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Charan Yerasi, Mohamad Lazkani, Prathik Kolluru, Varun Miryala, Jae Kim, Harsha Moole, Abhishek C Sawant, Michael Morris, Ashish Pershad
BACKGROUND: Left atrial appendage occlusion (LAAO) is a promising intervention for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Early outcomes following LAAO have been published in many studies with variable results. OBJECTIVE: This updated meta-analysis aims to provide a summary of the early outcomes of LAAO. METHODS: Medline/Pubmed, Ovid Journals, Clinical trials, Abstract meetings, Cochrane databases were searched from January 1st, 1999 to November 30th, 2016...
March 1, 2018: Journal of Interventional Cardiology
Duo Huang, Chi-Lap Wong, Kwan-Wa Cheng, Pak-Hei Chan, Wen-Sheng Yue, Chun-Ka Wong, Chi-Wai Ho, Ian C K Wong, Esther W Chan, Chung Wah Siu
INTRODUCTION: The importance of time in therapeutic range (TTR) in patients prescribed warfarin therapy for stroke prevention in atrial fibrillation (AF) cannot be overemphasised. AIM: To evaluate the impact of provision of TTR results during clinic visits on anticoagulation management. DESIGN: Single-centred, randomised controlled study. SETTING: Fifteen arrhythmia clinics in Hong Kong. PATIENTS: AF patients prescribed warfarin...
February 19, 2018: Postgraduate Medical Journal
Hubert Cochet, Xavier Iriart, Soumaya Sridi, Claudia Camaioni, Olivier Corneloup, Michel Montaudon, François Laurent, Wieme Selmi, Pauline Renou, Zakaria Jalal, Jean-Benoît Thambo
Aims: Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion. Methods and results: Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter...
February 2, 2018: European Heart Journal Cardiovascular Imaging
Felix K Weise, Stefano Bordignon, Laura Perrotta, Athanasios Konstantinou, Fabrizio Bologna, Takahiko Nagase, Shaojie Chen, K R Julian Chun, Boris Schmidt
AIMS: We aimed to assess the feasibility, efficacy and safety of short-term dual antiplatelet therapy (DAPT) for 6 weeks after left atrial appendage closure (LAAC). METHODS AND RESULTS: Data of the Cardioangiologisches Centrum Bethanien-LAAC registry were analysed. DAPT (aspirin 100mg plus clopidogrel 75mg) was administered until transoesophageal echocardiography (TEE) evaluation 6 weeks after LAAC. In the absence of significant peri-device flow or device-related thrombus (DRT) the medication was decreased to single antiplatelet therapy (SAPT)...
February 6, 2018: EuroIntervention
Nijole Bernaitis, Chi Keong Ching, Tony Badrick, Shailendra Anoopkumar-Dukie
Warfarin decreases stroke risk in atrial fibrillation patients, with efficacy and safety impacted by the quality of warfarin control, as measured by time in therapeutic range (TTR). Stroke and bleed risk scores are calculated prior to commencing warfarin, so it would be beneficial if these scores also identified likely warfarin control. Some studies have investigated CHADS2, CHA2DS2VASc, and HASBLED individually for this purpose, but application of all scores to diverse ethnic populations and at sites with differing overall control has not been investigated...
November 28, 2017: Heart, Lung & Circulation
Ênio Eduardo Guérios, Francisco Chamié, Márcio Montenegro, Eduardo Benchimol Saad, Fabio Sandoli de Brito, Paulo Avancini Caramori, Luiz Carlos Simões, Flávio Roberto Azevedo de Oliveira, Luiz Carlos Giuliano, Cláudio Munhoz da Fontoura Tavares
BACKGROUND: Left atrial appendage closure (LAAC) is an effective alternative to oral anticoagulation (OA) for the prevention of stroke in patients with non-valvular atrial fibrillation (NVAF). OBJECTIVE: To present the immediate results and late outcomes of patients submitted to LAAC and included in the Brazilian Registry of Percutaneous Left Atrial Appendage Closure. METHODS: 91 patients with NVAF, high stroke risk (CHA2DS2VASc score = 4...
October 19, 2017: Arquivos Brasileiros de Cardiologia
Joelle Kefer, Adel Aminian, Paul Vermeersch, Tom De Potter, Francis Stammen, Edouard Benit, Werner Budts, Luc Missault, Benny Drieghe, Ian Buysschaert, Kristoff Cornelis, Jean-Manuel Herzet, Antoine Guedes, Nadia Debbas, Maximo Rivero, Mathieu Lempereur, Stijn Lochy, Ruben Casado-Arroyo, Christophe Laruelle, Philippe Debruyne, Thierry Ledent
AIMS: This study aimed at assessing the safety and efficacy at mid-term follow-up of left atrial appendage occlusion (LAAO) using different devices, in real life in Belgium. METHODS AND RESULTS: Between June 2009 and November 2016, 457 consecutive patients (63% males, 75±12 yrs, CHA2DS2-VASc 4±0.6, HASBLED 3.5±0.7) undergoing LAAO were included. Technical success was 97.1%. There were 19 periprocedural major adverse events (4.1%) including three deaths (0.6%), nine tamponades (1...
October 3, 2017: EuroIntervention
Mohammed Suki, Limor Azulai Giter, Avishay Elis
BACKGROUND: Most of the data on atrial fibrillation is known from registries including mostly ambulatory patients. Less is known about atrial fibrillation among patients hospitalized at departments of medicine. OBJECTIVES: To explore the characteristics of atrial fibrillation in patients hospitalized at the departments of medicine, and their management during hospitalization, focusing on anticoagulation treatment. METHODS: A retrospective study was conducted based on reviewing patient charts at the departments of medicine of a tertiary medical center...
August 2017: Harefuah
Verena Tscholl, Felicitas Spann, Jane Moses, Patrick Nagel, Barbara Bellmann, Sebastian Biewener, Marie Amtenbrink, Andrea Stroux, Andreas Rillig, Ulf Landmesser, Mattias Roser
BACKGROUND: Thus far, the topic hemostatic agent PerClot® is used for surgical procedures. Data about the use of PerClot® for cardiac-rhythm-devices (CRD) implantation are missing. The aim of this study was to evaluate the safety and efficacy of PerClot® in patients with high bleeding risk. METHODS AND RESULTS: In this prospective randomized study we planned to include 150 patients admitted for CRD-Implantation receiving anticoagulation and/or dual-antiplatelet-therapy...
December 1, 2017: International Journal of Cardiology
Nijole Bernaitis, Chi Keong Ching, Liping Chen, Jin Shing Hon, Siew Chong Teo, Tony Badrick, Andrew K Davey, Shailendra Anoopkumar-Dukie
Warfarin reduces stroke risk in atrial fibrillation (AF) patients. The quality of warfarin control, measured by time in therapeutic range (TTR), impacts outcome and adverse events. One tool evaluating risk of adverse events and potential warfarin control would simplify risk-benefit assessment of warfarin. Recently, HASBLED was demonstrated effective for this purpose, but this was in well-controlled patients with deep vein thrombosis. HASBLED as a predictor of warfarin control has not been validated in other populations including differing indications, warfarin control levels and ethnicities...
June 21, 2017: Basic & Clinical Pharmacology & Toxicology
Jens Erik Nielsen-Kudsk, Søren Paaske Johnsen, Per Wester, Dorte Damgaard, Juhani Airaksinen, Juha Lund, Ole De Backer, Sami Pakarinen, Jacob Odenstedt, Saila Vikman, Magnus Settergren, Ole Kongstad, Mårten Rosenqvist, Derk W Krieger
AIMS: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral hemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. METHODS AND RESULTS: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the Amplatzer Cardiac Plug or the Amplatzer Amulet were compared to a propensity score matched group of 151 patients receiving standard medical therapy...
May 9, 2017: EuroIntervention
R O'Caoimh, E Igras, A Ramesh, B Power, K O'Connor, R Liston
BACKGROUND: Atrial fibrillation (AF) is common among frail older adults. Oral anticoagulation (OAC) is particularly challenging for these due to overlapping stroke and bleeding risk factor profiles. OBJECTIVE: To compare the utility of stroke and haemorrhage risk-prediction instruments in the treatment of AF among frail older adults. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: Frail residents in four nursing homes with a Clinical Frailty Scale score ≥5 (median 7±0)...
2017: Journal of Frailty & Aging
Özcan Başaran, Volkan Dogan, Murat Biteker, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin Çakıllı, Ceyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel, Cevat Kırma
OBJECTIVE: No studies have been conducted in Turkey to compare the quality of stroke prevention therapies provided in different healthcare settings in patients with atrial fibrillation (AF). Therefore, we aimed to evaluate possible differences between secondary (SH) and tertiary hospital (TH) settings in the effectiveness of implementing AF treatment strategies. METHODS: Baseline characteristics of 6273 patients with non-valvular AF enrolled in the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke Prevention Strategies in Turkey) study were compared...
May 2017: European Journal of Internal Medicine
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There are limited data with WATCHMAN (Boston Scientific Corporation, Natick, MA, USA) for left atrial appendage (LAA) closure in patients with nonvalvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at four major Canadian centers...
April 2017: Journal of Cardiovascular Electrophysiology
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
May 2017: Anatolian Journal of Cardiology
Daniela Poli, Emilia Antonucci, Francesco Dentali, Sophie Testa, Gualtiero Palareti
The most feared complication of vitamin K antagonists (VKAs) treatment is intracranial hemorrhage (ICH). The previously published CHIRONE Study fails to identify risk factors associated with ICH recurrence after VKAs resumption. The aim of this secondary analysis of the study is to evaluate if patients who need surgery or with severe neurological sequelae after the first episode show a higher risk of ICH recurrence. The HASBLED score was used to stratify bleeding risk and to evaluate the distribution of recurrence in relation to each class of risk...
January 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Amanda N Basto, Nathan P Fewel, Rajiv Gupta, Eileen M Stock, Mia Mia Ta
OBJECTIVE: To evaluate the use of dabigatran versus warfarin on time to elective direct current cardioversion (DCCV). METHODOLOGY: This retrospective observational study was conducted at a single Veterans Affairs hospital in the Southwestern region of the U.S. Patients with atrial fibrillation or atrial flutter who were initiated on either warfarin or dabigatran prior to DCCV were reviewed. The time to cardioversion was compared between warfarin and dabigatran, as well as costs of therapy, rescheduling rates, and adverse events...
April 2016: Journal of Atrial Fibrillation
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...
October 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
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