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Atrial fibrillation represents a common and challenging arrhythmia. A rational approach to management of the individual case depends on careful assessment of the temporal of the arrhythmia, any associated cardiovascular disease, and any particular features suggesting the advisability or risks of any particular treatment regimen. The nature of an arrhythmia(More)
OBJECTIVES This study investigated the efficacy and tolerability of low energy shocks for termination of atrial fibrillation in patients, using an endocardial electrode configuration that embraced both atria. BACKGROUND In animals, low energy biphasic shocks delivered between electrodes in the coronary sinus and right atrium have effectively terminated(More)
The degree of reduction in heart rate variability (HRV) after myocardial infarction has been shown to have prognostic significance, but HRV has not been studied extensively in patients with unstable angina. We assessed spectral and nonspectral measurements of HRV in 52 patients with unstable angina, 52 patients with acute myocardial infarction, and 41(More)
Atrial pacing may prevent the onset of atrial ~brillation (AF) because of suppression of a trigger such as atrial premature beats or because of the alteration of an underlying substrate. There is considerable evidence that the substrate for AF includes the dispersion of atrial electrophysiological parameters which is increased by bradycardia or sudden(More)
We evaluated reflex cardiac responses mediated by carotid baroreceptors in 14 patients with treated congestive heart failure and 14 age-matched healthy subjects. We used a neck chamber to deliver two types of pressure change: 5 s of continuous 50-mmHg suction and an R wave triggered, ramped neck pressure-suction sequence. Reflex latencies (functions of(More)
Sera from patients with Crohn's disease or ulcerative colitis, and from controls were examined by indirect immunofluorescence for antibody against two strains of pseudomonas-like cell-wall-defective bacterial variants. Serum samples from 22 of 25 patients with Crohn's disease produced fluorescence of both revertant cell-wall-defective bacterial strains.(More)
AIMS To characterize the nature and timing of atrial ectopics preceding clinical episodes of paroxysmal atrial fibrillation. METHODS AND RESULTS Holter recordings (n= 177, 60 patients, 58% male, mean age 61.7 +/- 11.5 years) were performed on patients with paroxysmal atrial fibrillation. These were subjected to standard analysis and recordings containing(More)
Determinants of the duration of episodes of atrial fibrillation (AF) in patients with paroxysmal atrial fibrillation (PAF) are poorly understood. However, autonomic tone shows circadian variation and is known to affect atrial electrophysiology. We therefore compared the duration of episodes of AF with an onset during the day (08:00-22:00) to those with an(More)
OBJECTIVE To investigate the efficacy of internal cardioversion using low energy shocks delivered with a biatrial electrode configuration in chronic atrial fibrillation resistant to transthoracic shocks. METHODS Low energy internal cardioversion was attempted in 11 patients who had been in atrial fibrillation for 233 (SD 193) days and had failed to(More)