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https://www.readbyqxmd.com/read/28927171/evolving-quality-standards-for-large-scale-registries-the-garfield-af-experience
#1
Keith A A Fox, Bernard J Gersh, Sory Traore, A John Camm, Gloria Kayani, Anders Krogh, Shweta Shweta, Ajay K Kakkar
Aims: Registries have the potential to capture treatment practices and outcomes in populations beyond the constraints of clinical trial settings. The value of data obtained depend critically upon robust quality standards (including source data verification [SDV] and training); features that are commonly absent from registries. This article outlines the quality standards developed for Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Methods and Results: GARFIELD-AF comprises ∼57 000 patients prospectively recruited over 6...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28925907/atrial-fibrillation-ablation-increases-inflammation-chemokine-modulation-suppresses-activation-of-leukocytes-isolated-after-ablation
#2
Alexandra Lucas, Mohammad Al-Ani, Sriram Ambadapadi, Jordan R Yaron, Donghang Zheng, Adisson Fortunel, Maia Doroton-Guevara, Liying Liu, Sufi Morshed, Jay Fricker, William Miles, Matthew McKillop
AIMS: Atrial fibrillation (AF) ablation is associated with increased circulating markers of inflammation. Innate immune, or inflammation, pathways up-regulate mononuclear cell responses and may increase risk for recurrent arrhythmia. Chemokines and serine protease coagulation pathways both activate innate immune responses. Here, we measured inflammatory markers in peripheral blood samples from patients after cryoballoon and/or radiofrequency pulmonary vein isolation and assessed the capacity for inhibition of chemokine and serine protease pathways to block cell activation...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28925871/biomarkers-associated-with-atrial-fibrosis-and-remodeling
#3
Polychronis Dilaveris, Christos-Konstantinos Antoniou, Panagiota Manolakou, Eleftherios Tsiamis, Konstantinos Gatzoulis, Dimitris Tousoulis
Atrial fibrillation is the most common rhythm disturbance encountered in clinical practice. Although often considered as solely arrhythmic in nature, current evidence has established that atrial myopathy constitutes both the substrate and the outcome of atrial fibrillation, thus initiating a vicious, self-perpetuating cycle. This myopathy is triggered by stress-induced (including pressure/volume overload, inflammation, oxidative stress) responses of atrial tissue, which in the long term become maladaptive, and combines elements of both structural, especially fibrosis, and electrical remodeling, with contemporary approaches yielding potentially useful biomarkers of these processes...
September 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28925721/the-more-effective-treatment-of-atrial-fibrillation-applying-the-natural-compounds-as-nadph-oxidase-and-ion-channel-inhibitors
#4
Samira Barangi, A Wallace Hayes, Gholamreza Karimi
Atrial fibrillation (AF) is the most common cardiac arrhythmia that occurs because of several different risk factors, e.g., valvular heart disease, coronary artery disease, age ≥75 years, hypertension and diabetes mellitus. One key risk factor that results in AF, is oxidative stress. Evidence suggests that there is a correlation between oxidative processes and the genesis of AF. Oxidative stress occurs when the generation of reactive oxygen species (ROS) increase due to excessive activity of enzymes including NADPH oxidase (NOX) and xanthine oxidase; or its degradation decrease by dysfunctional antioxidant enzyme systems, such as superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx)...
September 19, 2017: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/28925012/a-new-negative-allosteric-modulator-ap14145-for-the-study-of-small-conductance-calcium-activated-potassium-channels
#5
Rafel Simó-Vicens, Jeppe E Kirchhoff, Bernardo Dolce, Lea Abildgaard Jensen, Tobias Speerschneider, Ulrik S Sørensen, Morten Grunnet, Jonas G Diness, Bo H Bentzen
BACKGROUND AND PURPOSE: Small conductance Ca(2+) -activated K(+) (KCa 2) channels represent a promising atrial-selective target for treatment of atrial fibrillation (AF). Here, we establish the mechanism of KCa 2 inhibition by the new compound AP14145. EXPERIMENTAL APPROACH: Using site directed mutagenesis binding determinants for AP14145 inhibition were explored. AP14145 selectivity and mechanism of action were investigated by patch clamp recordings of heterologously expressed KCa 2 channels...
September 19, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#6
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28921386/midterm-outcomes-of-two-staged-hybrid-ablation-of-persistent-and-long-standing-persistent-atrial-fibrillation-using-the-versapolar-epicardial-surgical-device-and-subsequent-catheter-ablation
#7
Petr Budera, Pavel Osmancik, Dalibor Herman, Jana Zdarska, David Talavera, Anna Mala, Radka Prochazkova, Zbynek Straka
PURPOSE: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy for patients with non-paroxysmal AF, although, data regarding mid-term outcomes are limited. METHODS: Patients with persistent or long-standing persistent AF were enrolled. Initially, a thoracoscopic, right-sided, epicardial ablation was performed, with a goal of creating a box lesion on the posterior wall of the left atrium; a novel versapolar radiofrequency (RF) catheter was used...
September 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#8
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28919290/utility-and-limitations-of-long-term-monitoring-of-atrial-fibrillation-using-an-implantable-loop-recorder
#9
Randall Lee, Suneet Mittal
Atrial fibrillation (AF) is the most common cardiac arrhythmia diagnosed and treated in the world. The treatment of patients' symptoms as well as the prevention of stroke and heart failure is dependent on accurate detection and characterization of AF. A variety of electrocardiographic (ECG) monitoring techniques are being used for these purposes. However, these intermittent ECG monitoring techniques have been shown to under diagnose AF events, while having limited ability to characterize AF burden and density...
September 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28918897/colchicine-for-primary-prevention-of-atrial-fibrillation-after-open-heart-surgery-systematic-review-and-meta-analysis
#10
Carsten Lennerz, Manish Barman, Mahmoud Tantawy, Mark Sopher, Peter Whittaker
BACKGROUND: Atrial fibrillation occurs frequently after open-heart surgery. It is associated with increased morbidity and mortality, longer hospital stays, and increased healthcare costs. Prophylactic administration of colchicine may mitigate post-operative atrial fibrillation (POAF). METHODS: We searched PubMed, ClinicalTrials.gov and CENTRAL databases to identify randomized controlled trials (RCTs) that; (1) compared prophylactic use of colchicine to placebo, or usual care, in patients with sinus rhythm who underwent elective open-heart surgery and (2) reported POAF-incidence...
September 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28917011/prevalence-predictors-and-prognostic-implications-of-pr-interval-prolongation-in-patients-with-heart-failure
#11
Theodora Nikolaidou, Pierpaolo Pellicori, Jufen Zhang, Syed Kazmi, Kevin M Goode, John G Cleland, Andrew L Clark
AIMS: To determine the prevalence, incidence, predictors, and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. METHODS AND RESULTS: Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included...
September 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#12
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28915649/digoxin-induced-anemia-among-patients-with-atrial-fibrillation-and-heart-failure-clinical-data-analysis-and-drug-gene-interaction-network
#13
Yubi Lin, Siqi He, Ruiling Feng, Zhe Xu, Wanqun Chen, Zifeng Huang, Yang Liu, Qianhuan Zhang, Bin Zhang, Kejian Wang, Shulin Wu
Digoxin is widely used to treat various heart conditions. In order to clarify the association between digoxin and anemia adverse reaction, we inspected case reports submitted to the FDA Adverse Event Reporting System (FAERS) between January 2004 and December 2015. These reports involved 75618 atrial fibrillation patients and 15699 heart failure patients. Compared to other therapies, digoxin treatment was significantly more likely to be concurrent with anemia adverse reaction among both atrial fibrillation patients (pooled OR = 1...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915531/subclinical-hyperthyroidism-and-the-cardiovascular-disease
#14
Alessandro P Delitala
Thyroid hormone excess has complex metabolic effects, particularly on the cardiovascular system. Treatment of these conditions is universally suggested by international guidelines. Subclinical hyperthyroidism, defined by reduced or suppressed TSH levels in the presence of normal free thyroxine and free triiodothyronine values, is common in the general population and progressively increases with aging, being as high as 15.4% in subjects more than 75 years old and more frequent in subjects with nodular goiter...
September 15, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28914213/-medical-treatment-of-people-with-dementia-requires-dealing-with-uncertainty
#15
J P J Slaets
Here we report on a number of medical dilemmas during the final 6 years of life of a 78-year-old woman with dementia. Questions concerning both diagnostic procedures and treatment options are discussed. The first dilemma concerns mild symptoms leading to the diagnosis of paroxysmal atrial fibrillation and the requirement for anticoagulation; the second dilemma concerns vague symptoms of tiredness with anaemia leading to the diagnosis of colon cancer and the requirement for surgery. The conclusion is that there are no protocols that can be used to solve questions of this nature, and we need careful reflection with colleagues, the patient and important people in the patient's life in order to make decisions in the best interest of the quality of life as experienced by the patient...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28913672/reversal-of-dabigatran-associated-bleeding-using-idarucizumab-review-of-the-current-evidence
#16
REVIEW
Michela Giustozzi, Melina Verso, Giancarlo Agnelli, Cecilia Becattini
Major bleeding occurs in about 4% of patients while on treatment with direct oral anticoagulants (DOACs). The case-fatality rate associated with these events is estimated to be about 5%. The specific roles of antidotes, when used with DOACs in reducing the case fatality or improving the overall clinical course of these events, are not thoroughly understood. To this regard, the US Food and Drug Administration as well as European Medicines Agency have recently licensed idarucizumab for the management of patients with life-threatening bleeding or the need for urgent surgery/procedures while on treatment with dabigatran...
September 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28906384/the-safety-and-efficacy-of-oral-anticoagulants-with-dual-versus-single-antiplatelet-therapy-in-patients-after-percutaneous-coronary-intervention-a-meta-analysis
#17
Jie Chen, Li-Yu Wang, Chao Deng, Xing-Hua Jiang, Tu-Gang Chen
BACKGROUND: A growing number of patients require oral anticoagulant (OAC) after undergoing percutaneous coronary intervention (PCI) with stent implantation due to the development of atrial fibrillation, but the optimal antithrombotic regimen remains controversial in these patients. METHODS: We systematically searched PUBMED, EMBASE, and CENTRAL from inception until September 2016 for randomized controlled trials or cohort studies that evaluated the comparative effects of TT versus DT...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#18
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904234/fibrin-clot-permeability-as-a-predictor-of-stroke-and-bleeding-in-anticoagulated-patients-with-atrial-fibrillation
#19
Leszek Drabik, Paweł Wołkow, Anetta Undas
BACKGROUND AND PURPOSE: Formation of denser fiber networks has been reported in atrial fibrillation and ischemic stroke. In this longitudinal cohort study, we evaluated whether fibrin clot density may predict thromboembolic and bleeding risk in patients with atrial fibrillation on vitamin K antagonists. METHODS: In 236 patients with atrial fibrillation receiving vitamin K antagonists treatment, we measured ex vivo plasma clot permeability (Ks), a measure of the pore size in fibrin networks...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28902899/selective-autonomic-stimulation-of-the-av-node-fat-pad-to-control-rapid-post-operative-atrial-arrhythmias
#20
Marco A Mercader, Dingchao He, Aditya C Sharma, Mark C Marchitto, Gregory Trachiotis, Gene A Bornzin, Richard Jonas, Jeffrey P Moak
Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode...
2017: PloS One
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