericarditis. Histopathological findings of the pericardium showed mechanical stimulus localized pericarditis. This case demonstrates that contact of the screw of the active-fixation atrial lead with the pericardium may be a possible mechanism for pericarditis after pacemaker/ICD implantation. PMID:18439181

Kono, Koichi; Todoroki, Masakatsu; Karasawa, Tsuyoshi; Ito, Itaru; Tadokoro, Kazuyoshi; Shinbo, Goro; Horinaka, Shigeo; Matsuoka, Hiroaki; Mochizuki, Yoshihiko

2008-05-01

437

Paroxysmal Atrial Fibrillation Triggered By A Monomorphic Ventricular Couplet In A Patient With Acute Coronary Syndrome  

PubMed Central

Atrial fibrillation is a common arrhythmia in patients suffering from acute myocardial infarction, however its pathophysiological mechanisms are not fully understood. We describe the unusual case of a 76-year old woman admitted for non-ST-segment elevation myocardial infarction, who developed multiple episodes of paroxysmal atrial fibrillation triggered by monomorphic ventricular couplets. Beta-blocking and amiodarone therapy resulted efficacious in preventing arrhythmic recurrences. We then discuss the possible arrhythmogenic mechanisms, with special emphasis on the unique electrophysiological, hemodynamic, cellular and anatomical milieu created by acute myocardial ischemia.

De Mattia, Luca; Brieda, Marco; Dametto, Ermanno; Del Bianco, Federica; Nicolosi, Gian Luigi

2012-01-01

438

Infected Right Atrial Thrombus after Explantation of a Left Ventricular Assist Device  

PubMed Central

Finding the source of a fungal infection and selecting the most appropriate treatment for candidemia is often challenging for physicians, especially when the patient has a complex medical history. We describe the case of a 48-year-old woman who had persistent candidemia after undergoing explantation of a left ventricular assist device. The source of the infection was found to be a right atrial thrombus. The mass was removed, and the patient underwent aggressive treatment with micafungin. Removal of the right atrial mass, followed by potent antifungal treatment, resulted in a successful recovery.

Akay, Mehmet H.; Sirlak, Mustafa; Gregoric, Igor D.; Frazier, O. H.

2012-01-01

439

Effects of disopyramide on the atrial fibrillation threshold in the human atrium  

Microsoft Academic Search

The effects of disopyramide on the atrial fibrillation threshold (AFT) in the human atrium were investigated. To evaluate atrial vulnerability, the following electrophysiologic parameters were measured before and after the administration of disopyramide (2 mg\\/kg) in 12 patients with paroxysmal atrial fibrillation: The right atrial effective refractory period (ERP) and percentage maximum atrial fragmentation (%MAF) were measured by atrial premature

Kazuya Ishibashi; Daisuke Inoue; Ryuta Sakai; Miho Inoue; Takeshi Shirayama; Jun Asayama; Masao Nakagawa

1995-01-01

440

Likelihood of Brugada ECG pattern confirmed after propafenone administration for atrial fibrillation cardioversion.  

PubMed

It has been reported that Brugada syndrome is responsible for about half of the sudden cardiac death events with no evidence of structural heart disease. We report a case of hidden ECG Brugada pattern, revealed after oral propafenone administration in the setting of pharmaceutical atrial fibrillation cardioversion. PMID:21744716

Dragios, Theodore D; Manolis, Athanasios G; Kyriakides, Zenon S

2011-06-01

441

Emergent Surgical Intervention for Embolization of Atrial Septal Defect Closure Device  

PubMed Central

The percutaneous transcatheter closure of secundum atrial septal defect has recently become an increasingly widespread alternative to surgical closure in many centers. Although immediate, short, and intermediate term results of percutaneous transcatheter septal closure are promising, the procedure is not free from inherent complications that could be lethal. We report a case of device embolization necessitating emergent surgical retrieval.

Kim, Hyuck; Kim, Sung Jin; Kang, Jeong Ho; Chung, Won-Sang; Shin, Jin-Ho; Lim, Young-Hyo

2012-01-01

442

Cryptogenic stroke in a boy with atrial septal defect and hyperhomocysteinemia.  

PubMed

In children, clinical recognition of stroke and determination of its exact etiology are extremely difficult. The authors described a case of cryptogenic stroke in a 14-year-old-boy with asymptomatic atrial septal defect and hypercoagulable state. Paradoxical embolism was hypothesized as the responsible etiopathological mechanism. It is crucial to increase clinician awareness of stroke in children. PMID:18474934

Indolfi, Giuseppe; Bartolini, Elisa; Trapani, Sandra; Azzari, Chiara; Resti, Massimo

2008-05-12

443

Amplatzer Closure of Atrial Septal Defect and da Vinci Robot-Assisted Repair of Vascular Ring  

Microsoft Academic Search

Technology for minimally invasive approaches to congenital heart disease is a rapidly evolving field. This case report reviews a novel approach to combining two of the newer technologies available to treat a pediatric patient with an atrial septal defect (ASD) and a vascular ring. This report is the first to describe the use of the da Vinci surgical system to

R. G. Ohye; E. J. Devaney; J. Graziano; A. Ludomirsky

2004-01-01

444

Hyperthyroidism with periodic paralysis, acropachy, pre-tibial myxoedema, transient atrial fibrillation and myopathy  

PubMed Central

A case of thyrotoxicosis presenting with periodic paralysis and later complicated by acropachy, pretibial myxoedema and transient atrial fibrillation is described. This association has not been reported previously. Possible aetiological links are discussed. ImagesFig. 1Fig. 2Fig. 3Fig. 4

Guan, R.; Cheah, J. S.

1982-01-01

445

Delayed left ventricle-to-right atrial fistula following aortic valve replacement.  

PubMed

Fistula development between the left ventricular outflow tract and right atrium is a rare complication of aortic valve replacement (AVR), typically seen with calcific aortic stenosis or endocarditis. The case is reported of a left ventricle-to-right atrial fistula following mechanical AVR for aortic insufficiency. PMID:22808839

Anderson, Curtis A; Rodriguez, Evelio; Kypson, Alan P

2012-05-01

446

Right atrial bypass grafting for central venous obstruction associated with dialysis access: Another treatment option  

Microsoft Academic Search

Purpose: Central venous obstruction is a common problem in patients with chronic renal failure who undergo maintenance hemodialysis. We studied the use of right atrial bypass grafting in nine cases of central venous obstruction associated with upper extremity venous hypertension. To better understand the options for managing this condition, we discuss the roles of surgery and percutaneous transluminal angioplasty with

Rafik A. El-Sabrout; J. Michael Duncan

1999-01-01

447

Catheter ablation of persistent atrial fibrillation in a patient with dextrocardia.  

PubMed

Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side. Ablation of atrial fibrillation (AF) with such an inverted anatomy may be challenging for the manipulation of the catheters. Here we report a case of dextrocardia who underwent ablation for persistent AF guided by image integration system. PMID:22800910

Xue, Zeng-Ming; Sang, Cai-Hua; Dong, Jian-Zeng; Ma, Chang-Sheng

2012-05-01

448

Total anomalous pulmonary venous return with intact atrial septum and associated mitral stenosis  

Microsoft Academic Search

Total anomalous pulmonary venous return with an intact atrial septum is an uncommon lesion. With associated mitral stenosis each lung has a different pulmonary flow, individual vascular resistance, and function. This represents the first reported case of this anomaly treated by total correction and mitral valve replacement. Pulmonary flow reverted to normal distribution and heart size decreased, with a reversion

Walter G. Wolfe; Paul A. Ebert

1970-01-01

449

Isolated atrial fibrillation (IAF) after local anaesthesia with epinephrine in an anxious dental patient  

Microsoft Academic Search

Cardiac arrhythmias are not uncommon in dental practice, depending on many factors, including patient features, dental treatment and drugs administered. We describe a case of isolated atrial fibrillation (IAF) developed, in a young patient, soon after a supraperiosteal injection. The patient was admitted to hospital and recovered spontaneously. Since stress is a possible cause of IAF, this may has been