A 69 year old woman was treated with sotalol (320 mg daily) for intermittent atrial fibrillation. Sotalol was initially well tolerated and reversion to sinus rhythm with sinus bradycardia occurred 4 weeks after initiation of therapy. Shortly thereafter, the patient developed recurrent syncope due to torsade de pointes. This was treated successfully with intravenous magnesium infusion and withdr...

Thrombus formation in the left atrium is rare in patients in sinus rhythm. In three patients with extensive cardiac amyloidosis transthoracic echocardiography showed large atrial thrombi in or protruding into the body of the left atrium during sinus rhythm. Doppler studies showed no A wave on mitral inflow. Severe atrial and ventricular infiltration by amyloid may have resulted in mechanical at...

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Cardioversion for AF may be performed by either using direct current (DC) shock (electrical cardioversion) or using drugs (chemical cardioversion). Here we report a case of a patient with heart failure and AF, who reverted to the normal sinus rhythm on correction of hyperkalemia (electrogenic cardioversion). The patien...

Eight patients with complex rheumatic heart disease underwent the MAZE procedure combined with mitral valve replacement. Some of the patients also required aortic valve surgery or tricuspid repair. There was one early death related to a stroke. The remaining patients have been followed from 3 to 19 mo. Atrial fibrillation was ablated in all patients. Six patients are in sinus rhythm and one pat...

A 78-year-old male patient presented with repetitive fainting episodes. His electrocardiogram showed sinus rhythm with persistent ventricular bigeminy. Concealed sinus node dysfunction (SND) with consecutive bradycardia-induced ventricular hyperexcitability was suspected. Pharmacological testing with atropine resulted in accelerated junctional rhythm along with nearly total disappearance of the...

Verapamil was administered by intravenous injection to 181 patients with various cardiac arrhythmias. The automaticity of the cardiac pacemaker was slowed in sinus, idionodal, and idioventricular tachycardia. In atrial fibrillation the drug usually slowed the ventricular response and often made it regular. In some cases atrial flutter was converted to sinus rhythm, the ventricular response bein...

Atrioventricular nodal reentrant tachycardia (AVNRT) is a relatively common paroxysmal supraventricular tachycardia. This study investigated whether adenosine-5'-triphosphate (ATP) injection during sinus rhythm might be useful in the noninvasive diagnosis of dual AV nodal pathways. The study group consisted of 9 patients with slow/fast AVNRT and 11 control patients without antegrade dual AV nod...

Synchronized direct current shock (Lown, Amarasingham, and Neuman, 1962) has rapidly become established as an effective and safe method of treating cardiac arrhythmias, but controversy remains about the use of antiarrhythmic drugs in maintaining sinus rhythm following the procedure. Although quinidine is potentially dangerous (Thomson, 1956; Oram and Davies, 1964; Davies, Leak, and Oram, 1965),...

We report a case of trauma patient, whose heart rhythm and rate changed from sinus tachycardia to rapid atrial fibrillation. The change occurred immediately after the insertion of left thoracostomy tube. The patient did not respond to pharmacological treatment. Only when the tube was pulled out, the rhythm returned to sinus. Chest radiogram shows the position of the tube, in close proximity to ...

ONE of the aims in reverting atrial fibril-lation to sinus rhythm is to improve cardiac function. Previous studies comparing the cardiac output during atrial fibrillation and following the restoration of sinus rhythm have demonstrated no change to as much as 140 per cent increase.1-3 Because of the experimental design of these studies, the validity of the observation that an increase in cardiac...