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atrial fibrillation comparative

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https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#1
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29777366/is-ganglionated-plexus-ablation-effective-for-treating-atrial-fibrillation
#2
Michiko Watanabe, Hiroki Kohno, Yusuke Kondo, Hideki Ueda, Keiichi Ishida, Yusaku Tamura, Shinichiro Abe, Yasunori Sato, Yoshio Kobayashi, Goro Matsumiya
PURPOSE: Very few studies have investigated the efficacy of ganglionated plexus ablation during the conventional maze procedure. In this study, we sought to evaluate its additive effect in reducing recurrent atrial fibrillation after concomitant maze surgery. METHODS: A retrospective study was conducted of 79 patients who underwent Cox maze IV concomitantly with open-heart surgery with (GP group) or without (Maze group) ganglionated plexus mapping. All active ganglionated plexuses were ablated...
May 18, 2018: Surgery Today
https://www.readbyqxmd.com/read/29776576/safety-of-apixaban-in-combination-with-dronedarone-in-patients-with-atrial-fibrillation
#3
Leif Friberg
BACKGROUND: There have been concerns about bleeding risks for patients with atrial fibrillation treated with dronedarone in combination with new oral anticoagulants (NOACs). The aim of the study was to compare the bleeding risks with the apixaban + dronedarone and warfarin + dronedarone combinations. METHOD: Retrospective study of Swedish nationwide health registers. All patients with atrial fibrillation who used dronedarone in combination with apixaban or warfarin during 2013-2016 were identified...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29773835/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#4
Zhenhua Xing, Liang Tang, Pengfei Chen, Jiabing Huang, Xiaofan Peng, Xinqun Hu
Patients with left ventricular dysfunction (LVD) undergoing cardiac surgery have a high mortality rate. Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. It is not clear whether levosimendan can reduce mortality in cardiac surgery patients with LVD. The PubMed, Embase, and Cochrane Central databases were searched to identify randomized trials comparing levosimendan with conventional treatment in cardiac surgery patients with LVD. We derived pooled risk ratios (RRs) with random effects models...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29772981/treatment-of-recent-onset-atrial-fibrillation-with-quinidine-and-flecainide-in-thoroughbred-racehorses-107-cases-1987-2014
#5
Yuji Takahashi, Yuhiro Ishikawa, Hajime Ohmura
OBJECTIVE To compare the efficacy of quinidine and flecainide in treating naturally occurring, recent-onset atrial fibrillation (AF) in Thoroughbred racehorses. DESIGN Retrospective case series. ANIMALS 107 Thoroughbred racehorses. PROCEDURES Medical records of racehorses with AF that were treated with quinidine or flecainide between 1987 and 2014 were reviewed. Signalment, history, treatments, complications, and outcome data were collected. Horses were allocated to 2 groups according to the initial treatment: initial treatment with quinidine (group 1) or initial treatment with flecainide (group 2)...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29772576/wake-up-stroke-versus-stroke-with-known-onset-time-clinical-and-multimodality-ct-imaging-characteristics
#6
Jan W Dankbaar, Henri P Bienfait, Coen van den Berg, Edwin Bennink, Alexander D Horsch, Tom van Seeters, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
BACKGROUND: Current guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time. METHODS: All patients were selected from a large prospective cohort study (Dutch acute stroke study)...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#7
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768156/-impaired-kidney-function-in-patients-with-atrial-fibrillation-practical-aspects
#8
A V Melekhov, E F Dadashova, I G Nikitin
The article focuses on practical aspects of managing patients with a frequently observed combination of atrial fibrillation (AF) and chronic kidney disease (CKD). Based on the authors» own data taken as an example, incidence of different CKD stages in CKD patients was compared with international reports. EchoCG changes were shown to be related with CKD severity. Antithrombotic prevention administered to such patients in the settings of real practice was compared with the existing guidelines.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#9
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760204/model-based-meta-analysis-to-evaluate-optimal-doses-of-direct-oral-factor-xa-inhibitors-in-atrial-fibrillation-patients
#10
Hideki Yoshioka, Hiromi Sato, Hiroto Hatakeyama, Akihiro Hisaka
The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrial fibrillation were demonstrated compared with warfarin by several large clinical trials; however, subsequent meta-analyses reported a higher risk of major bleeding with rivaroxaban than with the other FXa inhibitors. In the present study, we first estimated the changes of prothrombin time (PT) in 5 randomized trials based on reported population pharmacokinetic and pharmacodynamic models and then carried out a model-based meta-analysis to obtain models describing the relationship between PT changes and the event rates of ischemic stroke/systemic embolism (SE) and of major bleeding...
May 22, 2018: Blood Advances
https://www.readbyqxmd.com/read/29759838/detection-of-subclinical-atrial-fibrillation-in-high-risk-patients-using-an-insertable-cardiac-monitor
#11
Tine J Philippsen, Lene S Christensen, Michael G Hansen, Jordi S Dahl, Axel Brandes
OBJECTIVES: The study sought to determine the incidence of subclinical atrial fibrillation (AF) in high-risk patients and to compare the effect of continuous versus intermittent monitoring. BACKGROUND: AF often occurs in a subclinical form, which makes it difficult to detect. The authors do not know the incidence of subclinical AF among patients ≥65 years of age with hypertension and diabetes mellitus. This group of patients has increased risk of developing AF and in addition a high thromboembolic risk, if AF is present...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759785/manual-versus-robotic-catheter-ablation-for-the-treatment-of-atrial-fibrillation-the-man-and-machine-trial
#12
Andreas Rillig, Boris Schmidt, Luigi Di Biase, Tina Lin, Leonie Scholz, Christian H Heeger, Andreas Metzner, Daniel Steven, Peter Wohlmuth, Stephan Willems, Chintan Trivedi, Joseph G Galllinghouse, Andrea Natale, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
OBJECTIVES: Circumferential pulmonary vein isolation (CPVI) using irrigated radiofrequency is the most frequently used ablation technique for the treatment of atrial fibrillation worldwide. BACKGROUND: To date, no large randomized multicenter trials have evaluated the efficacy and safety of CPVI using robotic navigation (RN) systems compared with the current gold standard of manual ablation (MN). METHODS: In this prospective, international multicenter noninferiority trial, 258 patients with paroxysmal or persistent atrial fibrillation were randomized for CPVI using either RN (RN group, n = 131) or manual ablation (MN group, n = 127)...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759676/outcomes-associated-with-electrical-cardioversion-for-atrial-fibrillation-when-performed-autonomously-by-an-advanced-practice-provider
#13
Theresa A Strzelczyk, Rachel M Kaplan, Meena Medler, Bradley P Knight
OBJECTIVES: This study sought to determine the feasibility, safety, and efficacy of elective electrical cardioversion (CV) for atrial fibrillation (AF) when performed autonomously by a trained advanced practice provider (APP) using a guideline-directed protocol. BACKGROUND: APPs have emerged as an integral part of the cardiovascular team. METHODS: A licensed advanced practice nurse-clinical nurse specialist was trained and obtained credentials to perform CVs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759674/population-based-evaluation-of-major-adverse-events-after-catheter-ablation-for-atrial-fibrillation
#14
Michelle Samuel, Mohammad Almohammadi, Meytal Avgil Tsadok, Jacqueline Joza, Cynthia A Jackevicius, Maria Koh, Hassan Behlouli, Atul Verma, Louise Pilote, Vidal Essebag
OBJECTIVES: The purpose of this study was to evaluate the safety and incidence of periprocedural adverse events (AEs) among patients who underwent catheter ablation (CA) for atrial fibrillation (AF) in Quebec and Ontario, Canada. BACKGROUND: CA is evolving into the mainstay therapy for patients with symptomatic AF refractory to antiarrhythmic medication. However, the safety of CA at the population level over time requires further evaluation. METHODS: A population-based cohort was constructed using administrative databases of all patients who underwent CA between 1999 and 2014 in Quebec and Ontario, Canada...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759666/patients-with-atrial-fibrillation-who-are-not-on-anticoagulant-treatment-due-to-increased-bleeding-risk-are-common-and-have-a-high-risk-of-stroke
#15
Björn Redfors, William A Gray, Randall J Lee, Kenneth A Ellenbogen, Machaon Bonafede, Ori Ben-Yehuda
OBJECTIVES: This study sought to determine how many patients with atrial fibrillation (AF) are not treated with oral anticoagulants (OAC) due to a high risk of bleeding and to characterize their risk of ischemic stroke in a real-world setting. BACKGROUND: AF is associated with a 5-fold increased risk of ischemic stroke. OAC reduce the risk of stroke in patients with AF who do not have an increased bleeding risk, but no comparably effective treatment exists for patients with contraindications to OAC...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759624/long-detection-programming-in-single-chamber-defibrillators-reduces-unnecessary-therapies-and-mortality-the-advance-iii-trial
#16
Maurizio Gasparini, Maurizio G Lunati, Alessandro Proclemer, Angel Arenal, Axel Kloppe, Josè B Martínez Ferrer, Ahmad S Hersi, Marcin Gulaj, Maurits C E Wijffels, Elisabetta Santi, Laura Manotta, Niraj Varma
OBJECTIVES: This study sought to evaluate the effects of programming a long detection in single-chamber (VVI) implantable cardioverter-defibrillators (ICDs) in the multicenter prospective ADVANCE III (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III) trial. BACKGROUND: Programming strategies may reduce unnecessary ICD shocks and their adverse effects but to date have been described only for dual-chamber ICDs. METHODS: A total of 545 subjects (85% male; atrial fibrillation 25%, left ventricular ejection fraction 31%, ischemic etiology 68%, secondary prevention indications 32%) receiving a VVI ICD were randomized to long detection (30 of 40 intervals) or standard programming (18 of 24 intervals) based on device type, atrial fibrillation history, and indication...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759622/5-year-outcome-of-pulmonary-vein-isolation-by-loss-of-pace-capture-on-the-ablation-line-versus-electrical-circumferential-pulmonary-vein-isolation
#17
Julia Moser, Arian Sultan, Jakob Lüker, Helge Servatius, Tim Salzbrunn, Manuel Altenburg, Benjamin Schäffer, Doreen Schreiber, Ruken Ö Akbulak, Julia Vogler, Boris A Hoffmann, Stephan Willems, Daniel Steven
OBJECTIVES: This study sought to compare long-term arrhythmia-free survival between electrical circumferential pulmonary vein isolation (PVI) and PVI with the endpoint of unexcitability along the ablation line. BACKGROUND: PVI is the standard ablation strategy of paroxysmal atrial fibrillation, although arrhythmia recurrence in long-term follow-up (FU) is high. The endpoint of unexcitability along the ablation line results in decreased arrhythmia recurrence compared to electrical PVI in 1-year FU...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759616/spatial-relationships-of-complex-fractionated-atrial-electrograms-and-continuous-electrical-activity-to-focal-electrical-sources-implications-for-substrate-ablation-in-human-atrial-fibrillation
#18
Simon Kochhäuser, Atul Verma, Rupin Dalvi, Adrian Suszko, Pouria Alipour, Prashanthan Sanders, Jean Champagne, Laurent Macle, Girish M Nair, Hugh Calkins, David J Wilber, Vijay S Chauhan
OBJECTIVES: This study sought to evaluate the spatial relationships of focal electrical sources (FSs) to complex fractionated atrial electrograms (CFAE) and continuous electrical activity (CEA). BACKGROUND: Fractionated atrial electrograms have been associated with atrial fibrillation (AF) drivers in computational studies and represent ablation targets in the management of persistent AF. METHODS: We included a subset of 66 patients (age: 63 [56, 67] years, 69% persistent AF) with electroanatomic data from the SELECT AF (Selective complex fractionated atrial electrograms targeting for atrial fibrillation) randomized control trial that compared the efficacy of CFAE with CEA ablation in AF patients undergoing pulmonary vein antral ablation...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759489/ablation-index-and-surround-flow-catheter-irrigation-impedance-based-appraisal-in-clinical-ablation
#19
Waqas Ullah, Ross J Hunter, Malcolm C Finlay, Ailsa McLean, Mehul B Dhinoja, Simon Sporton, Mark J Earley, Richard J Schilling
OBJECTIVES: This study sought to assess the impact of ablation power and catheter irrigation during clinical radiofrequency ablation using impedance drop. BACKGROUND: In preclinical studies, ablation power and catheter irrigation are determinants of ablation efficacy. METHODS: Static 30-s left atrial ablations were delivered in patients undergoing their first atrial fibrillation ablation. Impedance drop during ablation (as a measure of efficacy) was compared using the following: the force time integral (FTI); the FTI-P (a cumulative multiple FTI and ablation power), and ablation index (AI), a weighted algorithm including contact force, power, and duration...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759434/pulmonary-vein-re-isolation-as-a-routine-strategy-regardless-of-symptoms-the-pressure-randomized-controlled-trial
#20
Moloy Das, Gareth J Wynn, Yawer Saeed, Sean Gomes, Maureen Morgan, Christina Ronayne, Laura J Bonnett, Johan E P Waktare, Derick M Todd, Mark C S Hall, Richard L Snowdon, Simon Modi, Dhiraj Gupta
OBJECTIVES: The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. BACKGROUND: Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. METHODS: A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study)...
June 2017: JACC. Clinical Electrophysiology
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