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Detection of Spontaneous Termination of Atrial Fibrillation 1 Beth Logan, Jennifer Healey Cambridge Research Laboratory HP Laboratories Cambridge HPL-2004-165 October 1, 2004* E-mail: Beth.Logan@hp.com , Jennifer.Healey@hp.com atrial fibrillation , machine learning We present techniques to detect various types of terminating and non- terminating atrial fibrillation (AF) as required by the Computers in Cardiology Challenge 2004. First, we describe an automatic technique to distinguish non-terminating AF from terminating AF. Our method models R-R intervals using mixtures of Gaussians and achieves an accuracy of 90% on the training set and 77% on the challenge test set. Second, we describe a semi-automatic technique to distinguish immediately terminating AF from AF which terminates one minute later. Our method first uses spectral models to determine which ...

Spectral Analysis Techniques of Surface Electrocardiograms in Atrial Fibrillation Research and Clinical Management Andreas Bollmann, Daniela Husser, Martin Stridh, Leif Sornmo, Helmut U. Klein, S. Bertil Olsson Otto-von-Guericke-University Magdeburg, Germany Lund University, Sweden Page 2 Is Analysis of Fibrillatory Waves Useful for Treatment of Atrial Fibrillation ? SHIH-ANN CHEN, M.D., and CHING-TAI TAI, M.D. „As our increasing understanding of the mechanism of AF forms the basis for new treatment strategies, we believe that noninvasive methods such as spectrum analysis of fibrillatory waves , which is capable of detecting or monitoring changes in the characteristics of fibrillatory waves due to interventional procedures, will be useful for treatment of AF .“ ...

www.ipej.org 210 Review Article Catheter Ablation for Atrial Fibrillation Andre J. Gauri, MD, Bradley P. Knight, MD Division of Cardiology, Department of Internal Medicine,University of Chicago, Chicago Illinois Address for correspondence: Dr. Bradley P. Knight, MD, University of Chicago Hospitals, 5758 South Maryland, MC 9024, Chicago, IL 60637. E-mail: bknight@medicine.bsd.uchicago.edu Keywords: Atrial Fibrillation , Catheter Ablation A trial fibrillation (AF), the most common arrhythmia in adults, affects 1 in 25 people over the age of 60 years and 1 in 10 over the age of 80 years. 1 There is considerable morbidity, mortality and economic burden associated with AF, all of which will increase with the expanding elderly population. Until recently, pharmacologic therapy with AV nodal blocking agents, antiarrhythmics and anticoagulation ...

What is atrial fibrillation ? Atrial fibrillation (AF) is the name of a particular type of irregular heartbeat affecting more than one million Americans. In AF, the left atrium (left upper chamber) of the heart beats rapidly and irregularly. Normally, an organized rhythm is somewhere between 60 and 100 times every minute. In someone who has AF, the left atrium may beat as many as 400 times a minute. What does AF have to do with stroke? In AF, the irregular contractions of the left atrium cause blood to pool, which may result in the formation of blood clots. These clots can break loose and travel through the bloodstream to the brain, causing a stroke. Stroke can cause permanent disability, coma or death. If left untreated, AF can increase your stroke risk from four to six times. About 15 percent of all people who have a stroke have AF. Who has AF? ...

AF Ablation Catheter Ablation of Atrial Fibrillation at the University of Colorado at Denver and Health Science Center The Atrial Fibrillation (AF) Ablation Program at UCDHSC strives to achieve the highest level of efficacy while maintaining the safest approaches that have been thoroughly evaluated by experienced high-volume academic centers. Each patient with AF is evaluated and treated with an individualized approach based on the arrhythmia history and the results of the electrophysiologic study (EPS) performed at the time of the procedure. An AF ablation begins with catheters placed in the heart from the right and left femoral veins and right internal jugular vein. After an EPS has been performed, two transseptal punctures are made using intracardiac echocardiographic (ICE) guidance and fluoroscopy. Once the left atrium has been accessed, high dose intravenous anticoagulation (heparin) is started to prevent blood ...

Atrial fibrillation National clinical guideline for management in primary and secondary care Developed by The National Collaborating Centre for Chronic Conditions at the Royal College of Physicians This evidence-based guideline provides complete best practice guidance on the diagnosis and management of atrial fibrillation (AF) in most clinical situations related to this common cardiac arrhythmia. The guideline ¦ covers paroxysmal, persistent and permanent AF ¦ considers AF developing after surgical procedures ¦ offers advice on haemodynamically unstable AF ¦ gives recommendations for referral to specialist services ¦ provides full details of systematic reviews of the AF evidence base and health group modelling and considerations of the Guideline Development Group who were drawn from the country’s leading experts ...

www.ipej.org 40 Review Article Current Status of Internal Cardioversion in Atrial Fibrillation Andreas Plewan, MD and Eckhard Alt, MD Medizinische Klinik, Klinikum rechts der Isar, Technische Universität Munchen, Germany. Address for correspondence: Prof E Alt, Medizinische Klinik, Klinikum rechts der Isar, Ismaningerstr 22, 81675 Munchen, Germany. E mail: alt@med1.med.tu-muenchen.de Keywords: atrial fibrillation , internal cardioversion For more than 30 years transthoracic external cardioversion has been an established method for the restoration of sinus rhythm in patients with persistent atrial fibrillation . It was first described by Lown in 1963 1 . Though the success rate for external cardioversion ranges from 60-90 % 2- 4 , there is reduced efficacy in those patients with a high body-mass index and an increased transthoracic ...

Update in treatment of Atrial Fibrillation Dr. Emad Abd Wahed Consultant Physician & Emergency MD. FRCP( Edin.). MRCP( UK). CAEP( Canada) Atrial fibrillation (AF) is a relatively common arrhythmia that can have adverse consequences related to a reduction in cardiac output and to atrial thrombus formation that can lead to systemic embolization [1-4]. There are four major issues that must be addressed in the treatment of AF: • Reversion to normal sinus rhythm (NSR( • Maintenance of NSR • Control of the ventricular rate in patients with chronic AF • Prevention of systemic embolization Therapy is also influenced by whether the AF is paroxysmal or chronic (show figure 1A-1B.( The following discussion will focus on three areas: a brief summary of these four treatment issues, each of which is discussed in detail separately; the presentation and management ...

E VALUATION F ORM Controversies in Surgical Treatment of Atrial Fibrillation Project ID: 4179ES22 Postgraduate Institute for Medicine respects and appreciates your opinions. To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few minutes to complete this evaluation form. You must complete this evaluation form to receive acknowledgement of participation for this activity. Please answer the following questions by circling the appropriate rating: 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Fair 1 = Poor Extent to Which Program Activities Met the Identified Objectives After completing this activity, participants should be better able to: Discuss the efficacy of surgical ablation therapy in the management of atrial fibrillation . 5 4 3 2 1 ...

A Continuing Medical Education activity sponsored by Grant funds provided by Ablation Strategies for the Management of Atrial Fibrillation November 10 – 11, 2006 Kensington Court Hotel Ann Arbor, Michigan Page 2 Overview This course is designed for clinical electrophysiologists seeking contemporary techniques for radiofrequency catheter ablation of atrial fibrillation . Faculty will focus on catheter ablation techniques using radiofrequency energy. New image integration and mapping technology that improves navigation will also be discussed. Topics include clinical outcomes and complication prevention and management. Two patient cases will be broadcast live to demonstrate the ablation procedure and techniques. The live case demonstrations will be moderated and will allow for audience interaction. Participants will have ...

PRACTICE POINT 332 NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE JULY 2005 VOL 2 NO 7 www.nature.com/clinicalpractice/cardio Original article Wachtell K et al. (2005) Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the Losartan Intervention For End Point Reduction in Hypertension (LIFE) study. J Am Coll Cardiol 45: 712–719 SYNOPSIS KEYWORDS atenolol, atrial fibrillation , hypertension, losartan, stroke BACKGROUND It is not known whether angiotensin II type 1 receptor blockers provide better protec- tion than ß-blockers against new-onset atrial fibrillation (AF) in patients with hypertension. OBJECTIVE To compare the ability of losartan and ateno lol to prevent new-onset AF in patients with hypertension and left-ventricular hypertrophy. ...

Published by the New Zealand Guidelines Group Atrial Fibrillation Information for you, and your family, whänau and friends Page 2 CONTENTS Introduction 1 The heart 2 What is atrial fibrillation ? 3 How common is atrial fibrillation ? 4 What causes atrial fibrillation ? 5 What are the symptoms of atrial fibrillation ? 6 What tests may be needed? 7 Can atrial fibrillation cause problems? 8 What is the risk of stroke? 9 How is atrial fibrillation managed? 10 What if I need to be on warfarin? 14 Warfarin dosing 16 Further information Back cover The information in this brochure is based on the evidence- based guideline, The Management of People with Atrial Fibrillation and Flutter , 2005, published by the New Zealand Guidelines ...

apy versus first-line RFA in patients with 2 symptomatic episodes of AFl and normal left atrial size. After a 21-month follow-up, only 36% of the patients receiving drugs in their study were in NSR versus 80% of patients who underwent RFA. They also reported very high (63%) rehospitalization rates for symptomatic AFl in the group that received med- ications compared with RFA group. RFA was not only superior in maintaining NSR, but also had a positive impact on quality of life and lower occurrence of atrial fibrillation . Compared with the present study, the en- rolled patients in this study required a history of 2 episodes of AFl and normal left atrial size. Only 38% of patients had coronary artery disease; 54% had no structural heart disease and the ejection fraction was near normal (49 3%). In our study, we enrolled patients after their first episode of AFl, 60% of pa- tients ...

www.ipej.org 45 Editorial Suppression of Paroxysmal Atrial Fibrillation by Pacing Anoop K. Gupta, MD, DM, DNB, FACC Krishna Heart Institute, Ahmedabad, India. Address for correspondence: Dr. Anoop K. Gupta, MD, DM, DNB, FACC, Consultant Cardiologist and Electrophysiologist, Krishna Heart Institute, Ghuma, Ahmedabad. 380058. Gujarat, India. Email: anoopgupta@msn.com A trial Fibrillation (AF) affects approximately five million people world- wide. The incidence of AF increases with aging and more common in males. 1 Atrial fibrillation is the most common cardiogenic cause of stroke and exacerbates heart failure. Despite the prevalence of AF, it is still one of the most difficult arrhythmia to treat. 2 The management option of AF ranges from pharmacological therapy, catheter based ablation and surgery. However, non-traditional ...

September 2003 Atrial Fibrillation Fact Sheet Age-adjusted death rates for atrial fibrillation as a contributing cause— United States, 1999 Age adjusted to the 2000 U.S. population 13.0 – 19.9 26.0 – 31.9 20.0 – 25.9 32.0 – 37.9 Death rate per 100,000 13.0–19.9: Arizona, Arkansas, Florida, Georgia, Louisiana, Mississippi, New Hampshire, New Mexico, Oklahoma, South Dakota 26.0–31.9: California, Connecticut, Delaware, Idaho, Maine, Minnesota, North Dakota, Ohio, Oregon, South Carolina, Washington 20.0–25.9: Alabama, Colorado, District of Columbia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Massachusetts, Michigan, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, Tennessee, Utah, Virginia, Wisconsin, Wyoming 32.0–37.9: Alaska, Maryland, North Carolina, Pennsylvania, Rhode Island, Vermont, West Virginia ...

PATIENT & FAMILY EDUCATION / NYU Medical Center Atrial Fibrillation Created 5/02, last reviewed 03/06 pfrc04-000015 ATRIAL FIBRILLATION A Patient’s Guide Page 2 2 PATIENT & FAMILY EDUCATION / NYU Medical Center Atrial Fibrillation Created: 03/02; last reviewed 03/06 pfrc04-000015 Table of Contents Topic Page Number What is atrial fibrillation ? 3 Who gets atrial fibrillation ? 3 What causes atrial fibrillation ? 4 What are the symptoms of atrial fibrillation ? 4 What are the risks of atrial fibrillation ? 5 How is atrial fibrillation treated? 6 Patient responsibilities 6 When to call your health care provider 7 Resources 7 Page 3 3 PATIENT ...

Final Report for atrial fibrillation August 2005 Number of submissions: 2 Organisations that submitted: Department of Health (1) PCT (1) Proposed indicators The following new indicators were suggested: 1. The practice should have a register of patients with AF 2. % patients with atrial fibrillation who are currently treated with anti-platelet or anticoagulant therapy (unless a contra-indication or side effects are recorded) 3. % patients over 70 who have been checked for AF Rationale • Consistent with new chapter of the coronary heart disease NSF on arrhythmias and sudden cardiac death • NICE guideline due to be published in 2006 • Atrial fibrillation is common, and an important cause of morbidity and mortality • Relevant to stroke mortality targets Comment • Age specific prevalence of atrial fibrillation is rising, presumably due to improved ...

Atrial Fibrillation and Warfarin What is atrial fibrillation ? Another leaflet discusses atrial fibrillation (AF) in more detail. Briefly, AF means the heartbeat is fast and erratic. Initial treatment is to bring the heart rate down to normal to control symptoms. However, the heart rhythm remains erratic which sometimes leads to the complication of a stroke. Why is a stroke a possible complication of atrial fibrillation ? In AF there is turbulent blood flow in the heart chambers caused by the erratic heartbeat. This sometimes leads to a small blood clot forming in a heart chamber. A small blood clot can travel in the blood vessels until it gets stuck in a smaller blood vessel in the brain. Part of the blood supply to the brain may then be cut off, which causes a stroke. The risk of having a stroke varies depending on the cause of the AF, your age, and other 'risk factors'. ...

Atrial Fibrillation (AF) Understanding a normal heartbeat The heart has four chambers - two atria and two ventricles. The walls of these chambers are mainly made of special heart muscle. The chambers have to contract (squeeze) in the correct order for the heart to pump blood correctly with each heartbeat. The sequence of each normal heartbeat is as follows. The sinoatrial node (SA node) in the right atrium is a tiny in-built 'timer'. It fires off an electrical impulse at regular intervals. (About 60-80 per minute when you rest, and faster when you exercise. This controls the heart rate.) Each impulse spreads across both atria. This causes them to contract and pump blood through one way valves into the ventricles. The electrical impulse gets to the atrioventricular node (AV node) at the lower right atrium. This acts like a 'junction box' and the impulse is delayed slightly. ...

Unrestricted Data and Business Rules – Atrial fibrillation Indicator Set Author Paul Amos Version No 8.5 Version Date 18-May- 2006 New GMS Contract QOF Implementation Dataset And Business Rules - Atrial Fibrillation Page 2 Unrestricted Atrial fibrillation ruleset_R4_v8.5 Version Date: 18-May-2006 Amendment History: Version Date Amendment History The version number starts at 3.1 in order to coincide with existing datasets and business rules. Draft 3.1 21-Nov-2005 From Phil Brown Draft 3.2 22-Nov-2005 Amended following review by Peter Horsfield Draft 3.3 3-Dec-2005 Draft revised for internal review 7.4 23-Feb-2006 Amended following internal & 4 Countries review. Also includes uplifting to 7.4 to bring the 4-Byte documents ...

www.ipej.org 163 Review Article Atrial Fibrillation and Pacing Algorithms Paolo Terranova, MD *,† ; Barbara Severgnini, MD † ; Paolo Valli, MD † ; Simonetta Dell'Orto, MD † ; Enrico Maria Greco, MD † * U.O. Cardiologia e UTIC, Azienda Ospedaliera "S. Paolo" - Polo Universitario, Department of Medicine, Surgery and Odontoiatry, University of Milan, Italy. † U. O. di Cardiologia, Presidio Ospedaliero "Causa Pia Ospedaliera Uboldo", Cernusco sul Naviglio, Azienda Ospedaliera di Melegnano, Milano, Italy. Address for correspondence: Dott. Paolo Terranova, MD, U. O. Cardiologia, A. O. "S. Paolo", Dept. Medicine, Surgery and Odontoiatry University of Milan, Italy. E Mail: Paolo.Terranova@unimi.it Abstract Pacing prevention algorithms have been introduced in order to maximize the benefits ...

Discrimination between Atrial Flutter and Atrial Fibrillation by Computing a Flutter Index R Fischer 1 , G Klein 2 , B Widiger 1 , L Hoy 1 , Chr Zywietz 3 1 Dept of Biometrics, MHH, Hannover, Germany 2 Dept of Cardiology, MHH, Hannover, Germany 3 BIOSIGNA, Hannover, Germany Abstract We currently present the advanced development of our 12-lead ECG analyzing program HES. Recently our algorithm did not differentiate between atrial fibrillation or atrial flutter. Therefore, we now present a refined method for discrimination between atrial flutter and atrial fibrillation . The new approach contains two steps. In step one an algorithm has been developed that detects ‘sawtooth’-like atrial flutter waves within a one second ECG data interval. ...

www.ipej.org 93 Original Article Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation Stephan Geidel*, Jorg Ostermeyer*, Michael Lass*, Sigrid Boczor † , Karl-Heinz Kuck † *Department of Cardiac Surgery and † Department of Cardiology, AK St.Georg, Lohmuhlenstraße 5, 20099 Hamburg, Germany. Address for correspondence: Dr. Stephan Geidel, MD, Cardiac Surgeon, Department of Cardiac Surgery AK St. Georg Hamburg, Germany. Email: StGeidel@aol.com Abstract Objective: Permanent atrial fibrillation (pAF) is a serious problem in cardiac surgery: An incidence of 3.5% among all patients scheduled for open heart surgery, 9.8% in heart valve cases and 45.6% among patients with severe rheumatic mitral valve (MV) disease ...

www.ipej.org 224 Review Article Role of Atrial Fibrillation Threshold Evaluation on Guiding Treatment Takeshi Shirayama, MD, PhD Kyoto Prefectural University of Medicine, Department of Medicine, Division of Cardiology, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. Address for correspondence: Dr. Takeshi Shirayama, MD, PhD, Kyoto Prefectural University of Medicine, Department of Medicine, Division of Cardiology, Kawaramachi Hirokoji, Kamigyo- ku, Kyoto, 602-8566, Japan. E-mail: sirayama@koto.kpu-m.ac.jp Keywords: atrial fibrillation , electrophysiological test, therapy, prognosis Abstract Atrial fibrillation could be induced reproducibly by 50Hz rapid stimulation which was given through systolic and early diastolic phase of atrial excitation. Duration of atrial fibrillation induced in this way was roughly dependent on the current amplitude ...

1 Atrial Fibrillation Managing Expectations & Outcomes: Guidelines for the Successful Postoperative Treatment of Surgically Ablated Patients Prepared by: Joseph M. Craver, M.D. Professor of Surgery Cardiothoracic Surgery Emory University School of Medicine Emory Clinic Atlanta, GA Francis L Shannon, M.D. Cardiovascular Surgeon and Director of CV Quality Assurance William Beaumont Hospital Royal Oak, Michigan David E. Haines, M.D. Director, Heart Rhythm Center William Beaumont Hospital Royal Oak, Michigan Page 2 2 Introduction This document is intended as a guide for surgeons and referring physicians to postoperatively manage their patients who have had a Maze or modified Maze procedure in conjunction with another cardiac surgical procedure. Based on our combined experiences in separate ...

R esearchers believe the human genome encodes more than 300 different ion chan- nels, which are protein pores that control the flow of charged particles through a cell. Yet only 5% of drugs marketed today target ion channels. However, drugs targeting ion channels and trans- porters generate more than $24 billion in worldwide sales per year. According to the FDA, the number of new approved drugs targeting ion channels is equal to or even higher than that for drugs targeting pro- teases, polymerases and reverse transcriptases. Lack of interest is not what has hindered the development of drugs targeting ion channels since many ‘channelopathies’ such as cystic fibrosis, dia- betes, heart disease, deafness, blindness and epilep- sy can all result from malfunctions in ion channels. By Professor Andreas Busch Drug Discovery World Winter 2004/5 17 Lead Generation ...

G r e e n w i c h H o s p i t a l What is Atrial Fibrillation PATIENT/FAMILY INFORMATION SHEET What is atrial fibrillation ? Atrial fibrillation ( AF, A-Fib ) is a disturbance in heart rhythm that occurs when the coordination in pumping between the upper and lower chambers of the heart becomes disorganized, resulting in a very irregular pulse. The pulse may be fast or slow. What are the risks for developing atrial fibrillation ? Several factors can increase the risk of developing atrial fibrillation . Your risk increases if you have several of the risk factors at the same time. These risks include: • Dysfunction of the heart’s normal pacemaker (SA node) • Chronic diseases of the lung such as emphysema • Coronary or rheumatic heart disease. • Pericarditis ( a sharp pain in the chest related to breathing deeply) • Problems with the mitral valve ...