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https://www.readbyqxmd.com/read/29145634/risk-profiles-for-acute-health-events-after-incident-atrial-fibrillation-in-patients-with-end-stage-renal-disease-on-hemodialysis
#1
Medha Airy, Tara I Chang, Victoria Y Ding, Benjamin A Goldstein, Nisha Bansal, Jingbo Niu, Sankar D Navaneethan, Mintu P Turakhia, Wolfgang C Winkelmayer
Background: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). Methods: We studied older US patients who newly initiated HD for ESRD (2006-11) and who had not previously been diagnosed with AF, stroke, myocardial infarction (MI) or hip fracture. We used Cox regression with AF as a time-varying covariate, adjusted for socio-demographic characteristics and comorbidities to estimate hazard ratios [HRs (95% confidence intervals)] for the events of ischemic stroke, MI and death...
November 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29144514/catheter-ablation-of-atrial-fibrillation-in-elderly-population
#2
Josef Kautzner, Petr Peichl, Marek Sramko, Robert Cihak, Bashar Aldhoon, Dan Wichterle
Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#3
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29141842/treatment-of-atrial-fibrillation-and-concordance-with-the-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guidelines-findings-from-orbit-af-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation
#4
Adam S Barnett, Sunghee Kim, Gregg C Fonarow, Laine E Thomas, James A Reiffel, Larry A Allen, James V Freeman, Gerald Naccarelli, Kenneth W Mahaffey, Alan S Go, Peter R Kowey, Jack E Ansell, Bernard J Gersh, Elaine M Hylek, Eric D Peterson, Jonathan P Piccini
BACKGROUND: It is unclear how frequently patients with atrial fibrillation receive guideline-concordant (GC) care and whether guideline concordance is associated with improved outcomes. METHODS AND RESULTS: Using data from ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), we determined how frequently patients received care that was concordant with 11 recommendations from the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation guidelines pertaining to antithrombotic therapy, rate control, and antiarrhythmic medications...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29139276/preventing-stroke-and-assessing-risk-in-women
#5
Tracey Keteepe-Arachi, Sanjay Sharma
Ischaemic stroke is rare in premenopausal women but risk increases with advancing age and doubles in the ten years following the menopause. Up to the age of 75 years men have a 25% higher risk of suffering a stroke compared with women. However, the increased life expectancy of women ultimately results in a higher overall incidence. Twice as many women die from stroke compare with breast cancer. Women with cerebrovascular disease are more likely to present with atypical symptoms than men. Altered mental status (including unresponsiveness, confusion and behavioural change) is the most common nonconventional symptom, and is reported by 23% of women compared with 15% of men...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#6
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29132650/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#7
REVIEW
Marin Nishimura, Jonathan C Hsu
Over the past decade, there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the non-vitamin K antagonist oral anticoagulants (NOACs) demonstrated favorable clinical outcomes compared with warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) are a particularly complex issue. CKD and ESRD increase both the risk of stroke and bleeding, and since all of the NOACs undergo various levels of renal clearance, renal dysfunction inevitably affects the pharmacokinetics of the drug in each patient...
October 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29131836/opportunistic-screening-for-atrial-fibrillation-in-a-real-life-setting-in-general-practice-in-denmark-the-atrial-fibrillation-found-on-routine-detection-afford-non-interventional-study
#8
Jonas Hald, Peter Bo Poulsen, Ina Qvist, Lisbeth Holm, Dorte Wedell-Wedellsborg, Lars Dybro, Lars Frost
Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years of age is recommended by the European and Danish Societies of Cardiology. The study aim was to examine the detection rate of AF in consecutively screened patients in the primary care setting in Denmark. In an open, non-interventional, cluster, multicenter, cross-sectional, observational study patients ≥65 years of age entering consecutively into general practice clinics were invited to nurse-assisted opportunistic screening for AF...
2017: PloS One
https://www.readbyqxmd.com/read/29131434/five-year-impact-of-catheter-ablation-for-atrial-fibrillation-in-patients-with-a-prior-history-of-stroke
#9
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, J Peter Weiss
BACKGROUND: Catheter ablation of atrial fibrillation(AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke(CVA) represent a unique high-risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood. METHODS: Three patient groups with a prior CVA and 5 years of follow-up were matched 1:3:3 by propensity score(±0...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29131288/mechanisms-of-cardioembolic-stroke-revisited-atrial-cardiopathy
#10
Justyna Mączyńska, Iwona Kurkowska-Jastrzębska, Rafał Dąbrowski
There has been only moderate progress in our understanding of potential relation between atrial arrhythmia and stroke over years. Current approach is still based on a hypothesis that atrial contractile dysfunction due to fibrillation causes blood stasis, which accompanied by other factors acting together as Virchow's triad produces thrombus and embolism to the brain. In this review we would like to discuss a relatively new concept of atrial cardiopathy. It assumes that risk of thromboembolism is increased regardless of atrial rhythm, being largely driven by atrial tissue abnormalities, such as fibrosis, endothelial and myocytes dysfunction and atrial dilatation...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#11
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29127472/prognostic-impact-of-atrial-fibrillation-in-cardiogenic-shock-complicating-acute-myocardial-infarction-a-substudy-of-the-iabp-shock-ii-trial
#12
Suzanne de Waha, Katharina Schoene, Georg Fuernau, Steffen Desch, Ingo Eitel, Janine Pöss, Roza Meyer-Saraei, Charlotte Eitel, Roland Tilz, Gerhard Schuler, Karl Werdan, Steffen Schneider, Taoufik Ouarrak, Uwe Zeymer, Holger Thiele
BACKGROUND: Aim of the current study was to analyse the impact of atrial fibrillation (AF) on prognosis in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI), which has never been investigated yet. METHODS: The current analysis is a substudy of the IABP-SHOCK II trial. Patients were grouped according to the presence or absence of AF. The primary endpoint was all-cause mortality at 30-day follow-up. Secondary endpoints included all-cause mortality, recurrent myocardial infarction, repeat revascularisation, and stroke at 12 months...
November 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29126892/atrial-fibrillation-ablation-beyond-pulmonary-veins-the-role-of-left-atrial-appendage
#13
REVIEW
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126890/how-to-prevent-recognize-and-manage-complications-of-af-ablation
#14
REVIEW
Mauricio I Scanavacca
Ablation of atrial fibrillation (AF) is one of most complex procedures in electrophysiology. Many technical improvements have been incorporated lately in order to improve clinical results and reducing risks. Currently, cardiac tamponade, stroke, PV stenosis, phrenic palsy and atrial esophageal fistula are still recognized as the major risks of AF ablation, although their managements have been much better established. The aim of this article is to review recent data in how to avoid, to identify and to treat such complications...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29122724/detection-of-new-atrial-fibrillation-in-patients-with-cardiac-implanted-electronic-devices-and-factors-associated-with-transition-to-higher-device-detected-atrial-fibrillation-burden
#15
Giuseppe Boriani, Taya V Glotzer, Paul D Ziegler, Mirko De Melis, Lorenza Mangoni di S Stefano, Milan Sepsi, Maurizio Landolina, Maurizio Lunati, Thorsten Lewalter, A John Camm
BACKGROUND: In patients with cardiac implanted electronic devices (CIEDs) detection of new atrial fibrillation (AF) is associated with an increased risk of stroke. OBJECTIVE: To characterize daily AF burden at first detection and the rate of temporal transition to higher device detected AF burden. METHODS: A pooled analysis of data from three prospective studies was analyzed and 6580 patients (mean age 68±12 years, 72% male) with no history of AF and no anticoagulants at baseline were identified...
November 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29122636/clinical-outcomes-and-history-of-fall-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-insights-from-the-aristotle-trial
#16
Meena P Rao, Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Dan Atar, Elaine M Hylek, Michael Hanna, Lars Wallentin, Renato D Lopes, Bernard J Gersh, Christopher B Granger
PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population. METHODS: Of the 18,201 patients in ARISTOTLE, 16,491 had information about history of falling - 753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29121723/atrial-fibrillation-and-use-of-antithrombotic-medications-in-older-people-a-population-based-study
#17
Mozhu Ding, Laura Fratiglioni, Kristina Johnell, Johan Fastbom, Maria Ljungdahl, Chengxuan Qiu
BACKGROUND: Trends in the use of antithrombotic drugs in elderly patients with atrial fibrillation (AF) are largely unknown. We estimated the prevalence of AF in an older population, and examined whether use of anticoagulant and antiplatelet drugs in older AF patients has changed over time. METHODS: Data from the population-based Swedish National study on Aging and Care in Kungsholmen (n=3363, age≥60years, 64.9% women) were used (2001-2004 and 2007-2010). AF cases were identified through 12-lead electrocardiogram, physician examinations, and patient register records (ICD-10 code I48)...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29117953/brain-microbleeds-anticoagulation-and-hemorrhage-risk-meta-analysis-in-stroke-patients-with-af
#18
Andreas Charidimou, Christopher Karayiannis, Tae-Jin Song, Dilek Necioglu Orken, Vincent Thijs, Robin Lemmens, Jinkwon Kim, Su Mei Goh, Thanh G Phan, Cathy Soufan, Ronil V Chandra, Lee-Anne Slater, Shamir Haji, Vincent Mok, Solveig Horstmann, Kam Tat Leung, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe, Tsukasa Saito, Lawrence K S Wong, Yannie Soo, Roland Veltkamp, Kelly D Flemming, Toshio Imaizumi, Velandai Srikanth, Ji Hoe Heo
OBJECTIVES: To assess the association between cerebral microbleeds (CMBs) and future spontaneous intracerebral hemorrhage (ICH) risk in ischemic stroke patients with nonvalvular atrial fibrillation (AF) taking oral anticoagulants. METHODS: This was a meta-analysis of cohort studies with >50 patients with recent ischemic stroke and documented AF, brain MRI at baseline, long-term oral anticoagulation treatment, and ≥6 months of follow-up. Authors provided summary-level data on stroke outcomes stratified by CMB status...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29112751/multimorbidity-and-co-morbidity-in-atrial-fibrillation-and-effects-on-survival-findings-from-uk-biobank-cohort
#19
Bhautesh Dinesh Jani, Barbara I Nicholl, Ross McQueenie, Derek T Connelly, Peter Hanlon, Katie I Gallacher, Duncan Lee, Frances S Mair
Aims: To examine the number and type of co-morbid long-term health conditions (LTCs) and their associations with all-cause mortality in an atrial fibrillation (AF) population. Methods and results: Community cohort participants (UK Biobank n = 502 637) aged 37-73 years were recruited between 2006 and 2010. Self-reported LTCs (n = 42) identified in people with AF at baseline. All-cause mortality was available for a median follow-up of 7 years (interquartile range 76-93 months)...
November 2, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29111209/usefulness-of-the-2mace-score-to-predicts-adverse-cardiovascular-events-in-patients-with-atrial-fibrillation
#20
José Miguel Rivera-Caravaca, Francisco Marín, María Asunción Esteve-Pastor, Paula Raña-Míguez, Manuel Anguita, Javier Muñiz, Ángel Cequier, Vicente Bertomeu-Martínez, Mariano Valdés, Vicente Vicente, Gregory Yoke Hong Lip, Vanessa Roldán
We investigated the incidence of nonembolic adverse events in 2 cohorts of patients with atrial fibrillation (AF) and validated the 2MACE score ([metabolic syndrome, age ≥75] [doubled]; [myocardial infarction or revascularization, congestive heart failure {HF}, and stroke, transient ischemic attack or thromboembolism]) as predictor of major adverse cardiovascular events (MACEs). We recruited 2,630 patients with AF from 2 different cohorts (Murcia AF and FANTASIIA). The 2MACE score was calculated, and during a median of 7...
September 19, 2017: American Journal of Cardiology
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