Maithili Shenoy

Atrial fibrillation post cardiac bypass surgery

Atrial fibrillation occurs in 5-40% patients after coronary artery bypass graft surgery. Atrial fibrillation increases mortality and morbidity in the post-operative period. We sought to conduct a comprehensive review of literature focusing on pathophysiology, risk factors, prevention and treatment of post coronary artery bypass graft atrial fibrillation.

Purulent Pericardial Effusion From Community-Acquired Methicillin-Resistant Staphylococcus aureus

Abstract: Although the incidence of purulent pericarditis has decreased significantly in the modern antibiotic era, a high index of clinical suspicion should be maintained to diagnose this life-threatening illness at an early stage. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a global pathogen and notorious for its ability to cause infection in otherwise healthy individuals. However, it has been associated with purulent pericarditis only in some sporadic case reports. The authors describe a case of purulent pericardial effusion caused by CA-MRSA infection. To the best of our knowledge, this is only the fourth case of CA-MRSA pericarditis to be reported in English literature.

Major Electrocardiographic Abnormalities and 25-Hydroxy Vitamin D Deficiency: Insights from National Health and Nutrition Examination Survey-III

We explored the relationship between major electrocardiogram (ECG) abnormalities (mECG) and 25‐hydroxy (25‐OH) vitamin D deficiency (VDD) and the effect of mECG abnormalities on all‐cause and cardiovascular mortality in a healthy cohort with 25‐OH vitamin D insufficiency and deficiency.

Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava: Out of Mind is Out of Sight?

Persistent Left Superior Vena cava (LSVC) is the most common venous cardiac anomaly found in 0.3 0.5% [1-4] and in 4.3% of those with congenital cardiac anomaly. However, its association with absent Right Superior Vena Cava (RSVC) is rare (0.09 0.13%) [5]. It can be associated with situs inversus. It gives rise to increased risk of paradoxical embolism since it is associated with interatrial septal defect, unroofed coronary sinus or direct communication of the vein to left atrium [2]. A genetic culprit may be genes for leftright signaling [6]. Since it is a rare anomaly, the key is to keep it ‘in mind’ so that when we see it, we recognize it. We report a case of Persistent LSVC with absent RSVC discovered during pacemaker implantation.

Role of Lipid Lowering Therapy and Renin Angiotensin Blockade in Outcomes of Patients With Atrial Fibrillation

Role of Lipid Lowering Therapy and Renin Angiotensin Blockade in Outcomes of Patients With Atrial Fibrillation We read the recently published report by Saksena et al comparing cariovascular outcomes of individual aniarrhythmic drugs versus rate-control rugs using propensity score–matched ubcohorts in the Atrial Fibrillation Folow-Up Investigation of Rhythm Mangement (AFFIRM) trial. The investiators reported increases in composite ortality and the frequency of cardioascular hospital stay with individual ntiarrhythmic drugs and noncardiovasular mortality and intensive care unit ospital stay with amiodarone comared to rate-control therapy. We analyzed the outcomes of atrial brillation (AF) in the National Heart, ung, and Blood Institute public-use, imited-access data set of the AFFIRM rial. We addressed the impact of lipidowering therapy (LLT) on outcomes of F and observed decreases in all-cause ortality (hazard ratio [HR] 0.77, 95% onfidence interval [CI] 0.62 to 0.95, 0.01), ischemic stroke (HR 0.56, 5% CI 0.36 to 0.89, p 0.01), cardioascular mortality (HR 0.71, 95% CI .53 to 0.95, p 0.02), and the comined end point (HR 0.81, 95% CI 0.69 o 0.96, p 0.01) in patients with AF ho were receiving LLT. Drug interacions and adverse effects have been reorted with concomitant use of statins and miodarone, especially rhabomyolysis.