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Canadian Journal of Cardiology

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https://www.readbyqxmd.com/read/30401583/a-clinical-risk-scoring-tool-to-predict-readmission-after-cardiac-surgery-a-methodological-issue
#1
LETTER
Meisam Shahsavari, Soodeh Shahsavari
No abstract text is available yet for this article.
October 9, 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30414701/fibromuscular-dysplasia-of-coronary-and-brachial-artery
#2
Yohei Akiba, Ayaka Endo, Kenji Suzuki
No abstract text is available yet for this article.
September 17, 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30415964/searching-for-an-optimal-systolic-blood-pressure-target-a-balance-of-benefits-and-risks
#3
EDITORIAL
Alexander A Leung, Raj S Padwal
No abstract text is available yet for this article.
August 30, 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404757/managing-direct-oral-anticoagulants-in-patients-with-antiepileptic-medication
#4
Gil Dagan, Amichai Perlman, Sarit Hochberg-Klein, Yosef Kalish, Mordechai Muszkat
Current guidance recommends avoiding concomitant use of direct-acting oral anticoagulants and enzyme-inducing antiepileptic drugs because of theoretical drug interactions potentially leading to subtherapeutic drug concentrations and treatment failure. We describe a case documenting a significant interaction between phenobarbital and rivaroxaban, and then apixaban. This case illustrates and supports the concerns regarding concomitant use of these medications. Additionally, in this case the interaction was managed with concentration-guided dosing of apixaban, suggesting this approach may represent a feasible strategy for managing patients requiring treatment with direct-acting oral anticoagulants and enzyme-inducing antiepileptic drugs...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404756/insights-on-atrial-fibrillation-in-congenital-heart-disease
#5
Mohammad A Ebrahim, Carolina A Escudero, Michal J Kantoch, Isabelle F Vondermuhll, Joseph Atallah
Patients with congenital heart disease (CHD) have been surviving late into adulthood, with atrial arrhythmias being the most common long-term complication. In recent reports, atrial fibrillation (AF) tended to be the most common form of arrhythmias among groups of patients with adult CHD (ACHD) older than 50 years of age. When compared with their adult counterparts without CHD, AF in patients with ACHD has been characterized by a higher incidence and prevalence, younger age of onset, and a greater risk of progression to persistent AF...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404755/taking-the-pulse-of-atrial-fibrillation-a-practical-approach-to-rate-control
#6
Martin Aguilar, Stanley Nattel
Despite major advances in atrial fibrillation (AF) catheter ablation, rate control remains the most widely used management strategy for AF in the general population. In addition to its use as a primary approach to control symptoms and prevent complications of AF, rate control is often a necessary complement to rhythm-control strategies, especially with antiarrhythmic drugs. The value of rate-control therapy is supported by several large randomized clinical trials showing no difference in major cardiovascular outcomes between rate-control and rhythm-control strategies with currently available therapeutic approaches (antiarrhythmic drugs and/or catheter ablation)...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404754/the-impact-of-cardiac-rehabilitation-on-mental-and-physical-health-in-patients-with-atrial-fibrillation-a-matched-case-control-study
#7
Jennifer L Reed, Anna E Clarke, Ali M Faraz, David H Birnie, Heather E Tulloch, Robert D Reid, Andrew L Pipe
BACKGROUND: Patients with atrial fibrillation (AF) experience symptom burden, exercise intolerance, weight gain, poor mental health, and diminished quality of life (QoL). Cardiac rehabilitation (CR) is recommended for patients with heart disease, and its benefits are well established, yet clinical guidelines for patients with AF do not include the referral to CR. METHODS: In this matched retrospective, case-control study, we examined the impact of CR on changes in QoL, mental health, and cardiometabolic health indicators in patients with or without persistent or permanent AF...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404753/the-multiple-causes-of-stroke-in-atrial-fibrillation-thinking-broadly
#8
REVIEW
Atlantic D'Souza, Kenneth S Butcher, Brian H Buck
Atrial fibrillation (AF) is numerically the most important risk factor for stroke. It is well established that patients with AF have a 5-fold increased risk of stroke relative to those without and that anticoagulation reduces the risk of stroke by approximately two-thirds. Definitively attributing the mechanism of an individual stroke to AF is more problematic, however. In fact, there is no way to reliably establish the etiology of any ischemic infarction. This necessitates screening for all potential stroke risk factors and treating accordingly...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404752/data-linking-diabetes-mellitus-and-atrial-fibrillation-how-strong-is-the-evidence-from-epidemiology-and-pathophysiology-to-therapeutic-implications
#9
REVIEW
Răzvan C Şerban, Alina Scridon
According to estimates, around 5% of the world population has hazel eyes. And there are about as many people with diabetes mellitus (DM). Red hair occurs naturally in up to 2% of the human population. And about as many people are estimated to have atrial fibrillation (AF). If a hazel eyed person with red hair does not surprise us, should a diabetic patient with AF? Accumulating epidemiologic data suggest, however, that the DM-AF association may be more than a simple coincidence. But, how strong is this evidence? Experimental studies bring evidence for a DM-induced atrial proarrhythmic remodelling...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404751/persistent-atrial-fibrillation-ablation-where-do-we-go-from-here
#10
REVIEW
Atul Verma, Laurent Macle
Catheter ablation is being used increasingly for the treatment of atrial fibrillation (AF). Pulmonary vein antral isolation is considered the "cornerstone" for the ablation of AF. This approach has demonstrated consistent rates of success for paroxysmal AF, but the rates of success for persistent AF are lower. There has long been a hypothesis that additional ablation beyond pulmonary vein isolation is required to achieve better outcomes in the population with persistent AF. However, large clinical trials have demonstrated recently that such approaches as empiric linear ablation and/or ablation of complex fractionated electrograms may add no benefit over pulmonary vein isolation alone in persistent AF...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404750/mechanisms-and-clinical-significance-of-arrhythmia-induced-cardiomyopathy
#11
REVIEW
Alexandre Raymond-Paquin, Stanley Nattel, Reza Wakili, Rafik Tadros
Arrhythmia-induced cardiomyopathy (AIC) is characterized by left ventricular systolic dysfunction for which the primary cause is arrhythmia. The hallmark of AIC is its reversibility once the arrhythmia is properly controlled. Any tachyarrhythmia can potentially cause AIC (often called "tachycardiomyopathy"), with atrial fibrillation (AF) being by far the most common in clinical practice. The pathophysiological mechanisms underlying AIC need further clarification, but the available evidence, principally from animal models, implicates metabolic dysfunction due to increased oxygen requirements, neurohormonal adaptive mechanisms, and cellular Ca2+ mishandling as important contributors...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404749/atrial-fibrillation-and-heart-failure-untangling-a-modern-gordian-knot
#12
REVIEW
Allan C Skanes, Anthony S L Tang
Heart failure (HF) and atrial fibrillation (AF) share common risk factors and frequently coexist. Both are highly prevalent in our aging population, and mortality associated with the combination is significantly higher than for each alone. An intricate link exists between AF and HF, including interrelated mechanisms and pathophysiology. Asymptomatic left ventricular systolic or diastolic dysfunction can exacerbate or be exacerbated by AF, resulting in HF with reduced ejection fraction or preserved ejection fraction...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404748/antithrombotic-therapy-for-atrial-fibrillation-and-coronary-disease-demystified
#13
REVIEW
Jason G Andrade, Marc W Deyell, Graham C Wong, Laurent Macle
Atrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20% to 30% of those with AF also have coronary artery disease (CAD), and 5% to 15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on ischemic outcomes (AF-related stroke and systemic embolism, as well as ischemic coronary events)...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404747/the-guideline-policy-gap-in-direct-acting-oral-anticoagulants-usage-in-atrial-fibrillation-evidence-practice-and-public-policy-considerations
#14
REVIEW
Douglas Wan, Jeff S Healey, Chris S Simpson
Atrial fibrillation has a high disease burden-both in prevalence and associated consequences. Despite anticoagulation being an effective treatment in atrial fibrillation, stroke prevention is slow to reflect evidence-based practice. Real-world data reveal a substantial portion of patients who would benefit from anticoagulation, yet do not receive it adequately or at all. A large part of this suboptimal treatment is due to the underutilization of direct oral anticoagulants (DOACs). In response to abundant evidence published over a short timeframe, international guidelines have adopted DOAC usage ahead of policy and fund holders...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404746/the-importance-and-future-of-population-screening-for-atrial-fibrillation
#15
REVIEW
Seung Yong Shin, Gregory Y H Lip
Atrial fibrillation (AF) is a common and progressive heart rhythm disorder that causes structural, functional, and electrical remodelling of the heart. Although we do not fully understand AF yet, this arrhythmia is one clinical feature of a syndrome that is represented by irregularly irregular atrial rhythm accompanied by progressive atrial structural and functional remodelling. Although ischemic stroke, the most feared complication of AF, can be prevented by anticoagulation, the asymptomatic or paroxysmal nature of AF makes timely diagnosis of AF difficult...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404745/age-as-a-critical-determinant-of-atrial-fibrillation-a-two-sided-relationship
#16
REVIEW
Mikael Laredo, Victor Waldmann, Paul Khairy, Stanley Nattel
The incidence of atrial fibrillation (AF), the most common sustained arrhythmia and a major public health burden, increases exponentially with age. However, mechanisms underlying this long-recognized association remain incompletely understood. Experimental and human studies have demonstrated the involvement of aging in several arrhythmogenic processes, including atrial electrical and structural remodelling, disturbed calcium homeostasis, and enhanced atrial ectopic activity/increased vulnerability to re-entry induction...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404744/targeted-therapeutic-drug-monitoring-for-direct-oral-anticoagulants-what-is-its-potential-place-and-can-it-limit-black-swan-events
#17
EDITORIAL
D George Wyse
No abstract text is available yet for this article.
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30404743/2018-focused-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-atrial-fibrillation
#18
Jason G Andrade, Atul Verma, L Brent Mitchell, Ratika Parkash, Kori Leblanc, Clare Atzema, Jeff S Healey, Alan Bell, John Cairns, Stuart Connolly, Jafna Cox, Paul Dorian, David Gladstone, M Sean McMurtry, Girish M Nair, Louise Pilote, Jean-Francois Sarrazin, Mike Sharma, Allan Skanes, Mario Talajic, Teresa Tsang, Subodh Verma, D George Wyse, Stanley Nattel, Laurent Macle
The Canadian Cardiovascular Society (CCS) Atrial Fibrillation Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in atrial fibrillation (AF) management. This 2018 Focused Update addresses: (1) anticoagulation in the context of cardioversion of AF; (2) the management of antithrombotic therapy for patients with AF in the context of coronary artery disease; (3) investigation and management of subclinical AF; (4) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (5) acute pharmacological cardioversion of AF; (6) catheter ablation for AF, including patients with concomitant AF and heart failure; and (7) an integrated approach to the patient with AF and modifiable cardiovascular risk factors...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30297256/new-insights-into-the-use-of-cardiac-magnetic-resonance-imaging-to-guide-decision-making-in-atrial-fibrillation-management
#19
REVIEW
Tarek Zghaib, Saman Nazarian
Recent advances in cardiac magnetic resonance (CMR) imaging acquisition techniques have enabled the visualization of thin atrial myocardium with high temporal and spatial resolution and have the potential to shift atrial fibrillation (AF) management paradigms. Late gadolinium-enhancement (LGE)-CMR can noninvasively identify atrial arrhythmogenic scar substrates and has been shown to spatially correlate with low-voltage areas. Immediately after ablation, a combination of native T1-weighted, LGE, and T2-weighted imaging can assess ablation lesions and localize reversible edema, whereas late after ablation, LGE-CMR can visualize irreversible fibrosis and detect large ablation gaps...
November 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30274639/the-effects-of-cardiac-rehabilitation-in-patients-with-atrial-fibrillation-a-systematic-review
#20
REVIEW
Jennifer L Reed, Tasuku Terada, Daniele Chirico, Stephanie A Prince, Andrew L Pipe
BACKGROUND: Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is associated with substantial morbidity and mortality. Clinical guidelines for managing patients with AF do not include a referral to cardiac rehabilitation (CR) at present, although it is routine for most other cardiovascular conditions. The number of studies evaluating the impact of CR on the health of patients with AF is growing, but there has been no consolidation of the findings. The objective of this systematic review was to evaluate the impact of CR programs on physical and mental health outcomes in patients with all forms of AF...
October 2018: Canadian Journal of Cardiology
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