Background: Atrial fibrillation (AF) often progresses to more sustained forms and increases the risk of ischemic stroke or sinus node dysfunction. However, there have been no data on the clinical outcomes of patients who developed AF during head-up tilt testing (HUT).
Objective: The purpose of this study was to evaluate the clinical significance of AF detected during HUT performed for syncope evaluation.
Methods: We analyzed incidence, short- and long-term prognosis, and predictors of adverse outcomes of AF detected during HUT, which was performed in 6780 consecutive patients without AF history.
Results: Of the 6780 patients, 52 (0.8%) developed AF during passive tilting (n = 5), isoproterenol infusion (n = 32), and recovery phase (n = 15) of HUT, respectively. There was no short-term adverse event: spontaneous sinus conversion occurred in 43 patients (83%) within 48 hours. Over a median follow-up of 34.8 months, 24 patients (46%) had AF recurrence with initial presentation as ischemic stroke (n = 2), sinus node dysfunction requiring pacemaker (n = 10), and AF alone (n = 12). In addition, 19 of 24 recurred AF cases (79.2%) progressed to persistent/permanent forms. The index AF duration was identified as an independent predictor of AF recurrence. Patients with longer AF duration (≥1.0 hour) showed worse prognosis than did those with shorter AF duration (<1.0 hour).
Conclusion: The incidence of AF during HUT was ∼0.8%, and short-term prognosis was favorable. However, about half of the cases were complicated by long-term adverse outcomes. Therefore, regular follow-up might be warranted for patients with HUT-induced AF, particularly when AF duration is long.
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http://dx.doi.org/10.1016/j.hrthm.2018.11.030 | DOI Listing |
J Invasive Cardiol
January 2025
Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
JAMA Netw Open
January 2025
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Importance: The integration of patient-reported outcome (PRO) assessments in cardiovascular care has encountered considerable obstacles despite their established clinical relevance.
Objective: To assess the impact of a physician- and patient-friendly electronic PRO (ePRO) monitoring system on the quality of cardiovascular care in clinical practice.
Design, Setting, And Participants: This open-label, multicenter, pilot randomized clinical trial was phase 2 of a multiphase study that was conducted from October 2022 to October 2023 and focused on the implementation and evaluation of an ePRO monitoring system in outpatient clinics in Japan.
Physiol Res
December 2024
Children's Heart Center, Second Faculty of Medicine, Charles University and Motol University Hospital, Praha, Czech Republic.
Although the heart atria have a lesser functional importance than the ventricles, atria play an important role in the pathophysiology of heart failure and supraventricular arrhythmias, particularly atrial fibrillation. In addition, knowledge of atrial morphology recently became more relevant as cardiac electrophysiology and interventional procedures in the atria gained an increasingly significant role in the clinical management of patients with heart disease. The atrial chambers are thin-walled, and several vessels enter at the level of the atria.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK.
Cureus
December 2024
Internal Medicine, Hurley Medical Center, Flint, USA.
Catheter ablation procedure for symptomatic atrial fibrillation is an established treatment. Cardiac tamponade is one of the several complications associated with atrial fibrillation ablation. We present the case of a 60-year-old male with a past medical history of end-stage renal disease (ESRD) on hemodialysis, hypotension on midodrine, atrial fibrillation status post-ablation a week prior, and a cerebrovascular accident who presented to the emergency department with complaints of weakness, nausea, vomiting, confusion and some syncopal episodes for the past few days.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!