The outcomes of thyrotoxicosis related new-onset atrial fibrillation

INTRODUCTION: Although thyrotoxicosis (TT) is a common cause for atrial fibrillation (AF), the clinical outcomes of TT related new onset persistent AF remains unclear. METHODS AND RESULTS: Over 10-year period, 215 patients (pts) with TT with new onset-AF were studied. 15 pts with pre-existing heart diseases were excluded. Among 200 pts with TT related AF, their mean age was 64±17 years (41% male). At presentation, 14 pts (7%) had concomitant ischemic stroke (IS) and 77 pts (39%) developed congestive cardiac failure (CCF). Pts with IS had a higher prevalence of hypertension (HT) than those without IS (50 vs. 25%,p=0.04), but had no difference in age and sex (p>0.05). After mean follow-up of 45±37 months, 100 pts (50%) had spontaneous cardioversion (CV) at median time of 23 days. The median time to euthyroidism with anti-thyroid drug was 81 days. In univariate analysis, there were no significant differences in pts with or without CV with respect to age, male gender and diabetes (Table). However, pts without CV had a higher prevalence of HT and CCF at the time of presentation, lower usage of beta-blockers, larger left atrial (LA) and left ventricular (LV) size, and lower ejection fraction (EF) than those with CV (Table, P<0.05). Multivariate analysis demonstrated only LA is the independent predictor for CV (OR=3.9, P=0.01). CONCLUSION: TT related AF is related to high incidence of IS and CCF at presentation. After control of TT, spontaneous CV can occur in up to 50% pts. The sole independent predictors of CV is smaller LA.The American College of Cardiology 55th Annual Scientific Session, Atlanta, Ga, USA, 11-14 March 2006. In Journal of the American College of Cardiology, 2006, v. 47 n. 4 Suppl. 1, p. 10A, abstract no. 804-

Successful pulmonary vein isolation using transvenous catheter cryoablation improves quality-of-life in patients with atrial fibrillation

Background: Recent studies have demonstrated that transvenous catheter cryoablation is a safe and effective technique for creating pulmonary veins (PVs) electrical isolation for the treatment of atrial fibrillation (AF). However, the impacts of this procedure on quality-of-life (QoL) have not been evaluated. Methods and Results: We studied the effects of PV isolation using transvenous catheter cryoablation on QoL in 46 patients (34 men, mean age: 50 ± 12 years) with drug-refractory AF. QoL was assessed by Medical Outcomes Study Short Form-36 (SF-36) and Symptom Checklist at baseline and 3-month after cryoablation, and compared with those in a sex-age matched normal control. At 3-month follow-up, 24 of 46 patients (52%) had no recurrence of AF, including 11 patients who were not taking antiarrhythmic drugs. At baseline, patients with AF had significantly lower QoL scores in overall and in 5/8 subscales of SF-36 than the sex-age matched control group (P 0.05). The Symptom Checklist also showed significant reduction in both the symptoms frequency scores and symptoms severity scores at 3-month follow-up as compared with baseline (P < 0.05). Conclusions: Successful PV isolation using transvenous catheter cryoablation is associated with significant reduction in the frequency and severity of AF symptoms and improvement in the general QoL, reaching the levels of normal controls.link_to_subscribed_fulltex

Association between anti-thymocyte globulin administration and cytomegalic virus infection and/or CMV disease in cadaveric renal allograft recipients

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Improvement of sleep apnea in heart failure patients after cardiac resynchronization therapy is caused by relief of pulmonary congestion as reflected by a drop of pulmonary arterial pressure

link_to_OA_fulltext15th World Congress in Cardiac Electrophysiology and Cardiac Techniques - Cardiostim 2006, Nice –French Riviera, France, 14-17 June 2006. In Europace , 2006, v. 8 Supplement 1, p. 10/