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https://www.readbyqxmd.com/read/28709650/anticoagulation-control-in-warfarin-treated-patients-undergoing-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-enoxaparin-warfarin-in-patients-undergoing-cardioversion-of-atrial-fibrillation-trial
#1
Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette
In the Edoxaban Versus Enoxaparin-Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin-warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open blinded end-point trial, we analyzed patients randomized to enoxaparin-warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; and impact on primary end points (composite of stroke, systemic embolic event[SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant nonmajor bleeding)...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#2
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28701602/to-evaluate-dexmedetomidine-as-an-additive-to-propofol-for-sedation-for-elective-cardioversion-in-a-cardiac-intensive-care-unit-a-double-blind-randomized-controlled-trial
#3
Tanveer Singh Kundra, Parminder Kaur, P S Nagaraja, N Manjunatha
INTRODUCTION: Propofol may lead to patient recall and discomfort when used for sedation in elective cardioversion. The aim of the present study was to evaluate dexmedetomidine as an additive to propofol for sedation in elective cardioversion. MATERIALS AND METHODS: A total of 500 patients undergoing elective cardioversion were randomized into Group 1 (n = 250) and Group 2 (n = 250) on the basis of computer-generated randomization table. Patients in Group 1 were given dexmedetomidine (1 mcg/kg) over 10 min before giving propofol (1 mg/kg), while patients in Group 2 were given only propofol (1 mg/kg)...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698191/manual-versus-semiautomatic-rhythm-analysis-and-defibrillation-for-out-of-hospital-cardiac-arrest
#4
Ziad Nehme, Emily Andrew, Resmi Nair, Stephen Bernard, Karen Smith
BACKGROUND: Although manual and semiautomatic external defibrillation (SAED) are commonly used in the management of out-of-hospital cardiac arrest, the optimal strategy is not known. We hypothesized that SAED would reduce the time to first shock and lead to higher rates of cardioversion and survival compared with a manual strategy. METHODS AND RESULTS: Between July 2005 and June 2015, we included adult out-of-hospital cardiac arrest of presumed cardiac pathogenesis...
July 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28692548/comparison-of-vernakalant-and-ranolazine-in-atrial-fibrillation
#5
Gerrit Frommeyer, Magdalena Sterneberg, Dirk G Dechering, Simon Kochhäuser, Nils Bögeholz, Michael Fehr, Lars Eckardt
BACKGROUND: Current guidelines recommend vernakalant for pharmacologic cardioversion of recent-onset atrial fibrillation. However, this drug is not established as chronic therapy. METHODS AND RESULTS: In total, 15 rabbit hearts were Langendorff-perfused. A burst pacing protocol-induced atrial fibrillation in 7 of 15 hearts at baseline (10 episodes). Subsequently, a combination of acetylcholine and isoproterenol (ACH/ISO) has been administered to increase occurrence of atrial fibrillation resulting in a reduction of atrial action potential duration (-25 ms, P < 0...
July 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28680511/emergency-department-procedural-sedation-for-primary-electrical-cardioversion-a-comparison-with-procedural-sedations-for-other-reasons
#6
Michael Butler, Patrick Froese, Peter Zed, George Kovacs, Robert MacKinley, Kirk Magee, Mary-Lynn Watson, Samuel G Campbell
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia treated in the emergency department (ED), with primary electrical cardioversion (PEC) the preferred method of rhythm control. Anecdotally, patients undergoing ED procedural sedation (EDPS) for PEC differ from those requiring EDPS for other procedures: they are at higher risk of adverse events, and require fewer drugs and lower doses. We attempt to verify this using an EDPS registry at a Canadian, tertiary care teaching hospital...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28680466/atrial-fibrillation-with-a-structurally-normal-heart-in-pregnancy-an-international-survey-on-current-practice
#7
Annabelle Cumyn, Nadine Sauvé, Évelyne Rey
BACKGROUND: Little evidence exists for the optimal management of atrial fibrillation with a structurally normal heart in pregnancy. METHODS: A survey was sent to members of two associations to obtain input on optimal management of atrial fibrillation in pregnancy. The survey presented four cases with respect to (1) baseline investigations; (2) rate versus rhythm control; (3) chemical versus electrical cardioversion; and (4) anticoagulation. RESULTS: Sixty-one responders from 11 countries participated...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28678147/efficacy-of-second-generation-cryoballoon-ablation-in-paroxysmal-and-persistent-atrial-fibrillation-patients
#8
Antonio Curnis, Francesca Salghetti, Manuel Cerini, Francesca Vassanelli, Lorenza Inama, Clara Villa, Daniele Giacopelli, Abdallah Raweh, Luca Bontempi
AIMS: In this study, we aimed to compare the efficacy of single pulmonary vein isolation with the second-generation cryoballoon (CB-Adv) and predictors of atrial fibrillation recurrences in patients with paroxysmal (PAF) and persistent atrial fibrillation (PersAF). METHODS: Consecutive PAF and PersAF patients undergoing CB-Adv for the first time were enrolled. Patients were followed with in-clinic visits including Holter ECG. Atrial arrhythmic episodes symptomatic or documented lasting more than 30 s were considered as recurrences...
July 3, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28675629/long-term-follow-up-after-left-atrial-appendage-occlusion-with-comparison-of-transesophageal-echocardiography-vs-computed-tomography-to-guide-medical-therapy-and-data-about-post-closure-cardioversion
#9
Benjamin Berte, Christine Attenhofer Jost, Dominik Maurer, Anja Fäh-Gunz, Xavier Pillois, Barbara Naegeli, Monica Pfyffer, Gabor Sütsch, Christoph Scharf
AIMS: The use of left atrial appendage (LAA)-occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice-flow and outcome of electrical cardioversion (ECV) in these patients. METHODS AND RESULTS: Single-center prospective registry from 2009 to 2015 including all LAA-occluders to analyze success and complications during implantation and follow-up...
July 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#10
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28662483/intensity-of-anticoagulation-and-risk-of-thromboembolism-after-elective-cardioversion-of-atrial-fibrillation
#11
Tapio Hellman, Tuomas Kiviniemi, Ilpo Nuotio, Tuija Vasankari, Juha Hartikainen, Gregory Y H Lip, K E Juhani Airaksinen
BACKGROUND: Elective cardioversion (ECV) for atrial fibrillation (AF) is associated with a relatively low risk of thromboembolic complications. However, the optimal intensity of anticoagulation for ECV is unknown. We sought to assess the risk of thromboembolism in low (INR 2.0-2.4) vs. high (INR≥2.5) therapeutic range in a large retrospective cohort study. METHODS: This multi-centre "real world" study included 1424 ECVs in 1021 patients. The primary outcome was a stroke or a transient ischaemic attack (TIA) or a systemic embolus during the 30-day follow-up after ECV...
June 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28661896/vitamin-k-antagonists-versus-novel-oral-anticoagulants-for-elective-electrical-cardioversion-of-atrial-fibrillation
#12
Diana Ţînţ, Antoniu O Petriş, Ioana Pop, Rimma Melnic, Andreea-Mihaela Ignat, Liliana M Rogozea
BACKGROUND: The management strategy for patients with atrial fibrillation (AF) is often very complex, electrical cardioversion (EC) being often used to restore sinus rhythm in those patients. The increased risk of thromboembolic complications was lowered using anticoagulation therapy. Usually, the anticoagulation was achieved using vitamin K antagonists (VKAs), but over the last years we witnessed a wide implementation of the novel oral anticoagulants (NOACs). STUDY QUESTION: Study question was to compare the efficacy of NOACs versus VKAs in patients undergoing elective EC for persistent AF, by assessing the presence of left atrial spontaneous contrast and left atrial thrombi (LACS), as well as the occurrence of the thromboembolic events in the first month after the procedure...
April 26, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28660415/-new-onset-atrial-fibrillation-in-patients-with-sepsis
#13
REVIEW
M Keller, R Meierhenrich
BACKGROUND: Atrial fibrillation is the most common new onset arrhythmia in patients hospitalized with sepsis; however, there are no specific treatment guidelines and the ideal therapeutic approaches still remain unclear. OBJECTIVES: To begin with the current state of knowledge concerning the underling mechanisms, the incidence and prognostic impact of new onset atrial fibrillation during sepsis are presented. Then a possible therapeutic algorithm for the special situation of sepsis is derived with respect to the currently existing atrial fibrillation guidelines...
June 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28655151/cardioversion-of-atrial-fibrillation-in-a-real-world-setting-non-vitamin-k-antagonist-oral-anticoagulants-ensure-a-fast-and-safe-strategy-compared-to-warfarin
#14
Anne Sofie Frederiksen, Andi Eie Albertsen, Amanda Marie Somer Christesen, Nicklas Vinter, Lars Frost, Dorthe Svenstrup Møller
Aims: Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used as thromboembolic prophylaxis in cardioversion. We examined the waiting time to cardioversion and the outcomes in patients with non-valvular atrial fibrillation (AF) of > 48 h of duration who were treated with either NOACs or warfarin. Methods and results: Anticoagulation was handled in a structured, multidisciplinary AF-clinic. The objectives were the waiting time to cardioversion, and thromboembolism and major bleeding events within 60 days...
June 26, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28645513/atrial-fibrillation-current-therapies
#15
REVIEW
Romain Pariaut
A rate control or a rhythm control strategy can be applied to the management of atrial fibrillation. Rate control of atrial fibrillation consists of decreasing the ventricular response rate by limiting the number of supraventricular impulses that can travel through the atrioventricular node. The goal of decreasing heart rate in dogs with atrial fibrillation is usually achieved with a combination of the calcium channel blocker diltiazem and digoxin. Rhythm control of atrial fibrillation encompasses pharmacologic and nonpharmacologic methods to terminate the arrhythmia and restore sinus rhythm...
June 20, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28644585/a-cost-minimisation-analysis-of-noacs-compared-to-warfarin-to-attain-therapeutic-anticoagulation-amongst-af-patients-pre-and-post-cardioversion
#16
M O'Shea, A Murphy, A Kirby, G Allen, S O'Shea, R Curtin
Atrial fibrillation can be managed with anticoagulation and restoration of normal sinus rhythm using direct current cardioversion (DCCV). To reduce the risk of thromboembolism, anticoagulation pre-and-post DCCV is recommended. This study investigates the cost effectiveness of using NOACs compared to warfarin to attain therapeutic anticoagulation amongst AF patients pre-and-post DCCV. Propensity score matching revealed no statistically significant difference in outcomes from using NOACs and Warfarin. A cost minimisation study was performed; demonstrating a cost differential of €209 between those administered NOACs and warfarin pre- and post-DCCV...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28641379/clinical-events-preceding-switching-and-discontinuation-of-oral-anticoagulant-treatment-in-patients-with-atrial-fibrillation
#17
Maja Hellfritzsch, Erik Lerkevang Grove, Steen Elkjær Husted, Lotte Rasmussen, Birgitte Klindt Poulsen, Søren Paaske Johnsen, Jesper Hallas, Anton Pottegård
Aims: Switching between oral anticoagulants and treatment discontinuation are common events related to therapy with non-vitamin K antagonist oral anticoagulants (NOACs). However, knowledge on the reasons leading to these treatment changes is scarce. The aim of this study was to identify clinical events preceding anticoagulant switching and NOAC discontinuation during oral anticoagulant therapy in patients with atrial fibrillation. Methods and results: We performed a nationwide register-based study including Danish atrial fibrillation patients initiating a NOAC between August 2011 and February 2016 (n = 50 623)...
October 17, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28639773/-paradigm-shift-in-the-treatment-of-atrial-fibrillation-the-importance-of-risk-factor-management
#18
Stefania Aur, Patrizio Pascale
The prevalence of atrial fibrillation (AF) is constantly rising. Different studies have underlined the correlation between AF and modifiable risk factors such as obesity, obstructive sleep apnea, hypertension and sedentary lifestyle. Treatment of these comorbidities could significantly reduce the AF burden and the recurrence rate after cardioversion or ablation. These data should therefore lead to a paradigm shift in the management of AF. A strategy limited to catheter ablation or to the prescription of an antiarrhythmic drug is not sufficient...
May 24, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28635196/direct-oral-anticoagulants-in-patients-undergoing-cardioversion-insight-from-randomized-clinical-trials
#19
Stefania Angela Di Fusco, Furio Colivicchi, Nadia Aspromonte, Marco Tubaro, Alessandro Aiello, Massimo Santini
Anticoagulation, reducing the risk of thromboembolic events in patients undergoing cardioversion, is a cornerstone of peri-cardioversion management in patients with atrial fibrillation. We aimed to analyse published data on the efficacy and safety of direct oral anticoagulants (DOACs) in patients undergoing cardioversion. We performed a systematic review of randomized prospective clinical trials (RCTs) comparing DOACs with warfarin and reporting data on post-cardioversion outcomes of interest. Outcomes of interest were stroke, systemic thromboembolic events and major bleeding...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634971/impact-of-growing-cohorts-of-adults-with-con-genital-heart-disease-on-clinical-workload-a-20-year-experience-at-a-tertiary-care-centre
#20
Maria Padrutt, Isabelle Bracher, Francesca Bonassin, Bruno Santos Lopes, Christiane Gruner, Simon F Stämpfli, Thomas Wolber, Oliver Kretschmar, Angela Oxenius, Gabriella De Pasquale, Theresa Seeliger, Thomas F Lüscher, Christine Attenhofer Jost, Matthias Greutmann
BACKGROUND: Population based studies show a steady increase in adult patients with congenital heart defects. The aim of this study was to assess the evolution of such a patient cohort and its burden on clinical care at a dedicated tertiary care centre. METHODS: All patients with congenital heart disease followed up by a dedicated multidisciplinary team at our institution were identified (n = 1725). Disease characteristics, the increase in patient numbers and interventions and the increase in selected complications were analysed and compared between the first (1996-2005) and second (2006-2015) decades of the study period...
June 21, 2017: Swiss Medical Weekly
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