Vindingsykes6254

Data on adjunctive use of magnesium with ibutilide for conversion of persistent rheumatic atrial fibrillation and flutter to sinus rhythm is lacking.

We aimed to study the efficacy of adjunctive supplementation of intravenous magnesium with ibutilide for conversion of persistent rheumatic atrial fibrillation and flutter to sinus rhythm and to define a definite level of serum magnesium which leads to significant increase in rates of such conversion.

This was a prospective study including 33 Rheumatic heart disease patients (13 males and 20 females) with mean age of 49.27±11.4 years and persistent AF or AFl. All patients received intravenous magnesium to raise serum magnesium level in range of 4mg/dl to 4.5mg/dl prior to administration of Ibutilide. 25 out of 33 (76%) patients converted to sinus rhythm. Upon univariate analysis, presence of background beta blocker therapy, serum potassium and magnesium at time of Ibutilide injection were found to have significant relation with conversion to sinus rhythm. Upon multivariate analysis serum magnesium level at the time of Ibutilide injection was found to have significant contribution on post injection rhythm reversal (p-value=0.006). The level of magnesium at 3.8mg/dl was found to have maximum sensitivity of 96% and specificity of 62.5% for conversion to sinus rhythm by ibutilide with magnesium (p-value< 0.05).

Ibutilide is highly effective in cardioversion of persistent rheumatic atrial fibrillation/flutter patients. Raising Serum Magnesium levels above 3.8mg/dl significantly improves efficacy of ibutilide.

Ibutilide is highly effective in cardioversion of persistent rheumatic atrial fibrillation/flutter patients. Selleckchem GSK J4 Raising Serum Magnesium levels above 3.8 mg/dl significantly improves efficacy of ibutilide.

Stenting of coarctation of aorta with covered or uncovered stents is the accepted modality of treatment in older children and adults. The indications which mandate the use of covered stents are still unclear. We attempted to study the early and late outcomes after stenting of native and recurrent coarctation of aorta with uncovered and covered stents.

This is a retrospective study of patients who underwent stenting for coarctation of aorta with covered or non-covered stents at our institute. Early and late outcome for both the groups were studied.

Twenty patients underwent implantation of covered stent and twenty five patients had uncovered stent implantation. Patients in the covered stent group were older and had greater basal pressure gradient. More patients in the covered stent group had residual gradient >10mm Hg after the procedure. There was no mortality or aortic wall injury in either group. Four patients in the covered stent group underwent planned re-intervention and two had unplanned re-intervention. None of the patients in the uncovered stent group had re-intervention. Higher incidence of late lumen loss was noted in the covered stent group.

Uncovered stents can be safely implanted with minimal risk of aortic wall injury in patients with low risk anatomic features. Covered stent implantation is associated with higher incidence of planned and unplanned re-intervention.

Uncovered stents can be safely implanted with minimal risk of aortic wall injury in patients with low risk anatomic features. Covered stent implantation is associated with higher incidence of planned and unplanned re-intervention.

Isolated aortic valve disease (IAVD) has traditionally been a disease of elderly, etiology being either senile degeneration of a tricuspid aortic valve or calcification of a bicuspid aortic valve. However, there is scarcity of Indian data regarding demographic distribution and etiological patterns of IAVD in context of emerging therapies like transcatheter aortic valve implantation (TAVR).

A retrospective observational analysis of 60,560 echocardiograms over three years revealed 3728 newly diagnosed cases of valvular heart disease (VHD). Isolated mitral valve disease (IMVD) constituted 48.7% (n=1815) of all VHD, including 1104 (29.6%) cases of pure mitral stenosis (MS) which was the commonest single lesion followed by combined mitral and aortic valve disease (CMAVD) (n=1320, 34.5%), mixed aortic valve disease (MAVD) (n=349, 9.4%), isolated aortic stenosis (IAS) (n=179, 4.8%) and isolated aortic regurgitation (IAR) (n=75, 2.0%). IAS patients had bimodal age distribution with peaks in first and sixth decade, contributed by congenital and acquired IAS respectively. Acquired IAS comprised of degenerative tricuspid aortic valve (n=79, 58.1%; mean age 63.2±8.8 years), bicuspid aortic valve (BAV) (n=34, 25.0%; mean age 36.0±8.3 years), rheumatic (n=4, 2.9%; mean age 55.3±3.4 years) and non-rheumatic IAS with unclear morphology (n=19, 14%; mean age 48.5±9.3 years). 65.6% patients with acquired non-rheumatic isolated aortic stenosis were less than 60 years of age.

In Indian population, senile valvular degeneration is the commonest cause of acquired IAS with majority of them presenting before 60 years of age, thereby bereaving them with the option of TAVR as a treatment modality.

In Indian population, senile valvular degeneration is the commonest cause of acquired IAS with majority of them presenting before 60 years of age, thereby bereaving them with the option of TAVR as a treatment modality.

Assessment of the value of left atrial deformation indices for prediction of left atrial appendage functioning patients with non-valvular atrial fibrillation.

The study included 250 patients with non-valvular atrial fibrillation and normal left atrial dimension. Trans-thoracic and trans-esophageal echocardiography were performed. Patients were divided into two groups; patients with LAA thrombus (group I) and patients without LAA thrombus (group II), a correlation between trans-esophageal and trans-thoracic data was analyzed.

Group I included110 patients (44%) and Group II 140 patients (56%). By TDI mean LA strain and strain rate were lower in group I (21.89±7.75% vs 35.14±9.28%; p<0.001) and (1.15/sec, IQR 0.12-3/sec versus 2.1/sec, IQR 0.21-3/sec, p<0.001) respectively. By speckle tracking PALS and strain rate were lower in group I (24.79±7.78% vs 37.63±8.64%; p value<0.001) and (0.95±0.32/sec. Vs 1.27±0.32/sec p, value<0.001) respectively. By TEE; group I had lower LAA EF (39.2±13.55% vs 53.