BACKGROUNDRecent observational studies have shown that patients with higher Killips score (>I) have higher risk of new-onset atrial fibrillation (NOAF) following acute myocardial infarction (AMI), while others drew a neutral conclusion. The ultimate predictive value of high Killips class on NOAF remained obscure.

METHODSPubMed, Web of Science, China National Knowledge Infrastructure, and the Cochrane Controlled Trials Register Databases were searched until February 2015. Of the 3732 initially identified studies, 5 observational studies with 10,053 patients were analyzed.

RESULTSThe meta-analysis of these studies showed that higher Killips score on admission was associated with higher incidence of NOAF following AMI (odds ratio = 2.29, 95% confidence interval 1.96-2.67, P < 0.00001), while no significant differences exist among individual trials (P = 0.14 and I2 = 43%).

CONCLUSIONSKillips class >I was associated with the higher opportunity of developing NOAF following AMI.

Atrial Fibrillation ; diagnosis ; etiology ; Humans ; Myocardial Infarction ; complications ; Risk Factors

Aged ; Atrial Fibrillation ; diagnosis ; physiopathology ; Embolism ; diagnosis ; etiology ; Humans ; Male ; Upper Extremity ; pathology

Ablation of persistent atrial fibrillation is still a challenge for the ablationist. Extensive ablation is required under some conditions and could lead to some unintended complications. Here we report a case of atrium-atrioventricular node block complicating multiple catheter ablation procedures for persistent atrial fibrillation. After extensive ablation, including circumferential pulmonary vein ablation, linear ablation at the left atrial roof, mitral isthmus, atrial septum, cavotricuspid isthmus, and complex fractionated atrial electrogram ablation, conduction obstacle was found, and sinus impulse could not travel from the right atrium, atrial septum and left atrium to atrioventricular node. The case indicated that intensive ablation at some key sites, especially the interatrial septum, should be careful during ablation of atrial fibrillation.
Aged ; Atrial Fibrillation ; therapy ; Atrioventricular Block ; diagnosis ; etiology ; Atrioventricular Node ; pathology ; Catheter Ablation ; adverse effects ; Humans ; Male

Acute Disease ; Atrial Fibrillation ; diagnosis ; etiology ; therapy ; Child ; Child, Preschool ; Electrocardiography ; Humans ; Infant ; Myocarditis ; complications ; virology ; Virus Diseases ; complications

Clinical factors such as tall stature, lean body mass, obstructive sleep apnea, alcohol or caffeine, smoking, endurance sports, and genetic factors are proposed as risk factors for lone atrial fibrillation (LAF). The KORAF (KORean Atrial Fibrillation) study is a retrospective multicenter registry that enrolled 3,570 consecutive atrial fibrillation (AF) patients. Data on risk factors were available for 2,133 patients, of whom 398 (18.7%) were identified as having LAF. In univariate analysis, patients with LAF were more likely to be men (82.4% vs 59.8%, P < 0.001) and current smokers (25.9% vs 15.6%, P < 0.01), alcohol drinkers (55.3% vs 31.2%, P < 0.01) and frequent consumers of caffeinated beverages (> 2 cups/day) (31.7% vs 19.3%, P < 0.01), and have a family history of AF (9.0% vs 2.6%, P < 0.001) than the non-LAF patients. Multivariate analysis showed that male gender (OR, 2.30; 95% CI, 1.61-3.27, P < 0.01), family history of AF (OR, 3.12; 95% CI, 1.91-5.12, P < 0.01), current alcohol use (OR, 2.01; 95% CI, 1.46-2.76, P < 0.01), and frequent caffeinated beverage consumption (OR, 1.66; 95% CI, 1.20-2.29, P < 0.01) were independently associated with LAF. In Korean patients, LAF is more closely associated with male gender, family history of AF, current alcohol and frequent caffeinated beverage consumption than non-LAF.
Aged ; Alcohol Drinking ; Atrial Fibrillation/*diagnosis/etiology ; Body Mass Index ; Caffeine ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Registries ; Retrospective Studies ; Risk Factors ; Sex Factors ; Smoking

OBJECTIVETo identify the clinical predictors of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).

METHODS322 consecutive patients who had undergone isolated CABG were reviewed. Preoperative, intraoperative and postoperative data were collected. Patients were grouped according to whether AF appeared postoperatively.

RESULTSAF occurred in 75 patients (23.3%). Most cases of AF (85.6%) appeared on or before the third postoperative day. The mean age for patients with AF was 62.5 years compared with 56.7 years for patients without AF (P < 0.05). The mean aortic crossclamp time for patients with AF was 67 min compared with 60.3 min for patients without AF (P < 0.05). The mean duration of cardiopulmonary bypass for patients with AF was 109.6 min compared with 97.3 min for patients without AF (P < 0.05). The mean duration of mechanical ventilation for patients with AF was 19.1 h compared with 15.7 h for patients without AF (P < 0.05). Multivariate logistic regression analysis was used to identify the following independent predictors of postoperative AF (P < 0.05): age > or = 65 years (OR 2.7; 95% CI 1.5 to 5.1), lesions in the right coronary artery (OR 2.5; 95% CI 1.4 to 4.5), and early postoperative withdrawal of beta blocker (OR 3.9; 95% CI 2.1 to 7.7).

CONCLUSIONSAF remains the most common complication after CABG. Age and lesions in the right coronary artery can influence the incidence of AF, and beta blocker and magnesium may be the most economical and effective prevention for AF early after CABG.

Adult ; Age Factors ; Aged ; Atrial Fibrillation ; diagnosis ; etiology ; Coronary Artery Bypass ; adverse effects ; Coronary Vessels ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Prognosis

PURPOSE: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown. MATERIALS AND METHODS: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography. RESULTS: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6+/-2.2 cm2 vs. 4.7+/-1.7 cm2, p<0.001), left superior PV (3.8+/-1.5 cm2 vs. 3.4+/-1.2 cm2, p=0.019), and inferior PV (2.3+/-1.0 cm2 vs. 1.8+/-0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03-1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41-2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13-1.50, p<0.001) were independent predictors of stroke. CONCLUSION: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.
Aged ; Atrial Appendage/physiopathology/*radiography ; Atrial Fibrillation/*complications/diagnosis/physiopathology ; Atrial Function, Right/*physiology ; Female ; Heart Atria ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/*methods ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prognosis ; Pulmonary Veins/physiopathology/*radiography ; Stroke/diagnosis/*etiology ; Tomography, X-Ray Computed/methods

No abstract available.
Aged, 80 and over ; Amiodarone/*adverse effects ; Anti-Arrhythmia Agents/*adverse effects ; Atrial Fibrillation/diagnosis/*drug therapy ; Drug-Induced Liver Injury/*etiology/radiography ; Female ; Humans ; Liver/*drug effects/radiography ; Predictive Value of Tests ; *Tomography, X-Ray Computed

This study aimed to assess the influence of lobectomy and pneumonectomy on cardiac rhythm and on the dimensions and function of the right-side of the heart. Twelve dogs undergoing lobectomy and eight dogs undergoing pneumonectomy were evaluated preoperatively and one month postoperatively with electrocardiography and Doppler echocardiography at rest. Pulmonary artery systolic pressure (PASP) was estimated by the tricuspid regurgitation jet (TRJ) via the pulse wave Doppler velocity method. Systemic inflammatory response syndrome criteria (SIRS) were also evaluated based on the clinical and hematological findings in response to lobectomy and pneumonectomy. Following lobectomy and pneumonectomy, we predominantly detected atrial fibrillation and varying degrees of atrioventricular block (AVB). Dogs that died within seven days of the lobectomy (n = 2) or pneumonectomy (n = 1) had complete AVB. Preoperative right atrial, right ventricular, and pulmonary artery dimensions increased gradually during the 30 days (p<0.05) following pneumonectomy, but did not undergo significant changes during that same period after lobectomy. Mean PASP was 56.0 +/- 4.5 mmHg in dogs having significant TRJ after pneumonectomy. Pneumonectomy, but not lobectomy, could lead to increases (p<0.01) in the SIRS score within the first day post-surgery. In brief, it is important to conduct pre- and postoperative cardiac evaluation of dogs undergoing lung resections because cardiac problems are a common postoperative complication after such surgeries. In particular, complete AVB should be considered a life-threatening complication after pneumonectomy and lobectomy. In addition, pneumonectomy appears to increase the likelihood of pulmonary hypertension development in dogs.
Animals ; Atrial Fibrillation/diagnosis/veterinary ; Atrioventricular Block/diagnosis/*veterinary ; Blood Pressure/physiology ; Dogs ; Echocardiography/veterinary ; Electrocardiography/veterinary ; Pneumonectomy/adverse effects/*veterinary ; Postoperative Care/methods/*veterinary ; Postoperative Complications/diagnosis/*veterinary ; Preoperative Care/methods/*veterinary ; Systemic Inflammatory Response Syndrome/diagnosis/etiology/veterinary ; Tricuspid Valve Insufficiency/diagnosis/etiology/veterinary

The clinical significance of prolonged PR interval has not been evaluated in patients with frequent premature atrial contractions (PACs). We investigated whether prolonged PR interval could predict new occurrence of atrial fibrillation (AF) in patients with frequent PACs. We retrospectively analyzed 684 patients with frequent PACs (> 100 PACs/day) who performed repeated 24-hour Holter monitoring. Prolonged PR interval was defined as longer than 200 msec. Among 684 patients, 626 patients had normal PR intervals (group A) and 58 patients had prolonged PR intervals (group B). After a mean follow-up of 59.3 months, 14 patients (24.1%) in group B developed AF compared to 50 patients (8.0%) in group A (P < 0.001). Cox regression analysis showed that prolonged PR interval (hazard ratio [HR], 1.950; 95% CI, 1.029-3.698; P = 0.041), age (HR, 1.033; 95% CI, 1.006-1.060; P = 0.015), and left atrial (LA) dimension (HR, 1.061; 95% CI, 1.012-1.112; P = 0.015) were associated with AF occurrence. Prolonged PR interval, advanced age, and enlarged LA dimension are independent risk factors of AF occurrence in patients with frequent PACs.
Adult ; Age Factors ; Aged ; Area Under Curve ; Atrial Fibrillation/*diagnosis/etiology/mortality ; Atrial Premature Complexes/complications/*diagnosis ; *Electrocardiography, Ambulatory ; Female ; Follow-Up Studies ; Heart/diagnostic imaging ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Risk Factors ; Sex Factors