Potassium infusion increases the likelihood of conversion of recent-onset atrial fibrillation—A single-blinded, randomized clinical trial

Publication date: March 2020Source: American Heart Journal, Volume 221Author(s): Kiarash Tazmini, Mai S. Aa. Fraz, Ståle H. Nymo, Mathis K. Stokke, William E. Louch, Erik ØieBackgroundThe optimal antiarrhythmic management of recent-onset atrial fibrillation (ROAF) or atrial flutter is controversial and there is a considerable variability in clinical treatment strategies. It is not known if potassium infusion has the potential to convert ROAF or atrial flutter to sinus rhythm (SR). Therefore, we aimed to investigate if patients with ROAF or atrial flutter and plasma-potassium levels ≤4.0 mmol/L have increased probability to convert to SR if the plasma-potassium level is increased towards the upper reference range (4.1-5.0 mmol/L).MethodsIn a placebo-controlled, single-blinded trial, patients with ROAF or atrial flutter and plasma-potassium ≤4.0 mmol/L presenting between April 2013 and November 2017 were randomized to receive potassium chloride (KCl) infusion (n = 60) or placebo (n = 53). Patients in the KCl group received infusions at one of three different rates: 9.4 mmol/h (n = 11), 12 mmol/h (n = 19), or 15 mmol/h (n = 30).ResultsThere was no statistical difference in the number of conversions to SR between the KCl group and placebo [logrank test, P = .29; hazard ratio (HR) 1.20 (CI 0.72-1.98)]. However, KCl-infused patients who achieved an above-median hourly increase in plasma-potassium (>0.047 mmol/h) exhibited a significantl...
Source: American Heart Journal - Category: Cardiology Source Type: research

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RARITAN, NJ, February 10, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today the submission of a supplemental Biologics License Application (sBLA) to the U.S. Food and Drug Administration (FDA) seeking approval of DARZALEX® (daratumumab) in combination with Kyprolis® (carfilzomib) and dexamethasone (DKd) for relapsed/refractory multiple myeloma. The sBLA is supported by results from the Phase 3 CANDOR study, which compared treatment with DKd to carfilzomib and dexamethasone (Kd) in patients with multiple myeloma who relapsed after one to three prior lines of therapy. “Wh...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Authors: Tosun M, Bingül ES, Demirdöğen Y, Köknel Talu G Abstract Spontaneous epidural hemorrhage is one of the rare neuropathic pain etiologies. In this case, a 68-year-old patient, who had atrial fibrillation and cardioversion history, is evaluated for neuropathic pain due to spontaneous epidural hemorrhage that arose from oral anticoagulant therapy. As well as being unique in etiologic terms, we thought it is an uncommon occasion for management worth sharing. PMID: 32030701 [PubMed - in process]
Source: Agri Dergisi - Category: Anesthesiology Tags: Agri Source Type: research
Merlin PCS Programmer software model 3330, used with Confirm Rx Insertable Cardiac Monitor (ICM), Model DM3500, Sterile. The firm name on the label of the ICM is St. Jude Medical Cardiac Rhythm Management Division, Sylmar, CA. - Product Usage: The Confirm Rx insertable cardiac monitor is designed to detect arrhythmias and wirelessly transmit data to the Merlin.net Patient Care Network. The Confirm Rx ICM is indicated for the monitoring and diagnostic evaluation of patients who experience unexplained symptoms such as: dizziness, palpitations, chest pain, syncope, and shortness of breath, as well as patients who are at risk ...
Source: Medical Device Recalls - Category: Medical Devices Source Type: alerts
Case submitted and written by James Tavornwattana, edits by Pendell Meyers and Steve SmithA male in his 60s with diabetes presented to the ED with one hour of palpitations associated with a 30 min episode of throat burning sensation when he woke up this morning. He denied chest pain, shortness of breath, or lightheadedness.Initial ECG (0 hr):What do you think?Interpretation:Atrial fibrillation with rapid ventricular responseST depression that is maximal in V2-V4, also with lesser STD in V5, I, aVL, II and aVF. With multi-lead STD, there is of course STE in aVR.This pattern and location of STD (maxi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain.Here is the ECG:What do you think?Computer interpretation is below.Here is the computer interpretation:ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE WITH ABERRANT CONDUCTION OR VENTRICULAR PREMATURE COMPLEXESLEFT AXIS DEVIATION [QRS AXIS beyone -30]NONSPECIFIC ST and T-WAVE ABNORMALITYThe over-reading physician confirmed this diagnosis, which is incorrect.  It isnot atrial fibrillation.The rhythm is indeed irregularly irregular, so atrial fibrillation must be considered.There are 5 other rhythms that areirregularl...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 27 December 2019Source: American Heart JournalAuthor(s): Kiarash Tazmini, Mai S. Aa. Fraz, Ståle H. Nymo, Mathis K. Stokke, William E. Louch, Erik ØieAbstractBackgroundThe optimal antiarrhythmic management of recent-onset atrial fibrillation or atrial flutter (ROAF) is controversial and there is a considerable variability in clinical treatment strategies. It is not known if potassium infusion has the potential to convert ROAF to sinus rhythm (SR). Therefore, we aimed to investigate if patients with ROAF and plasma-potassium levels ≤4.0 mmol/L have increased probabilit...
Source: American Heart Journal - Category: Cardiology Source Type: research
CONCLUSIONS: This manuscript aims to present pertinent current research related to the implementation of ERAS programs in the field of cardiac surgery and provide a call to action for further investigation and adaption of ERAS in cardiac surgery. PMID: 31877291 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionsSelective same ‐day discharge after AF ablation is safe and feasible using a streamlined peri‐procedural care protocol. Wider adoption can potentially reduce health‐care costs while improving patient experience.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: ELECTROPHYSIOLOGY Source Type: research
ConclusionsPartial C7, complete T1 and T2, and partial T3 bilateral laminectomy was performed for evacuation of the spinal epidural hematoma. Following a 2-week course of acute inpatient rehabilitation, the patient returned to his baseline functional status. This case highlights the risks of self-manipulation of the neck and potentially other activities that significantly stretch or apply torque to the cervical spine. It also presents a clinical scenario in which practitioners of spinal manipulation therapy should be aware of patients undergoing anticoagulation therapy.
Source: Chiropractic and Manual Therapies - Category: Complementary Medicine Source Type: research
u S Abstract A 77-year-old man with a past medical history of myelodysplastic syndrome, coronary artery disease, hypertension, and chronic atrial fibrillation presented at the hematology outpatient clinic with progressive shortness of breath, weakness, and chest and back pain. Echocardiography was performed and the patient was diagnosed with severe pericardial effusion near the right ventricle. Pericardial drainage was performed. Erysipelothrix rhusiopathiae was isolated from the pericardial fluid. Complications of respiratory and renal failure developed during follow-up. The clinical and laboratory findings of ve...
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars Source Type: research
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