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JOURNAL ARTICLE
Dominik Linz, Jason G Andrade, Elena Arbelo, Giuseppe Boriani, Guenter Breithardt, A John Camm, Valeria Caso, Jens Cosedis Nielsen, Mirko De Melis, Tom De Potter, Wolfgang Dichtl, Søren Zoega Diederichsen, Dobromir Dobrev, Nicolas Doll, David Duncker, Elke Dworatzek, Lars Eckardt, Christoph Eisert, Larissa Fabritz, Michal Farkowski, David Filgueiras-Rama, Andreas Goette, Eduard Guasch, Guido Hack, Stéphane Hatem, Karl Georg Haeusler, Jeff S Healey, Hein Heidbuechel, Ziad Hijazi, Lucas H Hofmeister, Leif Hove-Madsen, Thomas Huebner, Stefan Kääb, Dipak Kotecha, Katarzyna Malaczynska-Rajpold, José Luis Merino, Andreas Metzner, Lluís Mont, Ghulam Andre Ng, Michael Oeff, Abdul Shokor Parwani, Helmut Puererfellner, Ursula Ravens, Michiel Rienstra, Prashanthan Sanders, Daniel Scherr, Renate Schnabel, Ulrich Schotten, Christian Sohns, Gerhard Steinbeck, Daniel Steven, Tobias Toennis, Stylianos Tzeis, Isabelle C van Gelder, Roderick H van Leerdam, Kevin Vernooy, Manish Wadhwa, Reza Wakili, Stephan Willems, Henning Witt, Stef Zeemering, Paulus Kirchhof
AIMS: Recent trial data demonstrate beneficial effects of active rhythm management in patients with atrial fibrillation (AF) and support the concept that a low arrhythmia burden is associated with a low risk of AF-related complications. The aim of this document is to summarize the key outcomes of the 9th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA). METHODS AND RESULTS: Eighty-three international experts met in Münster for 2 days in September 2023...
March 30, 2024: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
#22
REVIEW
Laura Besola, Dario Gregori, Alessandro Fiocco, Andrea Colli
The onset of atrial fibrillation (AF) has a direct association with left atrial appendage (LAA) function, as demonstrated by recent studies demonstrating the link between left atrial (LA) wall fibrosis, impaired contractility, and the development of AF. Non-valvular AF (NVAF) affects almost 30 million people worldwide, with this number expected to increase in the next 20 years. It is the main cause of ischemic stroke, with significant subsequent economic and social impact. Currently, the mainstay of stroke prevention in patients with NVAF is oral anticoagulation (OAC), which reduces the incidence of ischemic events at the stake of increased hemorrhagic events...
March 29, 2024: Annals of Cardiothoracic Surgery
#23
JOURNAL ARTICLE
Giulio Francesco Romiti, Bernadette Corica, Davide Antonio Mei, Arnaud Bisson, Giuseppe Boriani, Brian Olshansky, Tze-Fan Chao, Menno V Huisman, Marco Proietti, Gregory Y H Lip
BACKGROUND: Clinical complexity, as the interaction between ageing, frailty, multimorbidity and polypharmacy, is an increasing concern in patients with AF. There remains uncertainty regarding how combinations of comorbidities influence management and prognosis of patients with atrial fibrillation (AF). We aimed to identify phenotypes of AF patients according to comorbidities and to assess associations between comorbidity patterns, drug use and risk of major outcomes. METHODS: From the prospective GLORIA-AF Registry, we performed a latent class analysis based on 18 diseases, encompassing cardiovascular, metabolic, respiratory and other conditions; we then analysed the association between phenotypes of patients and (i) treatments received and (ii) the risk of major outcomes...
April 8, 2024: BMC Medicine
#24
JOURNAL ARTICLE
Jeppe Kofoed Petersen, Jawad Haider Butt, Adelina Yafasova, Christian Torp-Pedersen, Rikke Sørensen, Christina Kruuse, Naja Emborg Vinding, Anna Gundlund, Lars Køber, Emil Loldrup Fosbøl, Lauge Østergaard
BACKGROUND: First-time detected atrial fibrillation (AF) is associated with aggravated prognosis in patients admitted with acute coronary syndrome (ACS). Yet, among patients surviving beyond one year after ACS, it remains unclear how the recurrence of AF within the initial year after ACS affects the risk of stroke. METHODS: With Danish nationwide data from 2000 to 2021, we identified all patients with first-time ACS who were alive one year after discharge (index date)...
April 6, 2024: International Journal of Cardiology
#25
JOURNAL ARTICLE
Naruya Ishizue, Hidehira Fukaya, Jun Oikawa, Nobuhiro Sato, Sho Ogiso, Yusuke Murayama, Hironori Nakamura, Jun Kishihara, Shinichi Niwano, Junya Ako
BACKGROUND: The prognostic impact of atrial fibrillation (AF) and oral anticoagulation (OAC) therapy in patients with type B acute aortic dissection (AAD) remains unclear. Therefore, we investigated the prognostic impact of AF and OAC therapy in patients with type B AAD. METHODS: Consecutive patients diagnosed with AAD were included in this single-center, retrospective study. Patients with type B AAD were selected from the study population and divided into three groups: AF(+)/OAC(+), AF(+)/OAC(-), and AF(-)/OAC(-)...
April 2024: Journal of Arrhythmia
#26
JOURNAL ARTICLE
Emad Abu-Assi, Andrea Lizancos Castro, María Cespón Fernández, Inmaculada González Bermúdez, Sergio-Raposeiras Roubin
BACKGROUND: Recently, the direct oral anticoagulant (DOAC) score was developed and better predicted major bleeding in DOAC-treated patients with atrial fibrillation (AF) than HASBLED did. Little is known on the new score's performance regarding other bleeding risk in AF. METHODS: We studied 14,672 patients diagnosed with AF between 2014 and 2018. During follow-up, we assessed the performance of DOAC score compared with the HASBLED, ORBIT and SWISS scores at predicting major bleeding in DOACs and non-DOACs users...
April 3, 2024: International Journal of Cardiology
#27
JOURNAL ARTICLE
Edvard Liljedahl Sandberg, Sigrun Halvorsen, Trygve Berge, Jostein Grimsmo, Dan Atar, Bjørnar Leangen Grenne, Jarle Jortveit
AIMS: Users of homecare services are often excluded from clinical trials due to advanced age, multimorbidity, and frailty. Atrial fibrillation (AF) is a common and frequently undiagnosed arrhythmia in the elderly and is associated with severe mortality, morbidity, and healthcare costs. Timely identification prevents associated complications through evidence-based treatment. This study is aimed at assessing the feasibility of AF screening using new digital health technology in older people in a homecare setting...
2024: International Journal of Telemedicine and Applications
#28
JOURNAL ARTICLE
Wendy Wang, Lin Yee Chen, Rob F Walker, Alvaro Alonso, Faye L Norby, Kamakshi Lakshminarayan, Pamela L Lutsey
PURPOSE: Among patients with atrial fibrillation (AF), a nonpharmacologic option (e.g., percutaneous left atrial appendage occlusion [LAAO]) is needed for patients with oral anticoagulant (OAC) contraindications. Among beneficiaries in the Medicare fee-for-service coverage 20% sample databases (2015-18) who had AF and an elevated CHA2 DS2 -VASc score, we assessed the association between percutaneous LAAO versus OAC use and risk of stroke, hospitalized bleeding, and death. METHODS: Patients undergoing percutaneous LAAO were matched to up to five OAC users by sex, age, date of enrollment, index date, CHA2 DS2 -VASc score, and HAS-BLED score...
April 2024: Pharmacoepidemiology and Drug Safety
#29
REVIEW
George Bazoukis, Athanasios Saplaouras, Polyxeni Efthymiou, Andronicos Yiannikourides, Tong Liu, Dimitrios Sfairopoulos, Panagiotis Korantzopoulos, Dimitrios Varrias, Konstantinos P Letsas, Costas Thomopoulos, Gary Tse, Stavros Stavrakis
Cardiac amyloidosis (CA) is related to the aggregation of insoluble fibrous deposits of misfolded proteins within the myocardium. Transthyretin amyloidosis (ATTR) and immunoglobulin light-chain amyloidosis are the main forms of CA. Atrial fibrillation (AF) is a common arrhythmia in CA patients, especially in those with ATTR amyloidosis. Increased atrial preload and afterload, atrial enlargement, enhanced atrial wall stress, and autonomic dysfunction are the main mechanisms of AF in CA patients. CA is associated with the formation of endocardial thrombi and systemic embolism...
March 31, 2024: Journal of Cardiology
#30
JOURNAL ARTICLE
Meaghan Costello, Ericka E Tung, Karen M Fischer, Thomas M Jaeger
OBJECTIVES: To assess clinicians' prescribing practices for anticoagulation in older adults with atrial fibrillation or atrial flutter (AF/F) and determine factors common among those without anticoagulation. METHODS: We performed a community-based retrospective cohort study of adults aged 65 years and older with a history of nonvalvular AF/F to determine the rate of oral anticoagulation utilization. We also assessed for associations between anticoagulation use and comorbid conditions and common geriatric syndromes...
2024: Journal of Primary Care & Community Health
#31
REVIEW
Bingqing Zhao, Ye Yuan, Zheng Li, Ying Chen, Yali Gao, Baoling Yang, Jingyi Wu, Weihua Jia
OBJECTIVE: To evaluate intracerebral hemorrhage (ICH) risk in patients with ischemic stroke (IS) and cerebral microbleeds (CMBs) undergoing anticoagulation therapy for non-valvular atrial fibrillation (AF). METHODS: We conducted a comprehensive search across multiple databases, including Embase, PubMed, Cochrane, UpToDate, Scopus, WOS, and SinoMed. The search covered observational literature published from each database inception until February 1, 2023. We analyzed the prevalence of CMBs during the follow-up period, compared future ICH risk between patients with and without baseline CMBs (CMBs presence/absence, ≧5 CMBs), and examined factors influencing ICH occurrence in patients with CMBs...
2024: Frontiers in Neurology
#32
JOURNAL ARTICLE
Antonio Procopio, Francesco Radico, Felice Gragnano, Chiara Ghiglieno, Gaetano Fassini, Annalisa Filtz, Alessandro Barbarossa, Daniele Sacchetta, Massimiliano Faustino, Fabrizio Ricci, Antonio Dello Russo, Paolo Calabrò, Giuseppe Patti, Sabina Gallina, Giulia Renda
BACKGROUND: Transcatheter left atrial appendage occlusion (LAAO) has emerged as an alternative treatment for stroke prevention in patients with atrial fibrillation (AF) at high risk of thromboembolism, who cannot tolerate long-term oral anticoagulation (OAC). Questions persist regarding effectiveness and safety of this treatment and the optimal post-interventional antithrombotic regimen after LAAO. METHODS: We retrospectively gathered data from 428 patients who underwent percutaneous LAAO in 6 Italian high-volume centres, aimed at describing the real-world utilization, safety, and effectiveness of LAAO procedures, also assessing the clinical outcomes associated with different antithrombotic strategies...
April 2024: IJC Heart & Vasculature
#33
JOURNAL ARTICLE
Sophia Lee, Jeremy A Ross, Ali Zalpour, Jason T Henry, Cristhiam M Rojas Hernandez
Venous thromboembolism (VTE) and stroke carry significant mortality and morbidity in cancer patients. Direct oral anticoagulants (DOACs) have been demonstrated to be effective for the treatment of VTE and prevention of stroke in atrial fibrillation (AF). Bleeding rates are variable and are based on the cancer type and the patient's specific risk factors. There are approved specific antidotes for DOAC-associated bleeding. Other strategies are available for bleeding reversal, including the use of prothrombin complex concentrate (PCC)...
March 31, 2024: Journal of Thrombosis and Thrombolysis
#34
JOURNAL ARTICLE
Yasutaka Murakami, Kenichi Todo, Kazutaka Uchida, Hiroshi Yamagami, Nobuyuki Sakai, Yasufumi Gon, Shuhei Okazaki, Tsutomu Sasaki, Shinichi Yoshimura, Takeshi Morimoto, Hideki Mochizuki
Although low-dose direct oral anticoagulants (DOACs) are recommended for patients at high risk of bleeding complications, it remains unclear whether the dose reduction in real-world setting is also appropriate in patients after large-vessel occlusion (LVO) stroke. This study hypothesized that patients with atrial fibrillation (AF) and LVO receiving low-dose DOACs have an increased risk of ischemic and hemorrhagic events. The study aimed to assess 1 year morbidity and mortality in patients treated with standard-dose and low-dose apixaban after LVO stroke...
March 31, 2024: Journal of Thrombosis and Thrombolysis
#35
JOURNAL ARTICLE
Florian Doldi, Nele Geßler, Omar Anwar, Ann-Kathrin Kahle, Katharina Scherschel, Benjamin Rath, Julia Köbe, Philipp Sebastian Lange, Gerrit Frommeyer, Andreas Metzner, Christian Meyer, Stephan Willems, Karl-Heinz Kuck, Lars Eckardt
OBJECTIVE AND BACKGROUND: Data on incidence of in-hospital pulmonary embolisms (PE) after catheter ablation (CA) are scarce. To gain further insights, we sought to provide new findings through case-based analyses of administrative data. METHODS: Incidences of PE after CA of supraventricular tachycardias (SVT), atrial fibrillation (AF), atrial flutter (AFlu), and ventricular tachycardias (VT) in three German tertiary centers between 2005 and 2020 were determined and coded by the G-DRG (German Diagnosis Related Groups System) and OPS (German Operation and Procedure Classification) systems...
March 31, 2024: Thrombosis and Haemostasis
#36
JOURNAL ARTICLE
Juliane Frydenlund, Jan Brink Valentin, Marie Norredam, Lars Frost, Sam Riahi, Kristian Hay Kragholm, Henrik Bøggild, Gregory Y H Lip, Søren Paaske Johnsen
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia and results in a high risk of stroke. The number of immigrants is increasing globally, but little is known about potential differences in AF care across migrant populations. AIM: To investigate if initiation of oral anticoagulation therapy (OAC) differs for patients with incident AF in relation to country of origin. METHODS: A nationwide register-based study covering 1999-2017...
March 29, 2024: Open Heart
#37
JOURNAL ARTICLE
Giuseppe Armentaro, Daniele Pastori, Alberto Castagna, Valentino Condoleo, Velia Cassano, Carlo Alberto Pastura, Mattea Francica, Caterina Benincasa, Nicola D'Alterio, Franco Arturi, Giovanni Ruotolo, Angela Sciacqua
Atrial fibrillation (AF) represents the most common supraventricular arrhythmia, with a prevalence of 1-3 % in the world population. Growing evidences show that AF plays an important role as a risk factor for the development of cognitive impairment (CoI) and dementia, depression and functional limitation. The purpose of the study is to evaluate, in a large cohort of elderly hospitalized patients with nonvalvular AF (NVAF) on direct oral anticoagulants (DOACs) therapy, the prevalence of CoI, depression, and functional limitation, and to assess the different variables that may be detrimental or protective on the risk of CoI or functional limitation...
March 27, 2024: European Journal of Internal Medicine
#38
JOURNAL ARTICLE
Yin Feng Chen, Nan Nan Liu, Jing Yun Wang, Jing Shu Sun, Yi Xiao Wang, Hai Ying Jiang, Wei-Wei Zhou, Zu Lu Wang, Ming Liang
This study seeks to identify the anticoagulant efficacy of rivaroxaban treatment on thrombi detected using echocardiography of the left atrial appendage in 275 patients with persistent atrial fibrillation (AF). During follow-up after 9 to 24 weeks of Rivaroxaban treatment, patients were divided into 'effective group' (n = 143) and 'ineffective group' (n = 132) according to the thrombolytic effect of the drug. Left atrial diameter (LAD), left atrial ejection fraction (LAEF), left ventricular ejection fraction (LVEF), mean diameter of left atrial appendage (LAADmean), angle between left atrial appendage and left atrial (LAA-A), velocity of blood flow in left atrial appendage (LAA-v) and thrombus size were compared before and after drug administration...
March 25, 2024: Journal of Cardiovascular Pharmacology
#39
JOURNAL ARTICLE
Hannah Schwennesen, Jeffrey N Browndyke, Mary Cooter Wright, Marat Fudim, James P Daubert, Mark F Newman, Joseph P Mathew, Jonathan P Piccini
BACKGROUND: Cerebral microembolization and atrophy complicate atrial fibrillation (AF). OBJECTIVES: We aimed to compare changes in neuroimaging findings between AF patients treated with catheter ablation and those treated with medical therapy. METHODS: In this pilot study, we evaluated differences in the change in regional white matter hyperintensity burden (WMHb) and cognitive function from baseline to 6 weeks and 1 year in patients treated with AF ablation (n = 12) and patients treated with medical management alone (n = 11)...
February 2024: Heart rhythm O2
#40
REVIEW
Tim R Betts, Patrick A Calvert, Lee N Graham, Gerald J Clesham, Ashan Gunarathne, Brian Clapp, Dhiraj Gupta, Jan Kovac, James D Newton, David Hildick-Smith
Percutaneous left atrial appendage occlusion aims to reduce the risk of stroke in patients with AF, particularly those who are not good candidates for systemic anticoagulation. The procedure has been studied in large international randomised trials and registries and was approved by the National Institute for Health and Care Excellence in 2014 and by NHS England in 2018. This position statement summarises the evidence for left atrial appendage occlusion and presents the current indications. The options and consensus on best practice for pre-procedure planning, undertaking a safe and effective implant and appropriate post-procedure management and follow-up are described...
2024: Arrhythmia & Electrophysiology Review
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