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https://www.readbyqxmd.com/read/28738786/atrial-time-and-voltage-dispersion-are-both-needed-to-predict-new-onset-atrial-fibrillation-in-ischemic-stroke-patients
#1
Daniel Cortez, Maria Baturova, Arne Lindgren, Jonas Carlson, Yuri V Shubik, Bertil Olsson, Pyotr G Platonov
BACKGROUND: Atrial fibrillation (AF) is a known risk factor for ischemic stroke. Electrocardiographic predictors of AF in population studies such as the Framingham Heart Study, as well as in hypertensive patients have demonstrated a predictive value of the P-wave duration for development of AF. QRS vector magnitude has had a predictive value in ventricular arrhythmia development. We aimed to assess the value of the three-dimensional P-wave vector magnitude and its relationship to P-wave duration for prediction of new-onset AF after ischemic stroke...
July 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28737070/%C3%AE-blockers-on-discharge-from-acute-atrial-fibrillation-are-associated-with-decreased-mortality-and-lower-cerebrovascular-accidents-in-patients-with-heart-failure-and-reduced-ejection-fraction
#2
Charbel Abi Khalil, Mohammad Zubaid, Nidal Asaad, Wafa A Rashed, Adel Khalifa Hamad, Rajvir Singh, Jassim Al Suwaidi
The benefits of β-blockers in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) are controversial. The Gulf Survey of Atrial Fibrillation Events was a prospective, multinational, observational registry of consecutive patients with AF recruited from the emergency department (ED). We studied the incidence of 6- and 12-month mortality, hospitalization for HF or AF, and stroke/transient ischemic attacks (TIAs) in patients with HFrEF, in relation to β-blockers on discharge from the ED or the subsequent hospital stay...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#3
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28736385/thromboembolic-risk-bleeding-outcomes-and-effect-of-different-antithrombotic-strategies-in-very-elderly-patients-with-atrial-fibrillation-a-sub-analysis-from-the-prefer-in-af-prevention-of-thromboembolic-events-european-registry-in-atrial-fibrillation
#4
Giuseppe Patti, Markus Lucerna, Ladislav Pecen, Jolanta M Siller-Matula, Ilaria Cavallari, Paulus Kirchhof, Raffaele De Caterina
BACKGROUND: Increasing age predisposes to both thromboembolic and bleeding events in patients with atrial fibrillation; therefore, balancing risks and benefits of antithrombotic strategies in older populations is crucial. We investigated 1-year outcome with different antithrombotic approaches in very elderly atrial fibrillation patients (age ≥85 years) compared with younger patients. METHODS AND RESULTS: We accessed individual patients' data from the prospective PREFER in AF (PREvention oF thromboembolic events-European Registry in Atrial Fibrillation), compared outcomes with and without oral anticoagulation (OAC), and estimated weighed net clinical benefit in different age groups...
July 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733782/catheter-ablation-of-atrial-fibrillation-an-overview-for-clinicians
#5
REVIEW
Nebojša Mujović, Milan Marinković, Radoslaw Lenarczyk, Roland Tilz, Tatjana S Potpara
Catheter ablation (CA) of atrial fibrillation (AF) is currently one of the most commonly performed electrophysiology procedures. Ablation of paroxysmal AF is based on the elimination of triggers by pulmonary vein isolation (PVI), while different strategies for additional AF substrate modification on top of PVI have been proposed for ablation of persistent AF. Nowadays, various technologies for AF ablation are available. The radiofrequency point-by-point ablation navigated by electro-anatomical mapping system and cryo-balloon technology are comparable in terms of the efficacy and safety of the PVI procedure...
July 21, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28733435/different-implications-of-heart-failure-ischemic-stroke-and-mortality-between-nonvalvular-atrial-fibrillation-and-atrial-flutter-a-view-from-a-national-cohort-study
#6
Yu-Sheng Lin, Tien-Hsing Chen, Ching-Chi Chi, Ming-Shyan Lin, Tao-Hsin Tung, Chi-Hung Liu, Yung-Lung Chen, Mien-Cheng Chen
BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes between nonvalvular AF and AFL. METHODS AND RESULTS: AF and AFL patients without any prescribed anticoagulation were enrolled from a 13-year national cohort database. Under series exclusion criteria, ischemic stroke, heart failure hospitalization, and all-cause mortality were compared between the groups in real-world conditions and after propensity score matching...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#7
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#8
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28729311/a-review-of-rate-control-in-atrial-fibrillation-and-the-rationale-and-protocol-for-the-rate-af-trial
#9
Dipak Kotecha, Melanie Calvert, Jonathan J Deeks, Michael Griffith, Paulus Kirchhof, Gregory Yh Lip, Samir Mehta, Gemma Slinn, Mary Stanbury, Richard P Steeds, Jonathan N Townend
BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is common and causes impaired quality of life, an increased risk of stroke and death as well as frequent hospital admissions. The majority of patients with AF require control of heart rate. In this article , we summarise the limited evidence from clinical trials that guides prescription, and present the rationale and protocol for a new randomised trial. As rate control has not yet been shown to reduce mortality, there is a clear need to compare the impact of therapy on quality of life, cardiac function and exercise capacity...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727359/-stroke-prevention-in-patients-with-atrial-fibrillation
#10
Gaia Sirimarco, Lorenz Hirt, Roman Sztajzel, Fabienne Perren
Oral anticoagulation with vitamin K antagonists (VKA) was the cornerstone of stroke prevention in atrial fibrillation (AF). This review article presents the state of the art, with regard to the treatment options developed over the past few years, the new oral anticoagulants (NOAC). A search in PubMed for relevant published studies has been performed. Dabigatran and apixaban were superior to warfarin to reduce stroke risk or systemic embolism ; dabigatran, rivaroxaban and edoxaban were non-inferior. All NOAC are globally non-inferior to warfarin for stroke prevention in non-valvular AF and they have a superior safety profile, with a reduced intracranial bleeding risk...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28724590/long-term-antithrombotic-treatment-in-intracranial-hemorrhage-survivors-with-atrial-fibrillation
#11
Eleni Korompoki, Filippos T Filippidis, Peter B Nielsen, Angela Del Giudice, Gregory Y H Lip, Joji B Kuramatsu, Hagen B Huttner, Jiming Fang, Sam Schulman, Joan Martí-Fàbregas, Celine S Gathier, Anand Viswanathan, Alessandro Biffi, Daniela Poli, Christian Weimar, Uwe Malzahn, Peter Heuschmann, Roland Veltkamp
OBJECTIVE: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM)...
July 19, 2017: Neurology
https://www.readbyqxmd.com/read/28724512/the-health-buddies-app-as-a-novel-tool-to-improve-adherence-and-knowledge-in-atrial-fibrillation-patients-a-pilot-study
#12
Lien Desteghe, Kiki Kluts, Johan Vijgen, Pieter Koopman, Dagmara Dilling-Boer, Joris Schurmans, Paul Dendale, Hein Heidbuchel
BACKGROUND: Atrial fibrillation (AF) constitutes an important risk for stroke, especially in an ageing population. A new app (Health Buddies) was developed as a tool to improve adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in an elderly AF population by providing a virtual contract with their grandchildren, spelling out daily challenges for both. OBJECTIVE: The aim of this pilot study was to assess the feasibility and usability of the Health Buddies app in AF patients...
July 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28724315/persistent-atrial-fibrillation-vs-paroxysmal-atrial-fibrillation-differences-in-management
#13
Andrei D Margulescu, Lluis Mont Girbau
Atrial fibrillation (AF) is the most common human arrhythmia. AF is a progressive disease, initially being nonsustained and induced by trigger activity, and progressing towards persistent AF through alteration of the atrial myocardial substrate. Treatment of AF aims to decrease the risk of stroke and improve the quality of life, by preventing recurrences (rhythm control) or controlling the heart rate during AF (rate control). In the last 20 years, catheter-based and, less frequently, surgical and hybrid ablation techniques have proven more successful compared with drug therapy in achieving rhythm control in patients with AF...
July 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28720644/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-a-systematic-review-and-meta-analysis
#14
REVIEW
Kuo-Li Pan, Daniel E Singer, Bruce Ovbiagele, Yi-Ling Wu, Mohamed A Ahmed, Meng Lee
BACKGROUND: The original non-vitamin K antagonist oral anticoagulant (NOAC) trials in nonvalvular atrial fibrillation (AF) enrolled patients with native valve pathologies. The object of this study was to quantify the benefit-risk profiles of NOACs versus warfarin in AF patients with native valvular heart disease (VHD). METHODS AND RESULTS: Trials were identified by exhaustive literature search. Trial data were combined using inverse variance weighting to produce a meta-analytic summary hazard ratio (HR) and 95% confidence interval (CI) of efficacy and safety of NOACs versus warfarin...
July 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28719150/can-principles-of-the-surface-potential-be-combined-with-knowledge-of-natural-products-to-reduce-atrial-rhythm-disturbances
#15
EDITORIAL
H Ni, K Narsingani, H Zhang, W R Giles
Long lasting or chronic electrophysiological abnormalities in human atria are significant contributors to morbidity during healthy aging. Although both paroxysmal (brief) and chronic atrial fibrillation (AF) were considered to be benign; the notable association between maintained AF and stroke has resulted in AF now being a target for surgical intervention (ablation) and/or drug therapy. An interesting, forward looking paper from the Elinder Group(1) in this issue of Acta Physiologica reveals novel pharmacological agents and principles that could be the basis for more effective antiarrhythmic therapies for AF...
July 18, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28716216/1-4-times-increase-in-atrial-fibrillation-related-ischemic-stroke-and-tia-over-12years-in-a-stroke-center
#16
Qiong Yang, Leonid Churilov, Dongsheng Fan, Stephen Davis, Bernard Yan
BACKGROUND AND PURPOSE: Prevalence of atrial fibrillation (AF) has quadrupled in the past 50years in the general population. However, there is uncertainty regarding prevalence of AF over time in ischemic stroke patients given the aging population and enhanced surveillance of AF. We aimed to explore the changing prevalence of AF as well as other risk factors, stroke subtypes, investigations and pre-stroke medications among ischemic stroke and transient ischemic attack (TIA) patients. METHODS: We performed a retrospective analysis of data from a prospective database of consecutive patients with acute ischemic stroke and TIA from 2004 to 2015...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28715812/free-fatty-acid-is-associated-with-thrombogenicity-in-cardioembolic-stroke
#17
Woo-Keun Seo, Jin-Man Jung, Ji Hyun Kim, Seong-Beom Koh, Oh Young Bang, Kyungmi Oh
BACKGROUND: Recently, the role of free fatty acids (FFAs) in thromboembolism has re-emerged in the context of cardioembolic stroke. Therefore, we attempted to determine the role of FFAs in embolic risk in various potential sources of cardioembolism (PSCE). We hypothesized that if elevated FFA levels in stroke patients are associated with thrombogenesis, then patients with a well-known high risk of embolic sources would have high FFA levels. METHODS: Data collected from 2 hospital-based stroke registries were analyzed to investigate the association between FFA and PSCE...
July 18, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28714617/-left-atrial-appendage-occlusion-for-atrial-fibrillation
#18
Marco Roberto, Amir-Ali Fassa, Edoardo De Benedetti
Embolic stroke is the most dangerous complication of atrial fibrillation (AF). Oral anticoagulation represents the treatment of choice for thromboembolic (TE) prophylaxis in patients with a CHADS2VASc score ≥ 1 but is associated with a significant increase in haemorrhagic events. Almost 90 % of thrombi originate in the left atrial appendage. Registries have shown that percutaneous occlusion of this appendage reduces embolic risk and may be considered for TE prophylaxis in patients with a high TE (CHADS2VASc score ≥ 2) and haemorrhagic (HAS-BLED score ≥ 3) risk...
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28714523/echocardiographic-parameters-versus-cha2ds2-vasc-score-in-prediction-of-overall-cardiac-events-heart-failure-and-stroke-in-non-valvular-atrial-fibrillation
#19
Li-Tan Yang, Wei-Chuan Tsai, Ho-Ming Su
BACKGROUND: Apart from stroke, atrial fibrillation (AF) is associated with higher mortality and heart failure (HF), in which risk stratification scheme is lacking. Therefore this investigation examined the prognostic value of echocardiographic predictors against CHA₂DS₂-VASc score in permanent non-valvular AF (NVAF). METHOD: In 252 asymptomatic or mildly symptomatic consecutive patients with NVAF, comprehensive echocardiography was performed. Left atrial deformation parameters were also obtained by two-dimensional speckle tracking echocardiography...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28711451/atrial-fibrillation-in-heart-failure-with-preserved-mid-range-and-reduced-ejection-fraction
#20
Ulrik Sartipy, Ulf Dahlström, Michael Fu, Lars H Lund
OBJECTIVES: The study sought to assess the independent risk factors for, consequences of, and outcomes with atrial fibrillation (AF) compared with sinus rhythm (SR) in heart failure (HF) with preserved ejection fraction (HFpEF) versus HF with mid-range ejection fraction (HFmrEF) versus HF with reduced ejection fraction (HFrEF). BACKGROUND: AF is common in HF, but most data are from HFrEF. The importance of AF in HFpEF and MFmrEF is less well known. METHODS: In patients from 2000 to 2012 in the SwedeHF (Swedish Heart Failure Registry) registry, enriched with patient-level data from national health care registries, the authors assessed prevalence of, associations with and prognostic impact of AF in HFpEF versus HFmrEF versus HFrEF...
July 6, 2017: JACC. Heart Failure
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