Is Significance of Atrial Fibrillation in Acute Aortic Dissection Underestimated?

Is Atrial Fibrillation a Prognosticator in Acute Pulmonary Thromboembolism?

“…On the other hand, the influence of AF upon outcome has been underestimated in aortic dissection (44 references in PubMed) [6] . The relation between AF and pulmonary thromboembolism (PTE) has not been studied so extensively (413 references).…”

Atrial fibrillation, an epiphenomenon of acute Stanford type‐A aortic dissection with suspected intimo‐intimal intussusception

“…Aside the peculiar symptomatology, that in our case contributed, in a crucial way, to direct toward the solution of the clinical puzzle, it should be remembered that, even supraventricular AR, can sometimes be “only” epiphenomena of hypoxia. Indeed, AF is not rare in AAD, we suppose that the reduction of the oxygen supply to the sinoatrial nodal artery, that in 80% of the people origin from the right coronary, could induce arrhythmias. Finally, in order to reduce the time from diagnosis to surgery, that it is known to cut down the mortality of 50% in the first 48 hours, in our opinion, it is important to consider the supraventricular arrhythmias, alone with the D‐dimer that has been recently included, to the ADDRS to assess the susceptibility to develop arrhythmias…”

“…An ischemic damage of the SN, that in a large percentage of subjects is vascularized by the SN artery originated from the RC, is a well‐known cause of cardiac arrhythmias . Indeed, not infrequently, the ischemic hypothesis of AF usually is not taken into great consideration, even if it could be an epiphenomenon appearing during acute hypoxia, pneumonia, pulmonary embolism . Finally, it should be said that even the acute thrombosis of the SN artery has been implied into sinus node dysfunction, in the context of coronary artery disease …”

“…6 Indeed, not infrequently, the ischemic hypothesis 7 of AF usually is not taken into great consideration, even if it could be an epiphenomenon appearing during acute hypoxia, pneumonia, pulmonary embolism. 6,7 Finally, it should be said that even the acute thrombosis of the SN artery has been implied into sinus node dysfunction, in the context of coronary artery disease. 8…”

Should we prescribe “vasodilating” beta-blockers in Marfan syndrome to prevent aortic aneurysm and dissection?

“…BBs have three actions, considered useful in the prevention of AoD in MFS: diminishing blood pressure (BP), heart rate (HR) and LV contractility (rate of pressure change, dP/dt) 1, 4,6,19,22,23 . It is recommended in a nonpregnant patient that dosage be titrated to a resting HR of < 60 beats per minute 8 .…”