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acute ischemic stroke in AF

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https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#1
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28178140/utility-of-duranta-a-wireless-patch-type-electrocardiographic-monitoring-system-developed-in-japan-in-detecting-covert-atrial-fibrillation-in-patients-with-cryptogenic-stroke-a-case-report
#2
Hisanao Akiyama, Saki Nukui, Takashi Araga, Masashi Hoshino, Keita Tanaka, Satoru Kashima, Rie Sasaki, Kenji Uchino, Yasuhiro Hasegawa
RATIONALE: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151397/do-women-with-atrial-fibrillation-experience-more-severe-strokes-results-from-the-austrian-stroke-unit-registry
#3
Clemens Lang, Leonhard Seyfang, Julia Ferrari, Thomas Gattringer, Stefan Greisenegger, Karin Willeit, Thomas Toell, Stefan Krebs, Michael Brainin, Stefan Kiechl, Johann Willeit, Wilfried Lang, Michael Knoflach
BACKGROUND AND PURPOSE: Ischemic strokes associated with atrial fibrillation (AF) are more severe than those of other cause. We aim to study potential sex effects in this context. METHODS: In this cross-sectional study, 74 425 adults with acute ischemic stroke from the Austrian Stroke Unit Registry were included between March 2003 and January 2016. In 63 563 patients, data on the National Institutes of Health Stroke Scale on admission to the stroke unit, presence of AF, vascular risk factors, and comorbidities were complete...
February 1, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28149081/not-only-the-sugar-early-infarct-sign-hyperdense-middle-cerebral-artery-age-neurologic-deficit-score-but-also-atrial-fibrillation-is-predictive-for-symptomatic-intracranial-hemorrhage-after-intravenous-recombinant-tissue-plasminogen-activator
#4
Sombat Muengtaweepongsa, Pornpoj Prapa-Anantachai, Pornpat A Dharmasaroja
BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is the most unwanted adverse event in patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (i.v. rt-PA). Many tool scores are available to predict the probability of sICH. Among those scores, the Sugar, Early infarct sign, hyperDense middle cerebral artery, Age, Neurologic deficit (SEDAN) gives the highest area under the curve-receiver operating characteristic value. OBJECTIVE: We aimed to examine any factors other than the SEDAN score to predict the probability of sICH...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28090403/a-review-of-the-relationship-of-atrial-fibrillation-and-acute-coronary-syndrome
#5
Bory Kea, Tahroma Alligood, Vincent Manning, Merritt Raitt
Atrial fibrillation (AF) is the most common arrhythmia encountered by clinicians. Clinical decision-making focuses on reducing ischemic stroke risk in AF patients; however, AF is also associated with an increased risk of acute coronary syndromes (ACS). Patients with ACS and concurrent AF are less likely to receive appropriate therapies and more likely to experience adverse outcomes than ACS patients in sinus rhythm (SR). Clinicians may be able to stratify ACS patients at increased risk of AF development based on clinical characteristics...
September 2016: Current Emergency and Hospital Medicine Reports
https://www.readbyqxmd.com/read/28039855/use-of-oral-anticoagulant-therapy-in-older-adults-with-atrial-fibrillation-after-acute-ischemic-stroke
#6
Emer R McGrath, Alan S Go, Yuchiao Chang, Leila H Borowsky, Margaret C Fang, Kristi Reynolds, Daniel E Singer
OBJECTIVES: To explore barriers to anticoagulation in older adults with atrial fibrillation (AF) at high risk of stroke and to identify opportunities for interventions that might increase use of oral anticoagulants (OACs). DESIGN: Retrospective cohort study. SETTING: Two large community-based AF cohorts. PARTICIPANTS: Individuals with ischemic stroke surviving hospitalization (N = 1,405, mean age 79). MEASUREMENTS: Using structured chart review, reasons for nonuse of OAC were identified, and 1-year poststroke survival was assessed...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27965972/a-hybrid-signal-processing-of-rr-intervals-from-qtc-variation-searching-arrhythmia-and-improving-heart-rate-variability-assessment-in-acute-large-artery-ischemic-stroke
#7
S Rangsungnoen, P Chanbenjapipu, N Mathuradavong, K Suwanprasert
Sudden death caused by abnormal QTc and atrial fibrillation (AF) has been reported in stroke. Heart rate variability (HRV) is reduced with missing beats of RRI during arrhythmic episode and abnormal QTc variation during acute stroke. In this study, we develop a hybrid signal processing by Pan Tompkins QRS detection and Kalman filter estimator for meaningful missing beats and searching AF with prolonged QTc. We use this hybrid model to investigate RRIs of Lead II ECG in thirty acute stroke patients with long QTc and AF (LQTc-AF) and normal QTc without AF (NQTc-nonAF) and then assess them by HRV...
2016: Journal of Medical Engineering
https://www.readbyqxmd.com/read/27941401/new-standards-of-care-in-ischemic-stroke
#8
Bree K Chancellor, Koto Ishida
BACKGROUND: Ischemic arterial strokes of the ophthalmic artery and its branches and posterior cerebral artery are common causes of visual disability. Etiologies of stroke affecting the retina, optic nerve, optic radiation, and visual cortex overlap with other types of ischemic strokes. Stenosis of the internal carotid is the most common cause of central retinal artery occlusion (CRAO). One-fourth of patients with CRAO have cerebral strokes. We report recent developments in the acute treatment and secondary prevention of ischemic stroke of relevance to clinicians who encounter patients with acute vision loss...
December 8, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27909474/efficacy-high-procedural-safety-and-rapid-optimization-of-cryoballoon-atrial-fibrillation-ablation-in-the-hands-of-a-new-operator
#9
Eberhard Scholz, Patrick Lugenbiel, Patrick A Schweizer, Panagiotis Xynogalos, Claudia Seyler, Edgar Zitron, Rüdiger Becker, Hugo A Katus, Dierk Thomas
BACKGROUND: Cryoballoon (CB) ablation is successful in eliminating atrial fibrillation (AF). PURPOSE: The purpose of this study was to assess procedural efficacy and safety of CB ablation performed by a newly trained operator. METHODS: Forty patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB catheter ablation were prospectively enrolled. RESULTS: Electrical pulmonary vein (PV) isolation was achieved in all patients (156 PVs)...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27878420/a-5-year-clinical-follow-up-after-duty-cycled-phased-rf-ablation-of-paroxysmal-atrial-fibrillation
#10
Antoine Lepillier, Xavier Copie, Gilles Lascault, Olivier Paziaud, Olivier Piot
PURPOSE: Catheter radiofrequency ablation (RFA) is an effective treatment for symptomatic paroxysmal atrial fibrillation (AF). It has been demonstrated that the multielectrode pulmonary vein ablation catheter (PVAC) has favourable outcomes at 6-12 months post-ablation, but there are only few studies with a long-term follow-up. METHODS: We retrospectively reviewed 77 consecutive PVAC procedures in our centre, from November 2007 to December 2012. RFA was attempted in patients with symptomatic paroxysmal AF (mean age 58...
November 22, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27846983/gender-specific-differences-for-risk-of-disability-and-death-in-atrial-fibrillation-related-stroke
#11
Ryan C Martin, W Scott Burgin, Matthew B Schabath, Bonnie Kirby, Sanders H Chae, Michael G Fradley, David Z Rose, Arthur J Labovitz
In the latest American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines, CHA2DS2-VASc replaced the CHADS2 stroke risk assessment to determine prophylactic anticoagulation, reflecting female gender's association with stroke incidence in AF. However, little investigation has been pursued of potential risk factors associated with worsened stroke severity. In this study, we examined patients with AF with ischemic stroke patient characteristics associated with increased stroke severity...
January 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27750222/long-term-risk-of-stroke-after-transient-ischemic-attack
#12
Peter Appelros, Maria Háls Berglund, Jakob O Ström
BACKGROUND: In the absence of active management, the stroke risk after a transient ischemic attack (TIA) may be high. Almost 10 years ago, the results of the EXPRESS and SOS-TIA studies called for a more rapid management of TIA patients. The purpose of this study was to investigate the other stroke risks in the longer term, after the implementation of a more active approach to TIA. We also wanted to assess the predictive value of the ABCD2 score in this context. METHODS: Riksstroke is the national stroke registry in Sweden...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27733570/increasing-atrial-fibrillation-prevalence-in-acute-ischemic-stroke-and-tia
#13
Fadar Oliver Otite, Priyank Khandelwal, Seemant Chaturvedi, Jose G Romano, Ralph L Sacco, Amer M Malik
OBJECTIVE: To evaluate trends in atrial fibrillation (AF) prevalence in acute ischemic stroke (AIS) and TIA in the United States. METHODS: We used the Nationwide Inpatient Sample to retrospectively compute weighted prevalence of AF in AIS (n = 4,355,140) and TIA (n = 1,816,459) patients admitted to US hospitals from 2004 to 2013. Multivariate-adjusted models were used to evaluate the association of AF with clinical factors, mortality, length of stay, and cost. RESULTS: From 2004 to 2013, AF prevalence increased by 22% in AIS (20%-24%) and by 38% in TIA (12%-17%)...
November 8, 2016: Neurology
https://www.readbyqxmd.com/read/27702773/clinical-outcomes-in-3343-children-and-adults-with-rheumatic-heart-disease-from-14-low-and-middle-income-countries-2-year-follow-up-of-the-global-rheumatic-heart-disease-registry-the-remedy-study
#14
Liesl Zühlke, Ganesan Karthikeyan, Mark E Engel, Sumathy Rangarajan, Pam Mackie, Blanche Cupido, Katya Mauff, Shofiqul Islam, Rezeen Daniels, Veronica Francis, Stephen Ogendo, Bernard Gitura, Charles Mondo, Emmy Okello, Peter Lwabi, Mohammed M Al-Kebsi, Christopher Hugo-Hamman, Sahar S Sheta, Abraham Haileamlak, Wandimu Daniel, Dejuma Yadeta Goshu, Senbeta G Abdissa, Araya G Desta, Bekele A Shasho, Dufera M Begna, Ahmed ElSayed, Ahmed S Ibrahim, John Musuku, Fidelia Bode-Thomas, Christopher C Yilgwan, Ganiyu A Amusa, Olukemi Ige, Basil Okeahialam, Christopher Sutton, Rajeev Misra, Azza Abul Fadl, Neil Kennedy, Albertino Damasceno, Mahmoud U Sani, Okechukwu S Ogah, Taiwo Olunuga, Huda ElHassan, Ana Olga Mocumbi, Abiodun M Adeoye, Pindile S Mntla, Dike B Ojji, Joseph Mucumbitsi, Koon Teo, Salim Yusuf, Bongani M Mayosi
BACKGROUND: -There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease (RHD) or information on their predictors. We report the two year follow-up of individuals with RHD from 14 low and middle income countries in Africa and Asia. METHODS: -Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for two years to assess mortality, congestive heart failure (CHF), stroke or transient ischemic attack (TIA), recurrent acute rheumatic fever (ARF), and infective endocarditis (IE)...
October 4, 2016: Circulation
https://www.readbyqxmd.com/read/27697972/acute-cardiovascular-events-and-all-cause-mortality-in-patients-with-hyperthyroidism-a-population-based-cohort-study
#15
Olaf M Dekkers, Erzsébet Horváth-Puhó, Suzanne C Cannegieter, Jan P Vandenbroucke, Henrik Toft Sørensen, Jens Otto L Jørgensen
OBJECTIVE: Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. DESIGN: It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals...
January 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27695988/prognosis-in-patients-with-atrial-fibrillation-and-a-presumed-temporary-cause-in-a-community-based-cohort-study
#16
Laurent Fauchier, Nicolas Clementy, Arnaud Bisson, Karim Stamboul, Fabrice Ivanes, Denis Angoulvant, Dominique Babuty, Gregory Y H Lip
BACKGROUND: Atrial fibrillation (AF) may be related to acute and temporary causes, whether cardiovascular or non-cardiovascular. It remains unclear whether the risk of ischemic stroke is different in this setting, and whether antithrombotic management should be different in these patients. The objective of the study was to describe and compare the risk of stroke in AF patients with and with no such temporary precipitating cause. METHODS: Among 8962 patients with AF seen between 2000 and 2010, we focused our analysis on 4587 patients with non-permanent AF, of whom 740 (16 %) had at least one possible temporary cause of AF...
September 30, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27665101/combined-aspirin-and-anticoagulant-therapy-in-patients-with-atrial-fibrillation
#17
Charlotte H So, Mark H Eckman
The combined use of aspirin and oral anticoagulant therapy in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) has been questioned due to an increased risk of major bleeding with little to no benefit in preventing ischemic events. (1) To better understand patterns and indications for combined antiplatelet and anticoagulant therapy and identify patients who might reasonably be treated with oral anticoagulant (OAC) therapy alone. (2) To perform an updated literature review regarding the use of combined antiplatelet and OAC therapy in patients with AF and stable CAD...
January 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27649879/usefulness-of-atrial-fibrillation-as-a-marker-for-adverse-cardiovascular-outcomes-in-both-primary-and-secondary-prevention-in-patients-with-implantable-cardioverter-defibrillators
#18
Ian C Y Chang, Yusuf M Agamawi, Erin Austin, Wayne O Adkisson, Henri Roukoz, Lisa N von Wald, Scott Sakaguchi, David G Benditt, Lin Y Chen
Whether the risk factors for cardiovascular (CV) outcomes are different in primary versus secondary prevention implantable cardioverter-defibrillator (ICD) patients is unclear. We sought to identify predictors of CV outcomes in ICD recipients for primary (G1) versus secondary prevention (G2). Consecutive patients who had ICD implanted during August 2005 to December 2009 were included. The primary outcome was a composite of appropriate shock, acute coronary syndrome, ischemic stroke, coronary revascularization, heart failure exacerbation, CV hospitalization, or all-cause death...
August 23, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27575274/the-role-of-blood-transfusion-in-the-development-of-atrial-fibrillation-after-coronary-artery-bypass-grafting
#19
Athanasia Vlahou, Konstantinos Diplaris, Fotini Ampatzidou, Lampos Karagounnis, George Drossos
Objectives Atrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). It is associated with prolonged hospital stay and increased cost. The aim of this study is to investigate the relationship between transfusion of blood derivatives and occurrence of postoperative paroxysmal AF. Materials and Methods From June 2012 to February 2014, 446 patients undergoing CABG with cardiopulmonary bypass (CPB) were prospectively evaluated for occurrence of postoperative AF. Patients and procedural variables were recorded and were associated with the development of new-onset AF with logistic regression analysis...
December 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27559816/hospitalization-expenses-of-acute-ischemic-stroke-patients-with-atrial-fibrillation-relative-to-those-with-normal-sinus-rhythm
#20
Jiming Li, Weiliang Luo
BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is a risk factor for acute ischemic stroke (AIS). In mainland China, little is known of the hospitalization expenses of AIS patients with AF compared to those with normal sinus rhythm (SR). This study compared the itemized expenses of AIS patients with or without AF in a hospital in Huizhou City. METHODS: Patients hospitalized for AIS from March 2014 to March 2015 were enrolled, including 73 with AF and 751 with normal SR...
February 2017: Journal of Medical Economics
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