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https://www.readbyqxmd.com/read/29148592/oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#1
Kathrin Jobski, Falk Hoffmann, Stefan Herget-Rosenthal, Michael Dörks
AIMS: Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA. METHODS: Using claims data (2010-2014), we studied a cohort of new nursing home residents aged ≥ 65 years receiving OAC...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29148156/long-term-outcomes-for-different-surgical-strategies-to-treat-left-ventricular-outflow-tract-obstruction-in-hypertrophic-cardiomyopathy
#2
Richard Collis, Oliver Watkinson, Constantinos O'Mahony, Oliver P Guttmann, Antonis Pantazis, Maria Tome-Esteban, Victor Tsang, Venkatachalam Chandrasekaran, Christopher G A McGregor, Perry M Elliott
AIMS: Surgical intervention is used to treat dynamic left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy. This study assesses the effect of different surgical strategies on long-term mortality and morbidity. METHODS AND RESULTS: In total, 347 patients underwent surgical intervention for LVOTO (1988-2015). Group A (n = 272) underwent septal myectomy; Group B (n = 33), septal myectomy and mitral valve (MV) repair; Group C (n = 22), myectomy and MV replacement; and Group D (n = 20), MV replacement alone...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#3
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#4
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#5
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#6
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142379/dyspnea-eosinopenia-consolidation-acidemia-and-atrial-fibrillation-score-and-bap-65-score-tools-for-prediction-of-mortality-in-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-a-comparative-pilot-study
#7
Viral Sangwan, Dhruva Chaudhry, Roopa Malik
Introduction: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) being common and often fatal, prognostic tools in AECOPD are lacking. Materials and Methods: A prospective, observational study was carried out in fifty patients of AECOPD admitted in A and E department. Dyspnea, Eosinopenia, Consolidation, Acidemia and atrial Fibrillation (DECAF) score and elevated blood urea nitrogen, altered mental status, pulse >109, age >65 (BAP-65) score were calculated...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142156/outcomes-of-rate-control-treatment-in-patients-with-atrial-fibrillation-and-heart-failure%C3%A3-a-nationwide-cohort-study
#8
Hee Tae Yu, Pil-Sung Yang, Hancheol Lee, Seng Chan You, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Rate control is now a front-line therapy in the management of atrial fibrillation (AF). However, the survival benefits of different rate-control medications remain controversial, so we assessed the efficacy of rate-control medications in AF patients with concomitant heart failure (HF).Methods and Results:From January 2002 to December 2008, a total of 7,034 AF patients with a single type of rate-control drug or without rate-control treatment were enrolled from the Korea National Health Insurance Service database...
November 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29141843/stable-sr-electrophysiological-substrate-ablation-in-the-left-atrium-during-sinus-rhythm-for-the-treatment-of-nonparoxysmal-atrial-fibrillation-a-prospective-multicenter-randomized-clinical-trial
#9
Bing Yang, Chenyang Jiang, Yazhou Lin, Gang Yang, Huimin Chu, Heng Cai, Fengmin Lu, Xianzhang Zhan, Jian Xu, Xinhua Wang, Chi-Keong Ching, Balbir Singh, Young-Hoon Kim, Minglong Chen
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) alone or combined with adjuvant substrate modifications is unsatisfactory for atrial fibrillation (AF) control in nonparoxysmal AF patients. Ablation targeting the fibrotic areas after CPVI (STABLE-SR [Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm]) is a newly evolved substrate modification strategy. METHODS AND RESULTS: In this multicenter, randomized clinical trial, 229 symptomatic nonparoxysmal AF patients were 1:1 randomized to STABLE-SR group (n=114) or conventional STEPWISE group (n=115)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29141842/treatment-of-atrial-fibrillation-and-concordance-with-the-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guidelines-findings-from-orbit-af-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation
#10
Adam S Barnett, Sunghee Kim, Gregg C Fonarow, Laine E Thomas, James A Reiffel, Larry A Allen, James V Freeman, Gerald Naccarelli, Kenneth W Mahaffey, Alan S Go, Peter R Kowey, Jack E Ansell, Bernard J Gersh, Elaine M Hylek, Eric D Peterson, Jonathan P Piccini
BACKGROUND: It is unclear how frequently patients with atrial fibrillation receive guideline-concordant (GC) care and whether guideline concordance is associated with improved outcomes. METHODS AND RESULTS: Using data from ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), we determined how frequently patients received care that was concordant with 11 recommendations from the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation guidelines pertaining to antithrombotic therapy, rate control, and antiarrhythmic medications...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29141274/use-of-direct-oral-anticoagulants-in-the-first-year-after-market-entry-of-edoxaban-a-danish-nationwide-drug-utilization-study
#11
Anton Pottegård, Erik L Grove, Maja Hellfritzsch
OBJECTIVES: To describe the early uptake of edoxaban; the fourth direct oral anticoagulant (DOAC) to enter the market. METHODS: Using the Danish nationwide health registries, we identified new users of edoxaban (n = 609) from June 6 (day of marketing) through June 2017. For comparison, we also identified new users of dabigatran (n = 2211), rivaroxaban (n = 19 227), and apixaban (n = 14 736). Users were described regarding indication of use, previous anticoagulant experience, comorbidity, and co-medication...
November 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#12
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29136617/prognostic-factors-in-patients-with-an-implanted-pacemaker-after-80-years-of-age-in-a-4-year-follow-up
#13
Krystyna Krzemień-Wolska, Andrzej Tomasik, Celina Wojciechowska, Karolina Barańska-Pawełczak, Ewa Nowalany-Kozielska, Wojciech Jacheć
BACKGROUND: The controversy over electrotherapy for patients aged >80 years occurs already at the stage of qualification for this treatment type and concerns optimal device selection, the implantation strategy, and the overall benefit from pacemaker therapy. The group also has a considerable number of cardiovascular risk factors, and the data from the literature on the impact of the pacing mode on the remote prognosis of this group are ambiguous. OBJECTIVE: Assessment of the risk factors for death among patients with implanted pacemakers >80 years of age in a 4-year follow-up...
November 15, 2017: Gerontology
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#14
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29136152/concomitant-thoracoscopic-surgery-for-solitary-pulmonary-nodule-and-atrial-fibrillation
#15
Rongxin Lu, Ju Mei, Dongfang Zhao, Zhaolei Jiang, Haibo Xiao, Mingsong Wang, Nan Ma
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation...
November 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29135285/factors-associated-with-confidence-in-decision-making-and-satisfaction-with-risk-communication-among-patients-with-atrial-fibrillation
#16
Berith Hedberg, Dan Malm, Jan-Erik Karlsson, Kristofer Årestedt, Anders Broström
BACKGROUND: Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making. AIM: The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms...
November 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29135066/developing-and-sustaining-a-career-as-a-transdisciplinary-nurse-scientist
#17
Kathleen T Hickey
PURPOSE: The purpose of this article is to provide an overview of strategies to build and sustain a career as a nurse scientist. This article examines how to integrate technologies and precision approaches into clinical practice, research, and education of the next generation of nursing scholars. DESIGN: This article presents information for shaping a sustainable transdisciplinary career. Programs of research that utilize self-management to improve quality of life are discussed throughout the article...
November 14, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/29134434/fluoroscopy-free-af-ablation-using-transesophageal-echocardiography-and-electroanatomical-mapping-technology
#18
Benjamin O'Brien, Damian C Balmforth, Ross J Hunter, Richard J Schilling
PURPOSE: Guidelines recommend that radiation exposure during AF catheter ablation procedures should be 'as low as reasonably achievable' (ALARA), particularly since many patients may have multiple procedures. Consequently, avoiding radiation exposure altogether must, if safe to do so, be the ultimate goal. The primary objective was to determine the feasibility and efficacy of fluoroscopy-free AF ablation compared to the fluoroscopy-assisted procedure. METHODS: Patients underwent AF ablation using commercially available technology with no routine pre-procedural imaging...
November 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29132510/indications-and-methods-of-anticoagulation-reversal
#19
REVIEW
Jeremy L Holzmacher, Babak Sarani
The use of anticoagulation in the prevention of strokes due to atrial fibrillation or the treatment of venous thromboembolic disease has been on the rise. With the advent and proliferation of direct oral anticoagulation medications, the management of anticoagulation reversal has become increasingly complex, especially when urgent or emergent reversal is required. This review details the commonly used parenteral and oral anticoagulants, the treatment strategies necessary for their reversal, and therapies still in development...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132262/diastolic-dysfunction-is-common-in-survivors-of-pediatric-differentiated-thyroid-carcinoma
#20
Mariëlle Sanne Klein Hesselink, Gianni Bocca, Yoran M Hummel, Adrienne H Brouwers, Johannes G M Burgerhof, Eveline W C M van Dam, Jourik A Gietema, Bas Havekes, Marry M van den Heuvel-Eibrink, Eleonora P M Corssmit, Leontien Kremer, Romana Netea-Maier, Helena J H van der Pal, Robin Peeters, John Th M Plukker, Cécile M Ronckers, Hanneke M van Santen, Peter van der Meer, Thera P Links, Wim J E Tissing
INTRODUCTION: Whether pediatric patients with differentiated thyroid carcinoma (DTC) are at risk of developing treatment-related adverse effects on cardiac function is unknown. We therefore studied in long-term survivors of pediatric DTC the prevalence of cardiac dysfunction and atrial fibrillation (AF) in relation to treatment variables, and the association between cardiac dysfunction and plasma biomarkers. PATIENTS AND METHODS: In this nationwide prospective multicenter study, cardiac assessments were performed in 66 adult survivors of pediatric DTC (age at diagnosis ≤18 years and follow-up ≥5 years after diagnosis) treated in The Netherlands between 1970 and 2009...
November 13, 2017: Thyroid: Official Journal of the American Thyroid Association
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