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Fibrilation atrial guidelines

M Ortiz, J Masjuan, M I Egocheaga, A Martín, C Suarez, I Roldán, R Salgado, J J Mira, P Llamas
OBJECTIVE: To describe the milestones in the anticoagulant care process of atrial fibrillation patients (AF), as well as quality and safety indicators, in order to establish an integrated care process of these patients in the Community of Madrid. METHODS: A consensus conference technique was applied, with the participation of 21 professionals (seven in the Steering Group and 14 known experts), from the specialties of Emergency, Internal Medicine, Cardiology, Neurology, Haematology, Family Medicine, Nursing, and Quality...
May 2018: Journal of healthcare quality research
J W Song, W K Lee, S Lee, J K Shim, H J Kim, Y L Kwak
BACKGROUND: Repeated remote ischaemic conditioning (RIC) during weaning from cardiopulmonary bypass and in the early postoperative period may confer protection against acute kidney injury (AKI). We evaluated the effect of repeated RIC on the incidence of AKI in patients undergoing valvular heart surgery. METHODS: Patients were randomised into either the RIC (n=120) or control (n=124) group. A pneumatic tourniquet was placed on each patient's thigh. Upon removal of the aortic cross-clamp, three cycles of inflation for 5 min at 250 mm Hg (with 5 min intervals) were applied in the RIC group...
November 2018: British Journal of Anaesthesia
Ioannis Mastoris, Alexander G Mathioudakis
No abstract text is available yet for this article.
October 17, 2018: Journal of General Internal Medicine
Peter A Noseworthy, Juan P Brito, Marleen Kunneman, Ian G Hargraves, Claudia Zeballos-Palacios, Victor M Montori, Henry H Ting
Atrial fibrillation (AF) is an important risk factor for stroke. Although anticoagulation is effective in mitigating this risk, many high-risk patients are not anticoagulated in routine practice. Furthermore, as many as 50% of those who are prescribed an anticoagulant stop treatment within a year. This under treatment may be due, in part, to difficulty in navigating difficult decisions about initiating potentially lifelong therapy with significant costs, potential risks, and impact on daily life. To address these challenges, the most recent American guidelines issued a class I recommendation to use shared decision-making (SDM) to individualize patients' antithrombotic care...
October 17, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Afef Ben Halima, Sana Ouali, Mohamed Sami Mourali, Sonia Chabrak, Rafik Chettaoui, Manel Ben Halima, Abdeddayem Haggui, Noureddine Larbi, Salma Krichène, Sonia Marrakchi, Slim Kacem, Rim Chrigui, Mohamed Fahmi Abbes, Hédi Baccar, Nadia Baraket, Najeh Ben Halima, Ali Ben Khalfallah, Mohamed Ben Mbarek, Soraya Ben Youssef, Essia Boughzala, Mohamed Rachid Boujnah, Habiba Drissa, Habib Gamra, Ali Gasmi, Habib Haouala, Youssef Harrath, Ines Issa, Gouider Jeridi, Salem Kachboura, Samir Kammoun, Sondes Kraiem, Faouzi Maatouk, Sami Milouchi, Wided Nasraoui, Ali Neji, Khaled Sayahi, Wissem Sdiri, Wajih Smati, Samir Tlili, Leila Abid, Salem Abdesselem, Lilia Zakhama, Abdallah Mahdhaoui, Helmi Kammoun, Skander Ben Omrane, Faouzi Addad
BACKGROUND: Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiological pattern of heart disease has been seen in the last 3 decades; however, no large prospective multicenter trial reflecting national data has been published so far. Robust data on the contemporary epidemiological profile and management of AF patients in Tunisia are limited. OBJECTIVE: The aim of this study is to analyze, follow, and evaluate patients with AF in a large multicenter nationwide trial...
October 15, 2018: JMIR Research Protocols
Amin Polzin, Lisa Dannenberg, Georg Wolff, Carolin Helten, Alina Achillles, Thomas Hohlfeld, Tobias Zeus, Malte Kelm, Steffen Massberg, Tobias Petzold
Guidelines already recommend non-vitamin K oral anticoagulants (NOAC) over vitamin-K antagonists (VKA) for stroke prevention in patients with atrial fibrillation. However, recommendations are lacking with respect to which NOAC to use. At the moment, NOACs may employ two different molecular mechanisms: Factor IIa inhibition (dabigatran) and factor Xa inhibition (apixaban, edoxaban, rivaroxaban). The focus of this review is to compare and contrast potential differences between factor IIa- and factor Xa inhibition with respect to risk of myocardial infarction and to detail underlying mechanisms...
October 12, 2018: Pharmacology & Therapeutics
Delai Xu, Cujin Su, Jie Pan
Dabigatran etexilate (DE) was approved by the FDA in 2010 to reduce the risk of stroke and systemic embolism in adults with non-valvular atrial fibrillation (NVAF). Compared with warfarin, a traditional anticoagulant drug, DE exhibits a shorter half-life, improved dose-effect relationship, fewer food and drug interactions, and can be taken orally without monitoring the conventional coagulation index. DE can also prevent or reduce the severity of adverse events, such as attenuated drug efficacy or bleeding. It is convenient for patients to take DE due to low levels of individual variation...
October 11, 2018: Current Drug Metabolism
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
A 77-year-old male underwent elective bioprosthetic aortic valve replacement (23 mm Carpentier-Edwards Perimount MagnaEase) for severe aortic stenosis. His pre-discharge transthoracic echocardiogram (TTE) was normal. He presented 9 days after surgery with dyspnea and fever. He was in sinus rhythm. Blood cultures were taken and he was commenced on empirical antibiotics for possible infective endocarditis (subsequently all negative). Repeat TTE showed a well-seated prosthesis without regurgitation but elevated gradients (peak/mean gradients 69/48mmHg respectively)...
September 1, 2018: Echo Research and Practice
Alexander Iribarne, Anthony W DiScipio, Jock N McCullough, Reed Quinn, Bruce J Leavitt, Benjamin M Westbrook, Michael P Robich, Gerald L Sardella, John D Klemperer, Robert S Kramer, Paul W Weldner, Elaine M Olmstead, Cathy S Ross, David J Malenka
BACKGROUND: Society of Thoracic Surgeons guidelines recommend surgical ablation (SA) at the time of concomitant mitral operations, aortic valve replacement, coronary artery bypass grafting (CABG), and AVR plus CABG for patients in atrial fibrillation (AF). The goal of this analysis was to assess the influence of SA on long term survival. METHODS: A retrospective analysis of 20,407 consecutive CABG or valve procedures from 2008-2015 among 7 centers reporting to a prospectively maintained clinical registry was conducted...
October 6, 2018: Annals of Thoracic Surgery
Osman Kayapinar, Adnan Kaya, Muhammed Keskin, Mustafa Adem Tatlisu
BACKGROUND: Atrial fibrillation (AF) is a common complication of ST-segment elevation myocardial infarction (STEMI), and AF might require anticoagulant treatment in some conditions. STUDY QUESTION: There are no clear recommendations about vitamin K antagonist (VKA) use in patients with STEMI who complicated with new-onset transient AF. In this study, we examined the association of concomitant use of VKA and dual antiplatelet therapy (DAPT) with clinical outcomes of this patient population...
September 25, 2018: American Journal of Therapeutics
W Amara, D Mlayeh
There are many randomized trials evaluating non-vitamin K oral anticoagulants (NOAC) in patients with atrial fibrillation ablation. VENTURE AF, RE-CIRCUIT, and recently AXAFA have evaluated the three main NOACs in this indication. Other studies such as ABRIDGE J and AEIOU complemented these results. The management of the anticoagulation in these patients is one of the subjects of the European Society of Cardiology guidelines, as well, as, the EHRA guide recently released. The purpose of this article is to summarize published studies and guidelines...
October 5, 2018: Annales de Cardiologie et D'angéiologie
Yuichi Saito, Yoshio Kobayashi
In patients with atrial fibrillation (AF), concomitant coronary artery disease is often present, and vice versa. Optimal antithrombotic treatment for patients with AF undergoing percutaneous coronary intervention (PCI) is one of the major concerns in the field of cardiology. Triple therapy, a combination of oral anticoagulant (OAC) plus dual antiplatelet therapy with aspirin and P2Y12 inhibitor, has been used for patients with AF undergoing PCI in recent decades to reduce ischemic events under guideline recommendations...
October 4, 2018: Journal of Cardiology
Andrea Hetzenecker, Christoph Fisser, Stefan Stadler, Michael Arzt
In 2017 the German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin, DGSM) published the new S3 guideline "Nonrestorative Sleep/Sleep Disorders, chapter "Sleep-Related Breathing Disorders in Adults".Sleep apnea contributes to an increased morbidity and mortality in patients with cardiovascular diseases, e. g. coronary heart disease, heart failure and diabetes mellitus and is associated with an increased perioperative risk. It is also an important comorbidity in respiratory, neurologic and oncologic diseases...
October 2018: Deutsche Medizinische Wochenschrift
Martijn Stefan van Mourik, Jeroen Vendrik, Mohammad Abdelghani, Floortje van Kesteren, Jose P S Henriques, Antoine H G Driessen, Joanna J Wykrzykowska, Robbert J de Winter, Jan J Piek, Jan G Tijssen, Karel T Koch, Jan Baan, M Marije Vis
Objective: Transcatheter aortic valve implantation (TAVI) provides a significant symptom relief and mortality reduction in most patients; however, a substantial group of patients does not experience the same beneficial results according to physician-determined outcomes. Methods: Single-centre prospective design; the population comprises all consecutive patients undergoing TAVI in 2012-2017. TAVI futility was defined as the combined endpoint of either no symptomatic improvement or mortality at 1 year...
2018: Open Heart
Jennifer L Reed, Tasuku Terada, Daniele Chirico, Stephanie A Prince, Andrew L Pipe
BACKGROUND: Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is associated with substantial morbidity and mortality. Clinical guidelines for managing patients with AF do not include a referral to cardiac rehabilitation (CR) at present, although it is routine for most other cardiovascular conditions. The number of studies evaluating the impact of CR on the health of patients with AF is growing, but there has been no consolidation of the findings. The objective of this systematic review was to evaluate the impact of CR programs on physical and mental health outcomes in patients with all forms of AF...
October 2018: Canadian Journal of Cardiology
Sachin J Shah, Mark H Eckman, Sara Aspberg, Alan S Go, Daniel E Singer
Background: Stroke rates in patients with nonvalvular atrial fibrillation (AF) who are not receiving anticoagulant therapy vary widely across published studies; the resulting effect on the net clinical benefit of anticoagulation in AF is unknown. Objective: To determine the effect of variation in published AF stroke rates on the net clinical benefit of anticoagulation. Design: Markov model decision analysis. Warfarin was the base case, and non-vitamin K antagonist oral anticoagulants (NOACs) were modeled in a secondary analysis...
October 16, 2018: Annals of Internal Medicine
Jeroen Ml Hendriks, Hein Heidbüchel
The 2016 European Society of Cardiology guidelines for the management of atrial fibrillation recommends integrated care in the treatment of atrial fibrillation and follows a patient-centred, multidisciplinary team approach. Nurses and allied health professionals have a significant role to play in the management of chronic conditions such as atrial fibrillation, which is underlined by this guideline and the integrated care approach. In this article, members of the task force writing committee highlight significant evidence from this particular guideline as well as clinical implications for nurses and allied health professionals in their daily work with atrial fibrillation patients and their caregivers...
September 27, 2018: European Journal of Cardiovascular Nursing
Reinhold Kreutz, Insa M Schmidt, Dagmar Dräger, Franca Brüggen, Stefan Hörter, Christine Zwillich, Adelheid Kuhlmey, Paul Gellert
AIM: Evidence on antithrombotic therapy use in centenarians diagnosed with atrial fibrillation (AF) is sparse. Our objective was to investigate a possible underprescribing in centenarians relative to younger cohorts of the oldest-old. We assumed lower AF rates; and, within AF patients, lower use of anticoagulants in those who died as centenarians (aged ≥100 years) than in those who died aged in their 80s (≥80 years) or 90s (≥90 years). METHODS: The present study was a quarterly structured cohort study over the 6 years before death using administrative data from German institutionalized and non-institutionalized insured patients (whole sample n = 1398 and subsample of AF patients n = 401 subclassified according to age-of-death groups [≥80, ≥90, ≥100 years])...
September 26, 2018: Geriatrics & Gerontology International
Harpreet S Bhatia, Jonathan C Hsu, Robert J Kim
Atrial fibrillation and chronic kidney disease commonly occur together, which poses a therapeutic dilemma due to increased risk of both systemic thromboembolism and bleeding. Chronic kidney disease also has implications for medication selection. The objective of this review is to evaluate the options for anticoagulation for thromboembolism prevention in patients with atrial fibrillation and chronic kidney disease. We searched PubMed for studies of patients with atrial fibrillation and chronic kidney disease on warfarin or a direct oral anticoagulant for thromboembolism prevention through January 1, 2018, in addition to evaluating major trials evaluating direct oral anticoagulants and warfarin use as well as society guidelines...
September 27, 2018: Clinical Cardiology
Tania Ahuja, Veronica Raco, John Papadopoulos, David Green
Prescribing patterns for oral anticoagulants in patients with nonvalvular atrial fibrillation and venous thromboembolism is shifting from vitamin K antagonists, such as warfarin to the direct oral anticoagulants (DOACs), such as dabigatran, rivaroxaban, and apixaban. Although many hospital systems have implemented clinical decision support or enhanced monitoring for patients prescribed warfarin, there is limited evidence to suggest similar levels of enhanced monitoring for DOACs. The antithrombotic stewardship team at our institution developed guidelines and implemented computerized clinical decision support (CCDS) tools to enhance medication and patient safety related to the DOACs...
September 25, 2018: Journal of Patient Safety
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