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Stroke prediction atrial fibrillation

Lisette Wintgens, Aleksandr Romanov, Karen Phillips, Gabriel Ballesteros, Martin Swaans, Richard Folkeringa, Ignacio Garcia-Bolao, Evgeny Pokushalov, Lucas Boersma
Aims: Long-term freedom from atrial fibrillation (AF) after catheter ablation (CA) and consequently the potential for stroke reduction remain unpredictable. Percutaneous left atrial appendage closure (LAAC) is an effective mechanical alternative to oral anticoagulation (OAC) for stroke prevention in AF patients. This study aims to evaluate long-term clinical results of combined CA and LAAC in one single procedure. Methods and results: Patients with non-valvular AF who underwent combined CA and LAAC procedure were included in the retrospective compilation of independent prospective general LAAC registries at the individual centres...
March 13, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hua Gao, Xiaolong Sun, Wen Li, Qiong Gao, Jing Zhang, Yi Zhang, Yue Ma, Xiai Yang, Xiaogang Kang, Wen Jiang
Objective Stroke due to atrial fibrillation (AF) is common and frequently devastating. However, there is no specific tool to accurately estimate the risk of mortality. This study aims to develop and validate a comprehensive risk score for predicting 30-day mortality in the patients with AF-related stroke. Methods A retrospective multi-center clinical study was performed based on the data from the project of secondary prevention of stroke in patients with nonvalvular AF in Shaanxi province, China. A total of 1077 consecutive patients were randomly classified into derivation (66...
March 16, 2018: Neurological Research
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
April 2018: Therapeutic Advances in Cardiovascular Disease
Stephen A McCullough, Michael A Fifer, Pouya Mohajer, Patricia A Lowry, Caitlin O'Callaghan Reen, Aaron L Baggish, Gus J Vlahakes, Yuichi J Shimada
BACKGROUND: The clinical characteristics associated with elevated right atrial pressure (RAP) in hypertrophic cardiomyopathy (HCM) are unknown. Few data exist as to whether elevated RAP has prognostic implications in patients with HCM. This study investigated the clinical correlates and prognostic value of elevated RAP in HCM.Methods and Results:This retrospective cohort study was performed on 180 patients with HCM who underwent right heart catheterization between 1997 and 2014. Elevated RAP was defined as >8 mmHg...
March 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Samuli Jaakkola, Tuomas O Kiviniemi, Ilpo Nuotio, Juha Hartikainen, Pirjo Mustonen, Antti Palomäki, Jussi Jaakkola, Antti Ylitalo, Päivi Hartikainen, K E Juhani Airaksinen
CHA2 DS2 -VASc and HAS-BLED scores stratify the risk of thromboembolic and bleeding events respectively in patients with atrial fibrillation. There is only little information on how they differentiate which of the 2 clinically most important complications (ischemic stroke [IS] or an intracranial bleeding [IB]) the patient is more prone to suffer. We evaluated both scores in patients with either of these major complications. The FibStroke Study collected data on all patients with atrial fibrillation with either an IS or an IB event between 2003 and 2012 in 4 Finnish hospital districts...
February 12, 2018: American Journal of Cardiology
Christa A Hammond, Natalie J Blades, Sarwat I Chaudhry, John A Dodson, W T Longstreth, Susan R Heckbert, Bruce M Psaty, Alice M Arnold, Sascha Dublin, Colleen M Sitlani, Julius M Gardin, Stephen M Thielke, Michael G Nanna, Rebecca F Gottesman, Anne B Newman, Evan L Thacker
BACKGROUND: Heart failure (HF) is associated with cognitive impairment. However, we know little about the time course of cognitive change after HF diagnosis, the importance of comorbid atrial fibrillation, or the role of ejection fraction. We sought to determine the associations of incident HF with rates of cognitive decline and whether these differed by atrial fibrillation status or reduced versus preserved ejection fraction. METHODS AND RESULTS: Participants were 4864 men and women aged ≥65 years without a history of HF and free of clinical stroke in the CHS (Cardiovascular Health Study)-a community-based prospective cohort study in the United States, with cognition assessed annually from 1989/1990 through 1998/1999...
March 2018: Circulation. Heart Failure
M J Pekka Raatikainen, Tero Penttilä, Pasi Korhonen, Juha Mehtälä, Riitta Lassila, Mika Lehto
Aims: The impact of the quality of warfarin therapy on cardiovascular outcomes excluding stroke is largely unknown. The aims of this study were to evaluate the association between the warfarin control and the incidence and outcome of myocardial infarction (MI), and to validate the predictive value of the CHA2DS2-VASc score for MI in AF patients taking warfarin. Methods and Results: The nationwide FinWAF registry consists of 54568 AF patients (mean age 73.1±10...
March 5, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Brittany Ricci, Andrew D Chang, Morgan Hemendinger, Katarina Dakay, Shawna Cutting, Tina Burton, Brian MacGrory, Priya Narwal, Christopher Song, Antony Chu, Emile Mehanna, Ryan McTaggart, Mahesh Jayaraman, Karen Furie, Shadi Yaghi
BACKGROUND: Occult paroxysmal atrial fibrillation (AF) is detected in 16%-30% of patients with embolic stroke of unknown source (ESUS). The identification of AF predictors on outpatient cardiac monitoring can help guide clinicians decide on a duration or method of cardiac monitoring after ESUS. METHODS: We included all patients with ESUS who underwent an inpatient diagnostic evaluation and outpatient cardiac monitoring between January 1, 2013, and December 31, 2016...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hanis Zulkifly, Gregory Y H Lip, Deirdre A Lane
BACKGROUND: The most common type of arrhythmia in the USA and in European countries is atrial fibrillation (AF). The prevalence of AF is increasing worldwide with advances in technology, better prediction methods and increased awareness among healthcare professionals and patients. METHODS: This article summarises the literature on the epidemiology of AF worldwide according to continents, age and ethnicity/race, and also includes the prevalence of AF in stroke patients...
March 1, 2018: International Journal of Clinical Practice
Kenshi Hayashi, Toyonobu Tsuda, Akihiro Nomura, Noboru Fujino, Atsushi Nohara, Kenji Sakata, Tetsuo Konno, Chiaki Nakanishi, Hayato Tada, Yoji Nagata, Ryota Teramoto, Yoshihiro Tanaka, Masa-Aki Kawashiri, Masakazu Yamagishi
BACKGROUND: B-type natriuretic peptide (BNP) may be a predictor of stroke risk in patients with nonvalvular atrial fibrillation (NVAF); because heart failure is associated with the incidence of stroke in AF patients. However, limited data exist regarding the association between BNP at baseline and risks of thromboembolic events (TE) and death in NVAF patients.Methods and Results:We prospectively studied 1,013 NVAF patients (725 men, 72.8±9.7 years old) from the Hokuriku-plus AF Registry to determine the relationship between BNP at baseline and prognosis among Japanese NVAF patients...
March 1, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Ana Rahma Yuniarti, Febrian Setianto, Aroli Marcellinus, Han Jeong Hwang, Seong Wook Choi, Natalia Trayanova, Ki Moo Lim
There is growing interest in genetic arrhythmia since mutations in gene which encodes the ion channel underlie numerous arrhythmias. Hasegawa et al. reported that G229D mutation in KCNQ1 underlies atrial fibrillation due to significant shortening of action potential (AP) duration (APD) in atrial cells. Here, we predicted whether KCNQ1 G229D mutation affects ventricular fibrillation generation, although it shortens APD slightly compared to the atrial cell. We analyzed the effects of G229D mutation on electrical and mechanical ventricle behavior (not considered in previous studies)...
February 27, 2018: International Journal for Numerical Methods in Biomedical Engineering
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
Amrish Deshmukh, Ankit Bhatia, Emeka Anyanwu, Takeyoshi Ota, Valluvan Jeevanandam, Nir Uriel, Roderick Tung, Cevher Ozcan
This study sought to determine the incidence, predictors, and outcomes of postoperative atrial fibrillation (POAF) in patients undergoing implantation of left ventricular assist devices (LVADs). A retrospective analysis of all patients who underwent LVAD implantation from 2013 to 2014 was conducted. Postoperative AF, survival, and thrombotic complications were evaluated after surgery. A total of 47 patients (mean age, 56.4 ± 12.5 years; 33 male) were included and followed for a median of 331 days. Within 30 days of surgery, 13 (28%) patients developed POAF at mean 7...
February 24, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Rixia Liu, Xiaomeng Yang, Shuya Li, Yong Jiang, Yilong Wang, Yongjun Wang
It is important to identify candidates who warrant extended cardiac monitoring after ischemic stroke. We investigated the predictive performance of the CHADS2 and CHA2 DS2 -VASc scores for previously unknown atrial fibrillation during in-hospital electrocardiographic monitoring. Patients were selected from a prospective trial in China. The clinical prediction of the scores was examined using the C statistic. Multivariate logistic regressions were performed to analyze the relevant risk factors. Among 1315 patients enrolled in study, previously unknown atrial fibrillation was detected in 110 (8...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Giovanni Rovaris, Francesco Solimene, Antonio D'Onofrio, Gabriele Zanotto, Renato P Ricci, Tiziana Mazzella, Saverio Iacopino, Paolo Della Bella, Giampiero Maglia, Gaetano Senatore, Fabio Quartieri, Mauro Biffi, Antonio Curnis, Valeria Calvi, Antonio Rapacciuolo, Matteo Santamaria, Alessandro Capucci, Massimo Giammaria, Andrea Campana, Fabrizio Caravati, Daniele Giacopelli, Alessio Gargaro, Ennio C Pisanò
BACKGROUND: CHA2 DS2 -VASc is a validated score for predicting stroke in patients with atrial fibrillation (AF). OBJECTIVE: We sought to assess whether it can predict new-onset AF in a cohort of patients with cardiac implantable electronic devices (CIEDs) followed with remote monitoring. METHODS: Using the database of the Home Monitoring Expert Alliance project, we selected 2,410 patients with no documented AF who had received a CIED with diagnostics on atrial high rate episodes (AHRE)...
February 22, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Maurizio Galderisi, Erwan Donal, Julien Magne, Francesco Lo Iudice, Eustachio Agricola, Leyla Elif Sade, Matteo Cameli, Ehud Schwammenthal, Nuno Cardim, Bernard Cosyns, Andreas Hagendorff, Alexandar N Neskovic, Josè Luis Zamorano, Patrizio Lancellotti, Gilbert Habib, Thor Edvardsen, Bogdan A Popescu
The European Society of Cardiology (ESC) guidelines for management of atrial fibrillation (AF) recommend the use of CHA2DS2VASc risk score for assessment of thromboembolic (TE) risk, whereas the stratification of bleeding risk should be obtained by HAS-Bleed to balance the most appropriate anticoagulation (OAC) therapy. However, men with CHA2DS2VASc score = 1 and women with CHA2DS2VASc = 2, who are at intermediate TE risk, represent a grey zone where guidelines do not provide a definite OAC indication...
March 1, 2018: European Heart Journal Cardiovascular Imaging
Fang-Zhou Liu, Hong-Tao Liao, Wei-Dong Lin, Yu-Mei Xue, Xian-Zhang Zhan, Xian-Hong Fang, Fang Rao, Hai Deng, Jun Huang, Jo-Jo Hai, Hung-Fat Tse, Shu-Lin Wu
OBJECTIVES: To investigate the relationship between hyperuricemia and left atrial thrombus (LAT)/spontaneous echo contrast (SEC) and to determine the predictive value of hyperuricemia in non-valvular (NV) atrial fibrillation (AF) patients. METHODS: The study retrospectively reviewed 1198 consecutive patients (male 801, female 397, and mean age of 56.84 ± 12.22) who were diagnosed with AF and accepted transesophageal echocardiography (TEE) prior to catheter ablation, appendage occlusion and electrical cardioversion using a single-center database...
February 2, 2018: International Journal of Cardiology
Riku Arai, Shinya Suzuki, Hiroaki Semba, Takuto Arita, Naoharu Yagi, Takayuki Otsuka, Koichi Sagara, Kenichi Sasaki, Hiroto Kano, Shunsuke Matsuno, Yuko Kato, Tokuhisa Uejima, Yuji Oikawa, Takashi Kunihara, Junji Yajima, Takeshi Yamashita
BACKGROUND: The predictive role of E/e' on ischemic stroke (IS) and atrial fibrillation (AF) in Japanese patients without AF are unclear. METHODS AND RESULTS: Shinken database includes all the new patients visiting the Cardiovascular Institute Hospital in Tokyo, Japan. E/e' has been routinely measured since 2007. Patients without AF for whom E/e' was measured at the initial visit between 2007 and 2014 (n=11 477, mean age 57.2 years old, men 59.5%) were divided into E/e' tertiles (<8...
February 13, 2018: Journal of Cardiology
Linda S B Johnson, Anders P Persson, Per Wollmer, Steen Juul-Möller, Tord Juhlin, Gunnar Engström
BACKGROUND: Atrial fibrillation (AF) is defined as an irregular supraventricular tachycardia (SVT) without p-waves, with a duration >30s. It is not known whether AF characteristics in shorter SVT episodes predict AF and stroke. OBJECTIVES: To determine if irregularity and lack of p-waves, alone or in combination, at short SVT episodes increased the risk of incident AF and ischemic stroke. METHODS: The population-based Malmö Diet and Cancer study includes 24hECG screening of 377 AF-free individuals (mean age 64...
February 12, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
The TIMI-AF score was described to predict net clinical outcomes (NCOs) in atrial fibrillation (AF) patients receiving warfarin. However, this score derived from the ENGAGE AF-TIMI 48 trial, and no external validation exists in real world clinical practice. We tested the long-term predictive performance of the TIMI-AF score in comparison with CHA2 DS2 -VASc and HAS-BLED in a 'real-world' cohort of anticoagulated AF patients. METHODS: We included 1156 consecutive AF patients stable on vitamin K antagonist (INR 2...
March 2018: American Heart Journal
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