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https://www.readbyqxmd.com/read/27910092/management-of-atrial-fibrillation-in-elderly-adults
#1
Yaanik Desai, Mikhael F El-Chami, Angel R Leon, Faisal M Merchant
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27910004/dabigatran-overdose-a-case-report-of-acute-hepatitis-extracorporeal-treatment
#2
Mariagrazia Porru, Antonella Mameli, Maria E Cianchetti, Mario Musu, Paola Schirru, Maria F Ruberto, Doris Barcellona, Francesco Marongiu
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration...
December 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27909535/search-for-the-ideal-antithrombotic-drug-utopian-task-likely-is-implemented-already
#3
REVIEW
Petras Stirbys Md PhD
Atrial fibrillation is the most prevalent cardiac arrhythmia with a high risk of ischemic stroke. Thromboprophylaxis plays a key role in prevention of cardioembolic and non-cardioembolic events. Oral antithrombotic drugs are most often used to reduce hypercoagulable state. Patients may suffer from both under- and overtreatment compromising the outcomes. Medication peculiarities at large are well-known and widely debated. Non-adherence to antithrombotic drug regimen poses a significant risk of stroke. There is a pressing need for more detailed delineation of risk factors, namely by incorporation of the letter "N" (meaning "Non-adherence to drug therapy") into the well-known risk score alphanumeric display: CHA2DS2N-VASc...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909529/emergency-department-readmission-in-elderly-patients-after-acute-rhythm-or-rate-control-treatment-for-atrial-fibrillation
#4
Bonora Antonio, Turcato Gianni, Franchi Elena, Dilda Alice, Taioli Gabriele, Serafini Valentina, Sivero Valentina, Zannoni Massimo, Ricci Giorgio, Olivieri Oliviero
Atrial fibrillation (AF) is an age-related increasing disease, characterized by a high number of relapses frequently leading the patients to Emergency Department (ED). Despite AF relapses may be clinically heterogeneous, a proper management requires either a fast and effective restore of the sinus rhythm or a satisfactory control of the ventricular rate. Whether the strategy adopted in the ED could affect the course of disease is still debated. Therefore, the aim of our study was to evaluate the number of ED readmission for AF related symptoms and the event-free period in patients older than 70 years previously treated in ED for an AF recurrence, in order to assess a possible relationship with the acute strategy...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909522/safety-and-necessity-of-thermal-esophageal-probes-during-radiofrequency-ablation-for-the-treatment-of-atrial-fibrillation
#5
Antonio Fasano, Prof Emeritus, Luca Anfuso Md, Stefano Bozzi Md, Claudio Pandozi Prof
BACKGROUND: Radiofrequency ablation is extensively used to achieve pulmonary veins isolation for the cure of atrial fibrillation. Luminal esophageal temperature can be monitored by means of suitable probes to prevent the onset of lesions. OBJECTIVE: To compute the thermal field generated by the ablation, to investigate the interaction between the electromagnetic field and the probe sensors, and to provide a safe interpretation of the temperature detected by the probe, supported by clinical data...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909520/surgical-ablation-of-atrial-fibrillation-is-electrical-isolation-of-the-pulmonary-veins-a-must
#6
REVIEW
Bart Maesen Md PhD, Ines Van Loo Md, Laurent Pison Md PhD, Mark La Meir Md PhD
Ablation of atrial fibrillation (AF) is a well-established treatment option for patients with symptomatic AF refractory to antiarrhythmic drugs. The cornerstone of catheter ablation is electrical isolation of the pulmonary veins, since the pulmonary veins are the most common location for triggers of AF. Electrical reconnection of the pulmonary veins is associated with arrhythmia recurrence and therefore diminishes long-term success of catheter ablation of AF. Therefore, durable pulmonary vein isolation remains a condition sine qua non for catheter ablation of AF...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909516/the-role-of-noacs-in-atrial-fibrillation-management-a-qualitative-study
#7
Katherine Kirley Md Ms, Goutham Rao Md, Victoria Bauer Bs, Christopher Masi Md PhD
Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs). We interviewed primary care physicians and cardiologists involved in AF management in a variety of practice settings. We conducted interviews using a semi-structured format and analyzed the data using the Framework Method. Four themes emerged...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909515/myocardial-biopsy-in-idiopathic%C3%A2-atrial-fibrillation-and-other-arrhythmias-nosological-diagnosis-clinical-and-morphological-parallels-and-treatment
#8
O V Blagova, A V Nedostup, E A Kogan, V A Sulimov, S A Abugov, A G Kupriyanova, V A Zaydenov, A E Donnikov, E V Zaklyazminskaya, E A Okisheva
BACKGROUND: The nosological nature of "idiopathic" arrhythmias and the effect of etiotropic and pathogenetic treatment are often unknown. METHODS AND RESULTS: 19 patients (42.6±11.3 years, 9 women) with atrial fibrillation (n = 16), supraventricular (n = 10) and ventricular (n = 4) premature beats, supraventricular (n = 2) and ventricular tachycardia (n = 1), left bundle branch block (n= 2), AV block (n = 2) without structural heart changes. Viruses were identified (polymerase chain reaction, PCR) along with measurement of anti-heart antibodies (AHA) and endomyocardial biopsy (EMB)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909513/assessment-of-sinoatrial-node-function-in-patients-with-persistent-and-long-standing-persistent-forms-of-atrial-fibrillation-after-maze-iii-procedure-combined-with-mitral-valve-operation
#9
Kulikov Aleksei A, Bokeria Leo A
RESEARCH OBJECTIVE: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation. METHODS: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909511/internal-jugular-vein-complete-thrombosis-after-dual-chamber-pacemaker-implant
#10
Angelo Placci, Maria Mattioli, Maria Francesca Notarangelo, Gianluca Gonzi, Marco Zardini
Venous thrombosis after pacemaker implant is a known, although often underrecognized condition that can challenge system revision or upgrading, leading occasionally to thromboembolic complications. Several factors are considered to promote thrombus formation. Among them, alteration of blood flow mechanics due to the presence of catheters in the vessel lumen may itself play a pivotal role. Hereby we present the case of a 65-year old men who underwent a dual-chamber pacemaker implant in another institute for sick sinus syndrome by means of left cephalic venous access...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909504/long-term-evolution-of-patients-treated-for-paroxysmal-atrial-fibrillation-with-first-and-second-generation-cryoballoon-catheter-ablation-with-a-prospective-protocol-guided-by-complete-bidirectional-left-atrium-pulmonary-veins-disconnection-after-adenosine
#11
Jesus M Paylos Md PhD, Aracelis Morales Md, Luis Azcona Md, Marisol Paradela Md, Raquel Yagüe Md, Fernando Gómez-Guijarro Md, Lourdes Lacal Md, Clara Ferrero Rn, Octavio Rodríguez Md
INTRODUCTION: Cryoballoon ablation (CB) has proven effective for treating patients with paroxysmal atrial fibrillation (PAF). We analyzed our seven year follow-up of patients, treated for PAF with first (CB1) and second generation (CB2), with demonstration of LA-PV disconnection with bidirectional block (BB) after adenosine (AD). METHODS: Since November 2008 to May 2015, 128 patients, 97 male (58±7 years), without heart disease, highly symptomatic, refractory to antiarrhythmic drugs (AAD) were treated, and follow-up (1411 ±727 days)...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909503/first-and-second-generation-cryoballoon-ablation-efficacy-restoring-and-maintaining-sinus-rhythm-in-patients-electrically-selected-and-treated-for-long-standing-persistent-atrial-fibrillation-after-acute-complete-electrical-disconnection-of-pulmonary-veins
#12
Jesus M Paylos Md PhD, Luis Azcona Md, Lourdes Lacal Md, Marisol Paradela Md, Carmen Cilleros Md, Ildefonso Del Campo Md, Clara Ferrero Rn Carlos Martínez Md PhD, Aracelis Morales Md
Introduction Cryoballoon ablation (CB) has proven effective to treatment of patients (pts) with atrial fibrillation (AF). However, the isolated efficacy of CB to treat pts with long-standing persistent atrial fibrillation (LSPAF) is less know. We analyzed the acute results and the long-term follow-up of our pts suffering LSPAF and initially treated with CB. Methods A cohort of 44 pts, 37 male (84%) mean age (60±10 year) suffering LSPAF were treated with first (CB1): 15pts, and second (CB2): 29 pts, generation CB...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909489/advanced-mapping-systems-to-guide-atrial-fibrillation-ablation-electrical-information-that-matters
#13
REVIEW
Sotirios Nedios Md, Philipp Sommer Md, Andreas Bollmann Md PhD, Gerhard Hindricks Md
Catheter ablation is an established and widespread treatment for atrial fibrillation (AF). Contemporary electroanatomical mapping systems (EAMs) have been developed to facilitate mapping processes but remain limited by spatiotemporal and processing restrictions. Advanced mapping systems emerged from the need to better understand and ablate complex AF substrate, by improving the acquisition and illustration of electrophysiological information. In this review, we present you the recently advanced mapping systems for AF ablation in comparison to the established contemporary EAMs...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909484/lyme-arrhythmia-in-an-avid-golfer-a-diagnostic-challenge-and-a-therapeutic-dilemma
#14
Ujjwal Rastogi, Dr Nidhi Kumars
Lyme disease is a multisystem disorder affecting dermatologic, cardiac, nervous and musculoskeletal systems. Cardiac manifestations occur in about 5% of Lyme infections and stem from the involvement of the cardiac conduction system, resulting in varying degrees of sino-atrioventricular block. Occasionally, Lyme infection may also present with myopericarditis. Unlike isolated conduction node disease, myocardial involvement presents a great diagnostic and therapeutic dilemma for the physician. We report the case of a 68 year-old male cardiologist who presented with new onset exertional dyspnea and palpitations...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909479/atrial-fibrillation-ablation-in-adults-with-repaired-congenital-heart-disease
#15
REVIEW
Marta Acena Md, Ignasi Anguera Md PhD, Paolo D Dallaglio Md, Marcos Rodriguez Md, Xavier Sabaté Md PhD
The incidence of atrial fibrillation (AF) in congenital heart disease (CHD) adults has increased in the past decades due to a longer life expectancy of this population where the subjects are exposed to cardiac overflow, overpressure and structural changes for years. The literature regarding AF ablation in repaired CHD adults emphasizes the importance of intracardiac echocardiography (ICE) to perform the transseptal puncture and the ablation procedure in the left atrium (LA), both effectively and safely. In small case control studies, where the predominant congenital cardiomyopathy was the atrial septal defect, the most common strategy for ablation was antral isolation of the pulmonary veins showing results, at one year follow-up, similar to those in the general population...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909477/sotalol-versus-amiodarone-in-treatment-of-atrial-fibrillation
#16
John Somberg Md, Janos Molnar Md
The availability of intravenous (IV) Sotalol has equalized the treatment options since both amiodarone and sotalol are available in both IV and oral formulations. A review of the efficacy of sotalol as compared to amiodarone both for conversion of atrial fibrillation (AF) and maintenance of normal sinus rhythm (NSR) following cardiac surgery was undertaken. Standard methods of meta-analysis were employed. Full text publications of clinical trials written in English that compared the efficacy of sotalol to amiodarone were included in the analysis...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909475/ablation-of-atrial-fibrillation-in-combination-with-left-atrial-appendage-occlusion-in-a-single-procedure-rationale-and-technique
#17
REVIEW
Ignacio García-Bolao, Naiara Calvo, Alfonso Macias, Joaquin Barba, Nahikari Salterain, Pablo Ramos, Gabriel Ballesteros, Renzo Neglia
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and is associated with a fivefold increase in the risk of ischemic stroke and systemic embolism. Left atrial appendage (LAA) is the source of thrombi in up to 90% of patients with nonvalvular atrial fibrillation (AF). Although thromboembolic prophylaxis by means of oral anticoagulants (OAC) has been shown to be very effective (OAC), they also confer an inevitably risk of serious bleeding. Catheter ablation (CA) is an effective treatment for symptomatic AF but its role in stroke prevention remains unproved...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909474/efficacy-high-procedural-safety-and-rapid-optimization-of-cryoballoon-atrial-fibrillation-ablation-in-the-hands-of-a-new-operator
#18
Eberhard Scholz, Patrick Lugenbiel, Patrick A Schweizer, Panagiotis Xynogalos, Claudia Seyler, Edgar Zitron, Rüdiger Becker, Hugo A Katus, Dierk Thomas
BACKGROUND: Cryoballoon (CB) ablation is successful in eliminating atrial fibrillation (AF). PURPOSE: The purpose of this study was to assess procedural efficacy and safety of CB ablation performed by a newly trained operator. METHODS: Forty patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB catheter ablation were prospectively enrolled. RESULTS: Electrical pulmonary vein (PV) isolation was achieved in all patients (156 PVs)...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909473/cryoablation-for-the-treatment-of-drug-refractory-symptomatic-atrial-fibrillation-a-regional-medical-center-experience
#19
Robert Tonks Md, Hiba-Tul-Kareem Sayed Md, Ashley Adams Ba, William T Smith Md Facc
INTRODUCTION: PVI is an effective, guideline-based treatment for drug refractory symptomatic AF. Balloon cryoablation has been shown to be a safe and effective method for PVI. In the STOP-AF trial, data was produced from practitioners performing PVI with significant experience at high volume centers. This study evaluates the effectiveness and safety of treating symptomatic, drug refractory AF with PVI via cryoablation after implementation in a regional medical center. METHOD: This represents a retrospective analysis of outcomes after cryoablation treatment for AF in 71 patients over 354...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909470/clinical-and-economic-implications-of-af-related-stroke
#20
REVIEW
Dr Ali N Ali, Dr Ahmed Abdelhafiz
A major cause of morbidity and mortality among patients with atrial fibrillation (AF) relates to the increased risk of stroke. The burden of illness that AF imparts on stroke is likely to increase with our aging populations and increasingly sophisticated cardiac monitoring techniques. Understanding the clinical and economic differences between AF related ischaemic stroke and non-AF related stroke is important if we are to improve future cost effectiveness analyses of potential preventative treatments, but also to help educate clinical and policy decision makers on use or availability of treatments to prevent AF related stroke...
February 2016: Journal of Atrial Fibrillation
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