Atrial Arrhythmias in Endomyocardial Fibrosis

Abstract

Atrial arrhythmias occurred in 34 out of 97 patients with endomyocardial fibrosis. In 21 instances, atrial fibrillation or flutter was persistent. In 13 cases, atrial arrhythmia was transient and intermittent. It was necessary, in some patients with rapid ventricular re sponses, to employ direct-current cardioversion. Because of the severity of endomyocardial fibrosis at the time of clinical observation, further deterioration at the onset of an atrial arrhythmia was not impressive.

Relation of severe eosinophilia and microfilariasis to chronic African endomyocardial fibrosis.

“…Administration of diethylcarbamazine (Banocide) returned the total eosinophil count to normal, that is less than 500/mm3 in all the patients. Table 4 shows the close similarities between electro-Andy, Bishara, Soyinka cardiographic findings in these patients and those reported for cases of chronic endomyocardial fibrosis.9 [19][20][21][22][23] The cardiac silhouettes on chest radiograph were dominated by right, sided (particularly right atrial) dilatation (Fig. 1c).…”

Neglected cardiomyopathies in Africa

“…(36) In left-sided EMF there is usually a systolic murmur that is typically soft, short and confi ned to early systole, associated with a delayed opening snap, and a loud pulmonary component of the second sound, indicating increased pulmonary pressures. (60) The biological profi le of EMF patients is unspecifi c. Hypereosinophilia is a common fi nding (61) without any evidence of infection or parasitism. (62) The effusions, particularly the ascitic fl uid, are typically exudates having more leukocytes (predominantly lymphocytes) and higher protein content than expected in right heart failure.…”

“…There are usually low voltage QRS complexes, non-specifi c ST-T wave changes, conduction disturbances and atrial arrhythmias in advanced disease. (61) A tall and broad right atrial wave, "qr" pattern in the leads V3R or V1, and delayed right ventricular conduction are characteristic of right EMF. (56,57) The chest x-ray in right ventricular EMF shows severe right atrial enlargement, a bulge over the left heart border due to dilatation of the infundibulum, and hypoperfused lungs, while in left-sided EMF there is prominent main pulmonary artery, exaggeration of the blood vessels in the lung fi elds and left atrial enlargement.…”

Endomyocardial Fibrosis

“…Atrial fibrillation is present in a considerable number of cases upon presentation [5,56,61]. Low-voltage QRS complexes, nonspecific ST-T wave changes, and conduction disturbances are characteristic of advanced disease [62].…”

“…The mean survival after the onset of symptoms, initially at 2 years [61], seems to be improving with the use of new drugs for heart failure and arrhythmias as well as the use of surgical treatment before the advent of irreversible complications. Rapidly progressive heart failure may occur but evolution towards a long steady period without any deterioration is also possible.…”