Category Archives: Heart Rhythm

Determinants of Heart Rate Variability in the General Population: The Lifelines Cohort Study Determinants of Heart Rate Variability.

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Determinants of Heart Rate Variability in the General Population: The Lifelines Cohort Study Determinants of Heart Rate Variability.
Heart Rhythm. 2018 May 09;:
Authors: Tegegne BS, Man T, van Roon AM… Continue reading

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Progress towards the Prevention and Treatment of Atrial Fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, D.C., December 9-10, 2013.

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Tissue velocity imaging of the left atrium predicts response to flecainide in patients with acute atrial fibrillation.

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Tissue velocity imaging of the left atrium predicts response to flecainide in patients with acute atrial fibrillation.

Heart Rhythm. 2014 Mar;11(3):478-84

Authors: Limantoro I, De Vos CB, Delhaas T, Marcos E, Blaauw Y, Weijs B, Tieleman RG, Pisters R, Schotten U, Van Gelder IC, Crijns HJ

Abstract
BACKGROUND: Acute atrial fibrillation (AF) is often treated with the administration of intravenous flecainide; however, this treatment may not always be successful and is potentially hazardous. Previous studies suggest that electro-echocardiographic tissue velocity imaging (TVI) of the atrial wall may reflect atrial remodeling.
OBJECTIVE: To study whether atrial TVI can be used to identify nonresponders of flecainide administered intravenously in patients with acute AF.
METHODS: We used atrial TVI to measure atrial fibrillatory cycle length determined by using tissue velocity imaging (AFCL-TVI) and atrial fibrillatory wall motion velocity determined by using tissue velocity imaging (AFV-TVI) in the left atrium in 52 (55%) patients presenting with acute AF in the emergency department. These 2 parameters reflect electrical and structural remodeling, respectively. Standard baseline characteristics were recorded.
RESULTS: Patients were predominantly men (76%) and 64 ± 11 years old. Thirty-six (69%) patients had successful cardioversion after flecainide infusion. There were no significant differences in baseline characteristics between responders and nonresponders. Patients with a successful cardioversion had a longer mean AFCL-TVI and higher median (interquartile range) AFV-TVI compared with patients with failed cardioversion: 172 ± 29 ms vs 137 ± 35 ms (P < .001) and 4.2 (3.3-6.2) cm/s vs 2.3 (1.9-3.5) cm/s (P = .001).
CONCLUSIONS: Electro-echocardiographic atrial TVI measurement is a promising noninvasive tool for predicting outcome of pharmacological cardioversion. A short AFCL-TVI and a low AFV-TVI are related to failure of cardioversion of AF using flecainide.

PMID: 24321238 [PubMed – indexed for MEDLINE]

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Targeted sequencing in candidate genes for atrial fibrillation: the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study.

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Targeted sequencing in candidate genes for atrial fibrillation: the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study.

Heart Rhythm. 2014 Mar;11(3):452-7

Authors: Lin H, Sinner MF, Brody JA, Arking DE, Lunetta KL, Rienstra M, Lubitz SA, Magnani JW, Sotoodehnia N, McKnight B, McManus DD, Boerwinkle E, Psaty BM, Rotter JI, Bis JC, Gibbs RA, Muzny D, Kovar CL, Morrison AC, Gupta M, Folsom AR, Kääb S, Heckbert SR, Alonso A, Ellinor PT, Benjamin EJ, CHARGE Atrial Fibrillation Working Group

Abstract
BACKGROUND: Genome-wide association studies (GWAS) have identified common genetic variants that predispose to atrial fibrillation (AF). It is unclear whether rare and low-frequency variants in genes implicated by such GWAS confer additional risk of AF.
OBJECTIVE: To study the association of genetic variants with AF at GWAS top loci.
METHODS: In the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study, we selected and sequenced 77 target gene regions from GWAS loci of complex diseases or traits, including 4 genes hypothesized to be related to AF (PRRX1, CAV1, CAV2, and ZFHX3). Sequencing was performed in participants with (n = 948) and without (n = 3330) AF from the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Massachusetts General Hospital.
RESULTS: One common variant (rs11265611; P = 1.70 × 10(-6)) intronic to IL6R (interleukin-6 receptor gene) was significantly associated with AF after Bonferroni correction (odds ratio 0.70; 95% confidence interval 0.58-0.85). The variant was not genotyped or imputed by prior GWAS, but it is in linkage disequilibrium (r(2) = .69) with the single-nucleotide polymorphism, with the strongest association with AF so far at this locus (rs4845625). In the rare variant joint analysis, damaging variants within the PRRX1 region showed significant association with AF after Bonferroni correction (P = .01).
CONCLUSIONS: We identified 1 common single-nucleotide polymorphism and 1 gene region that were significantly associated with AF. Future sequencing efforts with larger sample sizes and more comprehensive genome coverage are anticipated to identify additional AF-related variants.

PMID: 24239840 [PubMed – indexed for MEDLINE]

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Functional Assessment of Potential Splice Site Variants in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.

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Functional Assessment of Potential Splice Site Variants in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.

Heart Rhythm. 2014 Jul 31;

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Digoxin in Patients with Permanent Atrial Fibrillation: Data from the RACE II Study.

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Digoxin in Patients with Permanent Atrial Fibrillation: Data from the RACE II Study.

Heart Rhythm. 2014 Jun 9;

Authors: Mulder BA, Van…

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Low rate of cardiac events in first-degree relatives of diagnosis-negative young sudden unexplained death syndrome victims during follow-up.

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Low rate of cardiac events in first-degree relatives of diagnosis-negative young sudden unexplained death syndrome victims during follow-up.

Heart Rhythm….

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Asymptomatic Persistent Atrial Fibrillation and Outcome – Results of the RACE study.

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Asymptomatic Persistent Atrial Fibrillation and Outcome – Results of the RACE study.

Heart Rhythm. 2014 Mar 13;

Authors: Rienstra M, Vermond RA, Crijns HJ, Tijssen JG, Van Gelder IC, for the RACE investigators

Abstract
BACKGROUND: Symptoms are a major driver for patients with atrial fibrillation (AF) to seek medical attention, and are important to titrate AF therapies. However, a large proportion of AF patients are asymptomatic.
OBJECTIVE: To investigate the clinical profile and prognosis of patients with asymptomatic recurrent persistent AF in the RACE study.
METHODS: Patients with asymptomatic AF (n=157, 30%) were compared to the 365(70%) symptomatic AF patients. The primary endpoint was a composite of cardiovascular morbidity and mortality.
RESULTS: Patients with asymptomatic AF were younger, and more often men than symptomatic patients. Cardiac diseases were less common. Quality of life(SF-36) was better in asymptomatic AF patients, and comparable to healthy controls. At baseline and during follow up, there were no differences in rate control, antiarrhythmic or anticoagulant drugs, cardioversions, and time in sinus rhythm. After a follow-up of 2.3±0.6 years, the primary endpoint occurred in 21(13%) asymptomatic AF patients and 83(23%) symptomatic AF patients. After adjusting for relevant covariates, asymptomatic AF was associated with a lower risk of the primary endpoint (hazard ratio 0.51, 95% confidence interval 0.29-0.92, p=0.024). This difference was driven by significantly less heart failure hospitalizations (0 versus 21[6%], and severe effects of antiarrhythmic drugs or digoxin (1[0.6%] versus 13[4%]). Importantly, no difference in the occurrence of thromboembolic complications was observed.
CONCLUSION: Patients with asymptomatic AF were more often men and had less cardiac disease. During follow-up, in asymptomatic AF patients heart failure hospitalizations and severe adverse effects of antiarrhythmic and rate control drugs occurred significantly less frequently.

PMID: 24632222 [PubMed – as supplied by publisher]

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Familial disease with a risk of sudden death: a longitudinal study of the psychological consequences of predictive testing for long QT syndrome.

Familial disease with a risk of sudden death: a longitudinal study of the psychological consequences of predictive testing for long QT syndrome.
Heart Rhythm. 2008 May;5(5):719-24
Authors: Hendriks KS, Hendriks MM, Birnie E, G… Continue reading

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