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Mathias Wolfrum, Adrian Attinger-Toller, Samera Shakir, Steffen Gloekler, Burkhardt Seifert, Aris Moschovitis, Ahmed Khattab, Francesco Maisano, Bernhard Meier, Fabian Nietlispach
OBJECTIVE: The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. BACKGROUND: The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. METHODS: Outcomes of 169 consecutive patients (age 73...
July 28, 2016: Catheterization and Cardiovascular Interventions
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Sebastian Biewener, Patrick Nagel, Saba Suhail, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: The efficacy of the second-generation cryoballoon (CB) in patients with paroxysmal atrial fibrillation (AF) has been demonstrated previously. Data on the efficacy of CB ablation in patients with persistent AF are sparse. OBJECTIVE: The aim of this study was to evaluate the 2-year success rate of pulmonary vein isolation in patients with persistent AF using the second-generation CB. METHODS: Fifty consecutive patients (mean age 64...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
D Baker, B Wilsmore, S Narasimhan
BACKGROUND: Direct oral anticoagulants (DOAC) are being increasingly utilised for stroke prevention in atrial fibrillation (AF) and atrial flutter. AIMS: To analyse the adoption and application of these drugs in a regional hospital inpatient cohort and compare with national prescribing data. METHODS: Digital medical records identified prescribed anticoagulants for patients admitted with AF and atrial flutter during 2013-2014. Analysis of patient demographics and stroke risk identified trends in prescribing DOAC versus warfarin...
July 2016: Internal Medicine Journal
Joelle Kefer, Apostolos Tzikas, Xavier Freixa, Samera Shakir, Sameer Gafoor, Jens Erik Nielsen-Kudsk, Sergio Berti, Gennaro Santoro, Adel Aminian, Ulf Landmesser, Fabian Nietlispach, Reda Ibrahim, Paolo Luciano Danna, Edouard Benit, Werner Budts, Francis Stammen, Tom De Potter, Tobias Tichelbäcker, Steffen Gloekler, Prapa Kanagaratnam, Marco Costa, Ignacio Cruz-Gonzalez, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Bernhard Meier, Heyder Omran
BACKGROUND: Left atrial appendage occlusion (LAAO) using the Amplatzer cardiac plug (ACP) is a preventive treatment of atrial fibrillation related thromboembolism. AIM: To assess the safety and efficacy of LAAO in patients with chronic kidney disease (CKD). METHODS: Among the ACP multicentre registry, 1014 patients (75±8yrs) with available renal function were included. RESULTS: Patients with CKD (N=375, CHA2DS2-VASc: 4...
March 15, 2016: International Journal of Cardiology
Bahij Kreidieh, Francia Rojas, Paul Schurmann, Amish S Dave, Amir Kashani, Moisés Rodríguez-Mañero, Miguel Valderrábano
BACKGROUND: Left atrial appendage (LAA) ligation with the Lariat device is being used for stroke prevention in atrial fibrillation. Residual leaks into the LAA are commonly reported after the procedure. Little is known about the anatomic LAA remodeling after Lariat ligation. METHODS AND RESULTS: In an exploratory study, we evaluated LAA 3-dimensional geometry via computed tomographic scan in 31 consecutive patients before Lariat closure and after a minimum of 30 days post procedure...
December 2015: Circulation. Arrhythmia and Electrophysiology
Daniel Hammersley, Steven Podd, Ari Gomes, Catherine Thomson, Thomas Keeble, Maureen Dooley, David Hildick-Smith
OBJECTIVE: To assess the success rate and safety outcomes of left atrial appendage occlusion (LAAO) procedures in a cohort of patients who had not undergone preprocedural imaging. BACKGROUND: LAAO patients usually undergo imaging with either transesophageal echocardiography (TEE) or computed tomography (CT) prior to the procedure itself. This preprocedural imaging may not be necessary. METHODS: The procedural success and major complication rates were assessed in a cohort of 52 patients who underwent LAAO without preprocedural imaging...
December 2015: Journal of Invasive Cardiology
Cynthia Wu, Michael Sean McMurtry, Roopinder K Sandhu, Erik Youngson, Justin A Ezekowitz, Padma Kaul, Finlay A McAlister
BACKGROUND AND PURPOSE: We studied whether anticoagulant use and outcomes differed between rural versus urban Canadian non-valvular atrial fibrillation (NVAF) patients prior to the introduction of direct oral anticoagulant drugs. METHODS: Retrospective cohort study of 25,284 adult Albertans with NVAF between April 1, 1999 and December 31, 2008. RESULTS: Compared to urban patients, rural patients were older (p = 0.0009) and had more comorbidities but lower bleeding risk at baseline...
2015: PloS One
Andreas Rillig, Tina Lin, Joaquina Plesman, Christian-H Heeger, Christine Lemes, Andreas Metzner, Shibu Mathew, Erik Wissner, Peter Wohlmuth, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
INTRODUCTION: Data on the novel oral anticoagulants (NOACS) during catheter ablation (CA) of atrial fibrillation (AF) are still limited. This study evaluated the periprocedural major complications (MC) of CA of AF, and compared Apixaban, Dabigatran, and Rivaroxaban with continuous phenoprocoumon. METHODS AND RESULTS: A total of 444 patients (mean age = 65.1 ± 9.4 years; 283 [64%] male) with paroxysmal (n = 180 [41%]), persistent (n = 256 [58%]), or longstanding-persistent AF were enrolled...
February 2016: Journal of Cardiovascular Electrophysiology
Ugur Onsel Turk, Esref Tuncer, Emin Alioglu, Kivanc Yuksel, Nihat Pekel, Emre Ozpelit, Ozcan Vuran, Istemihan Tengiz
BACKGROUND: Warfarin is highly efficacious in reducing stroke risk in patients with atrial fibrillation (AF). However, its safety and efficacy in stroke prevention is markedly influenced by its time in therapeutic range (TTR). The quality of anticoagulant therapy varies considerably among countries. Representative data concerning the quality of anticoagulant therapy and its effects on clinical outcomes in Turkey are lacking. METHODS: Warfarin in Therapeutic Range (WATER) registry is a prospective, observational study which followed 572 AF patients (mean age 67...
2015: Cardiology Journal
Boris Schmidt, Stefano Bordignon, Alexander Fuernkranz, Laura Perrotta, Detlef Scherer, K R Julian Chun
INTRODUCTION: Data on long-term follow-up (LTFU) after interventional closure of the left atrial appendage (LAAC) in patients with nonvalvular atrial fibrillation (AF) are scarce. We sought to determine the outcome of patients after LAAC with the first generation device. METHODS AND RESULTS: The Cardioangiologisches Centrum Bethanien (CCB) LAAC registry database was analyzed. Between October 2001 and July 2007, 45 AF patients (23 male, mean age 71 ± 6 years; mean CHA2 DS2 -VaSc 4...
August 2015: Journal of Cardiovascular Electrophysiology
Iwona Gorczyca-Michta, Beata Wożakowska-Kapłon
BACKGROUND: Prevention of thromboembolic complications is a priority in patients with atrial fibrillation (AF). Based on the current guidelines, the role of vitamin K antagonists (VKA) in stroke prevention has decreased in favour of novel oral anticoagulants (NOAC). AIM: To evaluate the proportion of AF patients who were prescribed a NOAC, compare populations of patients treated with VKA and NOAC, and identify factors predisposing to NOAC prescription at hospital discharge of AF patients...
2015: Kardiologia Polska
Simonetta Genovesi, Emanuela Rossi, Daniela Pogliani, Maurizio Gallieni, Andrea Stella, Fabio Badiali, Ferruccio Conte, Sonia Pasquali, Silvio Bertoli, Patrizia Ondei, Giuseppe Bonforte, Claudio Pozzi, Maria Grazia Valsecchi, Antonio Santoro
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in hemodialysis (HD) patients. It was suggested that oral anticoagulant therapy (OAT), the choice treatment for reducing the thromboembolic risk in AF patients, increases the incidence of both ischemic and hemorrhagic strokes in the HD population. Moreover, the therapy-related bleeding risk is particularly high in these patients. For these reasons there is no agreement on the use of OAT in HD patients with AF. The aim of this study was to evaluate the criteria adopted by nephrologists in prescribing OAT in HD patients with AF...
April 2014: Journal of Nephrology
P Kamtchueng, E Teiger
Stroke is an extremely common condition, the important functional and financial impact of which requires intense prevention policy. This strategy includes the prevention of thromboembolic complications of atrial fibrillation. The management of atrial fibrillation includes risk stratification for stroke with theCHA(2)DS(2)VASc score and assessment of hemorrhagic risk with HASBLED score. The reference preventive treatment is anticoagulant therapy with vitamin K antagonists. Nevertheless, many patients potentially eligible for this treatment will not benefit from it, because of a high risk of bleeding, or because recurrence of thromboembolism occurs despite well-conducted anticoagulation...
December 2013: Annales de Cardiologie et D'angéiologie
K R Julian Chun, Stefano Bordignon, Verena Urban, Laura Perrotta, Daniela Dugo, Alexander Fürnkranz, Bernd Nowak, Boris Schmidt
BACKGROUND: Currently, 2 different left atrial appendage (LAA) closure systems are available for stroke prevention in nonvalvular atrial fibrillation but comparative data are lacking. OBJECTIVES: To prospectively compare procedural data and patient outcome for 2 contemporary LAA closure systems and to investigate an alternative antithrombotic treatment regimen in high-risk patients. METHODS: Patients with nonvalvular atrial fibrillation, with high risk for stroke, and who either had contraindication or were not willing to accept oral anticoagulation were prospectively enrolled...
December 2013: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Tiago Pereira-Da-Silva, Teresa Souto Moura, Luísa Azevedo, Margarida Sá Pereira, Daniel Virella, Marta Alves, Luís Borges
INTRODUCTION AND OBJECTIVES: To evaluate the prescription rate of oral anticoagulants in atrial fibrillation, the factors associated with non-prescription, the reasons referred by the physicians for not prescribing anticoagulants including the new generation anticoagulants, and to perform a medium term follow-up assessment. MATERIALS AND METHODS: Prospective study on consecutive patients with atrial fibrillation with hospital discharge. The CHA2DS2VASc and HASBLED scores, associated comorbidities and medication prescribed before and at discharge were assessed...
March 2013: Acta Médica Portuguesa
Janina Stępińska, Katarzyna Czerwińska, Adam Witkowski, Maciej Dąbrowski, Zbigniew Chmielak, Krzysztof Kuśmierski, Tomasz Hryniewiecki, Marcin Demkow
BACKGROUND: The risk of bleedings in transcatheter aortic valve implantation (TAVI) patients increases due to age and concomitant diseases. The aim of the study was to assess the risk of bleedings, their influence on early prognosis of TAVI patients and utility of the TIMI and GUSTO scales in the evaluation of bleeding and in prediction of blood transfusion. METHODS: This was a single center study of in-hospital bleedings in 56 consecutive TAVI patients. Bleedings were classified according to the GUSTO and TIMI scales...
2013: Cardiology Journal
Anna C E Scowcroft, Sally Lee, Jonathan Mant
OBJECTIVE: To assess use of thromboprophylaxis in UK general practise among patients with atrial fibrillation (AF); to investigate whether elderly patients are less likely to receive anticoagulation therapy than younger patients. DESIGN: Retrospective cohort study SETTING: UK General Practice Research Database (GPRD) PATIENTS: Aged ≥60 years with a new diagnosis of AF (2000-2009). INTERVENTIONS: None. MAIN OUTCOME MEASURES: The main outcome measure was initiation of warfarin in the first year following diagnosis...
January 2013: Heart: Official Journal of the British Cardiac Society
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