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Atrial fibrillation and stroke

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https://www.readbyqxmd.com/read/28432712/stroke-etiology-and-collaterals-atheroembolic-strokes-have-greater-collateral-recruitment-than-cardioembolic-strokes
#1
L C Rebello, M Bouslama, D C Haussen, J A Grossberg, S Dehkharghani, A Anderson, S R Belagaje, N A Bianchi, M Grigoryan, M R Frankel, R G Nogueira
BACKGROUND AND PURPOSE: Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). METHOD: This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#2
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
https://www.readbyqxmd.com/read/28431610/duration-of-paroxysmal-atrial-fibrillation-in-cryptogenic-stroke-is-not-associated-with-stroke-severity-and-early-outcomes
#3
Chrissoula Liantinioti, Konstantinos Tympas, Aristeidis H Katsanos, John Parissis, Maria Chondrogianni, Christina Zompola, Georgios Papadimitropoulos, Michael Ioakeimidis, Sokratis Triantafyllou, Andromaxi Roussopoulou, Konstantinos Voumvourakis, John Lekakis, Gerasimos Filippatos, Leonidas Stefanis, Georgios Tsivgoulis
The current definition of paroxysmal atrial fibrillation (PAF) requires an arbitrary cut-off of >30s, but in clinical practice cryptogenic stroke (CS) patients with PAF duration of ≤30s are not usually excluded from anticoagulation therapy. We sought to evaluate the clinical relevance of short-duration (≤30s) PAF in CS. Consecutive CS patients with no prior AF history and sinus-rhythm on baseline electrocardiography (ECG) were prospectively evaluated over a three-year period. Baseline stroke severity was assessed by NIHSS-scores...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431475/validation-of-the-essen-stroke-risk-score-in-different-subtypes-of-ischemic-stroke
#4
Yi Liu, Yongjun Wang, William A Li, Aoshuang Yan, Yilong Wang
OBJECTIVE: Predictive scores are important tools for stratifying patients based on their risk of future vascular events and for selecting preventive therapies. The aim of this study is to validate the Essen Stroke Risk Score (ESRS) for stratifying stroke recurrence in different subtypes of non-atrial fibrillation ischemic stroke in a large Chinese cohort. METHODS: Data were derived from the Blood pressure and clinical Outcome in Stroke Survivors registry, which includes a cohort of 2204 stroke patients...
April 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28431068/self-reported-physical-activity-and-major-adverse-events-in-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-pilot-survey-on-atrial-fibrillation-eorp-af-general-registry
#5
Marco Proietti, Giuseppe Boriani, Cécile Laroche, Igor Diemberger, Mircea I Popescu, Lars H Rasmussen, Gianfranco Sinagra, Gheorghe-Andrei Dan, Aldo P Maggioni, Luigi Tavazzi, Deirdre A Lane, Gregory Y H Lip
Aims: Physical activity is protective against cardiovascular (CV) events, both in general population and in high-risk CV cohorts. However, the relationship between physical activity with major adverse outcomes in atrial fibrillation (AF) is not well-established. Our aim was to analyse this relationship in a 'real-world' AF population. Second, we investigated the influence of physical activity on arrhythmia progression. Methods and Results: We studied all patients enrolled in the EURObservational Research Programme on AF (EORP-AF) Pilot Survey...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430117/fluvastatin-therapy-could-not-decrease-progression-of-paroxysmal-atrial-fibrillation-in-non-valvular-disease-patients
#6
Qiang Tan, Shuangyue Zhang, Xiaoyi Zou, Jun Zhao, Jia Hao, Qian Sun
OBJECTIVE: This study aimed to evaluate whether fluvastatin therapy could decrease the probability of atrial fibrillation (AF) progression from paroxysmal AF to permanent AF and decrease the recurrence frequency of AF. METHODS: Analyses were performed using two-tailed Student's t test or Mann-Whitney U tests. Categorical variables were compared with the χ2 statistics or Fisher's exact test. Patients with paroxysmal AF were randomized case-control, prospective into either the fluvastatin group (n=61) or control group (n=57)...
April 10, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28429529/impaired-left-atrial-function-predicts-inappropriate-shocks-in-primary-prevention-implantable-cardioverter-defibrillator-candidates
#7
Susumu Tao, Hiroshi Ashikaga, Luisa A Ciuffo, Kihei Yoneyama, Joao A C Lima, Terry F Frank, Robert G Weiss, Gordon F Tomaselli, Katherine C Wu
INTRODUCTION: Inappropriate implantable cardioverter-defibrillator (ICD) shocks, commonly caused by atrial fibrillation (AF), are associated with an increased mortality. Because impaired left atrial (LA) function predicts development of AF, we hypothesized that impaired LA function predicts inappropriate shocks beyond a history of AF. METHODS AND RESULTS: We prospectively analyzed the association between LA function and incident inappropriate shocks in primary prevention ICD candidates...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#8
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28428449/current-status-and-outcomes-of-direct-oral-anticoagulant-use-in-real-world-atrial-fibrillation-patients%C3%A3-fushimi-af-registry
#9
Yugo Yamashita, Ryuji Uozumi, Yasuhiro Hamatani, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Satoshi Morita, Masaharu Akao
BACKGROUND: The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status...
April 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28428444/impact-of-atrial-fibrillation-on-the-clinical-course-of-apical-hypertrophic-cardiomyopathy
#10
Sang-Eun Lee, Jin-Kyu Park, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Apical hypertrophic cardiomyopathy (ApHCM) is considered a 'benign' form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM. METHODS: The occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years). RESULTS: AF occurred in 77 patients with ApHCM (prevalence, 25...
April 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation-in-asia
#11
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review showed great variability on the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiology studies on AF have been increasingly reported. METHODS: We therefore conducted an updated systematic review, to present the current knowledge base of AF epidemiology in Asian countries since our prior review. We also explored AF incidence and the risk of stroke in AF using meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427162/effect-of-age-on-long-term-outcomes-after-stroke-with-atrial-fibrillation-a-hospital-based-follow-up-study-in-china
#12
Tao Wang, Bin Li, Hongfei Gu, Yongzhong Lou, Xianjia Ning, Jinghua Wang, Zhongping An
Atrial fibrillation (AF) is an established predictor of poor outcomes after stroke. We aimed to assess the effect of age on outcomes at 1 year and 3 years in stroke patients with AF.We recruited acute ischemic stroke patients with AF between January 2006 and September 2014 in Tianjin, China. Clinical features and outcomes at 1 year and 3 years after stroke were compared between younger group and elderly group. Overall, 951 consecutive stroke patients with AF were included in this study. There was a higher mortality and dependency rate in the elderly group than in the young group at both 1 and 3 years after stroke...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28426886/risk-of-stroke-in-chronic-heart-failure-patients-with-preserved-ejection-fraction-but-without-atrial-fibrillation-analysis-of-the-charm-preserved-and-i-preserve-trials
#13
Azmil H Abdul-Rahim, Ana-Cristina Perez, Rachael L MacIsaac, Pardeep S Jhund, Brian L Claggett, Peter E Carson, Michel Komajda, Robert S McKelvie, Michael R Zile, Karl Swedberg, Salim Yusuf, Marc A Pfeffer, Scott D Solomon, Gregory Y H Lip, Kennedy R Lees, John J V McMurray
Aims: The incidence and predictors of stroke in patients with heart failure and preserved ejection fraction (HF-PEF), but without atrial fibrillation (AF), are unknown. We described the incidence of stroke in HF-PEF patients with and without AF and predictors of stroke in those without AF. Methods and results: We pooled data from the CHARM-Preserved and I-Preserve trials. Using Cox regression, we derived a model for stroke in patients without AF in this cohort and compared its performance with a published model in heart failure patients with reduced ejection fraction (HF-REF)-predictive variables: age, body mass index, New York Heart Association class, history of stroke, and insulin-treated diabetes...
March 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28425349/clinical-characteristics-of-unknown-symptom-onset-stroke-patients-with-and-without-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch
#14
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Salvador Pedraza, Robin Lemmens, Norbert Nighoghossian, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#15
Leon A Simons, Michael Ortiz, S Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28424659/online-measurement-of-microembolic-signal-burden-by-transcranial-doppler-during-catheter-ablation-for-atrial-fibrillation-results-of-a-multicenter-trial
#16
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Sabine Fredersdorf, Dobri Baldaranov, Lars Maier, Felix Schlachetzki
INTRODUCTION: Left atrial pulmonary vein isolation (PVI) is an accepted treatment option for patients with symptomatic atrial fibrillation (AF). This procedure can be complicated by stroke or silent cerebral embolism. Online measurement of microembolic signals (MESs) by transcranial Doppler (TCD) may be useful for characterizing thromboembolic burden during PVI. In this prospective multicenter trial, we investigated the burden, characteristics, and composition of MES during left atrial catheter ablation using a variety of catheter technologies...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28422270/characteristics-and-incidence-of-chronic-illness-in-community-dwelling-predominantly-male-u-s-veteran-centenarians
#17
Raya Elfadel Kheirbek, Ali Fokar, Nawar Shara, Leakie K Bell-Wilson, Hans J Moore, Edwin Olsen, Marc R Blackman, Maria D Llorente
OBJECTIVES: To assess the incidence of chronic illness and its effect on veteran centenarians. DESIGN: Retrospective longitudinal cohort study. SETTING: United States Veterans Affairs Corporate Data Warehouse (CDW). PARTICIPANTS: Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians). MEASUREMENTS: The Kaplan-Meier method was used to estimate cumulative incidence of chronic conditions according to age group...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28422144/risk-and-prediction-of-sudden-cardiac-death-and-ventricular-arrhythmias-for-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#18
Tze-Fan Chao, Chia-Jen Liu, Ta-Chuan Tuan, Su-Jung Chen, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen
Sudden cardiac death (SCD) is the most devastating manifestation of ventricular arrhythmias (VAs), and is the leading cause of mortality among atrial fibrillation (AF) patients. The goal of the present study was to investigate the incidence of SCD/VAs amongst patients with and without AF. We also aimed to identify important risk factors of SCD/VAs among AF patients. Using the "National Health Insurance Research Database" in Taiwan, a total of 352,656 AF and 352,656 non-AF patients without antecedent SCD/VAs were identified...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28420316/persistence-of-secondary-prevention-medication-and-related-factors-for-acute-ischemic-stroke-and-transient-ischemic-attack-in-china
#19
Yue Jiang, Xiaomeng Yang, Zixiao Li, Yuesong Pan, Yilong Wang, Yongjun Wang, Ruijun Ji, Chen Wang
OBJECTIVE: We recently measured the longitudinal use of secondary prevention medication following hospital discharge and the factors influencing persistence in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA) in China. METHODS: Patients with AIS and TIA who were enrolled in the China National Stroke Registry II from June 2012 to January 2013 were surveyed to determine persistence. The medications included antiplatelet therapies, warfarin, antihypertensive therapies, statins, and diabetes medications...
April 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#20
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
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