ABSTRACT
Background: Atrial fibrillation (AF) is the most prevalent chronic arrhythmia in the heart. AF accounts for one-third of rhythm disorder hospitalizations. AF increases profoundly the risk of stroke, heart failure, and death. This study used P-wave and transthoracic echocardiography with tissue Doppler imaging (TDI) to determine paroxysmal AF predictors in hypertensive individuals. Methods: This case control study was performed on 100 hypertensive adult patients. They were classified into two equal group: Group I included hypertensive patients diagnosed to have paroxysmal AF. Group II (control group) included hypertensive patients with normal sinus rhythm. All subjects were subjected to electrocardiographic and conventional and tissue Doppler Imaging measurements. Results: Pmax had significantly increased in PAF patients compared to sinus rhythm patients. PAL, PAR, PAI, LR, LI and IR had significantly increased in PAF patients compared to sinus rhythm patients. In Multivariate logistic regression analysis, Pmax, PAL, PAI, PAR, LR, LI and IR were found to be independent predictors for PAF. Therefore, Pmax, PAL PAI, PAR, LR, LI and IR were found to be significant predictors for PAF. Best cut-off values for Pmax, PAL, PAI, PAR, LR, LI and IR were: (118, 81, 61, 49.9, 34, 20 and 16 ms) with sensitivity (76, 96, 96, 88, 82, 86 and 77.5 ), specificity (84, 100, 98, 92, 78, 82 and 76) and the AUC of (0.850, 0.979, 0.987, 0.961, 0.836, 0.891 and 0.798) respectively. Conclusions: Electrocardiographic P-wave analysis and echocardiographic TDI may identify hypertension patients at risk for paroxysmal AF, since the combination of Pmax and TDI may help in predicting the development of AF in hypertensive individuals.
ABSTRACT
Background: This study describes cardiac pacing activity during 2021: demographic data of patients underwent permanent pacemaker implantation (PPM), risk factors, clinical presentations, indications, mode of pacing, and complications post PPM implantation. Cardiac pacemakers have become the common treatment of symptomatic bradycardia or high-grade atrioventricular block. Methods: The study was carried out at the department of cardiology Tanta University Hospitals. 102 patients were included in this study. This study was done over a period of six months from October 2020 until April 2021 and follow up for 6 months. All the data about the patients underwent permanent pacemaker implantation were collected by the coordinator in the participating cardiac center. Results: The most frequent risk factors of PPM implantation was hypertension (69%), followed by diabetes mellitus (29%), coronary artery disease (21%), chronic kidney disease (18%), hypothyroidism (6%), cardiomyopathy (3%), valvular heart disease (2%) and congenital heart disease (1%). The most common indication is complete heart block (69%), followed by second degree heart block "mobeitz type 2" (13%), slow atrial fibrillation (7%), symptomatic heart failure patients with LVEF ? 35% , QRS ? 150 ms (6%), trifascicular block (3%), sick sinus syndrome (2%). The most frequent mode of pacing used in our study was DDD mode (63%), followed by VVI mode (32%) with (78%) sinus rhythm and (22%) atrial fibrillation rhythm, then CRT-D (4%). Overall complication rate (9%) within 6 months. In our study the most common complication is infection (5%), followed by haematoma (1%), lead fracture (1%), pneumothorax (1%), and lead displacement (1%). Conclusion: Approximately three-quarters of the patients related to atrioventricular block underwent permanent pacemaker implantaion. Approximately more than half of pacemakers related to patients underwent permanent pacemaker implantation were dual chamber pacemakers. Infection is the most common complication in our study and this is important for strict infection control measures.
ABSTRACT
A wide dose - range of "Safi" was administered to mice and rats as well as to guinea - pigs and its oral toxicity [acute and chronic] was assessed. Also its LD, LD50 and Ed were determined