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Category Archives: Cardiology

Natural History of Atrial Fibrillation – New Study from American Heart Journal

Amidst the crowd of articles on medical therapeutics in the journals every week (it’s where the money is), I’m always pleased to find a good study on the pathophysiology of disease.

Here’s one from the American Heart Journal, Progression of paroxysmal atrial fibrillation to persistent atrial fibrillation in patients with bradyarrhythmias.

We know that some patients can have paroxysmal atrial fibrillation for decades, and others progress gradually to persistent atrial fibrillation.

The authors studies recordings from implantable devices for a bit over a year, looking at the “cumulative daily AT/AF burden.” The findings:

Seventy-eight patients (24%) progressed to persistent AT/AF during the follow-up period with a mean interval of 147 ± 149 days. Mean AT/AF burden increased progressively (slope 14 s/d, P < .001) over 500 days after implant, and median AT/AF burden also increased (P < .01) in this subgroup of patients. This increase was highly correlated with the presence of structural heart disease (P < .001).

Sodium bicarbonate better than Mucomist to prevent contrast nephropathy

Summary of a study in the American Heart Journal showing pretreatment with sodium bicarbonate is better than Mucomist and saline for prevention of contrast induced nephropathy in cardiac catheterization