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Søren Due Andersen, Torben Bjerregaard Larsen, Anders Gorst-Rasmussen, Yousef Yavarian, Gregory Y H Lip, Flemming W Bach
BACKGROUND: Nearly one in 5 patients with ischemic stroke will invariably experience a second stroke within 5 years. Stroke risk stratification schemes based solely on clinical variables perform only modestly in non-atrial fibrillation (AF) patients and improvement of these schemes will enhance their clinical utility. Cerebral white matter hyperintensities are associated with an increased risk of incident ischemic stroke in the general population, whereas their association with the risk of ischemic stroke recurrence is more ambiguous...
October 18, 2016: Cerebrovascular Diseases
Ngai-Yin Chan, Chi-Chung Choy
OBJECTIVE: The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. METHODS: In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. RESULTS: 56 (0...
October 12, 2016: Heart: Official Journal of the British Cardiac Society
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
Y Chugh, R T Faillace
The risk stratification of patients with coexisting non valvular atrial fibrillation and congestive heart failure, is often a clinical challenge, as the definitions of congestive heart failure in the popular CHADS2 and CHA2DS2VASc scoring systems, and amongst major clinical trials on Warfarin and Novel Oral Anticoagulants (NOAC) have heterogeneity. Available evidence reveals that any heart failure and/or left ventricular systolic dysfunction is associated with higher rates of stroke/systemic embolism and bleeding in patients with non valvular atrial fibrillation compared to patients without heart failure and normal left ventricular function...
September 17, 2016: International Journal of Cardiology
Michelle E Johnson, Cinira Lefèvre, Shuk-Li Collings, David Evans, Sebastian Kloss, Essra Ridha, Andrew Maguire
OBJECTIVES: To examine the characteristics and persistence in patients newly initiated with oral anticoagulants (OACs) for stroke prevention in non-valvular atrial fibrillation (NVAF). DESIGN: Cohort study in Clinical Practice Research Datalink. SETTING: UK primary care. PARTICIPANTS: 15 242 patients with NVAF newly prescribed apixaban, rivaroxaban, dabigatran or vitamin K antagonists (VKAs) between 1 December 2012 and 31 October 2014...
September 26, 2016: BMJ Open
Aarti A Patel, Winnie W Nelson, Jeff Schein
PURPOSE: The purpose of this study is to report on the effect of using CHA2DS2VASc (congestive heart failure, hypertension, age ≥75 years [doubled], type 1 or type 2 diabetes mellitus, stroke or transient ischemic attack or thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) rather than CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke) to determine candidacy for anticoagulant prophylaxis in insured patients with atrial fibrillation (AF)...
September 23, 2016: Clinical Therapeutics
Aristide Relwendé Yameogo, Jonas Koudougou Kologo, Germain Mandi, Hervé Poko Kabore, Georges Rosario Christian Millogo, Arthur André Taryetba Seghda, André Koudnoaga Samadoulougou, Patrice Zabsonre
INTRODUCTION: Atrial fibrillation is the commonest cardiac rythm disorder. Thromboembolic accidents are common complications that should be prevented by anticoagulant treatment. The aim of our study is to assess the use of vitamins K antagonists in the prevention of thromboembolic risk in atrial fibrillation. METHODS: It was a descriptive retrospective study of patients folders, performed in the cardiology department from January 1st 2010 to December 31st 2011. The study included all patients with non valvular atrial fibrillation...
2016: Pan African Medical Journal
Terese Lindberg, Doris M Bohman, Sölve Elmståhl, Claes Jogréus, Johan Sanmartin Berglund
PURPOSE: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom(®). METHODS: Two hundred elderly persons aged 66-93 years were recruited from the Swedish National Study on Aging and Care in 2010-2013, and data were collected via wireless LTR ECG-BodyKom...
2016: Clinical Interventions in Aging
Jonas Oldgren, Ziad Hijazi, Johan Lindbäck, John H Alexander, Stuart J Connolly, John W Eikelboom, Michael D Ezekowitz, Christopher B Granger, Elaine M Hylek, Renato D Lopes, Agneta Siegbahn, Salim Yusuf, Lars Wallentin
BACKGROUND: -Atrial fibrillation (AF) is associated with increased but variable risk of stroke. Our aim was to validate the recently developed biomarker-based ABC-stroke risk score and compare its performance with the CHA2DS2VASc and ATRIA risk scores. METHODS: -ABC-stroke score includes Age, Biomarkers (NT-proBNP and high-sensitivity [hs] troponin [cTn]), and Clinical history (prior stroke). This validation was based on 8,356 patients, 16,137 person-years of follow-up, and 219 adjudicated stroke or systemic embolic (SE) events in anticoagulated patients with AF in the RE-LY study...
August 28, 2016: Circulation
Michał Karczewski, Sebastian Woźniak, Radomir Skowronek, Marian Burysz, Marcin Fischer, Lech Anisimowicz, Marcin Demkow, Marek Konka, Wojciech Ogorzeja
AIM: To present the results of treatment and evaluate 6 months of follow-up in a group of patients with non-valvular atrial fibrillation, who underwent the procedure of percutaneous left atrial appendage occlusion (PLAAO). MATERIAL AND METHODS: Percutaneous left atrial appendage occlusion was performed in 34 patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation therapy. The risk of thromboembolic and bleeding complications was determined based on the CHA2DS2VASc and HAS-BLED scales...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Allan J Walkey, Emily K Quinn, Michael R Winter, David D McManus, Emelia J Benjamin
IMPORTANCE: Atrial fibrillation (AF) during sepsis is associated with an increased risk of ischemic stroke during hospitalization, but risks and benefits associated with anticoagulation for AF during sepsis are unclear. OBJECTIVE: To determine clinician practice patterns and patient risk of stroke and bleeding associated with use of anticoagulation for AF during sepsis. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study using enhanced administrative claims data from approximately 20% of patients hospitalized in the United States July 1, 2010, to June 30, 2013, examined patients with AF during sepsis who did not have additional indications for therapeutic anticoagulation...
September 1, 2016: JAMA Cardiology
Emily N Guhl, Donald Siddoway, Evan Adelstein, Raveen Bazaz, George S Mendenhall, Jan Nemec, Samir Saba, David Schwartzman, Andrew Voigt, Norman C Wang, Sandeep K Jain
BACKGROUND: Cryoballoon pulmonary vein isolation (PVI) has emerged as an alternative to radiofrequency PVI for atrial fibrillation (AF). Data are lacking to define the rates and predictors of complications, particularly phrenic nerve injury (PNI). METHODS AND RESULTS: We evaluated a single-center prospective registry of 450 consecutive patients undergoing cryoballoon PVI between 2011 and 2015. Patients were 59±10 years old, 26% were women, 58% had hypertension, their mean CHA2DS2VASc score was 1...
July 2016: Journal of the American Heart Association
Frederick North, Samuel Fox, Rajeev Chaudhry
BACKGROUND: Risk calculation is increasingly used in lipid management, congestive heart failure, and atrial fibrillation. The risk scores are then used for decisions about statin use, anticoagulation, and implantable defibrillator use. Calculating risks for patients and making decisions based on these risks is often done at the point of care and is an additional time burden for clinicians that can be decreased by automating the tasks and using clinical decision-making support. METHODS: Using Morae Recorder software, we timed 30 healthcare providers tasked with calculating the overall risk of cardiovascular events, sudden death in heart failure, and thrombotic event risk in atrial fibrillation...
2016: BMC Medical Informatics and Decision Making
Muhammad Sajawal Ali, Benjamin I Mba, Farah Diba Ciftci, Ahya Sajawal Ali
We describe the case of an 81-year-old female, diagnosed with hyperthyroidism-related atrial fibrillation. Given her CHA2DS2VASc score of 3, she was started on warfarin for stroke prevention. One month later, she was admitted with cardiac tamponade. This tamponade was suspected to be secondary to hemopericardium, based on the elevated international normalized ratio (INR), drop in haemoglobin and the radiodensity (55 HU) of the pericardial effusion on CT. The patient was a Jehovah's witness who therefore initially refused measures for reversing coagulopathy...
2016: BMJ Case Reports
Adam Ioannou, Sofia Metaxa, George Kassianos, Constantinos G Missouris
OBJECTIVE: Our aim was to assess whether the recommendations and guidelines for thromboprophylaxis in patients with atrial fibrillation (AF) have been adopted in general practice (GP). METHODS: We conducted a retrospective study using the GP computer database (Hatfield, UK) on all 9400 patients to assess the quality of anticoagulation in patients with a recorded diagnosis of AF. RESULTS: Of the 180 patients with a diagnosis of AF, 107 (59...
2016: Drugs in Context
Renato Pietro Ricci, Diego Vaccari, Loredana Morichelli, Gabriele Zanotto, Leonardo Calò, Antonio D'Onofrio, Antonio Curnis, Ennio C L Pisanò, René Nangah, Marco Brieda, Vittorio Calzolari, Donato Melissano, Nicola Rovai, Alessio Gargaro
BACKGROUND: Remote Monitoring (RM) of cardiac implantable electronic devices (CIEDs) is recommended in management of Atrial Fibrillation (AF), which is a recognized risk factor for thromboembolism. We tried to elucidate whether stroke incidence observed in a large, remotely monitored population was consistent with the CHA2DS2VASc risk profile. METHODS: Data from 1650 patients [76% male, age 72 (63-68), CHA2DS2VASc score 3.0 (2.0-4.0)] enrolled during the HomeGuide study and monitored with a daily-transmission RM system providing automatic alerts for AF, were analysed...
September 15, 2016: International Journal of Cardiology
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Sebastian Biewener, Patrick Nagel, Saba Suhail, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: The efficacy of the second-generation cryoballoon (CB) in patients with paroxysmal atrial fibrillation (AF) has been demonstrated previously. Data on the efficacy of CB ablation in patients with persistent AF are sparse. OBJECTIVE: The aim of this study was to evaluate the 2-year success rate of pulmonary vein isolation in patients with persistent AF using the second-generation CB. METHODS: Fifty consecutive patients (mean age 64...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Danai Kitkungvan, Faisal Nabi, Mohamad G Ghosn, Amish S Dave, Miguel Quinones, William A Zoghbi, Miguel Valderrabano, Dipan J Shah
OBJECTIVES: The goal of this study was to evaluate the diagnostic performance of a comprehensive, multicomponent cardiac magnetic resonance (CMR) study for assessment of left atrial (LA) and left atrial appendage (LAA) thrombus. BACKGROUND: Pre-operative evaluation for pulmonary vein isolation (PVI) typically requires tomographic imaging to define pulmonary venous anatomy and transesophageal echocardiogram (TEE) to assess for the presence of LA/LAA thrombus. CMR is increasingly being used to define pulmonary venous anatomy before PVI...
July 2016: JACC. Cardiovascular Imaging
Beata Kaczorowska, Małgorzata Pawełczyk, Monika Przybyła
Brain stroke is a grave society problem. About 20% ischemic strokes are cardiac related problems. Atrial fibrillation (AF) is the most common cause of ischemic strokes. Decision to deploy anticoagulant treatment with AF patient depends on bleeding and thrombo-embolic risk which summerise scale CHA(2)DS(2)VASc and HAS-BLED. Past recent years in AF treatment anticoagulants from the group of vitamin K antagonist were used. At present in brain stroke prevention and systemic emboilment, new oral anticoagulants (NOA) which weren't worst than vitamin K antagonists, and they are recomendet in most cases of AF unrelated with heart valve defets...
May 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Volkan Dogan, Özcan Başaran, Osman Beton, Mehmet Tekinalp, Ismail Bolat, Ezgi Kalaycioğlu, Ahmet Çağri Aykan, Onur Taşar, Özgen Şafak, Macit Kalçik, Mehmet Yaman, Cevat Kirma, Murat Biteker
BACKGROUND: Nonvalvular atrial fibrillation (NVAF) frequently coexists with coronary artery disease (CAD). However, the optimal antithrombotic strategy for patients with concomitant CAD and NVAF is controversial. The aim of this study is to assess the prevalence of CAD with NVAF and to determine antithrombotic treatment options in patients with or without a history of CAD. METHODS: ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey (RAMSES study) was a cross-sectional, multicenter, nationwide observational study carried out in NVAF patients...
September 2016: Coronary Artery Disease
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