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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...
February 23, 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...
January 17, 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 PharmD, Nathan P Fewel PharmD, Rajiv Gupta Md, Eileen M Stock PhD, Mia Ta PharmD
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
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
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