Overview of the Management of Atrial Fibrillation:

Kowey, Peter R.; Yan, Gan‐Xin; DiMino, Tara; Kocovic, Dusan Z.

doi:10.1046/j.1540-8167.2003.90405.x

Cited by 10 publications

(9 citation statements)

References 52 publications

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“…Present antiarrhythmic drug approaches for sinus rhythm maintenance suffer from limited efficacy and a significant risk of adverse effects, particularly proarrhythmia. 1 One potential approach to improving drug therapy is the identification of novel ionic targets. 2 We have previously identified a time-dependent inwardly rectifying…”

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confidence: 99%

Kir3-Based Inward Rectifier Potassium Current

et al. 2006

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Background-We previously characterized a novel K ϩ current (I KH ) with properties of constitutively active acetylcholinerelated current in dog atrium. I KH is sensitive to tertiapin-Q (IC 50 Ϸ10 nmol/L), a highly selective Kir3 current blocker. This study assessed the role of I KH in atrial tachycardia (AT)-remodeled canine left atrium (LA) with the use of tertiapin-Q as a probe. Methods and Results-Dogs were subjected to 7 to 13 days of AT (400 bpm). Coronary-perfused LA preparations were studied intact or subjected to cardiomyocyte isolation. I KH was recorded with patch-clamp methods. AT pacing increased time-dependent hyperpolarization-activated current (I KH ) at Ϫ110 mV from Ϫ1.8Ϯ0.3 (control) to Ϫ3.4Ϯ0.5 pA/pF (AT) and the 100-nmol/L tertiapin-sensitive component from Ϫ1.5Ϯ0.4 (control) to Ϫ3.3Ϯ0.6 pA/pF (AT). Prolonged atrial tachyarrhythmias could be induced with single extrastimuli in AT-remodeled, but not control, preparations, reflecting the atrial fibrillation-promoting effects of AT remodeling. In AT-remodeled preparations, tachyarrhythmia duration averaged 11.0Ϯ5.2 seconds, with a cycle length of 108Ϯ6 ms. Tertiapin-Q decreased tachyarrhythmia duration (to 0.6Ϯ0.1 second; PϽ0.001) and increased tachyarrhythmia cycle length (to 175Ϯ10 ms; PϽ0.001). Atrial action potential duration (APD) was increased 65Ϯ6% by tertiapin in AT-remodeled hearts versus 19Ϯ2% (PϽ0.001) in control. In 2 AT-remodeled preparations, tachyarrhythmia lasted uninterrupted for Ͼ20 minutes; tertiapin-Q slowed and then terminated arrhythmia in both. Tertiapin had no effect on left ventricular cardiomyocyte currents or APD. Conclusions-AT remodeling increases I KH , and a highly selective Kir3 current antagonist, tertiapin-Q, increases APD and suppresses atrial tachyarrhythmias in AT-remodeled preparations without affecting ventricular electrophysiology. Constitutive acetylcholine-related K ϩ current contributes to AT-remodeling effects in dogs and is a potentially interesting antiarrhythmic target.

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confidence: 99%

Kir3-Based Inward Rectifier Potassium Current

et al. 2006

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“…On the contrary all patients over 65, or patients with risk factors regardless of their age should receive anticoagulation with drugs such as warfarin or acenocumarol. Of note, the antithrombotic treatment in patients with paroxysmal or asymptomatic AF is often omitted [20][21][22]. Obviously, this is an error since current evidence strongly suggests that such patients should receive anticoagulation at the same level of intensity as patients with other forms of AF [4,11,13].…”

Section: Reduction Of Thromboembolic Riskmentioning

confidence: 99%

“…Obviously, this is an error since current evidence strongly suggests that such patients should receive anticoagulation at the same level of intensity as patients with other forms of AF [4,11,13]. Asymptomatic or short paroxysmal episodes of AF predispose to stroke while the first presenting symptom of AF is stroke in a sizable percentage of patients [21,22]. Another common mistake is the premature discontinuation of antithrombotic treatment in patients with thromboembolic risk factors after successful cardioversion.…”

Section: Reduction Of Thromboembolic Riskmentioning

confidence: 99%

“…Even though pre-treatment with amiodarone can facilitate the programmed electrical cardioversion [40], it can convert a proportion of patients who have not received adequate anticoagulation and thus indirectly promote thromboembolic events. A novel strategy for safest AF cardioversion proposes the use of TEE for atrial thrombus detection [22,42]. If TEE fail to detect atrial thrombi the patient can be cardioverted promptly after initiation of anticoagulation with heparin followed by warfarin.…”

Section: Rhythm Controlmentioning

confidence: 99%

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Errors and pitfalls in the non-invasive management of atrial fibrillation

Korantzopoulos

Kolettis

Goudevenos

et al. 2005

International Journal of Cardiology

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“…1, адаптировано по [10,11]). Тем не менее вопрос о влиянии нейромодуляции на аритмогенез до конца не изучен [12][13][14].…”

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The First in Russia Experience of Successful Implementation of Constant Neurostimulation of the Spinal Cord in the Complex Treatment of a Patient with Permanent Form of Atrial Fibrillation Combined with Spinal Stenosis

Yakovlev

Yakovleva²,

Chaykovskaya

et al. 2019

Kardiologiia

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This article describes for the first time in the domestic literature a clinical case of the therapeutic effect of neuromodulation on the permanent form of atrial fibrillation and chronic heart failure in an elderly patient with spinal stenosis which led to the development of pain syndrome and movement disorders. For the treatment of neurological pathology, at the beginning epidural administration of drugs was applied, followed by spinal cord stimulation trial and implantation of permanent neurostimulator. At each stage of treatment conducted by a functional neurosurgeon the patient had a spontaneous restoration of sinus rhythm, and during continuous neurostimulation a stable retention of sinus rhythm and regression of heart failure symptoms have been observed throughout a long observation period. The article also presents the data of a few experimental and clinical studies on the use of neuromodulation in cardiology, describes the method of implantation of spinal electrodes and analyzes possible mechanisms of modulation of the autonomic innervation of the heart, implemented by spinal cord stimulation.

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Overview of the Management of Atrial Fibrillation:

Cited by 10 publications

References 52 publications

Kir3-Based Inward Rectifier Potassium Current

Kir3-Based Inward Rectifier Potassium Current

Errors and pitfalls in the non-invasive management of atrial fibrillation

The First in Russia Experience of Successful Implementation of Constant Neurostimulation of the Spinal Cord in the Complex Treatment of a Patient with Permanent Form of Atrial Fibrillation Combined with Spinal Stenosis

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