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Michael W Farrar

Publications and source records attributed to Michael W Farrar.

3 recordsLinked to original sources

Use of an echocardiographic contrast agent to establish safety of cardioversion in a patient with a ligated left atrial appendage.

Transesophageal echocardiographic-guided cardioversion is a safe, accepted technique to minimize risk of stroke and embolic events when electrically converting atrial fibrillation to normal sinus rhythm. The presence of thrombus in the left atrial appendage (LAA) is a contraindication to performing cardioversion in these patients. For patients with a surgically ligated LAA, thrombus may be more prevalent and may still represent an embolic risk because of incomplete closure of the LAA. We report use of an echocardiographic contrast agent in a patient with a thrombus in a ligated LAA to determine safety of cardioversion.

Albumins↗

Chest pain evaluation: a common clinical problem.

The clinical approach described here initially utilizing a careful focused history and physical examination, 12 lead ECG, as well as serum biomarkers, allows for an informed initial impression of the chest pain patient. Based upon the findings the practitioner can then initiate appropriate therapy or further testing based on this solid database. The therapy can vary from simple medical therapy involving aspirin and beta blockers to an invasive evaluation potentially involving percutaneous coronary interventions. If further non-invasive evaluation is chosen, then the choices for testing are as outlined here. The guidelines listed will help in selecting the appropriate test for the individual patient. We believe the approach used in this paper will help insure high quality cost-effective care of the chest pain patient.

Algorithms↗

Atrial fibrillation in athletes.

A 60-year old male physician on staff at North Kansas City Hospital was admitted with paroxysmal atrial fibrillation. The physician is an avid long-distance runner. Ultimately, three other male physicians on staff, all long-distance runners, were identified as having lone atrial fibrillation. This prompted a literature search which initially indicated a higher than normal incidence of atrial fibrillation in endurance and elite athletes. However, recent data has questioned the validity of this observation. The management of the athlete with atrial fibrillation poses special concerns and can be problematic. The incidence, causes, implications, and management of atrial fibrillation in athletes is the subject of this review.

Atrial Fibrillation↗