Document Detail


Coexisting normal sinus rhythm and atrial fibrillation 18 years after heart transplant.
MedLine Citation:
PMID:  19017017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial fibrillation is an important cardiogenic cause of embolic phenomenon to the brain leading to stroke and long-term disability. Recognition of atrial fibrillation is of cardinal importance in the workup of stroke and transient ischemic attack (to prevent future strokes) by the timely institution of anticoagulation therapy. We describe a patient with history of standard orthotopic heart transplant (st.OHT) who had no clinical or electrocardiographic signs of atrial fibrillation. He presented with a transient ischemic attack (TIA) and subsequently was found to have two distinct left atrial appendages (LAA) in two different rhythms based on transesophageal echocardiography (TEE) and pulse wave (PW) Doppler. The donor LAA was in normal sinus rhythm (NSR) and recipient LAA in atrial fibrillation (AF). This was an extremely rare but important diagnosis in our patient, which led to the institution of anticoagulation therapy rather than aspirin and dipyridamole as described in neurological literature. We discuss different types of heart transplant techniques and their causatum on postoperative atrial tachycardias. Significance of TEE in the scenario of TIA and follow-up in heart transplant patients is also canvassed.
Authors:
Raghav Gupta; Faisal Latif; Tarun W Dasari; Pedro Lozano
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  792-4     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. raghav-gupta@ouhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use*
Atrial Fibrillation / complications,  drug therapy,  etiology*,  physiopathology,  ultrasonography*
Diagnosis, Differential
Echocardiography, Doppler, Pulsed
Echocardiography, Transesophageal
Heart Transplantation / adverse effects*,  methods
Humans
Ischemic Attack, Transient / etiology*,  physiopathology
Male
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Anticoagulants

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


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