Minimally Symptomatic Atrial Fibrillation Patients Derive Significant Symptom Relief Following Rate Control or Rhythm Control Therapy.

Background: It can be challenging to convince asymptomatic to minimally symptomatic patients to pursue treatment of their atrial fibrillation (AF). We hypothesized that once in sinus rhythm, asymptomatic to minimally symptomatic patients would realize they were compensating for moderate symptoms, and that we could quantify this via the Canadian Cardiovascular Society Severity of AF (CCS-SAF) score.

Methods: All patients in our study come from the Symptom Mitigation in Atrial Fibrillation (SMART) study.

Ablation of atrial tachycardia and atrial flutter in heart failure.

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.

"Stable" ventricular tachycardia is not a benign rhythm : insights from the antiarrhythmics versus implantable defibrillators (AVID) registry.

Background: Sustained ventricular tachycardia (VT) can be unstable, can be associated with serious symptoms, or can be stable and relatively free of symptoms. Patients with unstable VT are at high risk for sudden death and are best treated with an implantable defibrillator. The prognosis of patients with stable VT is controversial, and it is unknown whether implantable cardioverter-defibrillator therapy is beneficial.

Ventricular tachycardia as default diagnosis in broad complex tachycardia.

In the differential diagnosis of broad-complex tachycardia, the most important decision is whether or not the tachycardia is ventricular, since this type carries the worst prognosis. However, the rules for a diagnosis of ventricular tachycardia are so complex that they are not satisfied in many cases, and the default diagnosis, supraventricular tachycardia, is erroneously accepted. We sought to reverse this strategy; unless simple rules for a positive diagnosis of supraventricular tachycardia were satisfied, ventricular tachycardia was diagnosed by default.

Effect of carbohydrate rich versus fat rich loads on gas exchange and walking performance in patients with chronic obstructive lung disease.

Background: High calorie intakes, especially as carbohydrate, increase carbon dioxide production (VCO2) and may precipitate respiratory failure in patients with severe pulmonary disease. Energy obtained from fat results in less carbon dioxide and thus may permit a reduced level of alveolar ventilation for any given arterial blood carbon dioxide tension (PaCO2).

Methods: Ten patients with stable severe chronic obstructive lung disease underwent a six minute walk before and 45 minutes after taking 920 kcal of a fat rich drink, an isocalorific amount of a carbohydrate rich drink, and an equal volume of a non-calorific control liquid on three separate days, in a double blind randomised crossover study.