1. Sistemska embolija s hrano zaradi atrio-ezofagealne fistule po alkoholni ablaciji Marshalove vene : prikaz primeraŽiva Ledinek, Marko Hojnik, 2024, drugi znanstveni članki Opis: Ablacijski poseg je pogosta metoda, ki se uporablja v zdravljenju simptomatskih pacientov s persistentno atrijsko fibrilacijo (AEF). Po tovrstnih posegih so opisani možni različni zapleti, najhujši med njimi je pojav atrioezofagealne fistule. Čeprav pride do AEF redko, je smrtnost tega zapleta visoka. Prepoznava AEF je težavna, zlasti med urgentno obravnavo zaradi nenadnega poslabšanja kliničnega stanja, saj je klinična slika AEF nespecifična in vključuje predvsem nenadno nastalo nevrološko simptomatiko zaradi zračne embolije ali embolije s hrano.
Ključne besede: food embolism, atrio-esophageal fistula, alcohol ablation, case report, atrial fibrillation
Objavljeno v DKUM: 28.01.2025; Ogledov: 0; Prenosov: 28
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2. Effects of atrial fibrillation on the human ventricleSteffen Pabel, Maria Knierim, Thea Stehle, Felix Alebrand, Michael Paulus, Marcel Sieme, Melissa Herwig, Friedrich Barsch, Thomas Körtl, Arnold Pöppl, Simon Sedej, 2022, izvirni znanstveni članek Opis: Rationale: Atrial fibrillation (AF) and heart failure often coexist, but their interaction is poorly understood. Clinical data indicate that the arrhythmic component of AF may contribute to left ventricular (LV) dysfunction.
Objective: This study investigates the effects and molecular mechanisms of AF on the human LV.
Methods and results: Ventricular myocardium from patients with aortic stenosis and preserved LV function with sinus rhythm or rate-controlled AF was studied. LV myocardium from patients with sinus rhythm and patients with AF showed no differences in fibrosis. In functional studies, systolic Ca2+ transient amplitude of LV cardiomyocytes was reduced in patients with AF, while diastolic Ca2+ levels and Ca2+ transient kinetics were not statistically different. These results were confirmed in LV cardiomyocytes from nonfailing donors with sinus rhythm or AF. Moreover, normofrequent AF was simulated in vitro using arrhythmic or rhythmic pacing (both at 60 bpm). After 24 hours of AF-simulation, human LV cardiomyocytes from nonfailing donors showed an impaired Ca2+ transient amplitude. For a standardized investigation of AF-simulation, human iPSC-cardiomyocytes were tested. Seven days of AF-simulation caused reduced systolic Ca2+ transient amplitude and sarcoplasmic reticulum Ca2+ load likely because of an increased diastolic sarcoplasmic reticulum Ca2+ leak. Moreover, cytosolic Na+ concentration was elevated and action potential duration was prolonged after AF-simulation. We detected an increased late Na+ current as a potential trigger for the detrimentally altered Ca2+/Na+-interplay. Mechanistically, reactive oxygen species were higher in the LV of patients with AF. CaMKII (Ca2+/calmodulin-dependent protein kinase IIδc) was found to be more oxidized at Met281/282 in the LV of patients with AF leading to an increased CaMKII activity and consequent increased RyR2 phosphorylation. CaMKII inhibition and ROS scavenging ameliorated impaired systolic Ca2+ handling after AF-simulation.
Conclusions: AF causes distinct functional and molecular remodeling of the human LV. This translational study provides the first mechanistic characterization and the potential negative impact of AF in the absence of tachycardia on the human ventricle.
Ključne besede: atrial fibrillation, calcium-calmodulin-dependent protein kinase type 2, excitation contraction coupling, heart failure, oxidative stress
Objavljeno v DKUM: 28.06.2024; Ogledov: 115; Prenosov: 15
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3. Prediction of maintenance of sinus rhythm after electrical cardioversion of atrial fibrillation by non-deterministic modellingPetra Žohar, Miha Kovačič, Miran Brezočnik, Matej Podbregar, 2005, izvirni znanstveni članek Opis: Atrial fibrillation (AF) is the most common rhythm disorder. Because of the high recurrence rate of AF after cardioversion and because of potential side effects of electrical cardioversion, it is clinically important to predict persistence of sinus rhythm after electrical cardioversion before it is attempted. The aim of our study was the development of a mathematical model by"genetic" programming (GP), a non-deterministic modelling technique, which would predict maintenance of sinus rhythm after electrical cardioversion of persistent AF. PATIENTS AND METHODS: Ninety-seven patients with persistent AF lasting more than 48 h, undergoing the first attempt at transthoracic cardioversion were included in this prospective study. Persistence of AF before the cardioversion attempt, amiodarone treatment, left atrial dimension,mean, standard deviation and approximate entropy of ECG R-R intervals were collected. The data of 53 patients were randomly selected from the database and used for GP modelling; the other 44 data sets were used for model testing. RESULTS: In 23 patients sinus rhythm persisted at 3 months. In the other 21 patients sinus rhythm was not achieved or its duration was less than 3 months. The model developed by GP failed to predict maintenance ofsinus rhythm at 3 months in one patient and in six patients falsely predicted maintenance of sinus rhythm. Positive and negative likelihood ratiosof the model for testing data were 4.32 and 0.05, respectively. Using this model 15 of 21 (71.4%) cardioversions not resulting in sinus rhythm at 3 months would have been avoided, whereas 22 of 23 (95.6%) cardioversions resulting in sinus rhythm at 3 months would have been administered. CONCLUSION: This model developed by GP, including clinical data, ECG data from the time-domain and nonlinear dynamics can predict maintenance of sinus rhythm. Further research is needed to explore its utility in the present or anexpanded form.
Ključne besede: optimisation methods, evolutionary optimisation methods, genetic algorithms, genetic programming, defibrillation, cardiac arrest prediction, atrial fibrillation, electrical cardioversion, prediction
Objavljeno v DKUM: 01.06.2012; Ogledov: 2352; Prenosov: 87
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