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guideline in atrial fibrilation

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https://www.readbyqxmd.com/read/28439617/-stroke-prophylaxis-in-atrial-fibrillation-when-how-and-for-whom
#1
T Maurer, C Sohns
In patients suffering from atrial fibrillation (AF), modern antithrombotic therapy and anticoagulation strategies should be individualized based on shared decision making including patient preferences and the absolute and relative risks of stroke and bleeding. Estimation of the individual risk for stroke is still based on the CHA2DS2-VASc score. Based on the most recent guidelines for the management of AF, oral anticoagulation therapy should be considered for men with a CHA2DS2-VASc score ≥1 and women with a score ≥2, balancing the expected stroke reduction, risk of bleeding and patient preference...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28424890/left-atrial-electromechanical-conduction-time-predicts-atrial-fibrillation-in-patients-with-mitral-stenosis-a-5-year-follow-up-speckle-tracking-echocardiography-study
#2
Ozkan Candan, Cetin Gecmen, Arzu Kalayci, Cem Dogan, Emrah Bayam, Mehmet Ozkan
Prolonged left atrial electromechanical conduction time is related with atrial electrical remodeling, and is predictive of the development of atrial fibrillation. The aim of our study was to examine whether left atrial electromechanical conduction time (EMT) and left atrial strain as measured by speckle tracking echocardiography (STE) are predictors for the development of atrial fibrillation (AF) in patients with mitral stenosis (MS) at 5-year follow-up. A total of 81 patients (61% females; mean age 38.1 ± 12...
April 19, 2017: International Journal of Cardiovascular Imaging
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
#3
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
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#4
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28413184/risk-of-ischemic-stroke-in-patients-with-non-valvular-atrial-fibrillation-not-receiving-oral-anticoagulants%C3%A3-korean-nationwide-population-based-study
#5
Si-Hyuck Kang, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Myung-Jin Cha, Youngjin Cho, Il-Young Oh, Seil Oh
BACKGROUND: Atrial fibrillation, the most common cardiac arrhythmia, is associated with an elevated thromboembolic risk, including ischemic stroke. Guidelines recommend the stratification of individual stroke risk and tailored antithrombotic therapy. This study investigated the demographics, comorbidities, and prognosis of non-valvular AF (NVAF) in Korean patients.Methods and Results:We extracted data on 10,846 patients with newly diagnosed NVAF who were naïve to oral anticoagulants from the National Health Insurance Service-National Sample Cohort...
April 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28408027/is-atrial-fibrillation-a-preventable-disease
#6
REVIEW
Xin Du, Jianzeng Dong, Changsheng Ma
Atrial fibrillation (AF) is an increasing burden worldwide. However, AF prevention has not been emphasized enough in clinical practice or guidelines. In this paper, the authors review the associations of modifiable lifestyle factors, including alcohol abuse, smoking, physical inactivity, and unhealthy psychological stress, with the risk for AF development. The authors also review the associations of cardiovascular risk factors that can be better managed, including obesity and overweight, high blood pressure, diabetes, dyslipidemia, obstructive sleep apnea, and other cardiovascular diseases, with the risk for AF...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28400546/management-of-bleeding-or-urgent-interventions-in-patients-treated-with-direct-oral-anticoagulants-doacs-2017-management-proposals-in-poland
#7
Piotr Pruszczyk, Anna Tomaszuk-Kazberuk, Agnieszka Słowik, Rafał Drwila, Grażyna Rydzewska, Krzysztof J Filipiak, Zbigniew Gaciong, Jarosław Kaźmierczak, Wojciech Marczyński, Jerzy Windyga, Adam Kobayashi, Janina Stepińska
Direct oral anticoagulants (DOACs) - apixaban, dabigatran, edoxaban and rivaroxaban - are mainly used in the prevention of thromboembolic complications in atrial fibrillation patients and in the treatment of venous thromboembolism. As compared to vitamin K antagonists (VKAs), they are characterized by at least similar efficacy and better safety profiles, especially with respect to intracranial hemorrhages. DOACs are more convenient therapeutic agents. The European Society of Cardiology 2016 guidelines clearly favor DOACs over VKAs in AF patients...
March 15, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28398376/-efficacy-and-safety-of-oral-anticoagulants-in-frail-elderly-patients-with-atrial-fibrillation-an-unsolved-problem
#8
Paolo Alboni, Nicola Stucci, Elena Cojocaru, Andrea Ungar
At present, the efficacy and safety of anticoagulants, warfarin, or new oral anticoagulants in frail patients remain unknown, as these patients have largely been excluded from both randomized trials and "real-world" studies; as a result, the guidelines do not provide guidance for the management of this population. Frail patients with atrial fibrillation (AF) are significantly less likely to receive oral anticoagulants compared to their nonfrail counterparts; is that an expression of reasonable prudence or malpractice? In this regard, some aspects of physical frailty should be considered: (i) increased vulnerability to stressors, including pharmacological agents with potential severe adverse effects; (ii) frail elderly patients are at high risk of falls and, therefore, of severe traumatic hemorrhages on oral anticoagulation; (iii) frail patients are more likely to have complications during intercurrent affections, potentially responsible for hemorrhages...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398365/-digitalis-a-drug-to-be-scrapped
#9
Franco Cosmi, Barbara Tarquini, Beatrice Mariottoni, Deborah Cosmi
We performed a comprehensive review of the scientific literature on the use of digoxin in heart failure and atrial fibrillation. In congestive heart failure (CHF) there is only one randomized trial with a statistical sample sufficiently large. In this trial (DIG trial), which enrolled patients with systolic left ventricular dysfunction in sinus rhythm, digoxin had a neutral action on mortality and modestly reduced the overall need of hospitalization. The study was conducted in the pre-beta-blocker era and, therefore, it has a doubtful application to the current clinical context...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28395917/-compliance-with-recommendations-in-secondary-prevention-of-stroke-in-primary-care
#10
Carmen Tamayo-Ojeda, Neus Parellada-Esquius, Betlem Salvador-González, Pilar Ángeles Oriol-Torón, M Dolores Rodríguez-Garrido, Dolores Muñoz-Segura
OBJECTIVE: Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. DESIGN: Multi-centre cross-sectional. SETTING: Health primary care centres in a metropolitan area (944,280 inhabitants). PARTICIPANTS: Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. MAIN MEASUREMENTS: Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event...
April 7, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28395912/dobutamine-stress-echocardiography-impact-of-abnormal-blood-potassium-levels-on-cardiac-arrhythmias
#11
Jared G Bird, Robert B McCully, Patricia A Pellikka, Garvan C Kane
BACKGROUND: Guidelines suggest that an abnormal blood potassium level is a relative contraindication to performing dobutamine stress echocardiography (DSE). However, this has not been previously studied. METHODS: We reviewed a consecutive series of patients who had potassium testing within 48 hours of undergoing DSE for the evaluation of myocardial ischemia over a 10-year period (N = 13,198). Normal potassium range in our laboratory is 3.6-5.2 mmol/L. Hemolyzed samples were not included...
April 7, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28393880/ethnicity-and-anticoagulation-management-of-hospitalized-patients-with-atrial-fibrillation-in-northwest-china
#12
Xinchun Cheng, Xianhui Zhou, Shifei Song, Min Wu, Roza Baolatejiang, Yanmei Lu, Yaodong Li, Wenhui Zhang, Wenkui Lv, Yuanzheng Ye, Qina Zhou, Hongli Wang, Jianghua Zhang, Qiang Xing, Baopeng Tang
The therapeutic management and health challenges caused by atrial fibrillation (AF) differ between different groups. The purpose of this study was to investigate the clinical features of patients hospitalized with AF and to explore the use of anticoagulation treatments in Han and Uygur patients in Xinjiang, northwest China. Data were collected from a retrospective descriptive study involving patients hospitalized at 13 hospitals in Xinjiang, China from Jul 1, 2014 to Jun 31, 2015. Anticoagulation management was measured according to guideline-recommended risk scores...
April 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28393567/prognostic-impact-of-heart-rate-in-elderly-with-systolic-heart-failure-and-concomitant-atrial-fibrillation
#13
Salim Barywani, Max Petzold
OBJECTIVE: The present study aimed to investigate the impact of resting heart rate (HR) on 5-year all-cause mortality in patients ≥80 years with heart failure (HF) with reduced ejection fraction (HFrEF) and concomitant atrial fibrillation (AF) after optimal up-titration of beta-blockers (BBs). METHODS: Patients (n = 185) aged ≥80 years with HF and left ventricular ejection fraction ≤40% were included between January 2000 and January 2008 from two university hospitals, Sahlgrenska and Östra and retrospectively studied from January 2 to May 30, 2013...
April 10, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28389612/benefits-of-emergency-departments-contribution-to-stroke-prophylaxis-in-atrial-fibrillation-the-emerg-af-study-emergency-department-stroke-prophylaxis-and-guidelines-implementation-in-atrial-fibrillation
#14
Blanca Coll-Vinent, Alfonso Martín, Juan Sánchez, Juan Tamargo, Coral Suero, Francisco Malagón, Mercedes Varona, Manuel Cancio, Susana Sánchez, José Carbajosa, José Ríos, Georgina Casanovas, Carles Ràfols, Carmen Del Arco
BACKGROUND AND PURPOSE: Long-term benefits of initiating stroke prophylaxis in the emergency department (ED) are unknown. We analyzed the long-term safety and benefits of ED prescription of anticoagulation in atrial fibrillation patients. METHODS: Prospective, multicenter, observational cohort of consecutive atrial fibrillation patients was performed in 62 Spanish EDs. Clinical variables and thromboprophylaxis prescribed at discharge were collected at inclusion...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28385080/blood-pressure-control-in-anticoagulated-patients-with-hypertension-and-atrial-fibrillation
#15
Vivencio Barrios, Carlos Escobar, Luis Prieto Valiente, Jose María Lobos, Diego Vargas-Ortega, Jose Polo, Nuria Marin Montañés
OBJECTIVE: To determine the clinical profile and blood pressure (BP) control rates of anticoagulated patients with hypertension and atrial fibrillation (AF). METHODS: The PAULA study was a multicenter cross-sectional/retrospective observational study conducted throughout Spain. The study included patients with nonvalvular AF who were receiving vitamin K antagonist therapy during the past year and were attended at primary care setting. Adequate BP control was defined according to 2013 ESC/ESH guidelines...
April 7, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28379461/current-practice-trends-for-use-of-early-venous-thromboembolism-prophylaxis-after-intracerebral-hemorrhage
#16
Laurel J Cherian, Eric E Smith, Lee H Schwamm, Gregg C Fonarow, Phillip J Schulte, Ying Xian, Jingjing Wu, Shyam K Prabhakaran
BACKGROUND: Venous thromboembolism (VTE) is common after intracerebral hemorrhage (ICH). Guidelines recommend early VTE prophylaxis. OBJECTIVE: To determine characteristics associated with early chemoprophylaxis (CP) after ICH in the Get With The Guidelines-Stroke registry. METHODS: In this observational cohort study, we identified patients with ICH between January 1, 2009 and September 30, 2013, who (1) were non-ambulatory and/or not comfort care measures by hospital day 2; (2) were not transferred to another acute care facility; and (3) had known VTE prophylaxis status at end of hospital day 2...
April 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28378924/educational-and-behavioural-interventions-for-anticoagulant-therapy-in-patients-with-atrial-fibrillation
#17
REVIEW
Danielle E Clarkesmith, Helen M Pattison, Phyo H Khaing, Deirdre A Lane
BACKGROUND: Current guidelines recommend oral anticoagulation therapy for patients with atrial fibrillation (AF) with one or more risk factors for stroke; however, anticoagulation control (time in therapeutic range (TTR)) with vitamin K antagonists (VKAs) is dependent on many factors. Educational and behavioural interventions may impact patients' ability to maintain their international normalised ratio (INR) control. This is an updated version of the original review first published in 2013...
April 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28369313/corrigendum-to-2016-esc-guidelines-for-the-management-of-atrial-fibrillation-developed-in-collaboration-with-eacts
#18
(no author information available yet)
No abstract text is available yet for this article.
March 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28369234/postoperative-atrial-fibrillation-following-cardiac-surgery-a-persistent-complication
#19
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28347441/assessment-of-a-personalized-and-distributed-patient-guidance-system
#20
Mor Peleg, Yuval Shahar, Silvana Quaglini, Tom Broens, Roxana Budasu, Nick Fung, Adi Fux, Gema García-Sáez, Ayelet Goldstein, Arturo González-Ferrer, Hermie Hermens, M Elena Hernando, Val Jones, Guy Klebanov, Denis Klimov, Daniel Knoppel, Nekane Larburu, Carlos Marcos, Iñaki Martínez-Sarriegui, Carlo Napolitano, Àngels Pallàs, Angel Palomares, Enea Parimbelli, Belén Pons, Mercedes Rigla, Lucia Sacchi, Erez Shalom, Pnina Soffer, Boris van Schooten
OBJECTIVES: The MobiGuide project aimed to establish a ubiquitous, user-friendly, patient-centered mobile decision-support system for patients and for their care providers, based on the continuous application of clinical guidelines and on semantically integrated electronic health records. Patients would be empowered by the system, which would enable them to lead their normal daily lives in their regular environment, while feeling safe, because their health state would be continuously monitored using mobile sensors and self-reporting of symptoms...
May 2017: International Journal of Medical Informatics
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