Document Detail


Remission of paroxysmal atrial fibrillation with iron reduction in haemophilia A.
MedLine Citation:
PMID:  20236353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SUMMARY: Two male first cousins with mild haemophilia A had baseline factor VIII levels of 12-15% and experienced bleeding requiring coagulation factor infusion therapy with trauma and surgical procedures. Both the patients with haemophilia A also had electrocardiographically documented symptomatic paroxysmal atrial fibrillation (PAF) for several years that had become resistant to pharmacological suppression. Radiofrequency ablation was considered in both the cases but deferred considering refusal of consent by the patients to undergo the procedure. Remission of arrhythmias has been reported in patients with iron-overload syndromes. Body iron stores assessed by serum ferritin levels were elevated in both men but neither had the C282Y or H63D genes for haemochromatosis. Calibrated reduction of iron stores by serial phlebotomy, avoiding iron deficiency, was followed by remission of symptomatic PAF in both cases. Iron reduction may be an effective treatment for arrhythmias apart from the classic iron-overload syndromes and deserves further study particularly in patients with bleeding disorders who might be at risk for arrhythmias and other diseases of ageing.
Authors:
L R Zacharski; L McKernan; M E Metzger; M G Malone; V Samnotra; A Bhargava; P R Steiner; C A Rauwerdink; D L Ornstein; C J Cornell
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-03-04
Journal Detail:
Title:  Haemophilia : the official journal of the World Federation of Hemophilia     Volume:  16     ISSN:  1365-2516     ISO Abbreviation:  Haemophilia     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2011-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442916     Medline TA:  Haemophilia     Country:  England    
Other Details:
Languages:  eng     Pagination:  726-30     Citation Subset:  IM    
Affiliation:
Section of Hematology/Oncology, Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. leo.r.zacharski@dartmouth.edu
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / etiology*,  therapy*
Factor VIII / administration & dosage
Ferritins / blood
Hemophilia A / complications*,  therapy
Humans
Iron Overload / complications*,  therapy*
Male
Middle Aged
Phlebotomy*
Treatment Outcome
Chemical
Reg. No./Substance:
9001-27-8/Factor VIII; 9007-73-2/Ferritins

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


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