Objectives To conducted a meta-analysis assessing the relationship between Obstructive Sleep Apnea (OSA) and the risk of Atrial Fibrillation (AF) Methods We searched PUBMED, Medline, and Cochrane Library using the keywords “atrial fibrillation”, “obstructive sleep apnea” and “sleep disordered breathing (SDB)”. All subjects included had established diagnosis of OSA/SDB. We then compared the occurrence of AF versus no AF. Analysis done with Comprehensive Meta-Analysis package V3 (Biostat, USA). Results A total of 579 results were generated. Duplicates were removed and 372 records were excluded based on irrelevant abstracts, titles, study design not consistent with the stated outcome, or full-text unavailable. Twelve studies meeting the inclusion criteria were reviewed in full-text; 2 of these articles were eventually removed due to unconfirmed OSA diagnostic modality, and one was also removed based on a control group inconsistent with the other studies. Therefore, a total of 9 studies were included (n=19,837). Sample sizes ranged from n=160 patients to n=6841 patients. The risk of AF was found to be higher among OSA/SDB versus control group (OR; 2.120, C.I: 1.845–2.436, Z; 10.598 p: <0.001). The heterogeneity observed for the pooled analysis was Q-value; 22.487 df (Q); 8 P-value; 0.004, I-squared; 64.424 Tau2; 0.098, suggesting appropriate study selection and moderate heterogeneity. Conclusion OSA/SDB is strongly associated with AFib confirming the notion that OSA/SDB populations are high risk for development of AF. Prospective studies are needed to ascertain the effect of the treatment of OSA/SDB for the prevention of AF, a growing health burden with serious consequences.
A rare case of anomalous origin of the right coronary artery from the pulmonary artery associated with a large aortopulmonary window in a 4-month-old boy is reported. The right coronary artery is exposed to systemic pressure and carries fairly well-oxygenated blood to the myocardium. Angiographic diagnosis could be difficult because of the simultaneous filling of both great arteries which obscures the origin of the anomalous vessel. Closure of the aortopulmonary window alone could result in acute myocardial ischaemia. A plastic procedure for correction of this association of defects, which should allow normal growth, is described.
Marijuana is the most common drug of abuse in the United States. Marijuana acts on cannabinoid receptors CB1, CB2 and another distinct endothelial receptor. Marijuana is known to cause tachycardia, hypotension and hypertension. Various arrhythmias including atrial fibrillation, atrial flutter, II degree AV block, ventricular fibrillation, ventricular tachycardia, asystole and brugada pattern associated with marijuana use have been reported. We here present an interesting case of Type I Brugada pattern in electrocardiography (ECG) in a 36 year old healthy African American male who presented after smoking four joints. Urine toxicology test proved marijuana use. Acute coronary syndrome was ruled out, coronary angiogram revealed normal coronaries, 2D echocardiogram showed no evidence of structural heart disease. Upon resolution of Brugada pattern in ECG, procainamide challenge performed in electrophysiology laboratory did not induce Brugada pattern. Patient was asked to return to hospital if he developed fever that did not resolve with antipyretics. Further studies are required to to understand the effect of marijuana on cardiac ion channels.
The consequences of rupture of an aortic dissection into the interatrial space include the development of an aorto-right atrialfistula. A case of aorto-right atrialfistula with successful surgical repair is described, and the typical clinical features of this syndrome are outlined. The pathogenesis of this complication is also discussed.The complications of aortic dissection include occlusion of the vessels arising from the aorta, haemopericardium, pleural effusion, and the development of aortic incompetence. Among the less common complications is haematoma of the interatrial septum (Yacoub, Schottenfeld, and Kittle, I972). Rarely, such a haematoma may rupture into the right atrium thereby giving rise to an aorto-right atrial fistula (Dulake and Ashfield, I964; Kuipers and Schatz, I963; Temple, Rainey, and Anabtawi, I966).This report describes such a case in which surgical repair was successful. Case reportThe patient, a man, aged 54, presented in June I966 after the sudden onset of central chest pain radiating into his right arm, back, lower abdomen, and legs. On admission, he was initially hypotensive, but subsequently his blood pressure rose to 220/IIO mmHg before hypotensive treatment was instituted. The abnormal cardiac findings included a collapsing pulse, a continuous murmur at the right sternal edge, and an early diastolic murmur at the left lower end of the stemum. All peripheral pulses were present and equal. Electrocardiogram showed sinus rhythm with a normal PR interval, a mean QRS axis of -330, and complete right bundle-branch block. Chest x-ray showed cardiac enlargement with dilatation of the ascending aorta. A mass miniature chest x-ray performed in i96o had shown a similar appearance. There was no other past history.He recovered quickly from this initial attack, but after discharge from hospital he noted chest pain on severe exertion. Cardiac catheterization was carried out and confirmed aortic dissection extending from the aortic valve region to below the diaphragm. There was no evi-1 Present address: The London Hospital, London Ei.dence of a left-to-right shunt from oxygen saturation data nor from aortography. In I972, he began to notice increasing exertional dyspnoea in addition to angina. The heart size had increased on chest x-ray. An electrocardiogram now showed the development of first-degree atrioventricular block in addition to the previously noted right bundlebranch block. In view of his clinical and radiological deterioration, operation was recommended.At operation in November I972, there was an aneurysm of the ascending aorta measuring 25 cm in diameter. A transverse intimal tear 5 cm in length was situated I 5 cm above the left and non-coronary sinuses. The lower part of the dissection displaced the commissure between the left and non-coronary cusps resulting in prolapse of these cusps. There was a fistula measuring 3 to 4 mm in diameter into the right atrium from the false lumen of the aorta (Fig. I).The aneurysm was excised leaving a 3 cm cuff of aortic wall around the fistula fo...
Two cases are described of late pseudoaneurysm of the ascending aorta caused by dehiscence of infected aortocoronary vein graft suture lines. Both cases were associated with early postoperative Staphylococcus aureus superficial wound infection. This complication should be suspected in patients developing protracted wound infections after operation, particularly when associated with rigors.
Attributed to Alternating-Current Leak in a Swimming Pool Implantable cardioverter-defibrillators (ICDs) I mplantable cardioverter-defibrillators (ICDs) provide primary and secondary prevention of sudden cardiac death in patients who are predisposed to malignant ventricular arrhythmias.1-3 Despite the clinical efficacy and improved technical specifications of newer ICDs, inappropriate shocks can still affect patients who have implanted devices. We review the case of a patient whose inappropriate ICD shocks were most likely caused by the leakage of small amounts of alternating current in a swimming pool. Case ReportA 63-year-old man with a history of atrial fibrillation, coronary artery disease, myocardial infarction, multivessel coronary artery bypass grafting, and ischemic cardiomyopathy presented at our electrophysiology clinic for device interrogation. Two months earlier, the patient's previous permanent pacemaker had been upgraded to a biventricular ICD: a Protecta XT model D314TRG CRT-D ( The patient had experienced 2 distinct device discharges immediately after jumping into a swimming pool while vacationing in St. Lucia approximately 2 weeks before the current presentation. He described no prodromal symptoms, chest pain, palpitations, dizziness, syncope, or aftereffects. A cardiologist in St. Lucia had ruled out ischemia, heart failure, and electrolyte disturbances.Interrogation of the ICD revealed 2 shocks for electrical activity that the device had interpreted as ventricular fibrillation (Fig. 1). The remainder of the interrogation report revealed normal function, sensing, and evaluation of thresholds by iterative output testing; 3 unrelated episodes of paroxysmal atrial fibrillation had not evoked therapy. The discharges corresponded with the times when the patient was in the swimming pool.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.