[Retrospective study of auricular fibrillation of recent onset in a hospital emergency service: frequency, clinical presentation, and predictive factors of early conversion to sinus rhythm]. / Estudio retrospectivo de la fibrilación auricular de reciente comienzo en un servicio de urgencias hospitalario: frecuencia, presentación clínica y factores predictivos de conversión precoz a ritmo sinusal.

AIM: To evaluate the proportion of emergencies due to recent-onset atrial fibrillation (AF), its clinical characteristics and in-hospital follow-up. The clinical predictors of conversion to sinus rhythm within the first 24 hours were analyzed. PATIENTS AND METHODS: 34,445 consecutive reports from patients presenting themselves at the emergency room of a community hospital during 15 months were retrospectively studied. The clinical reports of all patients (n = 186) with symptoms of recent onset AF (< 15 days) were reviewed. RESULTS: Hypertension (n = 77.41%) and lone AF (52 patients, 28%) were the most common etiologies. Forty seven patients (25%) presented with heart failure and the onset time was > 24 hours in 77 cases (41%). Conversion to sinus rhythm was observed in 71 out of 166 patients with at least 24 hours of follow-up (42.8%). Age < 60 years, the absence of cardiac disease, a NYHA functional class I, the absence of heart failure at the emergency room and the time from onset < 24 hours were significantly associated with conversion to sinus rhythm. The last two variables were selected as independent predictors by logistic regression analysis (sensitivity: 80%, specificity: 68%). CONCLUSIONS: We conclude that recent-onset AF represents 0.54% of all the hospital emergencies. The time from onset and the presence of heart failure predict the probability of conversion to sinus rhythm within the first 24 hours.

[The long-term clinical results of the implanting of intracoronary stents in current practice]. / Resultados clínicos a largo plazo del implante de stents intracoronarios en la práctica actual.

INTRODUCTION: Published Stress and Benestent studies, obtained in selected populations under technical conditions that do not reflect present practice with intercoronary stenting showed a clinical benefit of coronary stenting. OBJECTIVE: To assess clinical longterm outcome of coronary stenting in current practice and to compare coronary lesions with and without Stress/Benestent criteria. METHODS: 216 consecutive patients with successful placement of 279 stents in 256 lesions and no major in-hospital events. Mean clinical follow-up was 16.7 +/- 10.4 months. Standard technique included seven types, high pressure balloon inflation (15.6 +/- 2.2 atm) and post-stenting treatment of four weeks with aspirin and ticlopidine. RESULTS: Cumulative rates of target lesion revascularization were 9.7% at 6 months, 13.5% at 12 months and 15.1% at 18, 24 and 36 months. Cumulative rates of combined clinical end-point (death, myocardial infarction and target lesion revascularization) were 11.3%, at 6 months, 13.9% at 1 year, 19.3% at 2 years and 21.1% at 3 years. No Stress/Benestent lesions were 193; 75%, and had a higher incidence of target lesion revascularization (17.9 vs 7.5%, Log Rank = 0.015) and combined clinical end-point (22.4 vs 10%, Log Rank = 0.025), than Stress/Benestent lesions. CONCLUSION: Coronary stenting of no Stress/Benestent lesions have a less favourable clinical longterm outcome. However, clinical outcome in a nonselected population at the present time is similar to the old Stress/Benestent studies, probably because of technical improvements.

[Transient atrial fibrillation induced by adenosine in a patient with atrial tachycardia]. / Fibrilación auricular transitoria inducida por adenosina en una paciente con taquicardia auricular.

The administration of adenosine during atrial tachycardia usually terminates the arrhythmia or induces AV block and makes the diagnosis clear. We present a patient with atrial tachycardia in which the administration of adenosine induced a transient atrial fibrillation (AF). A continuous transition between both arrhythmias was observed and the original tachycardia persisted after the termination of the AF. This proarrhythmic effect may be due to the adenosine-mediated shortening of the atrial refractory periods, which produces a decreased wavelength of the reentry circuits and the potential coexistence of several wave-fronts in the atria, favoring the development of AF. The recognition of this uncommon effect is important, since the repeated administration of increasing doses of adenosine may induce sustained AF.