Successful surgical treatment of atrial fibrillation: review and clinical update

Article Abstract:

Atrial fibrillation, the most common form of sustained abnormal heart rhythms, involves a rapid and random heart rhythm originating in an upper chamber of the heart. This type of arrhythmia occurs in about 10 percent of persons over 60 years of age. Most patients adapt to the changes caused by atrial fibrillation, but often an abnormal blood clot (thromboembolism) may develop because of changes in blood flow, causing a heart attack or a stroke. Drug therapy sometimes helps, but when it does not, surgery is tried. Of the several types of surgical treatment of atrial fibrillation developed, none have proven adequate for eliminating the condition. New imaging techniques have made ''mapping'' of an organ during surgery possible, and a study was undertaken to apply this technology to the identification of areas of abnormal electrical conductivity in the heart, which could then be by-passed by surgical incisions. Twenty-two patients underwent surgery using a new technique, the maze procedure, for atrial fibrillation. Eight (36 percent) of the patients developed complications during the month following surgery, including arrhythmias in all eight, postoperative bleeding in three patients, and stroke, pneumonia, lupus (an autoimmune disease), and cholestasis (interruption of the bile flow in the liver system) in one patient each. However, the complications were successfully treated and there were no deaths. Nine patients have required the insertion of pacemakers, and the procedure damaged the sinoatrial node (SAN) in two patients. The new surgical procedure treated fibrillation successfully in all 22 patients, and allowed treatment with a single drug to control atrial flutter (rapid beats of the upper chambers of the heart) in 14 percent of the patients. It restored normal rhythm in 77 percent of patients, while in the rest, a pacemaker was required. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Heart, Electrophysiology, Heart surgery

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Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III study

Article Abstract:

Certain conditions can identify people with atrial fibrillation who have a low risk of stroke. Atrial fibrillation is a very fast heartbeat that can cause blood clots to travel to the brain, causing a stroke. Researchers followed 892 people with atrial fibrillation who were taking aspirin to determine the number who would have a stroke. The rate of stroke in these patients was 2% per year and the rate of disabling stroke was only 0.8%. These patients had no history of heart failure or severe hypertension.

Health aspects, Complications and side effects, Stroke (Disease), Stroke, Aspirin

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Sodium channel mutations and susceptibility to heart failure and atrial fibrillation

Article Abstract:

A novel gene for dilated cardiomyopathy (DCM) at a previously mapped locus is identified and the spectrum of mutations in the gene within a DCM cohort is defined. Further, the frequency of DCM among relatives inheriting a mutation in this gene is also determined.

Science & research, Mutation (Biology), Mutation, Heart failure, Sodium channels

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