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https://www.readbyqxmd.com/read/28217309/qrs-duration-versus-morphology-and-survival-after-cardiac-resynchronization-therapy
#1
Mand J H Khidir, Victoria Delgado, Nina Ajmone Marsan, Martin J Schalij, Jeroen J Bax
AIMS: The prognostic implications of QRS duration and morphology in heart failure patients treated with cardiac resynchronization therapy (CRT) remains debated. The present evaluation investigated the association between QRS duration (<150 vs. ≥150 ms) and QRS morphology (left bundle brand block [LBBB] vs. non-LBBB) and long-term prognosis of a large cohort of unselected heart failure patients treated with CRT according to contemporary guidelines. METHODS AND RESULTS: Of 973 heart failure patients treated with CRT (mean age 66...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#2
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#3
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#4
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#5
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#6
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28153995/atrial-fibrillation-and-ventricular-arrhythmias-sex-differences-in-electrophysiology-epidemiology-clinical-presentation-and-clinical-outcomes
#7
Anne M Gillis
Sex-specific differences in the epidemiology, pathophysiology, clinical presentation, clinical treatment, and clinical outcomes of atrial fibrillation (AF), sustained ventricular arrhythmias, and sudden cardiac death are recognized. Sex hormones cause differences in cardiac electrophysiological parameters between men and women that may affect the risk for arrhythmias. The incidence and prevalence of AF is lower in women than in men. However, because women live longer and AF prevalence increases with age, the absolute number of women with AF exceeds that of men...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28150348/management-of-acute-ischaemic-stroke-in-patients-with-dementia
#8
REVIEW
A Subic, P Cermakova, B Norrving, B Winblad, M von Euler, M G Kramberger, M Eriksdotter, S Garcia-Ptacek
An estimated 10% of stroke patients have an underlying dementia. As a consequence, health professionals often face the challenge of managing patients with dementia presenting with an acute stroke. Patients with dementia are less likely to receive thrombolysis (0.56-10% vs. 1-16% thrombolysis rates in the general population), be admitted to a stroke unit or receive some types of care. Anticoagulation for secondary stroke prevention is sometimes withheld, despite dementia not being listed as an exclusion criterion in current guidelines...
February 2, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28143688/sleep-apnea-state-of-the-art
#9
REVIEW
Martin R Cowie
Many patient with, or at risk of, cardiovascular disease have sleep disordered breathing (SDB), which can be either obstructive (with intermittent collapse of the upper airway) or central (episodic loss of respiratory drive). SDB is associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in SDB have either been neutral (obstructive sleep apnea) or suggested the possibility of harm, likely from increased sudden death, in central sleep apnea...
December 20, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28139836/personalized-assessment-based-and-tiered-medical-education-curriculum-integrating-treatment-guidelines-for-atrial-fibrillation
#10
Brian C Lee, Karyn D Ruiz-Cordell, Steven M Haimowitz, Cara Williams, Bruce S Stambler, Anthia Mandarakas
BACKGROUND: This continuing medical education (CME) curriculum utilizes the Learner Assessment Platform (LAP), providing learners with personalized educational pathways related to atrial fibrillation treatment. HYPOTHESIS: There are improvements in knowledge among physician learners after CME, especially among LAP learners. METHODS: In this LAP-based curriculum, an evaluation of learner deficits on designated learning objectives was conducted in tier 1 and used to direct learners to individualized tier 2 activities...
January 31, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28138764/-ablation-for-atrial-fibrillation-in-the-elderly
#11
Clemens Jilek, Thorsten Lewalter
Atrial fibrillation is mainly an arrhythmia among the elderly. The current ESC guideline determines that there is no justification to deny atrial fibrillation ablation to any age group; however, the guideline does not provide specific scientific data. Thus, the goal of this article is to summarize the data on efficacy and safety of atrial fibrillation ablation among elderly people and give treatment recommendations: (1) The success of atrial fibrillation ablation is the same between elderly and younger patients...
January 30, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28130373/catheter-ablation-for-atrial-flutter-a-survey-by-the-european-heart-rhythm-association-and-canadian-heart-rhythm-society
#12
Benedict M Glover, Jian Chen, Kathryn L Hong, Serge Boveda, Adrian Baranchuk, Kristina H Haugaa, Paul Dorian, Tatjana S Potpara, Eugene Crystal, Brent Mitchell, Roland Tilz, Peter Leong-Sit, Nikolaos Dagres
The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus (CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28129663/risk-stratification-models-in-atrial-fibrillation
#13
Farhan Shahid, Gregory Y H Lip
Atrial fibrillation (AF) is associated with an increased risk of stroke compared with the general population. AF-related stroke confers a higher mortality and morbidity risk, and thus, early detection and assessment for the initiation of effective stroke prevention with oral anticoagulation are crucial. Simple and practical risk assessment tools are essential to facilitate stroke and bleeding risk assessment in busy clinics and wards to aid decision making. At present, the CHA2DS2VASc score is recommended by guidelines as the most simple and practical method of assessing stroke risk in AF patients...
January 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28122078/atrial-fibrillation-type-2-diabetes-and-non-vitamin-k-antagonist-oral-anticoagulants-a-review
#14
Anna Plitt, Darren K McGuire, Robert P Giugliano
Importance: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a 5-fold increase in the risk for stroke. Type 2 diabetes is an independent risk factor for both stroke and atrial fibrillation, and in the setting of AF, type 2 diabetes is independently associated with a 2% to 3.5% increase in absolute stroke rate per year. The overlap in the pathophysiologies of AF and type 2 diabetes are not well understood, and current practice guidelines provide few recommendations regarding patients with both conditions...
January 25, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28120297/personalizing-bridging-anticoagulation-in-patients-with-nonvalvular-atrial-fibrillation-a-microsimulation-analysis
#15
Matthew A Pappas, Geoffrey D Barnes, Sandeep Vijan
BACKGROUND: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating warfarin or require interruption of anticoagulation. Current guidelines recommend bridging for patients at high risk of stroke. Among patients with atrial fibrillation and one or more risk factors for ischemic stroke, the recently published BRIDGE trial found forgoing bridging during interruption to be, on average, noninferior to bridging with respect to ischemic complications, with significantly fewer hemorrhagic complications...
January 24, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28111055/oral-anticoagulant-use-in-octogenarian-european-patients-with-atrial-fibrillation-a-subanalysis-of-prefer-in-af
#16
Olivier Hanon, Jean-Sébastien Vidal, Jean-Yves Le Heuzey, Paulus Kirchhof, Raffaele De Caterina, Josef Schmitt, Petra Laeis, Pier Mannuccio Mannucci, Maura Marcucci
BACKGROUND: Few studies describe oral anticoagulant (OAC) prescription practices in very elderly patients with atrial fibrillation (AF). METHODS: In this sub-analysis of the PREFER in AF study, performed in 2012, patients were stratified according to age (<80 [n=5565] and ≥80years [n=1660]) and OAC treatment. Factors associated with OAC prescription were analyzed in a multivariate logistic regression model with backward elimination of variables least associated with OAC use...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28106013/-2016-european-society-of-cardiology-guidelines-on-atrial-fibrillation-what-is-new
#17
EDITORIAL
Murat Özdemir
No abstract text is available yet for this article.
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28105602/ibrutinib-a-review-in-chronic-lymphocytic-leukaemia
#18
Emma D Deeks
Ibrutinib (Imbruvica(®)) is an oral irreversible inhibitor of Bruton's tyrosine kinase, a B-cell receptor (BCR) signalling kinase expressed by various haematopoietic cells, B-cell lymphomas and leukaemias. The drug is indicated for the treatment of certain haematological malignancies, including chronic lymphocytic leukaemia (CLL)/small lymphocytic lymphoma (SLL), which are the focus of this review. In phase III CLL/SLL trials, ibrutinib monotherapy was more effective than chlorambucil in the first-line treatment of elderly patients (RESONATE-2) and more effective than ofatumumab in previously-treated adults (RESONATE)...
February 2017: Drugs
https://www.readbyqxmd.com/read/28104790/contemporary-management-of-patients-undergoing-atrial-fibrillation-ablation-in-hospital-and-1-year-follow-up-findings-from-the-esc-ehra-atrial-fibrillation-ablation-long-term-registry
#19
Elena Arbelo, Josep Brugada, Carina Blomström Lundqvist, Cécile Laroche, Josef Kautzner, Evgeny Pokushalov, Pekka Raatikainen, Michael Efremidis, Gerhard Hindricks, Alberto Barrera, Aldo Maggioni, Luigi Tavazzi, Nikolaos Dagres
AIMS: The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. METHODS AND RESULTS: A total of 104 centres in 27 European countries participated and were asked to enrol 20-50 consecutive patients scheduled for first and re-do AFib ablation. Pre-procedural, procedural and 1-year follow-up data were captured on a web-based electronic case record form...
January 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28090072/reconsideration-of-inferior-vena-cava-parameters-for-estimating-right-atrial-pressure-in-an-east-asian-population%C3%A3-comparative-simultaneous-ultrasound-catheterization-study
#20
Takayuki Kawata, Masao Daimon, Seitetsu L Lee, Koichi Kimura, Naoko Sawada, Shuo-Ju Chiang, Keitaro Mahara, Takeshi Okubo, Tomoko Nakao, Megumi Hirokawa, Boqing Xu, Tomoko S Kato, Masafumi Watanabe, Yutaka Yatomi, Issei Komuro
BACKGROUND: Ultrasound measurements of the inferior vena cava (IVC) diameter (IVCD), together with its respiratory variation, provide a noninvasive estimate of right atrial pressure (RAP). However, there is a paucity of studies that have compared this technique with simultaneous catheterization. We explored the best cut-off values of IVC parameters for elevated RAP in comparison with RAP measured by catheterization.Methods and Results:We prospectively enrolled 120 East Asian patients who were scheduled for catheterization...
January 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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