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Anticoagulation for a flutter

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https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#1
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29128265/atrial-flutter-has-less-left-atrial-spontaneous-contrast-and-higher-left-atrial-appendage-emptying-velocity-compared-with-atrial-fibrillation
#2
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. There are clear guidelines in anticoagulation management of patient's with atrial fibrillation, however, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography (TEE); thereby possibly leading to a lower stroke risk...
November 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29117873/implementation-of-an-emergency-department-atrial-fibrillation-and-flutter-pathway-improves-rates-of-appropriate-anticoagulation-reduces-length-of-stay-and-thirty-day-revisit-rates-for-congestive-heart-failure
#3
David Barbic, Chris DeWitt, Devin Harris, Robert Stenstrom, Eric Grafstein, Crane Wu, Cristian Vadeanu, Brett Heilbron, Jenelle Haaf, Stanley Tung, Dan Kalla, Julian Marsden, Jim Christenson, Frank Scheuermeyer
OBJECTIVES: An evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation. METHODS: This is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians...
November 9, 2017: CJEM
https://www.readbyqxmd.com/read/29114736/association-of-warfarin-use-with-lower-overall-cancer-incidence-among-patients-older-than-50-years
#4
Gry S Haaland, Ragnhild S Falk, Oddbjørn Straume, James B Lorens
Importance: In cancer models, warfarin inhibits AXL receptor tyrosine kinase-dependent tumorigenesis and enhances antitumor immune responses at doses not reaching anticoagulation levels. This study investigates the association between warfarin use and cancer incidence in a large, unselected population-based cohort. Objective: To examine the association between warfarin use and cancer incidence. Design, Setting, and Participants: This population-based cohort study with subgroup analysis used the Norwegian National Registry coupled with the Norwegian Prescription Database and the Cancer Registry of Norway...
November 6, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29032886/prevalence-and-risk-factors-for-paroxysmal-atrial-fibrillation-and-flutter-detection-after-cryptogenic-ischemic-stroke
#5
Claire Carrazco, Daniel Golyan, Michael Kahen, Karen Black, Richard B Libman, Jeffrey M Katz
INTRODUCTION: Long-term cardiac monitoring with implantable loop recorders (ILRs) has revealed occult paroxysmal atrial fibrillation and flutter (PAF) in a substantial minority of cryptogenic ischemic stroke (CIS) patients. Herein, we aim to define the prevalence, clinical relevance, and risk factors for PAF detection following early poststroke ILR implantation. MATERIALS AND METHODS: A retrospective study of CIS patients (n = 100, mean age 65.8 years; 52.5% female) who underwent ILR insertion during, or soon after, index stroke admission...
October 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28966115/elective-cardioversion-in-the-era-of-novel-oral-anticoagulants-does-a-nurse-administered-verbal-questionnaire-for-compliance-negate-the-need-for-routine-transoesophageal-echocardiography
#6
Matthew K Rowe, Naomi Lollback, Leanne Slater, John Hill, Paul A Gould, Gerald C Kaye
BACKGROUND: Anticoagulation prior to elective external direct current cardioversion (EDCCV) is mandatory. The inability to monitor compliance with novel oral anticoagulants (NOACs) raises a potential safety issue. We aimed to evaluate whether a structured, nurse-led assessment of compliance prior to EDCCV ensures safety without the need for routine transoesophageal echocardiography (TOE). METHODS: Data was prospectively collected on consecutive patients undergoing EDCCV during 2014-2015...
September 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#7
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28797718/atrial-arrhythmias-after-lung-transplantation
#8
REVIEW
Henri Roukoz, David G Benditt
Atrial arrhythmias are a common complication after lung transplant (LT), occurring in about 16-46% of LT patients early postoperatively, and in about 14% during longer-term follow-up. They have a significant impact on postoperative in-hospital length of stay and may have an impact on overall mortality. In this report, we review the incidence and risk factors of post lung transplant AA, their pathogenesis and their impact on short- and long-term outcomes. Pharmacological management options are reviewed. In brief, early atrial arrhythmias tend to be mostly atrial fibrillation and are treated acutely with a rate control strategy followed if needed by rhythm control for 4-6 weeks...
August 1, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28752228/the-dx-af-study-a-prospective-multicenter-randomized-controlled-trial-comparing-vdd-icd-to-vvi-icd-in-detecting-sub-clinical-atrial-fibrillation-in-defibrillator-patients
#9
Mohammed Shurrab, Amir Janmohamed, Jean-François Sarrazin, Felix Ayala-Paredes, Marcio Sturmer, Randall Williams, Satish Toal, Chris Lane, Kevin E Thorpe, Jeff S Healey, Eugene Crystal
PURPOSE: Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Appropriate detection of AF and early initiation of oral anticoagulation therapy are critical to reduce the risk of stroke. Patients with implantable cardioverter defibrillators (ICD) are at high risk of developing AF. The purpose of the Dx-AF study is to demonstrate that a novel single-lead VDD-ICD system (Linox smart S DX) will facilitate adequate recognition of sub-clinical AF and ultimately stroke prevention with a comparable safety profile in comparison to VVI-ICD...
October 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28709762/prevalence-of-paroxysmal-atrial-fibrillation-in-a-population-assessed-by-continuous-24-hour-monitoring
#10
João Primo, Helena Gonçalves, Ana Macedo, Paula Russo, Telma Monteiro, João Guimarães, Ovídio Costa
INTRODUCTION: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice and a major cause of morbidity, due to the associated risk of stroke. However, since it is often paroxysmal, it is commonly underdiagnosed and undertreated. OBJECTIVES: The primary objective of this prospective study was to determine the prevalence of paroxysmal atrial fibrillation (PAF) in patients aged 40 and above in a population who underwent continuous 24-hour electrocardiographic monitoring...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28699943/dosing-accuracy-of-direct-oral-anticoagulants-in-an-academic-medical-center
#11
Janice Schwartz, Steve Merrill, Noelle de Leon, Ashley Thompson, Margaret Fang
BACKGROUND/OBJECTIVE: Direct-acting oral anticoagulants (DOACs) are increasingly used to prevent or treat thromboembolism. We conducted a study to compare how well initial DOAC prescribing for adult inpatients adhered to dosing recommendations approved by the US Food and Drug Administration (FDA). DESIGN: Retrospective analysis. SETTING: Single academic medical center, July 1, 2014 to June 30, 2015. PATIENTS: 508 adult inpatients...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28690312/wolff-parkinson-white-syndrome-with-ventricular-hypertrophy-in-a-brazilian-family
#12
Lenises de Paula van der Steld, Oscar Campuzano, Alexandra Pérez-Serra, Mabel Moura de Barros Zamorano, Selma Sousa Matos, Ramon Brugada
BACKGROUND PRKAG2 syndrome diagnosis is already well-defined as Wolff-Parkinson-White syndrome (WPW), ventricular hypertrophy (VH) due to glycogen accumulation, and conduction system disease (CSD). Because of its rarity, there is a lack of literature focused on the treatment. The present study aimed to describe appropriate strategies for the treatment of affected family members with PRKAG2 syndrome with a long follow-up period. CASE REPORT We studied 60 selected individuals from 84 family members (32 males, 53...
July 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28652320/trends-in-utilization-of-warfarin-and-direct-oral-anticoagulants-in-older-adult-patients-with-atrial-fibrillation
#13
Abdullah A Alalwan, Stacy A Voils, Abraham G Hartzema
PURPOSE: Results of a study to determine trends in oral anticoagulant (OAC) use and OAC switching in patients with atrial fibrillation (AF) or atrial flutter are presented. METHODS: Warfarin has been the most prescribed anticoagulant in patients with AF for decades. Since 2010, several direct OACs (DOACs) have gained U.S. marketing approval for stroke prevention in AF or atrial flutter. A cross-sectional longitudinal analysis was conducted using healthcare and prescription claims databases to characterize OAC use and rates of OAC and DOAC switching during the period 2008-14 in cohorts of Medicare beneficiaries 65 years of age or older with AF or atrial flutter...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28592234/design-and-rationale-for-the-warfa-trial-a-randomized-controlled-cross-over-trial-testing-the-therapeutic-equivalence-of-branded-and-generic-warfarin-in-atrial-fibrillation-patients-in-brazil
#14
Carolina Gomes Freitas, Michael Walsh, Álvaro Nagib Atallah
BACKGROUND: Warfarin is a commonly used anticoagulant. Whether a given dose of the different formulations of Brazilian warfarin will result in the same effect on the international normalized ratio (INR) is uncertain. The aim of the WARFA trial is to determine whether the branded and two generic warfarins available in Brazil differ in their effect on the INR. METHODS: WARFA is a cross-over RCT comparing three warfarins. The formulations tested are the branded Marevan® (Uniao Quimica/Farmoquimica) and two generic warfarin (manufactured respectively by Uniao Quimica Farmaceutica Nacional and Laboratorio Teuto Brasileiro)...
June 7, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28553875/assessment-of-the-left-atrial-appendage-morphology-in-patients-aafter-ischemic-stroke-the-assam-study-protocol
#15
Jakub Baran, Ilona Michałowska, Ilona Kowalik, Piotr Kułakowski
Stroke remains the most dangerous and frightening complication of atrial fibrillation (AF). Causal relationship between ischemic stroke and atrial arrhythmias such as AF or atrial flutter has been well established. Numerous factors predisposing to peripheral embolism in patients with AF have been well established and included in the CHA2DS2Vasc score. Although proper anticoagulation minimizes the risk attributable to "known" risk factors, stroke may still occur. Thus, "unknown" risk factors may play an important role in stroke risk stratification in patients with AF...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#16
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develop atrial fibrillation after cavotricuspid isthmus (CTI) ablation. No uniform recommendations are available to guide anticoagulation regimes or electrocardiogram (ECG) monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland, and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: ablation strategy, oral anticoagulation (OAC) management, and ECG monitoring after successful CTI ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28546529/the-safety-of-electrical-cardioversion-under-the-control-of-transesophageal-echocardiography-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#17
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AF) requires adequate oral anticoagulation (OAC) prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    Assessment of risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of DCC under transesophageal echocardiography control (TEE) in patients with inadequate anticoagulation. PATIENTS AND METHODS    From the cohort of 316 patients admitted for DCC, 139 (age 63...
May 25, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28509703/pathway-for-the-management-of-atrial-fibrillation-and-atrial-flutter
#18
Eyal Herzog, Edgar Argulian, Steven B Levy, Emad F Aziz
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance encountered in clinical practice, and its prevalence is increasing as the population ages. The American College of Cardiology, the American Heart Association, and the European Society of Cardiology established guidelines for the management of patients with AF. Atrial flutter (Afl) is less common and is often associated with or preceded by AF or occurs in an isolated pattern. A major limitation of the currently published guidelines for the management of patients with AF and Afl is their complexity, the fact that official guidelines are published separately for each of these arrhythmias, and that they were published several years ago...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28465968/lower-body-weight-in-men-an-epidemiological-predictor-of-enlarged-left-atrium-in-sinus-rhythm-patients-with-dilated-heart
#19
Aurora Bakalli, Ljubica Georgievska-Ismail, Nebi Musliu, Dardan Koçinaj
BACKGROUND/AIMS: The source of thrombi in patients with dilated cardiomyopathy is not necessarily from the dilated left ventricle. Left atrium (LA) and left atrial appendage (LAA) might be in charge for relatively high rate of systemic embolizations in these patients. The main aim of our study was to identify epidemiological predictors in sinus rhythm patients with dilated heart for LA and LAA dilation and/or dysfunction. PATIENTS AND METHODS: This was a prospective cross-sectional study conducted from 2009 to 2014 in 101 sinus rhythm patients with dilated heart...
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28420481/safety-and-feasibility-of-subcutaneous-purse-string-suture-of-the-femoral-vein-after-electrophysiological-procedures-on-uninterrupted-oral-anticoagulation
#20
COMPARATIVE STUDY
Marc Kottmaier, Felix Bourier, Tilko Reents, Alina Reiter, Marielouise Kornmayer, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Michael Deiss, Stephanie Brooks, Christian Grebmer, Carsten Lennerz, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer
The aim of this study was to compare safety and feasibility of a subcutaneous purse-string suture (PSS) with manual compression (MC) to gain hemostasis in patients after multiple femoral venous punctures undergoing electrophysiological procedures on uninterrupted oral anticoagulation (OAK). A total of 784 patients who underwent catheter ablation for atrial fibrillation (n = 564) or (a)typical atrial flutter (n = 220) were assessed. Four hundred sixty-two patients received PSS (58.9%) and 322 patients (41...
June 1, 2017: American Journal of Cardiology
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