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Anticoagulation for a flutter

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https://www.readbyqxmd.com/read/29761512/oral-anticoagulation-and-left-atrial-thrombi-resolution-in-non-rheumatic-atrial-fibrillation-or-flutter-a-systematic-review-and-meta-analysis
#1
Norman C Wang, Matthew D Sather, Aliza Hussain, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, William E Katz, Alaa A Shalaby, Andrew H Voigt, Samir Saba
BACKGROUND: Oral anticoagulation (OAC) is prescribed for left atrial thrombi (LAT) in non-rheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The study objective was to review the existing evidence regarding LAT resolution in non-rheumatic AF and/or AFL with OAC agents. METHODS: Data sources included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) between January 1, 1991 and February 1, 2017. English-language studies that assessed LAT resolution with OAC agents in subjects with non-rheumatic AF and/or AFL, by serial transesophageal echocardiography (TEE), and with follow-up times ≥3 weeks and < 1 year were selected...
May 14, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#2
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/29746708/left-atrial-thrombus-two-years-after-placement-of-a-left-atrial-appendage-closure-device
#3
David H Yoo, Brian Clark, Daniel Nguyen, Timm-Michael Dickfeld, Andrew S Zohlman, Libin Wang, Vincent Y See
A 72-year-old man who underwent a left atrial appendage (LAA) closure device two years ago, presented with atrial flutter with rapid ventricular rate and was referred for cardioversion. Pre-cardioversion transesophageal echocardiogram (TEE) showed left atrial thrombus and therefore the procedure was aborted. Currently, there is no guideline on imaging surveillance or anticoagulation in patients with LAA closure device who develop intracardiac thrombus after the initial six month surveillance period. This article is protected by copyright...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29694285/real-world-health-care-costs-based-on-medication-adherence-and-risk-of-stroke-and-bleeding-in-patients-treated-with-novel-anticoagulant-therapy
#4
Chinmay G Deshpande, Stephen Kogut, Cynthia Willey
BACKGROUND: With the lack of real-world evidence, the challenge for drug reimbursement policy decision makers is to understand medication adherence behavior among users of novel oral anticoagulants (NOACs) and its effect on overall cost savings. No study has examined and quantified the burden of cost in high-risk patients taking NOAC therapy. OBJECTIVE: To examine the association of cost with adherence, comorbidity, and risk of stroke and bleeding in patients taking NOACs (rivaroxaban and dabigatran)...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29580630/feasibility-of-performing-radiofrequency-catheter-ablation-and-endomyocardial-biopsy-in-the-same-setting
#5
J William Schleifer, Kevin K Manocha, Samuel J Asirvatham, Peter A Noseworthy, Rajiv Gulati, Paul A Friedman, Malini Madhavan, Thomas M Munger, Leslie T Cooper, Guy S Reeder, David R Holmes, Suraj Kapa
In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57% male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25%) for ventricular arrhythmias and in 2 (3%) for typical atrial flutter...
March 5, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29579189/cardiac-voltage-gated-sodium-channel-mutations-associated-with-left-atrial-dysfunction-and-stroke-in-children
#6
Adrien Moreau, Alexandre Janin, Gilles Millat, Philippe Chevalier
Aims: Cardiac atrial arrhythmias are the most common type of heart rhythm disorders. Its genetic elucidation remains challenging with poor understanding of cellular and molecular processes. These arrhythmias usually affect elderly population but in rare cases, young children may also suffer from such electrical diseases. Severe complications, including stroke, are commonly age related. This study aims to identify a genetic link between electro-mechanic atrial dysfunction and stroke in children...
March 22, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29536479/repeated-administration-of-idarucizumab-to-a-patient-with-dabigatran-overdose
#7
Zdeňka Hajšmanová, Pavla Šigutová, Alena Lavičková
Idarucizumab is designed to reverse the anticoagulant effect of dabigatran. This case report describes the administration of three independent doses of idarucizumab to a 76-year-old man suffering from atrial flutter being treated with dabigatran to prevent ischaemic stroke. The last dose of dabigatran was administered in the morning of the same day the patient was transferred to hospital because of the need for urgent pericardium puncture. Baseline dTT (dilute thrombin time) reached 700 ng/mL as glomerular filtration (GF) dropped to 0...
February 2018: Hämostaseologie
https://www.readbyqxmd.com/read/29532536/periprocedural-management-of-anticoagulation-for-atrial-fibrillation-catheter-ablation-in-direct-oral-anticoagulant-treated-patients
#8
Anne-Céline Martin, Sarah Lessire, Isabelle Leblanc, Anne-Sophie Dincq, Ivan Philip, Isabelle Gouin-Thibault, Anne Godier
BACKGROUND: Guidelines recommend performing atrial fibrillation (AF) catheter ablation without interruption of a direct oral anticoagulants (DOACs) and to administer unfractionated heparin (UFH) for an activated clotting time (ACT) ≥300 seconds, by analogy with vitamin K antagonist (VKA). Nevertheless, pharmacological differences between DOACs and VKA, especially regarding ACT sensitivity and UFH response, prevent extrapolation from VKA to DOACs. HYPOTHESIS: The level of anticoagulation at the time of the procedure in uninterrupted DOAC-treated patients is unpredictable and would complicate intraprocedural UFH administration and monitoring...
March 13, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29518801/new-atrial-fibrillation-diagnosed-perioperatively-anticoagulation-practices-in-a-secondary-hospital
#9
Alyssa Kirby, Sisira Jayathissa
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia encountered perioperatively in patients undergoing non-cardiac surgery. There is emerging evidence suggesting high risk of ischaemic stroke. There are no clear guidelines surrounding initiation of anticoagulation in this setting. This study evaluates current practice in anticoagulant management of new perioperative AF at Hutt Hospital. METHODS: We have undertaken a retrospective study of 3,558 patients aged 60 years and over admitted for non-cardiac surgery at Hutt Hospital in 2014, to assess incidence of new AF/flutter and review how they were managed in regards to anticoagulation...
March 9, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29482375/antithrombotic-therapy-underutilization-in-patients-with-atrial-flutter
#10
Sanghun Lee, Nam Kyung Je
BACKGROUND: Patients with atrial fibrillation not being adequately treated with oral anticoagulant (OAC) therapy, with therapy underutilization or premature termination, have been commonly reported. However, studies on the utilization pattern of OAC therapy for patients with atrial flutter (AFL) are few. The aim of this study was to investigate the utilization of OAC therapy, and its influencing factors for patients with AFL in South Korea, as well as the types and percentages of anticoagulants used...
May 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29466488/uninterrupted-use-of-oral-anticoagulants-for-the-ablation-of-atrial-flutter-a-single-center-cohort-of-154-patients
#11
Tiago Luiz Luz Leiria, Alexandre Kreling Medeiros, Eduardo Dytz Almeida, Antonio Lessa Gaudie Ley, Catarine Benta Lopes Dos Santos, Roberto Toffani Sant'Anna, Marcelo Lapa Kruse, Leonardo Martins Pires, Gustavo Glotz de Lima
BACKGROUND: The uninterrupted use of oral anticoagulation (OAC) with vitamin K antagonists (VKAs) for electrophysiology procedures has been more and more recommended. The clinical practice in our service recommends the continuous use of these drugs for atrial flutter ablation. There is little evidence as to the uninterrupted use of non-vitamin K antagonist oral anticoagulants (NOACs) in this scenario. OBJECTIVE: To compare the rates of complications related with the uninterrupted use of different types of oral anticoagulants in patients referred to atrial flutter (AFL) ablation...
February 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29440949/the-prevalence-of-long-term-oral-anticoagulation-therapy-in-a-cardiology-center-in-bucharest-romania
#12
Adelina-Mihaela Sorescu, Tudor Enache, Suzana Guberna
Background and aims: Few studies discuss the prevalence of oral anticoagulation therapy (OAT) in clinical practice, despite their increasing use worldwide. In America, studies established that 20% to 80% of the patients with indication benefit from OAT. In Romania, there is no data regarding the utilization of oral anticoagulants. Thus, this study aims to determine the trends of OAT. Methods: We designed a cross-sectional study of the patients admitted to the Cardiology Department of the "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, from the 1st of November 2016 until the 31st of January 2017...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29367535/management-of-arrhythmias-in-heart-failure
#13
REVIEW
Daniele Masarone, Giuseppe Limongelli, Marta Rubino, Fabio Valente, Rossella Vastarella, Ernesto Ammendola, Rita Gravino, Marina Verrengia, Gemma Salerno, Giuseppe Pacileo
Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount to prevent systemic or cerebral embolism. Patients with heart failure are also prone to develop ventricular arrhythmias that can present a challenge to the managing clinician...
February 28, 2017: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29366379/pharmacy-student-monitoring-of-direct-oral-anticoagulants
#14
Jennifer J Kim, Hailey L Hill, James B Groce, James M Granfortuna, Tanya K Makhlouf
BACKGROUND: Best practice recommendations are lacking. Thus far, literature has described pharmacist-led DOAC monitoring. OBJECTIVE: The purpose of this study is to describe a DOAC monitoring program involving pharmacy students. METHODS: This was an observational analysis of a quality improvement initiative. A clinical pharmacist preceptor identified clinic patients taking DOACs by running a report using the electronic medical record. Pharmacy students conducted chart reviews, called pharmacies for 6-month refill histories, and interviewed and educated patients...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29360845/non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-for-the-prevention-of-spontaneous-echo-contrast-and-thrombus-in-patients-with-atrial-fibrillation-or-flutter-undergoing-cardioversion-a-trans-esophageal-echocardiography-study
#15
Yun Gi Kim, Jong-Il Choi, Mi-Na Kim, Dong-Hyuk Cho, Suk-Kyu Oh, Hyungdon Kook, Hee-Soon Park, Kwang No Lee, Yong-Soo Baek, Seung-Young Roh, Jaemin Shim, Seong-Mi Park, Wan Joo Shim, Young-Hoon Kim
Spontaneous echo-contrast (SEC) and thrombus observed in trans-esophageal echocardiography (TEE) is known as a strong surrogate marker for future risk of ischemic stroke in patients with atrial fibrillation (AF) or atrial flutter (AFL). The efficacy of non-vitamin K antagonist oral anticoagulants (NOAC) compared to warfarin to prevent SEC or thrombus in patients with AF or AFL is currently unknown. AF or AFL patients who underwent direct current cardioversion (DCCV) and pre-DCCV TEE evaluation from January 2014 to October 2016 in a single center were analyzed...
2018: PloS One
https://www.readbyqxmd.com/read/29334815/impact-of-medication-adherence-on-risk-of-ischemic-stroke-major-bleeding-and-deep-vein-thrombosis-in-atrial-fibrillation-patients-using-novel-oral-anticoagulants
#16
Chinmay G Deshpande, Stephen Kogut, Robert Laforge, Cynthia Willey
OBJECTIVES: Our study examined the impact of adherence to novel oral anticoagulants [NOACs - dabigatran and rivaroxaban] on ischemic-stroke (IS), major-bleeding (MB), deep-vein-thrombosis and pulmonary-embolism (DVTPE) risk in a large, nationwide, propensity-matched sample. METHODS: A retrospective cohort study utilized data from a US commercial managed-care database (2010-2012). Adult patients with ≥1 diagnosis of atrial fibrillation/flutter (ICD-9 427.31/32), >1 prescription of NOACs and CHA2 DS2 -VASc score ≥1 were included...
February 15, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29320668/the-impact-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-on-anticoagulation-therapy-in-rural-australia
#17
Jamie W Bellinge, Jarrad J Paul, Liam S Walsh, Lokesh Garg, Gerald F Watts, Carl Schultz
OBJECTIVE: To determine the use of different anticoagulation therapies in rural Western Australia; to establish whether remoteness from health care services affects the choice of anticoagulation therapy; to gather preliminary data on anticoagulation therapy safety and efficacy. DESIGN: Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014-2015. SETTING: Four hospitals serving two-thirds of the rural population of Western Australia...
January 15, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29250225/atrial-fibrillation-in-patients-with-congenital-heart-disease
#18
REVIEW
Tabitha G Moe, Victor A Abrich, Edward K Rhee
Advances in surgical techniques have led to the survival of most patients with congenital heart disease (CHD) up to their adulthood. During their lifetime, many of them develop atrial tachyarrhythmias due to atrial dilatation and scarring from surgical procedures. More complex defects and palliative repairs are linked to a higher incidence and earlier occurrence of arrhythmias. Atrial fibrillation (AF) is common in patients who have atrial septal defects repaired after age 55 and in patients with tetralogy of Fallot repaired after age 45...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29223435/atrial-fibrillation-decision-support-tool-population-perspective
#19
Mark H Eckman, Alexandru Costea, Mehran Attari, Jitender Munjal, Ruth E Wise, Carol Knochelmann, Matthew L Flaherty, Pete Baker, Robert Ireton, Brett M Harnett, Anthony C Leonard, Dylan Steen, Adam Rose, John Kues
BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#20
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
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