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Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain...
March 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchel et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation...
March 17, 2018: European Heart Journal
Geoffrey H Tison, José M Sanchez, Brandon Ballinger, Avesh Singh, Jeffrey E Olgin, Mark J Pletcher, Eric Vittinghoff, Emily S Lee, Shannon M Fan, Rachel A Gladstone, Carlos Mikell, Nimit Sohoni, Johnson Hsieh, Gregory M Marcus
Importance: Atrial fibrillation (AF) affects 34 million people worldwide and is a leading cause of stroke. A readily accessible means to continuously monitor for AF could prevent large numbers of strokes and death. Objective: To develop and validate a deep neural network to detect AF using smartwatch data. Design, Setting, and Participants: In this multinational cardiovascular remote cohort study coordinated at the University of California, San Francisco, smartwatches were used to obtain heart rate and step count data for algorithm development...
March 21, 2018: JAMA Cardiology
Michael R Kaufmann, Matthew S McKillop, Thomas A Burkart, Mark Panna, Jamie B Conti, William M Miles
Direct-current cardioversion is an important means of managing arrhythmias. During treatment, carefully synchronizing energy delivery to the QRS complex is necessary to avoid ventricular fibrillation caused by a shock during the vulnerable period of ventricular repolarization, that is, a shock on the T wave. The presence of an accessory pathway and ventricular preexcitation can lead to difficulty in distinguishing the QRS complex from the T wave because of bizarre, wide, irregular QRS complexes and prominent repolarization...
February 2018: Texas Heart Institute Journal
Wi Jin Kim, Georgios Zenonos, Michael M McDowell, Paul A Gardner, Johnathan A Engh
No abstract text is available yet for this article.
March 15, 2018: World Neurosurgery
Renate B Schnabel, Ladislav Pecen, Daniel Engler, Markus Lucerna, Jean Marc Sellal, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood. METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women)...
March 17, 2018: Heart: Official Journal of the British Cardiac Society
Chen Chen, Xinbin Zhou, Min Zhu, Shenjie Chen, Jie Chen, Hongwen Cai, Jin Dai, Xiaoming Xu, Wei Mao
PURPOSE: The superiority of catheter ablation (CA) for persistent (and long-standing persistent) atrial fibrillation (AF) is currently not well defined. We performed a meta-analysis of randomized controlled trials (RCTs) to assess the clinical outcomes of CA compared with medical therapy in persistent AF patients. METHODS: We systematically searched PubMed, EMBASE, the Cochrane Library, and for RCTs comparing CA with medical therapy in patients with persistent AF...
March 16, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Philipp Stieger, Obaida R Rana, Erol Saygili, Haschmatulla Zazai, Thomas Rauwolf, Conrad Genz, Rajen Bali, Ruediger C Braun-Dullaeus, Samir M Said
BACKGROUND: Implantable cardioverter/defibrillator (ICD) shocks can cause myocardial injury, contributing to the progression of the underlying heart disease. The aim was to evaluate whether internal electrical cardioversion (int-CV) via the ICD or conventional external CV (ext-CV) of persistent atrial fibrillation (AF) in heart failure (HF) patients induces myocardial injury and initiates inflammation. METHODS AND RESULTS: A total of 115 HF patients with an ejection fraction between 20% and 45% were prospectively enrolled...
March 12, 2018: Journal of Cardiology
Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
Joseph M Bumgarner, Cameron T Lambert, Ayman A Hussein, Daniel J Cantillon, Bryan Baranowski, Kathy Wolski, Bruce D Lindsay, Oussama M Wazni, Khaldoun G Tarakji
BACKGROUND: The Kardia Band (KB) is a novel technology that enables patients to record a rhythm strip using an Apple smartwatch. The band is paired with an app providing automated detection of atrial fibrillation (AF). OBJECTIVES: To examine whether the KB could accurately differentiate sinus rhythm (SR) from AF compared to physician-interpreted 12-lead ECGs and KB recordings. METHODS: Consecutive patients with AF presenting for cardioversion (CV) were enrolled...
March 7, 2018: Journal of the American College of Cardiology
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Mouhannad M Sadek, Varsha Chaugai, Mark J Cleland, Timothy J Zakutney, David H Birnie, F Daniel Ramirez
BACKGROUND: The relevance of transthoracic impedance (TTI) to electrical cardioversion (ECV) success for atrial tachyarrhythmias when using biphasic waveform defibrillators is unknown. HYPOTHESIS: TTI is predictive of ECV success with contemporary defibrillators. METHODS: De-identified data stored in biphasic defibrillator memory cards from ECV attempts for atrial fibrillation (AF) or atrial flutter (AFL) over a two-year period at our center were evaluated...
March 13, 2018: Clinical Cardiology
Takashi Komatsu, Fusanori Kunugita, Mahito Ozawa, Yoshihiro Satoh, Reisuke Yoshizawa, Shingen Owada, Youhei Sawa, Yoshihiro Morino, Motoyuki Nakamura
Background and methods There is little information concerning the influence of the heart rhythm on the vascular endothelial function in patients with non-valvular atrial fibrillation (AF) compared with studies concerning sinus rhythm (SR). The present study included paroxysmal (n=184) or chronic (n=53) AF patients without heart failure and control subjects with SR (n=79) matched for age, gender and the CHA2 DS2 -VASc score. Paroxysmal AF was defined as episodes that terminated spontaneously within 7 days, while chronic AF was defined as longstanding AF that was refractory to cardioversion for 12 months or longer...
March 9, 2018: Internal Medicine
Guy Rozen, Jeena Vaid, Seyed Mohammadreza Hosseini, M Ihsan Kaadan, Allon Rafael, Attila Roka, Yukkee C Poh, Ming-Zher Poh, Edwin Kevin Heist, Jeremy Neil Ruskin
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with significant morbidity, increased mortality, and rising health-care costs. Simple and available tools for the accurate detection of arrhythmia recurrence in patients after electrical cardioversion (CV) or ablation procedures for AF can help to guide therapeutic decisions. We conducted a prospective, single-center study to evaluate the accuracy of Cardiio Rhythm Mobile Application (CRMA) for AF detection. Patients >18 years of age who were scheduled for elective CV for AF were enrolled in the study...
February 13, 2018: American Journal of Cardiology
Alessandro Capucci, Laura Cipolletta, Federico Guerra, Irene Giannini
The main aim of current research on the field of atrial fibrillation (AF) treatment is to find new antiarrhythmic drugs with less side effects. Areas covered: Dronedarone and vernakalant showed promising result in term of efficacy and safety in selected patients. Ranolazine and colchicine are obtaining a role as a potential antiarrhythmic drug. Ivabradine is used in experimental studies for the rate control of AF. Moreover, new compounds (vanoxerine, moxonidine, budiodarone) are still under investigation. Monoclonal antibodies or selective antagonist of potassium channel are under investigation for long term maintenance of sinus rhythm...
March 6, 2018: Expert Opinion on Emerging Drugs
Deepa Prasad, Joni Steinberg, Christopher Snyder
Introduction Newborn atrial flutter can be treated by medications, pacing, or direct current cardioversion. The purpose is to compare the cost-effectiveness of digoxin, pacing, and direct current cardioversion for the treatment of atrial flutter in neonates. Materials and methods A decision tree model was developed comparing the efficacy and cost of digoxin, pacing, and direct current cardioversion based on a meta-analysis of published studies of success rates of cardioversion of neonatal atrial flutter (age<2 months)...
March 6, 2018: Cardiology in the Young
Bharath Yarlagadda, Venkat Vuddanda, Tawseef Dar, Mohammad-Ali Jazayeri, Valay Parikh, Mohit K Turagam, Madhav Lavu, Sindhu Reddy Avula, Donita Atkins, Sudharani Bommana, Rakesh Gopinathannair, Madhu Reddy Yeruva, Dhanunjaya Lakkireddy
Background: We sought to investigate and compare the safety and efficacy of two commonly used antiarrhythmic drugs, Dofetilide (DF) and Sotalol (SL), during inpatient drug initiation in patients with symptomatic atrial fibrillation (AF). Methods: We performed a single center retrospective study of consecutive patients, admitted for initiation of either DF or SL, for AF between 2012 and 2015. Rates of successful cardioversion, QT interval prolongation, adverse events and drug discontinuations were calculated and compared...
December 2017: Journal of Atrial Fibrillation
Matteo Cameli, Stefano Lunghetti, Giulia Elena Mandoli, Francesca Maria Righini, Matteo Lisi, Valeria Curci, Cristina Di Tommaso, Marco Solari, Dan Nistor, Annalaura Gismondi, Marta Focardi, Roberto Favilli, Sergio Mondillo
Background and Purpose: Atrial fibrillation (AF) has a high prevalence in the population and it is responsible for up to the 25% of the strokes in elderly people. The aim of our study was to assess the correlations of left atrial (LA) functional parameter, global peak atrial longitudinal strain (PALS), derived from speckle tracking echocardiography (STE), with transesophageal echocardiography (TEE) findings in patients with persistent AF undergoing TEE before electrical cardioversion or ablation procedures...
December 2017: Journal of Atrial Fibrillation
Melissa L Morello, Philip R Khoury, Timothy K Knilans, Gruschen Veldtman, David S Spar, Jeffery B Anderson, Richard J Czosek
OBJECTIVES: Evaluate the efficacy, outcomes and complications associated with DCCV in the treatment of arrhythmias in pediatric and adult CHD populations and identify patient and procedural characteristics associated with adverse events. BACKGROUND: Pediatric and adult patients with congenital heart disease (CHD) are at risk of atrial arrhythmias. Direct current cardioversion (DCCV) is effective but is associated with potential complications. METHODS: In this single-center retrospective series, patients undergoing DCCV Jan 2010-May 2015 were identified and categorized as pediatric (< 18 years) or adult (> 18 years)...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
Elisabeth A J de Vos, Yolien J Hagen, Michael I Meesters, Nada Osmanovic, Christa Boer, Marcel A de Leeuw
BACKGROUND: Procedures requiring optimisation of the coagulation status of patients using vitamin K antagonists are frequently postponed due to the late availability of laboratory international normalised ratio (INR) test results. A point-of-care (POC) alternative may facilitate early decision-making in peri-operative patients. OBJECTIVES: To assess the level of agreement between the POC-INR and the laboratory INR in patients who continue or stop vitamin K antagonists to determine whether the POC test may be a good alternative to the laboratory INR...
February 22, 2018: European Journal of Anaesthesiology
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