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https://www.readbyqxmd.com/read/28217222/non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-for-cardioversion-of-atrial-fibrillation-in-clinical-practice-a-single-center-experience
#1
Naoki Shibata, Itsuro Morishima, Kenji Okumura, Yasuhiro Morita, Kensuke Takagi, Ruka Yoshida, Hiroaki Nagai, Toshiro Tomomatsu, Yoshihiro Ikai, Kazushi Terada, Kazuhito Tsuzuki, Hideyuki Tsuboi, Takahito Sone, Toyoaki Murohara
BACKGROUND: Anticoagulation therapy with the vitamin K antagonist (VKA) warfarin has been demonstrated to reduce thromboembolic risk after electrical cardioversion (ECV). However, data concerning ECV with non-VKA oral anticoagulants (NOACs) is limited. The objective of this study was to determine the efficacy and safety of NOACs in patients undergoing ECV in a real-world clinical practice at a single center in Japan. METHODS: We retrospectively analyzed the data of 406 consecutive patients who underwent ECV for atrial fibrillation (AF) or flutter under anticoagulation with one of the three NOACs (n=149) or with a VKA (n=257)...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#2
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28191906/intracardiac-echocardiography-for-verification-for-left-atrial-appendage-thrombus-presence-detected-by-transesophageal-echocardiography-the-actionice-ii-study
#3
Jakub Baran, Beata Zaborska, Roman Piotrowski, Malgorzata Sikora-Frąc, Ewa Pilichowska-Paszkiet, Piotr Kułakowski
BACKGROUND: Transesophageal echocardiography (TEE) remains the gold standard for exclusion of left atrial appendage (LAA) thrombus in patients scheduled for direct electrical cardioversion (DEC) or atrial fibrillation (AF) ablation. Recently, intracardiac echocardiography (ICE) of the pulmonary artery (PA) has been shown to provide excellent LAA images and to be useful in verification of equivocal TEE findings. HYPOTHESIS: ICE of the PA may have a role in detecting false-positive TEE results...
February 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28190617/chronic-obstructive-pulmonary-disease-predicts-higher-incidence-and-in-hospital-mortality-for-atrial-fibrillation-an-observational-study-using-hospital-discharge-data-in-spain-2004-2013
#4
Manuel Méndez-Bailón, Ana Lopez-de-Andrés, Javier de Miguel-Diez, José Mª de Miguel-Yanes, Valentín Hernández-Barrera, Nuria Muñoz-Rivas, Noel Lorenzo-Villalba, Rodrigo Jiménez-García
BACKGROUND: Our objectives were to describe and compare trends in the incidence of hospitalization for atrial fibrillation (AF) in patients with and without chronic obstructive pulmonary disease (COPD) in Spain during 2004-2013 and to assess the effect of COPD on the in-hospital mortality (IHM) of patients with AF. METHODS: We performed a retrospective study using the Spanish National Hospital Discharge Database. The study population comprised patients≥40years with a primary diagnosis of AF...
February 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28188041/chronic-obstructive-pulmonary-disease-and-atrial-fibrillation-an-unknown-relationship
#5
REVIEW
Christos A Goudis
Chronic obstructive pulmonary disease (COPD) is independently associated with atrial fibrillation (AF). Decreased oxygenation, hypercapnia, pulmonary hypertension, diastolic dysfunction, oxidative stress, inflammation, changes in atrial size by altered respiratory physiology, increased arrhythmogenicity from nonpulmonary vein foci commonly located in the right atrium, and respiratory drugs have been implicated in the pathogenesis of AF in COPD. The understanding of the relationship between COPD and AF is of particular importance, as the presence of the arrhythmia has significant impact on mortality, especially in COPD exacerbations...
February 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28182279/ranolazine-added-to-amiodarone-facilitates-earlier-conversion-of-atrial-fibrillation-compared-to-amiodarone-only-therapy
#6
Nikos Tsanaxidis, Isaac Aidonidis, Apostolia Hatziefthimiou, Stella S Daskalopoulou, Grigorios Giamouzis, Filippos Triposkiadis, Ioannis Skoularigis
Amiodarone (AMIO) is for many years effectively used to control ventricular rate during atrial fibrillation (AF) and to convert it into sinus rhythm. However, due to its delayed onset of action, ranolazine (RAN), a new antianginal agent with atrial-selective electrophysiologic properties, has recently been attempted as add-on therapy with AMIO to facilitate AF conversion. To establish the role of this combination therapy, we enrolled 173 consecutive patients (68±10 years, 54% male) with recent-onset (< 48 h duration) AF who were eligible for pharmacologic cardioversion...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28168639/chemical-cardioversion-of-recent-onset-atrial-fibrillation-in-the-emergency-department-using-vernakalant-hydrochloride-achieves-safe-and-rapid-restoration-of-sinus-rhythm-and-facilitates-same-day-discharge
#7
P Stoneman, P Gilligan, P Mahon, R Sheahan
BACKGROUND: Vernakalant hydrochloride is a rapid-acting antiarrhythmic drug licensed in the EU since 2010 for the conversion of recent-onset atrial fibrillation with proven efficacy and safety when compared with placebo and amiodarone in randomized clinical trials. AIMS: The aim of our study was to determine the feasibility of same day discharge (following 2 h monitoring) from the emergency department after successful cardioversion using vernakalant hydrochloride...
February 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28153995/atrial-fibrillation-and-ventricular-arrhythmias-sex-differences-in-electrophysiology-epidemiology-clinical-presentation-and-clinical-outcomes
#8
Anne M Gillis
Sex-specific differences in the epidemiology, pathophysiology, clinical presentation, clinical treatment, and clinical outcomes of atrial fibrillation (AF), sustained ventricular arrhythmias, and sudden cardiac death are recognized. Sex hormones cause differences in cardiac electrophysiological parameters between men and women that may affect the risk for arrhythmias. The incidence and prevalence of AF is lower in women than in men. However, because women live longer and AF prevalence increases with age, the absolute number of women with AF exceeds that of men...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#9
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28144262/staged-hybrid-ablation-for-persistent-and-longstanding-persistent-atrial-fibrillation-effectively-restores-sinus-rhythm-in-long-term-observation
#10
Michal Zembala, Krzysztof Filipiak, Oskar Kowalski, Piotr Buchta, Tomasz Niklewski, Pawel Nadziakiewicz, Rafał Koba, Mariusz Gąsior, Zbigniew Kalarus, Marian Zembala
INTRODUCTION: Hybrid ablation (HABL) of atrial fibrillation combining endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome the limitations of current therapeutic options for patients with persistent (PSAF) and longstanding persistent atrial fibrillation (LSPAF). The purpose of this study was to evaluate the procedural safety and feasibility as well as effectiveness of HABL in patients with PSAF and LSPAF 1 year after the procedure...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28143406/vitamin-c-for-preventing-atrial-fibrillation-in-high-risk-patients-a-systematic-review-and-meta-analysis
#11
Harri Hemilä, Timo Suonsyrjä
BACKGROUND: Atrial fibrillation (AF), a common arrhythmia contributing substantially to cardiac morbidity, is associated with oxidative stress and, being an antioxidant, vitamin C might influence it. METHODS: We searched the Cochrane CENTRAL Register, MEDLINE, and Scopus databases for randomised trials on vitamin C that measured AF as an outcome in high risk patients. The two authors independently assessed the trials for inclusion, assessed the risk of bias, and extracted data...
February 1, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#12
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28129962/impact-of-electrical-cardioversion-on-quality-of-life-for-the-treatment-of-atrial-fibrillation
#13
Roopinder K Sandhu, Marcie Smigorowsky, Evan Lockwood, Anamaria Savu, Padma Kaul, Finlay A McAlister
BACKGROUND: Despite being a common intervention to restore sinus rhythm in patients with atrial fibrillation (AF), limited data exist on the impact of electrical cardioversion on quality of life (QoL) outcomes in clinical practice. METHODS: This was a prospective cohort study of consecutive patients with AF referred for outpatient electrical cardioversion at 2 hospitals in Edmonton from 2013-2014. Baseline demographics, clinical characteristics, medications, and procedure details were obtained...
November 23, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28119381/brain-emboli-after-left-ventricular-endocardial-ablation
#14
Isaac R Whitman, Rachel A Gladstone, Nitish Badhwar, Henry H Hsia, Byron Lee, S Andrew Josephson, Karl M Meisel, William P Dillon, Christopher Hess, Edward P Gerstenfeld, Gregory M Marcus
BACKGROUND: -Catheter ablation for ventricular tachycardia (VT) and premature ventricular complexes (PVCs) is common. Catheter ablation of atrial fibrillation is associated with a risk of cerebral emboli attributed to cardioversions and numerous ablation lesions in the low-flow left atrium, but cerebral embolic risk in ventricular ablation has not been evaluated. METHODS: -We enrolled 18 consecutive patients meeting study criteria scheduled for VT or PVC ablation over a 9-month period...
January 24, 2017: Circulation
https://www.readbyqxmd.com/read/28110987/outcomes-for-emergency-department-patients-with-recent-onset-atrial-fibrillation-and-flutter-treated-in-canadian-hospitals
#15
Ian G Stiell, Catherine M Clement, Brian H Rowe, Robert J Brison, D George Wyse, David Birnie, Paul Dorian, Eddy Lang, Jeffrey J Perry, Bjug Borgundvaag, Debra Eagles, Damian Redfearn, Jennifer Brinkhurst, George A Wells
STUDY OBJECTIVE: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. METHODS: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28108860/early-cardioversion-in-atrial-fibrillation-earlier-is-better-but-not-always-and-maybe-not-immediately
#16
REVIEW
Paloma G Piña, Alexandru B Chicos
Atrial fibrillation (AF) is the most common cardiac arrhythmia in humans. One of its important features is the tendency to become more persistent over time, even in the absence of underlying progressive heart disease. Conversion and maintenance of sinus rhythm by pharmacological or electrical methods become increasingly difficult the longer the arrhythmia persists. Electrical, mechanical, structural, and autonomic remodeling processes have been implicated in the mechanisms of AF initiation, perpetuation, and progression...
January 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28100174/prediction-of-ineffective-elective-cardioversion-of-atrial-fibrillation-a-retrospective-multi-center-patient-cohort-study
#17
Tapio Hellman, Tuomas Kiviniemi, Tuija Vasankari, Ilpo Nuotio, Fausto Biancari, Aissa Bah, Juha Hartikainen, Marianne Mäkäräinen, K E Juhani Airaksinen
BACKGROUND: Elective cardioversion (ECV) of atrial fibrillation (AF) is a standard procedure to restore sinus rhythm. However, predictors for ineffective ECV (failure of ECV or recurrence of AF within 30 days) are unknown. METHODS: We investigated 1998 ECVs performed for AF lasting >48 h in 1,342 patients in a retrospective multi-center study. Follow-up data were collected from 30 days after ECV. RESULTS: Median number of cardioversions was one per patient with a range of 1-10...
January 18, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28077507/stroke-and-mortality-risk-in-patients-with-various-patterns-of-atrial-fibrillation-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction-48
#18
Mark S Link, Robert P Giugliano, Christian T Ruff, Benjamin M Scirica, Heikke Huikuri, Ali Oto, Andrea E Crompton, Sabina A Murphy, Hans Lanz, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
BACKGROUND: Whether the pattern of atrial fibrillation (AF) modifies the risk/benefit of anticoagulation is controversial. In ENGAGE AF-TIMI 48 trial (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48), the factor Xa inhibitor edoxaban was noninferior to warfarin in preventing stroke or systemic embolic events and significantly reduced bleeding and cardiovascular mortality. However, detailed analyses by AF pattern have not been reported...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28069273/does-antiarrhythmic-drugs-premedication-improve-electrical-cardioversion-success-in-persistent-atrial-fibrillation
#19
Elisabetta Toso, Mario Iannaccone, Domenico Caponi, Francesco Rotondi, Antonio Santoro, Cristina Gallo, Marco Scaglione, Fiorenzo Gaita
AIMS: Aim of this study is to evaluate the impact of antiarrhythmic drugs (AADs) administration for at least one month before ECV on the acute and long term success rate of the procedure. METHODS: 1313 consecutive persistent AF patients were enrolled in 3 different centers (Turin, Asti and Avellino): 692 patients received AADs before and after ECV (group A), 621 patients were treated only after the procedure, at discharge (group B). Primary end point was the restoration and maintenance of sinus rhythm acutely and at a long-term follow up...
December 29, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28062018/atrial-fibrillation-in-a-structurally-normal-heart-during-pregnancy-a-review-of-cases-from-a-registry-and-from-the-literature
#20
Nadine Sauvé, Évelyne Rey, Annabelle Cumyn
OBJECTIVES: Atrial fibrillation (AF) in a structurally normal heart is rare during pregnancy. We wished to use our experience to expand the literature on the causes and management of this condition. METHODS: All members of Groupe d'Étude en Médecine Obstétricale du Québec (GÉMOQ) were invited to record cases of AF in a structurally normal heart during pregnancy to the group's Registry. We searched Medline, PubMed, and Google Scholar (1946 to 15 April 2016) for relevant articles using the key words "atrial fibrillation" and "pregnancy...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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