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Lone Atrial Fibrillation is Associated with Pectus Excavatum.
MedLine Citation:
PMID:  23692892     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Pectus excavatum is a skeletal abnormality which may have cardiac manifestations. OBJECTIVE: To determine if pectus excavatum is associated with lone atrial fibrillation. METHODS: The Pectus Severity Index (PSI) is the ratio of the lateral diameter of the chest to thedistance between sternum and spine on CT scan. A normal PSI is ≤ 2.5 whereas patients withsevere pectus excavatum have a PSI >3.25. We calculated the PSI of 220 consecutive patients withAF who underwent radiofrequency catheter ablation from September 2008 to 2012 and compared this to the PSI of 225 controls without a history of AF undergoing chest CT. RESULTS:: Mean PSI was higher in patients with lone AF (2.72 =/- 0.07) compared to non-lone AF(2.25 +/- 0.03) or controls (2.26 +/- 0.03) (p<0.001). The likelihood of mild, moderate, or severepectus excavatum was higher in lone AF compared to non-lone AF and controls (p<0.001). Patientswith lone AF were over 5 times as likely to have severe pectus excavatum compared to non-lone AF or controls (p<0.001) even after adjustment for potential confounders. CONCLUSIONS:: Nearly 2/3 of patients with lone AF have at least mild pectus excavatum and 17%have severe pectus, which is significantly higher than in patients with non-lone AF or controls. Thisassociation suggests a potential genetic or mechanical abnormality may be common to the twodisorders. Our study may provide insight into the pathogenesis of lone AF.3 ABBREVIATIONS: atrial fibrillation (AF), lone atrial fibrillation (lone AF), Pectus Severity Index (PSI),computed tomography (CT), Symptom Mitigation in Atrial Fibrillation Study (SMART Study),University of North Carolina (UNC), hypertension (HTN), coronary artery disease (CAD), heartfailure (CHF), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG).
Authors:
Nicole T Tran; J Larry Klein; J Paul Mounsey; Eugene H Chung; Jennifer D Schwartz; Irion Pursell; Anil K Gehi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-18
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-5-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
Affiliation:
Department of Medicine, University of North Carolina at Chapel HillAddress.
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