Kardiol Pol
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Controlled Clinical Trial
Stunning of the left atrium after pharmacological cardioversion of atrial fibrillation.
Stunning of the left atrium and atrial appendage is a well known but not fully clarified phenomenon observed during the cardioversion of atrial fibrillation regardless of the cardioversion method attempted. ⋯ Successful pharmacological cardioversion of atrial fibrillation causes the left atrium and left atrial appendage contractility impairment similar to that observed with other methods of the sinus rhythm restoration. Following the AF cardioversion the level of left atrial stunning is higher in the patients treated with propafenone than in subjects receiving amiodarone.
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A case of a 70 year old female with permanent atrial fibrillation and a history of stroke is presented. Echocardiography showed the presence of an oval mass in the left atrium which suggested thrombus or atrial myxoma. The patient underwent urgent cardiac surgery during which a long thrombus, originating from the left atrial appendage, was successfully removed.
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Comparative Study
Impact of sinus rhythm restoration and maintenance on left ventricular function and exercise tolerance in patients with persistent atrial fibrillation.
Although early improvement of haemodynamic parameters following successful cardioversion of atrial fibrillation (AF) has been well documented, the long-term benefits of sinus rhythm (SR) restoration are less obvious, mainly due to a high rate of AF relapses. ⋯ Successful cardioversion of persistent AF resulted in a significant improvement of exercise capacity and a decrease in heart failure symptoms during one year follow-up period only in patients who maintained SR.
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Although increased left atrial size (LA) has been long regarded as one of the factors negatively influencing the long-term maintenance of sinus rhythm (SR) following cardioversion (CV) of atrial fibrillation (AF), some reports suggested that CV might be effective also in patients with large LA.Aim. We sought to determine the role of LA enlargement in long-term SR maintenance after CV of persistent AF. ⋯ LA enlargement does not preclude a favourable outcome after CV of AF. The decrease in LA area occurring during 30 days following CV favours long term SR maintenance.
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Case Reports
[Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope--case report].
Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope - case report. A case of a 67-year-old female with recurrent syncope is presented. In spite of extensive investigation, the cause of syncope remained unknown. ⋯ One month after implantation the patient suffered two syncopal episodes. ECG recorded by ILR showed asystolic pause of 8 seconds at the time of conversion of atrial fibrillation to sinus rhythm. This was the first ILR implantation in Poland which was covered by public health insurance and not by private funds.