Atrial fibrillation in acute Chagas disease acquired via oral transmission: a case report

Abstract Atrial fibrillation (AF), a type of supraventricular arrhythmia increases the risk of thromboembolism. Chagas disease has been reported in the Brazilian Amazon region over approximately 20 years. Cardiac abnormalities are recorded in at least 50% of patients and among these, 3.3% develop AF. We describe a case of a 41-year-old man from Muaná, Pará State, who reported a 30-day history of a febrile illness. Acute Chagas disease was confirmed, and an electrocardiogram revealed AF. He was treated with antiparasitic and anti-arrhythmic drugs, beta blockers, and anticoagulants. Reversion to sinus rhythm was observed at his 9-month follow-up.

Long-term outcome of pulmonary vein isolation in patients with paroxysmal atrial fibrillation and Brugada syndrome.

Aims: The therapeutical management of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might lead to to the development of ventricular arrhythmias. This study sought to evaluate the clinical outcome in a consecutive series of patients with BS having undergone pulmonary vein (PV) isolation by means of radiofrequency (RF) or cryoballoon (CB) ablation and the efficacy of catheter ablation for preventing inappropriate interventions delivered by implantable cardioverter defibrillators (ICD) on a 3-year follow up. Methods and results: Twenty-three consecutive patients with BS (13 males; mean age was 47 ± 18 years) having undergone PV isolation for drug-resistant paroxysmal AF were enrolled. Eleven patients (48%) had an ICD implanted of whom four had inappropriate shocks secondary to rapid AF. Over a mean follow-up period of 35.0 ± 25.4 months (median 36 months) the freedom from AF recurrence after the index PV isolation procedure was 74% without AADs. Patients with inappropriate ICD interventions for AF did not present futher ICD shocks after AF ablation. No major complications occurred. Conclusion: Catheter ablation is a valid therapeutic choice for patients with BS and paroxysmal AF considering the high success rates, the limitations of the AADs and the safety of the procedure, and it should be taken into consideration especially in those patients presenting inappropriate ICD shocks due to rapid AF.

Left atrial mobile hydatid cyst mimicking left atrial myxoma and mitral stenosis and causing heart failure and arrhythmia.

Cardiac hydatid cysts are very rare in hydatid cyst disease. We report herein a case of hydatid cyst mimicking left atrial myxoma. A 78-year-old woman was admitted to our hospital with complaint of dyspnea and signs pulmonary edema and mitral stenosis. Echocardiography showed left atrial mobile, mostly solid mass with wall calcifications moving towards the orifice of the mitral valve. We also found loculated giant hepatic and right pulmonary cysts. We aimed to report this case because of mimicking mitral stenosis and left atrial myxoma and causing heart failure.

Solitary pericardial hydatid cyst.

Hydatid cyst of the heart is an uncommon presentation of human echinococcosis which may lead to life-threatening conditions. Diagnosis should be suspected in every case of cyst-like mass in persons coming from areas where echinococcus granulosus is endemic. Echocardiography, computed tomography and magnetic resonance imaging can help in the differential diagnosis of the lesion. Even if some reports of successful therapy with benzimidazoles have been described, the treatment of choice is the surgical excision of the cyst. Pericardiectomy with cyst removal is feasible with low morbidity and mortality rates even in elder patients. The authors describe the successful surgical management of a single giant pericardial hydatid cyst in a 78-year-old woman from North Africa.