ABSTRACT
We report a prospective study which began on February 1[st], 1999. 70 consecutive and non selected patients got an dobutamine stress echocardiography. The major indication, in 53% of cases, was detection of coronary disease in patients suffering from chest pain but whose stress testing were not conclusive. Dobutamin was continuously and intraveinously administered at doses ranging from 5 to 40 microg. Maximal dose was obtained in 73% of cases. The most frequent reason that led us to stop the test was the reach of the target cardiac frequency [85 of FMT]. We observed 7 severe rythmic complications [2 auricular fibrillation, 1 flutter, 2 episodes of frequent and polymorphic ESV, 2 TVNS]. One patient presented a myocardial infarction during dobutamin echography whereas the basic kinetics was normal. 26 patients got a coronarography within 3 days following echography. Stress echography detected a significant coronary stenosis [ >/= 50%], with a sensitivity of 86%, a specificity of 83% and a precision in the diagnosis of 84%
ABSTRACT
Auricular fibrillation is the most common sustained cardiac arrhythmia, yet the optimal strategy for its management remains unclear. Since the study AFFIRM from which resulted them final were deferred in December 2002, the assumption of responsibility of the fibrillation of the old subject tends to become clarified. 86 patients at least 65 years or more were enrolled in our retrospective study from January 1997 to June 2003. The mean age is 70 years [65 to 82 years] and sex ratio to 0.79. 34% had a history of hypertension and 12 % had a coronary artery disease. 2 groups were individualized, according to the year of admission before or after 2002. It comes out from these work 2 points: the restoration of the sinusal rhythm was the first choice. In the event of failure, the option was to maintain fibrillation and this, in the 2 groups. The AVK were founded in the large majority of the cases only after year 2002