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pharmacology prophylaxis atrial fibrillation

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https://www.readbyqxmd.com/read/29476748/preventing-postoperative-atrial-fibrillation-after-noncardiac-surgery-a-meta-analysis
#1
Adam Oesterle, Benjamin Weber, Roderick Tung, Niteesh K Choudhry, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Although postoperative atrial fibrillation is common after noncardiac surgery, there is a paucity of data regarding prophylaxis. We sought to determine whether pharmacologic prophylaxis reduces the incidence of postoperative atrial fibrillation after noncardiac surgery. METHODS: We performed an electronic search of Ovid MEDLINE, the Cochrane central register of controlled trials database, and SCOPUS from inception to September 7, 2016 and included prospective randomized studies in which patients in sinus rhythm underwent noncardiac surgery and examined the incidence of postoperative atrial fibrillation as well as secondary safety outcomes...
July 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29369958/epidural-hematoma-following-cessation-of-a-direct-oral-anticoagulant-a-case-report
#2
Jessica E Burjorjee, Rachel Rooney, Melanie Jaeger
OBJECTIVE: In this case report, we describe a case of epidural hematoma following epidural analgesia in a patient with recent cessation of a direct oral anticoagulant (DOAC). CASE REPORT: An 89-year-old woman requiring upper abdominal surgery presented with multiple comorbidities, including a prior cerebrovascular accident resulting in a left-sided hemiparesis and atrial fibrillation requiring anticoagulation with rivaroxaban. In accordance with our departmental guidelines at the time of procedure, rivaroxaban was discontinued 4 days preoperatively...
April 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29289938/pharmacological-interventions-for-preventing-post-operative-atrial-fibrillation-in-patients-undergoing-cardiac-surgery-a-network-meta-analysis-protocol
#3
Xiaoqin Wang, Liang Yao, Long Ge, Lun Li, Fuxiang Liang, Qi Zhou, Yaolong Chen, Yongfeng Wang, Kehu Yang
INTRODUCTION: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, and randomised clinical trials (RCTs) and systematic reviews have been conducted to compare and evaluate different pharmacological interventions for preventing POAF. This study aimed to explore the effect of different pharmacological interventions for prophylaxis against POAF after cardiac surgery using network meta-analysis (NMA). METHODS AND ANALYSIS: A systematic search will be performed in PubMed, EMBASE and the Cochrane Library to identify RCTs, systematic reviews, meta-analyses or NMA of different pharmacological interventions for POAF...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138609/non-valvular-atrial-fibrillation-impact-of-apixaban-on-patient-outcomes
#4
REVIEW
Adam Ioannou, Irene Tsappa, Sofia Metaxa, Constantinos G Missouris
Atrial fibrillation is the most common arrhythmia worldwide, and carries a significantly increased risk of thromboembolic stroke. Initially, vitamin K antagonists were used as stroke prophylaxis; but more recently, a group of drugs known as novel oral anticoagulants have been developed. Apixaban belongs to this group of drugs, and is a factor Xa inhibitor that has emerged as a popular pharmacological agent worldwide. In this review, we will provide an overview of the pivotal trials in the development of apixaban, while also critically evaluating the new emerging real-world data, and discussing the effectiveness, safety, economic viability and future prospects of apixaban and how it impacts on patient outcomes in those with non-valvular atrial fibrillation...
2017: Patient related Outcome Measures
https://www.readbyqxmd.com/read/29120136/postoperative-atrial-fibrillation-prophylaxis-and-lung-resection-%C3%A2-our-experience-with-608-consecutive-patients
#5
Vjekoslav Karadža, Dinko Stančić-Rokotov, Jasna Špiček Macan, Nevenka Hodoba, Nevenka Kolarić, Sanja Sakan
Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. This period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29029665/mohs-micrographic-surgery-key-pharmacologic-considerations
#6
Diana Fischer, Patricia Orlando, Laura Shane-McWhorter
OBJECTIVE: To describe Mohs micrographic surgery and evaluate whether direct oral anticoagulants should be withheld in patients with atrial fibrillation (Afib) prior to the procedure and to consider what type of antibiotic prophylaxis should be used. SETTING: A community setting in which an elderly patient is living independently at home. PRACTICE DESCRIPTION: Academic-affiliated internal medicine clinic that cares for adult patients of all ages, including elderly patients living independently in their own home...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28862063/the-safety-of-edoxaban-for-treating-atrial-fibrillation
#7
REVIEW
Matthias Hammwöhner, Andreas Goette
Atrial Fibrillation (AF) has a worldwide increasing incidence and prevalence, putting patients at risk for atrial thrombus formation and consecutive thromboembolic events. Morbidity and mortality have become a significant global public health care burden. Thus, there is increasing need for safe and effective medical prophylaxis of thromboembolic events. Edoxaban is the fourth approved non-vitamin K oral anticoagulant (NOAC) that has been introduced into the market for the prophylaxis of stroke or systemic embolism in non valvulär AF patients after dabigatran, rivaroxaban, and apixaban...
November 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28701603/is-endothelin-gene-polymorphism-associated-with-postoperative-atrial-fibrillation-in-patients-undergoing-coronary-artery-bypass-grafting
#8
Ira Dhawan, Minati Choudhury, Milind P Hote, Anushree Gupta, Poonam Malhotra, Kalaivani V Mani
BACKGROUND: The mechanism of development of atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG) has not been clearly defined, and the involvement of multiple factors such as advanced age, withdrawal of β-blockers, inadequate atrial protection, and electrolyte imbalance, particularly hypomagnesemia has been documented by several authors. Despite all the available pharmacologic prophylaxis, incidence of AF still remains high in this group of patients...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28685701/the-role-of-quinidine-in-the-pharmacological-therapy-of-ventricular-arrhythmias-quinidine
#9
REVIEW
Bojana Bozic, Teodora Vidonja Uzelac, Aleksandra Kezic, Milica Bajcetic
Historically, quinidine was the first medicine used in the therapy of heart arrhythmias. Studies in the early 20th century identified quinidine, a diastereomer of the antimalarial quinine, as the most potent of the antiarrhythmic substances extracted from the cinchona plant. Quinidine is used by the 1920s, as an antiarrhythmic agent to maintain sinus rhythm after the conversion from atrial flutter or atrial fibrillation and to prevent recurrence of ventricular tachycardia or ventricular fibrillation. Its value in chronic prophylaxis of relapse of ventricular arrhythmia was brought under suspicion after publishing of meta analysis that showed that the application of quinidine increases mortality...
2018: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/28511557/impact-of-a-perioperative-prophylaxis-guideline-on-post-cardiothoracic-surgery-atrial-fibrillation
#10
Rosanna Li, C Michael White, Jola Mehmeti, Spencer T Martin, Laura C Hobbs
BACKGROUND: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). OBJECTIVE: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. METHODS: Data were retrospectively collected on 400 adults (200 patients pre-guideline implementation and 200 patients post-guideline implementation) with a CHA2 DS2 -VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS...
September 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28497941/antiarrhythmic-effects-of-ranolazine-used-both-alone-for-prevention-of-atrial-fibrillation-and-as-an-add-on-to-intravenous-amiodarone-for-its-pharmacological-cardioversion-a-meta-analysis
#11
Renato De Vecchis, Carmelina Ariano, Anna Giasi, Carmela Cioppa
INTRODUCTION: Recent evidence from relatively small randomized controlled trials would seem to support a useful role of ranolazine for the prevention and treatment of atrial fibrillation (AF). The present study is aimed at providing information about the possible beneficial anti-arrhythmic properties of ranolazine. In particular, the meta-analysis carried out in this study focuses on the application of ranolazine to prophylaxis and treatment of atrial fibrillation. EVIDENCE ACQUISITION: Both methods randomized controlled trials (RCTs) and non-randomized observational studies concerning the effects of ranolazine on AF were included in the meta-analysis...
June 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28496855/pharmacological-therapy-in-stroke-prophylaxis-the-new-versus-the-old-agents
#12
REVIEW
Abhishek Maan, E Kevin Heist, Jeremy N Ruskin, Moussa Mansour
Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. AF is a potent risk factor for stroke and systemic thromboembolism. Patients with AF have been observed to have a worse outcome following stroke, therefore prevention of stroke in patients with AF is of paramount importance. Antithrombotic therapy is crucial for prevention of stroke in patients with AF. Vitamin K antagonists (VKAs) have been the traditional anticoagulants for prevention of stroke in patients with AF...
June 2013: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28118212/delayed-anaphylaxis-to-mammalian-meat-following-tick-exposure-and-its-impact-on-anesthetic-management-for-cardiac-surgery-a-case-report
#13
Amanda M Kleiman, Keith E Littlewood, Danja S Groves
Hypersensitivity reactions to mammalian meat following tick exposure are increasing in prevalence and provide a unique challenge to anesthesiologists. The reactions, including anaphylaxis, are delayed and therefore may not be easily recognized and treated. The risk is especially high in cardiac surgery, where several potential triggers, including biological valves as well as heparin, are used frequently. In the presence of such hypersensitivity, prophylactic measures including preoperative testing and pharmacologic prophylaxis may be useful in modulating the immune response such that triggering agents may be used relatively safely...
April 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27581874/cost-effectiveness-analysis-of-left-atrial-appendage-occlusion-compared-with-pharmacological-strategies-for-stroke-prevention-in-atrial-fibrillation
#14
Vivian Wing-Yan Lee, Ronald Bing-Ching Tsai, Ines Hang-Iao Chow, Bryan Ping-Yen Yan, Mehmet Gungor Kaya, Jai-Wun Park, Yat-Yin Lam
BACKGROUND: Transcatheter left atrial appendage occlusion (LAAO) is a promising therapy for stroke prophylaxis in non-valvular atrial fibrillation (NVAF) but its cost-effectiveness remains understudied. This study evaluated the cost-effectiveness of LAAO for stroke prophylaxis in NVAF. METHODS: A Markov decision analytic model was used to compare the cost-effectiveness of LAAO with 7 pharmacological strategies: aspirin alone, clopidogrel plus aspirin, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban...
August 31, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27540038/percutaneous-left-atrial-appendage-occlusion-the-munich-consensus-document-on-definitions-endpoints-and-data-collection-requirements-for-clinical-studies
#15
Apostolos Tzikas, David R Holmes, Sameer Gafoor, Carlos E Ruiz, Carina Blomström-Lundqvist, Hans-Christoph Diener, Riccardo Cappato, Saibal Kar, Randal J Lee, Robert A Byrne, Reda Ibrahim, Dhanunjaya Lakkireddy, Osama I Soliman, Michael Nabauer, Steffen Schneider, Johannes Brachmann, Jeffrey L Saver, Klaus Tiemann, Horst Sievert, A John Camm, Thorsten Lewalter
The increasing interest in left atrial appendage occlusion (LAAO) for ischaemic stroke prevention in atrial fibrillation (AF) fuels the need for more clinical data on the safety and effectiveness of this therapy. Besides an assessment of the effectiveness of the therapy in specific patients groups, comparisons with pharmacological stroke prophylaxis, surgical approaches, and other device-based therapies are warranted. This paper documents the consensus reached among clinical experts in relevant disciplines from Europe and North America, European cardiology professional societies, and representatives from the medical device industry regarding definitions for parameters and endpoints to be assessed in clinical studies...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27173870/percutaneous-left-atrial-appendage-occlusion-the-munich-consensus-document-on-definitions-endpoints-and-data-collection-requirements-for-clinical-studies
#16
REVIEW
Apostolos Tzikas, David R Holmes, Sameer Gafoor, Carlos E Ruiz, Carina Blomström-Lundqvist, Hans-Christoph Diener, Riccardo Cappato, Saibal Kar, Randal J Lee, Robert A Byrne, Reda Ibrahim, Dhanunjaya Lakkireddy, Osama I Soliman, Michael Näbauer, Steffen Schneider, Johannes Brachman, Jeffrey L Saver, Klaus Tiemann, Horst Sievert, A John Camm, Thorsten Lewalter
The increasing interest in left atrial appendage occlusion (LAAO) for ischaemic stroke prevention in atrial fibrillation (AF) fuels the need for more clinical data on the safety and effectiveness of this therapy. Besides an assessment of the effectiveness of the therapy in specific patient groups, comparisons with pharmacological stroke prophylaxis, surgical approaches and other device-based therapies are warranted. This paper documents the consensus reached among clinical experts in relevant disciplines from Europe and North America, European cardiology professional societies and representatives from the medical device industry regarding definitions for parameters and endpoints to be assessed in clinical studies...
May 17, 2016: EuroIntervention
https://www.readbyqxmd.com/read/26861870/-new-oral-anticoagulants-for-prophylaxis-of-stroke-results-of-an-expert-conference-on-practical-use-in-geriatric-patients
#17
REVIEW
Philipp Bahrmann, Fred Harms, Christian Martin Schambeck, Martin Wehling, Jürgen Flohr
Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with novel oral anticoagulants (NOAC) to prevent ischemic stroke. This article highlights the outcome of an expert meeting on the practical use of NOAC in elderly patients. An interdisciplinary group of experts discussed the current situation of stroke prevention in geriatric patients and its practical management in daily clinical practice. The topic was examined through focused impulse presentations and critical analyses as the basis for the expert consensus...
April 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/26846223/-typical-atrial-flutter-diagnosis-and-therapy
#18
REVIEW
Dierk Thomas, Lars Eckardt, Heidi L Estner, Malte Kuniss, Christian Meyer, Hans-Ruprecht Neuberger, Philipp Sommer, Daniel Steven, Frederik Voss, Hendrik Bonnemeier
Typical, cavotricuspid-dependent atrial flutter is the most common atrial macroreentry tachycardia. The incidence of atrial flutter (typical and atypical forms) is age-dependent with 5/100,000 in patients less than 50 years and approximately 600/100,000 in subjects > 80 years of age. Concomitant heart failure or pulmonary disease further increases the risk of typical atrial flutter.Patients with atrial flutter may present with symptoms of palpitations, reduced exercise capacity, chest pain, or dyspnea...
March 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/26290342/what-are-the-risk-factors-for-cerebrovascular-accidents-after-elective-orthopaedic-surgery
#19
Shobhit V Minhas, Preeya Goyal, Alpesh A Patel
BACKGROUND: Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. QUESTIONS/PURPOSES: Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures...
March 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26071992/meta-analysis-of-chads2-score-in-predicting-atrial-fibrillation
#20
Yajuan Yang, Zhiwei Zhang, Chee Y Ng, Guangping Li, Tong Liu
The CHADS2 score is a validated clinical tool used for the risk stratification of stroke in the presence of atrial fibrillation (AF). Recently, some studies have shown that CHADS2 score may predict the risk of AF, which yielded conflicting results. The purpose of this study is to perform a meta-analysis of observational studies to examine the association between the CHADS2 score and risk of AF. Using PubMed and EMBASE database, we searched published articles by November 2014 to identify studies that evaluated the association between CHADS2 score and the risk of AF...
August 15, 2015: American Journal of Cardiology
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