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Anticoagulation for a flutter

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https://www.readbyqxmd.com/read/28217222/non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-for-cardioversion-of-atrial-fibrillation-in-clinical-practice-a-single-center-experience
#1
Naoki Shibata, Itsuro Morishima, Kenji Okumura, Yasuhiro Morita, Kensuke Takagi, Ruka Yoshida, Hiroaki Nagai, Toshiro Tomomatsu, Yoshihiro Ikai, Kazushi Terada, Kazuhito Tsuzuki, Hideyuki Tsuboi, Takahito Sone, Toyoaki Murohara
BACKGROUND: Anticoagulation therapy with the vitamin K antagonist (VKA) warfarin has been demonstrated to reduce thromboembolic risk after electrical cardioversion (ECV). However, data concerning ECV with non-VKA oral anticoagulants (NOACs) is limited. The objective of this study was to determine the efficacy and safety of NOACs in patients undergoing ECV in a real-world clinical practice at a single center in Japan. METHODS: We retrospectively analyzed the data of 406 consecutive patients who underwent ECV for atrial fibrillation (AF) or flutter under anticoagulation with one of the three NOACs (n=149) or with a VKA (n=257)...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28187920/holter-electrocardiogram-monitoring-in-patients-with-acute-ischaemic-stroke-find-afrandomised-an-open-label-randomised-controlled-trial
#2
Rolf Wachter, Klaus Gröschel, Götz Gelbrich, Gerhard F Hamann, Pawel Kermer, Jan Liman, Joachim Seegers, Katrin Wasser, Anna Schulte, Falko Jürries, Anna Messerschmid, Nico Behnke, Sonja Gröschel, Timo Uphaus, Anne Grings, Tugba Ibis, Sven Klimpe, Michaela Wagner-Heck, Magdalena Arnold, Evgeny Protsenko, Peter U Heuschmann, David Conen, Mark Weber-Krüger
BACKGROUND: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. METHODS: Find-AFRANDOMISED is an open-label randomised study done at four centres in Germany...
February 8, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28130373/catheter-ablation-for-atrial-flutter-a-survey-by-the-european-heart-rhythm-association-and-canadian-heart-rhythm-society
#3
Benedict M Glover, Jian Chen, Kathryn L Hong, Serge Boveda, Adrian Baranchuk, Kristina H Haugaa, Paul Dorian, Tatjana S Potpara, Eugene Crystal, Brent Mitchell, Roland Tilz, Peter Leong-Sit, Nikolaos Dagres
The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus (CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28110987/outcomes-for-emergency-department-patients-with-recent-onset-atrial-fibrillation-and-flutter-treated-in-canadian-hospitals
#4
Ian G Stiell, Catherine M Clement, Brian H Rowe, Robert J Brison, D George Wyse, David Birnie, Paul Dorian, Eddy Lang, Jeffrey J Perry, Bjug Borgundvaag, Debra Eagles, Damian Redfearn, Jennifer Brinkhurst, George A Wells
STUDY OBJECTIVE: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. METHODS: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28070875/atrial-fibrillation-inducibility-during-cavotricuspid-isthmus-dependent-atrial-flutter-ablation-as-a-predictor-of-clinical-atrial-fibrillation-a-meta-analysis
#5
Jorge Romero, Juan Carlos Diaz, Luigi Di Biase, Saurabh Kumar, David Briceno, Usha B Tedrow, Carolina R Valencia, Samuel H Baldinger, Bruce Koplan, Laurence M Epstein, Roy John, Gregory F Michaud, William G Stevenson
BACKGROUND: Atrial fibrillation (AF) and cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow-up after successful AFL ablation. METHODS: A systemic review of Medline, Cochrane, and Embase was done for all the clinical studies in which assessment of AF inducibility in patients undergoing ablation for CTI AFL was performed...
January 9, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28069839/incidence-of-new-onset-atrial-fibrillation-after-cavotricuspid-isthmus-ablation-for-atrial-flutter
#6
Umut Celikyurt, Sven Knecht, Michael Kuehne, Tobias Reichlin, Aline Muehl, Florian Spies, Stefan Osswald, Christian Sticherling
AIMS: In patients with cavotricuspid isthmus (CTI) ablation for atrial flutter (AFL), the decision to hold oral anticoagulation (OAC) often becomes an issue. The purpose of this study was to describe the incidence of the development of atrial fibrillation (AF) after CTI ablation in patients with documented AFL with and without a previous history of AF and to identify risk predictors for the occurrence of AF after CTI. METHODS AND RESULTS: We included 364 consecutive patients undergoing successful CTI ablation...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28057775/catheter-ablation-for-atrial-flutter-a-survey-by-the-european-heart-rhythm-association-and-canadian-heart-rhythm-society
#7
Benedict M Glover, Jian Chen, Kathryn L Hong, Serge Boveda, Adrian Baranchuk, Kristina H Haugaa, Paul Dorian, Tatjana S Potpara, Eugene Crystal, Brent Mitchell, Roland Tilz, Peter Leong-Sit, Nikolaos Dagres
The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus : CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries...
January 5, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27909492/a-comparison-between-dabigatran-and-warfarin-on-time-to-elective-cardioversion
#8
Amanda N Basto PharmD, Nathan P Fewel PharmD, Rajiv Gupta Md, Eileen M Stock PhD, Mia Ta PharmD
OBJECTIVE: To evaluate the use of dabigatran versus warfarin on time to elective direct current cardioversion (DCCV). METHODOLOGY: This retrospective observational study was conducted at a single Veterans Affairs hospital in the Southwestern region of the U.S. Patients with atrial fibrillation or atrial flutter who were initiated on either warfarin or dabigatran prior to DCCV were reviewed. The time to cardioversion was compared between warfarin and dabigatran, as well as costs of therapy, rescheduling rates, and adverse events...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27780690/risk-of-atrial-fibrillation-and-bleeding-diathesis-associated-with-ibrutinib-treatment-a-systematic-review-and-pooled-analysis-of-four-randomized-controlled-trials
#9
Seongseok Yun, Nicole D Vincelette, Utkarsh Acharya, Ivo Abraham
BACKGROUND: Clinical trials raised concern that ibrutinib may increase the risk of atrial fibrillation/flutter (Afib/Aflutter) and major bleeding. However, the association has not been statistically validated, and there is no consensus regarding optimal management of anticoagulation among patients receiving ibrutinib who develop Afib/Aflutter. We performed a systematic review and pooled analysis to precisely assess the risk of Afib/Aflutter and bleeding associated with ibrutinib treatment in patients with hematologic malignancies...
September 19, 2016: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/27769294/incidence-of-left-atrial-abnormalities-under-treatment-with-dabigatran-rivaroxaban-and-vitamin-k-antagonists
#10
Stefan Reers, Tolga Agdirlioglu, Michael Kellner, Matthias Borowski, Holger Thiele, Johannes Waltenberger, Michael Reppel
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran or rivaroxaban are alternatives to vitamin K antagonists (VKAs) for prevention of stroke and systemic embolism in patients with atrial fibrillation (AF) and atrial flutter (AFL). Incidences of risk factors for left atrium (LA) and left atrial appendage (LAA) thrombus formation, such as dense spontaneous echo contrast (SEC), low LAA velocity (LAAV) <20 cm/s under treatment with dabigatran and rivaroxaban in comparison with VKAs are unknown...
October 21, 2016: European Journal of Medical Research
https://www.readbyqxmd.com/read/27554091/management-and-outcome-of-periprocedural-cardiac-perforation-and-tamponade-with-radiofrequency-catheter-ablation-of-cardiac-arrhythmias-a-single-medium-volume-center-experience
#11
Nebojša Mujović, Milan Marinković, Nebojša Marković, Aleksandar Kocijančić, Vladan Kovačević, Dragan Simić, Arsen Ristić, Goran Stanković, Biljana Miličić, Svetozar Putnik, Bosiljka Vujisić-Tešić, Tatjana S Potpara
INTRODUCTION: Cardiac tamponade (CT) is a life-threatening complication of radiofrequency ablation (RFA). The course and outcome of CT in low-to-medium volume electrophysiology centers are underreported. METHODS: We analyzed the incidence, management and outcomes of CT in 1500 consecutive RFAs performed in our center during 2011-2016. RESULTS: Of 1500 RFAs performed in 1352 patients (age 55 years, interquartile range: 41-63), 569 were left-sided procedures (n = 406 with transseptal access)...
October 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27522997/massive-right-atrial-thrombus-formation-followed-by-an-atrial-flutter-with-1-1-atrioventricular-conduction-in-a-patient-with-arrhythmogenic-right-ventricular-cardiomyopathy
#12
Kanako Ito, Yu-Ki Iwasaki, Yuhi Fujimoto, Eiichiro Oka, Kenta Takahashi, Ippei Tsuboi, Kenji Yodogawa, Meiso Hayashi, Yasushi Miyauchi, Wataru Shimizu
A 46-year-old man was admitted to our hospital for near syncope and palpitations. An electrocardiogram showed a common type of atrial flutter (AFL) with 1:1 atrioventricular conduction. Transthoracic echocardiography revealed a massive right atrial (RA) thrombus with a huge RA and right ventricle. The patient was diagnosed with arrhythmogenic right ventricular cardiomyopathy. It was difficult to control the heart rate with beta-blockers during AFL, which resulted in the deterioration of right-sided heart failure...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27502860/left-atrial-thrombus-resolution-in-atrial-fibrillation-or-flutter-results-of-a-prospective-study-with-rivaroxaban-x-tra-and-a-retrospective-observational-registry-providing-baseline-data-clot-af
#13
Gregory Y H Lip, Christoph Hammerstingl, Francisco Marin, Riccardo Cappato, Isabelle Ling Meng, Bodo Kirsch, Martin van Eickels, Ariel Cohen
BACKGROUND: Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) or atrial flutter, with the CLOT-AF registry providing retrospective data after standard-of-care therapy in this setting. METHODS: X-TRA was a prospective, single-arm, open-label, multicenter study that investigated rivaroxaban treatment for 6 weeks for LA/LAA thrombus resolution in patients with nonvalvular AF or atrial flutter and LA/LAA thrombus confirmed at baseline on a transesophageal echocardiogram (TEE)...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27422488/interatrial-conduction-time-can-predict-new-onset-atrial-fibrillation-after-radiofrequency-ablation-of-isolated-typical-atrial-flutter
#14
Ryuta Henmi, Koichiro Ejima, Morio Shoda, Daigo Yagishita, Nobuhisa Hagiwara
INTRODUCTION: Many patients with successful atrial flutter (AFL) ablation will develop atrial fibrillation (AF) during follow-up. This study aimed to determine whether prolonged interatrial conduction time (IACT) is associated with risk for new-onset AF after ablation of isolated, typical AFL. METHODS: Participants were 80 consecutive patients who underwent successful radiofrequency ablation of isolated, typical AFL from 2004 to 2012. Patients with any history of AF prior to AFL ablation were excluded...
July 16, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27421846/the-risk-of-thromboembolic-complications-in-fontan-patients-with-atrial-flutter-fibrillation-treated-with-electrical-cardioversion
#15
Jiuann-Huey I Lin, Adam C Kean, Timothy M Cordes
Atrial flutter or fibrillation (AFF) remains a major chronic complication of the Fontan procedure. This complication further predisposes this patient population to thromboembolic events. However, the incidence of thromboembolic complications in Fontan patients with AFF prior to or acutely after electrical cardioversion is unknown. This study aimed to characterize the risk of post-cardioversion thromboembolic events in this population. We performed a retrospective medical record review of all patients with a history of Fontan operation treated with direct current cardioversion for AFF at Riley Children's Hospital between June 1992 and March 2014...
October 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27412902/no-decline-in-the-risk-of-stroke-following-incident-atrial-fibrillation-since-2000-in-the-community-a-concerning-trend
#16
Alanna M Chamberlain, Robert D Brown, Alvaro Alonso, Bernard J Gersh, Jill M Killian, Susan A Weston, Véronique L Roger
BACKGROUND: While atrial fibrillation is a recognized risk factor for stroke, contemporary data on trends in stroke incidence after the diagnosis of atrial fibrillation are scarce. METHODS AND RESULTS: Olmsted County, MN residents with incident atrial fibrillation or atrial flutter (collectively referred to as AF) from 2000 to 2010 were identified. Cox regression determined associations of year of AF diagnosis with ischemic stroke and transient ischemic attack (TIA) occurring through 2013...
June 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27326208/poor-adherence-to-anticoagulation-guidelines-in-patients-with-non-valvular-atrial-fibrillation-treated-in-a-tertiary-cardiology-unit
#17
Guan Sen Kew, Mabel Tan, Toon Wei Lim
INTRODUCTION: Atrial fibrillation (AF) is a well-known cause of strokes and all major society guidelines recommend oral anticoagulants (OAC) such as vitamin K antagonists (VKA) for patients with concomitant risk factors to prevent them. However, compliance with these guidelines is historically poor. This study aims to evaluate the adherence to CHADS2 (congestive heart failure, hypertension,age ≥75 years, diabetes mellitus and prior stroke or transient ischaemic attack) guidelines, explore reasons and evaluate outcomes for non-adherence in a tertiary cardiology unit...
2015: Heart Asia
https://www.readbyqxmd.com/read/27111448/a-stunning-left-atrial-appendage-thrombus
#18
Sajid Ali, Justin Ugwu, Yousuf Kanjwal
BACKGROUND: Left atrial appendage thrombus formation is a known major complication of atrial fibrillation and atrial flutter which increases the risk of embolism and stroke. This risk of thrombosis is greatly increased with a lack of anticoagulation. After conversion to a normal sinus rhythm in these arrhythmias, the risk of thrombus formation in the left atrium persists through a phenomenon termed atrial myocardial stunning. CASE: We present the case of a patient who previously underwent successful pulmonary vein isolation and was found to be in typical isthmus-dependent atrial flutter with a questionable recurrence of atrial fibrillation...
2016: Cardiology
https://www.readbyqxmd.com/read/27060690/correlation-of-left-atrial-appendage-ejection-velocities-with-the-chads2-and-cha2ds2-vasc-scores
#19
Craig B Clark, Nelson A Telles Garcia, Catherine Hackett Renner, Sarah M Ryan
BACKGROUND: In patients with atrial fibrillation or flutter, a left atrial appendage ejection velocity measured via transesophageal echocardiography equal to or less than 40 cm/sec has been shown to correlate with an increased risk of developing left atrial appendage thrombus while velocities greater than 40 cm/sec are at lower risk. The CHADS2 and CHA2DS2-VASc scores calculated from clinical variables have been developed to risk stratify patients with atrial fibrillation/flutter in regard to the need for anticoagulation...
August 2016: Echocardiography
https://www.readbyqxmd.com/read/27040617/adoption-of-direct-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation
#20
D Baker, B Wilsmore, S Narasimhan
BACKGROUND: Direct oral anticoagulants (DOAC) are being increasingly utilised for stroke prevention in atrial fibrillation (AF) and atrial flutter. AIMS: To analyse the adoption and application of these drugs in a regional hospital inpatient cohort and compare with national prescribing data. METHODS: Digital medical records identified prescribed anticoagulants for patients admitted with AF and atrial flutter during 2013-2014. Analysis of patient demographics and stroke risk identified trends in prescribing DOAC versus warfarin...
July 2016: Internal Medicine Journal
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