Document Detail

Cardiac biopsy in patients with "primary" atrial fibrillation. Histologic evidence of occult myocardial diseases.
MedLine Citation:
PMID:  1864099     Owner:  NLM     Status:  MEDLINE    
Fourteen patients (ten men and four women; mean age, 37 years) with lone atrial fibrillation (AF) (1 to 18 months' duration) were evaluated by thyroid function tests, two-dimensional echocardiography, hemodynamics, coronary angiography, and left ventricular endomyocardial biopsy, because of unresponsiveness to the usual antiarrhythmic therapy. The results of the T3, T4, TSH, and TRH tests were normal in all patients; cardiac valves and ventricular and atrial sizes (left atrium less than 40 mm) were within the normal limits; also normal were LVEDP (less than or equal to 10 mm Hg) and EF (greater than 0.50). Histologic findings were abnormal in all cases, with three patients showing cardiomyopathic changes, three other patients showing active myocarditis (lymphocytic in two and eosinophilic in one), and eight patients with nonspecific necrosis or fibrosis or both. Steroids (prednisone; 50 mg/m2 of body surface area daily) used in addition to antiarrhythmic therapy in patients with eosinophilic and lymphocytic active myocarditis were able to cause reversion to sinus rhythm, while the other patients continued to have AF. This study documents that occult myocardial diseases (myocarditis, cardiomyopathy, and nonspecific necrosis or fibrosis) can underlie "primary" AF. The addition of steroids to antiarrhythmic therapy in patients with refractory AF and histologic evidence of active myocarditis seems to be useful in controlling the arrhythmia.
A Frustaci; M Caldarulo; A Buffon; F Bellocci; R Fenici; D Melina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  100     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-06     Completed Date:  1991-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  303-6     Citation Subset:  AIM; IM    
Department of Cardiology, Catholic University, Rome, Italy.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use
Atrial Fibrillation / drug therapy,  pathology*
Cardiomyopathies / drug therapy,  pathology*
Cardiomyopathy, Hypertrophic / pathology
Diagnosis, Differential
Endomyocardial Fibrosis / pathology
Middle Aged
Myocarditis / pathology
Myocardium / pathology*
Prednisone / therapeutic use
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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