Occurrence of symptoms after catheter ablation of atrial fibrillation.

OBJECTIVES: The aim of our study was to verify the efficiency of catheter ablation of atrial fibrillation (CA AF) according to the "atrial fibrillation (AF) burden"(time spent in AF) and symptoms related to AF. METHODS: We retrospectively analysed a selected set of 133 patients with atrial fibrillation (81% men, 19% women) who underwent an invasive therapy in the form of CA AF and at the same time had an implanted long-term ECG loop recorder (Reveal XT) in a period of eight years. We investigated AF burden and objective symptoms of AF by data obtained from a long-term implantable ECG loop recorder. Subjective symptoms related to AF were identified during outpatient controls. RESULTS: Firstly, our results demonstrate for the first time a clinically relevant increase in the occurrence of asymptomatic episodes of AF after CA AF. Secondly, when analysing AF symptoms and AF burden at the same time, CA AF in terms of reduction of symptoms and shortening the time in AF had a better effect in patients undergoing 1 procedure (CA AF) compared to patients undergoing repeated procedures (re CA AF). CONCLUSION: The increase in the occurrence of asymptomatic episodes of AF is of considerable importance both for the clinical evaluation of ablation efficacy and for individualized clinical management of patients, especially with respect to antithrombotic therapy (Fig. 10, Ref. 19).

Lower omega-3 index is a marker of increased propensity of hypertensive rat heart to malignant arrhythmias.

Polyunsaturated omega-3 fatty acids (omega-3 PUFA) are important components of cell membrane affecting its function and their deficiency is deleterious to health. We have previously shown that spontaneously hypertensive rats (SHR) are prone to life-threatening arrhythmias that are reduced by omega-3 PUFA intake. Purpose of this study was to explore plasma and red blood cells (RBC) profile of omega-3 and omega-6 PUFA as well as to determine omega-3 index, a risk factor for sudden cardiac death, in aged SHR and the effect of omega-3 PUFA intake. Male and female 12-month-old SHR and age-matched Wistar rats fed with omega-3 PUFA (200 mg/kg BW/day/2 month) were compared with untreated rats. Composition of omega-3 PUFA: alpha linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as omega-6 PUFA: linoleic acid and arachidonic acid was analyzed by gas chromatography. Results showed sex- and strain-related differences of basal omega-3 and omega-6 PUFA levels in plasma and RBC as well as in response to omega-3 PUFA intake. Comparing to Wistar rats omega-3 index, expressed as a percentage of EPA+DHA of total fatty acids, was lower in SHR and it increased due to consumption of omega-3 PUFA. Findings support our hypothesis that lower omega-3 index may be also a marker of increased propensity of the hypertensive rat heart to malignant arrhythmias.

Evaluation of alternative calculation methods for determining LDL cholesterol.

BACKGROUND: Due to limitations of the Friedewald formula, alternative methods for calculating low-density lipoprotein cholesterol (LDL-C) were suggested. We evaluated utility of these methods. METHODS: Ninety three subjects free of coronary heart disease were considered. LDL-C was measured by the homogeneous method, and calculated by the Friedewald formula LDL-C = TC-HDL-(TG/2.2) (LDL1) and alternative formulas LDL-C = 0.41 TC - 0.32 TG + 1.70 apoB - 0.27 (LDL2) and LDL-C = 0.94 TC - 0.94 HDL - 0.435 TG (LDL3). RESULTS: All three formulas underestimated the measured LDL-C, both in the whole group and in subgroups according to TG levels (TG < 1.7 and in a range of 1.7-4.5 mmol/l, p < 0.001 for all). We found significantly higher bias for all three formulas in subjects with 1.7 < or = TG < 4.5 mmol/l levels. The Friedewald formula showed the lowest assay bias in all the groups investigated. The mean absolute bias for LDL1 was 7.6%, 18.3% for LDL2 and 13.6% for LDL3, respectively. Linear regression analysis showed correlation of calculated LDL-C values with the direct method in the range of r = 0.82 - 0.90 (p < 0.0001 for all, except of LDL2 in 1.7 < or = TG < 4.5 mmol/l group where p = 0.0011). CONCLUSIONS: The Friedewald formula seems to be a better estimator of LDL-C in our study than the other two alternative formulas; however, it underestimated the LDL-C levels.