[TREATMENT OF AURICULAR FIBRILLATION AND AURICULAR FLUTTER BY EXTERNAL ELECTRIC SHOCKS (DIRECT CURRENT). APROPOS OF 150 CASES].
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Auricular fibrillation was observed in 17.8% of patients with large-focal myocardial infarction, mainly in females (p 0.01). The localization of myocardial infarction had no impact on the incidence of auricular fibrillation. The precursors of auricular fibrillation included atrial extrasystoli and an elevated electrolyte coefficient of the blood NaeKe. In the group of patients with myocardial infarction and auricular fibrillation mortality was more common among the females. Auricular fibrillation developing beyond the first postinfarction day worsened the prognosis considerably. The outcome of myocardial infarction did not much depend on the duration of auricular fibrillation and on the cardiac contraction frequency.
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AIMS: To find the prevalence of auricular fibrillation in over-65s. DESIGN: Descriptive cross-sectional study through face-to-face interview and electrocardiogram. SETTING: La Solana Health District, Talavera de la Reina (Toledo). PARTICIPANTS: The entire population aged 65 or over (1206 people). Main measurements. Structured interview, study of patients clinical history, taking of blood pressure, and electrocardiogram with standardised measurement. RESULTS: 5.6% prevalence of auricular fibrillation. Distribution according to gender: 4.5% in men and 6.4% in women (p = 0.060; adjusted OR, 1.5). Prevalence of auricular fibrillation by age groups: from 65 to 74, 3.9%; from 75 to 84, 7.8%; over 85, 18.2% (p = 0.0001; adjusted OR, 2.14). CONCLUSIONS: There is greater prevalence of auricular fibrillation in the over 65s than in the general population. Prevalence increases with age. Gender has no statistical significance in the 65 to 74 age group, though it has in the over-85 group, in whom auricular fibrillation is more prevalent in women.
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OBJECTIVE: To find just how suitable thromboembolism prophylaxis (TEP) is in a group of patients with chronic auricular fibrillation belonging to the primary care environment. DESIGN: Cross-sectional and descriptive multi-centre study. SETTING: The study was performed at 3 urban primary care centres in Madrid. PARTICIPANTS: All the patients recorded up to April 2001 with the diagnosis of chronic auricular fibrillation (n=274) were included. Patients with no clinical history or who had a valve prosthesis were excluded. MAIN MEASUREMENTS: Demographic variables, existence of factors of risk of embolism, presence of counter-indications for oral anti-coagulants, and the kind of thromboembolic prophylaxis taken were collected. RESULTS: A total of 274 patients were evaluated. Average age was 75 (SD, 9) and 52% were women. 82% of patients had at least one factor of risk of thromboembolism. The most commonly used kind of TEP was oral anti-coagulants. 45% of patients did not receive suitable TEP. 13.5% of patients at risk of embolism and who had no kind of TEP were found. CONCLUSIONS: There is a high percentage of patients with chronic auricular fibrillation and a high risk of embolism, who do not receive adequate TEP, in the absence of counter-indications to taking oral anticoagulants. There is great scope for improvement, which is within professionals' possibilities.