Document Detail


Frequencies and types of arrhythmias in patients with systemic light-chain amyloidosis with cardiac involvement undergoing stem cell transplantation on telemetry monitoring.
MedLine Citation:
PMID:  19766769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac patients with systemic light-chain amyloidosis have a high incidence of arrhythmias and arrhythmia-related death. We aimed to describe the arrhythmias, determine patient characteristics associated with the development of ventricular arrhythmias, and the utility of telemetric monitoring in patients with cardiac involvement due to AL amyloidosis undergoing stem cell transplantation (SCT). Arrhythmia events of 24 consecutive cardiac patients with AL who underwent SCT with continuous telemetric monitoring were retrospectively reviewed. The relation between number and severity of ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) and baseline clinical, laboratory, and echocardiographic data were determined. Atrial and ventricular arrhythmias were found in all patients. Nonsustained VT was the most frequent event (267 total events). Therapeutic intervention for arrhythmias was required in 20 patients; in 3 patients, life-threatening arrhythmias were detected and treated. There was an inverse relation between VT/VF and cardiac output (r = -0.72, p <0.0001), cardiac index (r = -0.71, p = 0.0001), and stroke volume (r = -0.59, p = 0.0029). There was also a relation between VT/VF and brain natriuretic peptide before SCT (r = 0.47, p = 0.019) and average brain natriuretic peptide levels during admission for SCT (r = 0.62, p = 0.0012), troponin I levels at diagnosis (r = 0.47, p = 0.022), and serum creatinine levels before SCT (r = 0.62, p = 0.001). In conclusion, patients with cardiac amyloidosis undergoing SCT have a high incidence of ventricular and atrial arrhythmias; decreased cardiac output was strongly associated with significant ventricular arrhythmias. Continuous telemetric monitoring contributed to patient safety during SCT.
Authors:
Yuliya B Goldsmith; Jennifer Liu; Joanne Chou; James Hoffman; Raymond L Comenzo; Richard M Steingart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  990-4     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, New York Methodist Hospital, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Amyloidosis / complications,  diagnosis,  mortality,  surgery*
Analysis of Variance
Anti-Arrhythmia Agents / therapeutic use
Arrhythmias, Cardiac / complications,  diagnosis,  mortality,  therapy*
Cardiac Output
Cohort Studies
Combined Modality Therapy
Electrocardiography
Female
Humans
Male
Middle Aged
Monitoring, Intraoperative / methods*
Pacemaker, Artificial
Probability
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Statistics, Nonparametric
Stem Cell Transplantation / methods*
Stroke Volume
Survival Rate
Tachycardia, Ventricular / complications,  diagnosis,  mortality,  therapy
Telemetry*
Treatment Outcome
Ventricular Fibrillation / complications,  diagnosis,  mortality,  therapy
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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


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