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Spontaneous Conversion (spontaneous + conversion)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

IMAGE SECTION: Stunning of Left Atrial Appendage after Spontaneous Conversion of Atrial Fibrillation

ECHOCARDIOGRAPHY, Issue 3 2008
Mikko Savontaus M.D.
No abstract is available for this article. [source]

A Short-Term, Randomized, Double-Blind, Parallel-Group Study to Evaluate the Efficacy and Safety of Dronedarone versus Amiodarone in Patients with Persistent Atrial Fibrillation: The DIONYSOS Study

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2010
JEAN-YVES LE HEUZEY M.D.
Dronedarone versus Amiodarone in Patients with AF.,,Introduction: We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF). Methods: Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at least 6 months. Primary composite endpoint was recurrence of AF (including unsuccessful electrical cardioversion, no spontaneous conversion and no electrical cardioversion) or premature study discontinuation. Main safety endpoint (MSE) was occurrence of thyroid-, hepatic-, pulmonary-, neurologic-, skin-, eye-, or gastrointestinal-specific events, or premature study drug discontinuation following an adverse event. Results: Median treatment duration was 7 months. The primary composite endpoint was 75.1 and 58.8% with dronedarone and amiodarone, respectively, at 12 months (hazard ratio [HR] 1.59; 95% confidence interval [CI] 1.28,1.98; P < 0.0001), mainly driven by AF recurrence with dronedarone compared with amiodarone (63.5 vs 42.0%). AF recurrence after successful cardioversion was 36.5 and 24.3% with dronedarone and amiodarone, respectively. Premature drug discontinuation tended to be less frequent with dronedarone (10.4 vs 13.3%). MSE was 39.3 and 44.5% with dronedarone and amiodarone, respectively, at 12 months (HR = 0.80; 95% CI 0.60,1.07; P = 0.129), and mainly driven by fewer thyroid, neurologic, skin, and ocular events in the dronedarone group. Conclusion: In this short-term study, dronedarone was less effective than amiodarone in decreasing AF recurrence, but had a better safety profile, specifically with regard to thyroid and neurologic events and a lack of interaction with oral anticoagulants. (J Cardiovasc Electrophysiol, Vol. 21, pp. 597-605, June 2010) [source]

Electrophysiological Differences of the Spontaneous Onset of Paroxysmal and Persistent Atrial Fibrillation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2007
STEFAN WEBER M.D.
Background: Information about the spatiotemporal organization of atrial activity at the onset of atrial fibrillation (AF) is still limited. Methods: AF mapping was performed in 30 patients with AF (mean age 53 ± 9 years, 26 males) by deploying a noncontact mapping balloon in the left atrium (LA). Twenty-four patients had paroxysmal AF and six patients had persistent AF. Three types of AF episodes were analyzed: nonsustained AF (lasting , 30 seconds), sustained AF (lasting > 30 seconds, with spontaneous conversion or requiring internal cardioversion and subsequent stable sinus rhythm), and persistent AF episodes (stable sinus rhythm lasting , 1 minute after cardioversion). Results: A total of 101 spontaneous AF onset episodes were analyzed. Analysis of AF onset showed that there was a progressive shortening of the initial cycle lengths from nonsustained episodes to sustained episodes and to persistent AF episodes. There was an earlier and more rapid reduction in the cycle lengths from persistent episodes to sustained episodes and to nonsustained episodes of AF (P < 0.05 for persistent vs sustained and for sustained vs nonsustained episodes). The development of multiwavelet activity and disorganization of conduction occurred earlier in persistent and sustained episodes than in nonsustained AF episodes. LA size was greater in patients with persistent AF episodes compared with patients with sustained or nonsustained AF episodes. Conclusions: Electrophysiological events that develop at the onset of AF seem to be different in different types of AF. A more rapid degeneration into the fibrillatory activity was observed in persistent and sustained AF than in nonsustained AF episodes. [source]

Atrial Lead Placement During Atrial Fibrillation.

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 7 2000
Is Restitution of Sinus Rhythm Required for Proper Lead Function?
Unexpected atrial fibrillation (AF) during implantation of an atrial pacemaker lead is sometimes encountered. Infra-operative cardioversion may lengthen and complicate the implantation process. This study prospectively investigates the performance of atrial leads implanted during AF (group A) and compares atrial sensing and pacing properties to an age- and sex-matched control group in which sinus rhythm had been restored before atrial lead placement (group B). Patient groups consisted of 32 patients each. All patients received DDDE pacemakers and bipolar, steroid-elating, active fixation atrial leads. In patients with AF at the time of implantation (group A), a minimal intracardiac fibrillatory amplitude of at least 1.0 mV was required for acceptable atrial lead placement. In patients with restored sinus rhythm (group B). a voltage threshold < 1.5 V at 0.5 ms and a minimal atrial potential amplitude > 1.5 mV was required. Patients of group A in whom spontaneous conversion to sinus rhythm did not occur within 4 weeks after implantation underwent electrical cardioversion to sinus rhythm. Pacemaker interrogations were performed 3, 6, and 12 months after implantation. In group A, implantation time was significantly shorter as compared to group B (58.7 ± 8.6 minutes vs 73.0 ± 17.3 minutes, P < 0.001). Mean atrial potential amplitude during AF was correlated with the telemetered atrial potential during sinus rhythm (r = 0.49, P < 0.001), but not with the atrial stimulation threshold. Twelve months after implantation, sensing thresholds (1.74 ± 0.52 mV vs 1.78 ± 0.69 mV, P = 0.98) and stimulation thresholds (1.09 ± 0.42 V vs 1.01 ± 0.31 V.P = 0.66) did not differ between groups A and B. However, in three, patients of group A, chronic atrial sensing threshold was , 1 mV requiring atria) sensitivities of at least 0.35 mV to achieve reliable atrial sensing. Atrial lead placement during AF is feasible and reduces implantation time. However, bipolar atrial leads and the option to program high atrial sensitivities are required. [source]