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Paroxysmal atrial fibrillation oral anticoagulant

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https://www.readbyqxmd.com/read/29688312/a-prospective-5-year-follow-up-after-population-based-systematic-screening-for-atrial-fibrillation
#1
Johan Engdahl, Anders Holmén, Mårten Rosenqvist, Ulf Strömberg
Aims: Thrombo-embolic stroke risk in atrial fibrillation (AF) is significantly reduced with oral anticoagulant (OAC) treatment. Atrial fibrillation is often asymptomatic (silent) and therefore undiagnosed. The long-term course of silent AF as well as OAC treatment adherence after AF screening is not known. We aim at studying long-term adherence to OAC treatment, AF symptoms, and stroke incidence on population level after systematic AF screening. Methods and results: All inhabitants in a Swedish municipality who were born in 1934 and 1935 (n = 1335) were invited to participate in an AF screening trial between 2010 and 2012...
April 24, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29549695/district-vs-academic-hospitals-differences-in-the-clinical-characteristics-of-patients-with-af-without-valvular-heart-disease-treated-with-oral-anticoagulants
#2
Janusz Bednarski, Paweł Balsam, Agata Tymińska, Krzysztof Ozierański, Katarzyna Żukowska, Martyna Zaleska, Katarzyna Szepietowska, Kacper Maciejewski, Michał Peller, Anna Praska-Oginska, Inna Zaboyska, Grzegorz Opolski
INTRODUCTION Atrial fibrillation (AF) is the most common cardiac arrhythmia with a significant risk of morbidity and mortality. Non-vitamin K antagonists (NOAC) are the first line drugs in stroke prevention in AF patients. The oral anticoagulation therapy (OAC) therapy may differ between medical centres. OBJECTIVES The study aimed to compare the clinical characteristic of AF patients treated with OAC between district and academic hospitals. PATIENTS AND METHODS This analysis consisted of 3528 patients from the multicentre, retrospective CRAFT study (NCT02987062): 2666 patients from academic hospital (Group A) and 862 patients from district hospital (Group B)...
March 17, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29547906/combined-atrial-fibrillation-ablation-and-left-atrial-appendage-closure-long-term-follow-up-from-a-large-multicentre-registry
#3
Lisette Wintgens, Aleksandr Romanov, Karen Phillips, Gabriel Ballesteros, Martin Swaans, Richard Folkeringa, Ignacio Garcia-Bolao, Evgeny Pokushalov, Lucas Boersma
Aims: Long-term freedom from atrial fibrillation (AF) after catheter ablation (CA) and consequently the potential for stroke reduction remain unpredictable. Percutaneous left atrial appendage closure (LAAC) is an effective mechanical alternative to oral anticoagulation (OAC) for stroke prevention in AF patients. This study aims to evaluate long-term clinical results of combined CA and LAAC in one single procedure. Methods and results: Patients with non-valvular AF who underwent combined CA and LAAC procedure were included in the retrospective compilation of independent prospective general LAAC registries at the individual centres...
March 13, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29546729/stroke-prevention-strategies-in-north-american-patients-with-atrial-fibrillation-the-gloria-af-registry-program
#4
William F McIntyre, David Conen, Brian Olshansky, Jonathan L Halperin, Emil Hayek, Menno V Huisman, Gregory Y H Lip, Shihai Lu, Jeff S Healey
BACKGROUND: Antithrombotic prophylaxis with oral anticoagulation (OAC) substantially reduces stroke and mortality in patients with atrial fibrillation (AF). HYPOTHESIS: Analysis of data in the Global Registry on Long-Term Antithrombotic Treatments in Patients With Atrial Fibrillation (GLORIA-AF), an international, observational registry of patients with newly diagnosed AF, can identify factors associated with treatment decisions and outcomes. METHODS: Multivariable regression identified patient, physician, and temporal factors associated with OAC prescription, compared with management with antiplatelet drugs or no antithrombotic drugs in North American patients enrolled between November 2011 and February 2014...
March 15, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29502944/registry-of-japanese-patients-with-atrial-fibrillation-focused-on-anticoagulant-therapy-in-the-new-era-the-raffine-registry-study-design-and-baseline-characteristics
#5
Sakiko Miyazaki, Katsumi Miyauchi, Hidemori Hayashi, Ryota Tanaka, Shuko Nojiri, Tadashi Miyazaki, Masataka Sumiyoshi, Satoru Suwa, Yuji Nakazato, Takao Urabe, Nobutaka Hattori, Hiroyuki Daida
BACKGROUND: The management of atrial fibrillation (AF) has evolved with the development of direct oral anticoagulants (DOACs), but data on their clinical effectiveness and safety outside clinical trial settings are limited. METHOD: The RAFFINE registry is an observational, multicenter, prospective registry of Japanese patients with AF, designed to follow clinical events over 3 years. Patient enrollment was conducted from 2013 to 2015 at university hospitals, general hospitals, and private clinics to ensure inclusion of a broad spectrum of representative AF patients...
June 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29453328/management-of-atrial-fibrillation-in-patients-with-rheumatic-mitral-stenosis
#6
REVIEW
Bernard Iung, Antoine Leenhardt, Fabrice Extramiana
Atrial fibrillation (AF) is frequent in patients with rheumatic mitral stenosis (MS). Pressure overload leads to marked structural and electrical remodelling of left atrium. The frequency of persistent AF increases with age and paroxysmal, asymptomatic, AF seems even more frequent. The occurrence of AF worsens the haemodynamic tolerance of MS and markedly increases the risk of thromboembolic events. AF has a negative impact on the natural history of MS and on its outcome after commissurotomy. The respective indications of rhythm and rate control should be adapted to patient characteristics, particularly the consequences of MS, and take into account the high risk of recurrence of AF...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29436194/comparison-of-rhythm-and-rate-control-strategies-for-stroke-occurrence-in-a-prospective-cohort-of-atrial-fibrillation-patients
#7
COMPARATIVE STUDY
Yu Jeong Choi, Ki Woon Kang, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung
PURPOSE: Comparisons of rhythm and rate control strategies for stroke prevention in patients with atrial fibrillation (AF) are still inconclusive. We compared differences in clinical outcomes between the rhythm and rate control strategies. MATERIALS AND METHODS: The COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry prospectively enrolled 6000 patients who were treated for AF using real-world guideline adherence at multiple referral centers...
March 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29404874/direct-oral-anti-coagulants-compared-to-vitamin-k-antagonists-in-cardioversion-of-atrial-fibrillation-an-updated-meta-analysis
#8
REVIEW
Natale Daniele Brunetti, Nicola Tarantino, Luisa De Gennaro, Michele Correale, Francesco Santoro, Matteo Di Biase
Pharmacological or electrical cardioversion allows immediate symptoms improvement in the setting of paroxysmal or persistent atrial fibrillation (AF), although the periprocedural risk of systemic embolism should be considered. Recently, there was a great interest on the safety and efficacy of direct oral anticoagulants (DOACs) when used for the cardioversion of non-valvular AF. We performed a random-effects meta-analysis of patients undergoing both electrical and pharmacologic cardioversion for non-valvular AF in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, X-VeRT, ENSURE-AF, and EMANATE trials...
May 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29371374/reasons-for-and-consequences-of-oral-anticoagulant-underuse-in-atrial-fibrillation-with-heart-failure
#9
Gianluigi Savarese, Ulrik Sartipy, Leif Friberg, Ulf Dahlström, Lars H Lund
OBJECTIVE: Atrial fibrillation (AF) is common in patients with heart failure (HF), and oral anticoagulants (OAC) are indicated. The aim was to assess prevalence of, predictors of and consequences of OAC non-use. METHODS: We included patients with AF, HF and no previous valve replacement from the Swedish Heart Failure Registry. High and low CHA2 DS2 -VASc and HAS-BLED scores were defined as above/below median. Multivariable logistic regressions were used to assess the associations between baseline characteristics and OAC use and between CHA2 DS2 -VASc and HAS-BLED scores and OAC use...
January 25, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29297187/evaluation-of-the-recommended-prevention-of-thrombosis-in-hospitalised-patients-with-atrial-fibrillation-and-high-thromboembolism-risk
#10
Iwona Gorczyca, Beata Wożakowska-Kapłon, Katarzyna Starzyk, Anna Szpotowicz, Anna Stec
BACKGROUND: According to the applicable guidelines for stroke prevention, patients with a high risk of thromboembolic com-plications should receive oral anticoagulants. AIM: The objective of the present study is to evaluate the prevention of thrombosis in patients with diagnosed atrial fibrillation (AF) on discharge and a high risk of stroke. METHODS: The present study is a retrospective single-centre registry. The analysis was carried out on the basis of the data on 4099 patients with non-valvular AF, who were discharged from the cardiology department in the years 2004-2012...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29223435/atrial-fibrillation-decision-support-tool-population-perspective
#11
Mark H Eckman, Alexandru Costea, Mehran Attari, Jitender Munjal, Ruth E Wise, Carol Knochelmann, Matthew L Flaherty, Pete Baker, Robert Ireton, Brett M Harnett, Anthony C Leonard, Dylan Steen, Adam Rose, John Kues
BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29181265/off-label-use-of-direct-oral-anticoagulants-for-left-ventricular-thrombus-is-it-appropriate
#12
George Degheim, Abeer Berry, Marcel Zughaib
A 57 year old gentleman with a history of non-ischemic cardiomyopathy and paroxysmal atrial fibrillation presented with worsening lower extremity edema and dyspnea on exertion. He had been compliant with his medications including rivaroxaban (Xarelto) for atrial fibrillation that he takes with the evening meal daily. His echocardiogram showed an ejection fraction of 10-15% and a new left ventricle (LV) apical thrombus. During his hospital stay, he developed right sided weakness. Magnetic Resonance Imaging showed a subacute infarct involving the left parietal lobe...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/29171211/a-prospective-survey-of-atrial-fibrillation-management-for-real-world-guideline-adherence-comparison-study-of-drugs-for-symptom-control-and-complication-prevention-of-atrial-fibrillation-code-af-registry
#13
Hyeongsoo Kim, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Ki Woon Kang, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung
BACKGROUND AND OBJECTIVES: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. METHODS: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea...
November 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29016369/newly-developed-left-ventricular-apical-thrombus-under-dabigatran-treatment
#14
Adem Adar, Orhan Onalan, Fahri Cakan
: Left ventricular (LV) thrombi are mostly formed in the aneurysmal or akinetic segment of the LV apex. Thromboembolism to the brain is usually fatal. There is not enough information available regarding the use of these new oral anticoagulant agents in LV thrombi. In this case, we present a 56-year-old male patient who was given dabigatran (150 mg, twice a day) for paroxysmal atrial fibrillation after experiencing anterior myocardial infarction. During the use of dabigatran, thrombus formation, which was not present earlier, was observed in the LV apical aneurysm...
January 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28972957/comparison-of-different-oral-anticoagulant-regimens-in-patients-with-atrial-fibrillation-undergoing-ablation-or-cardioversion
#15
Monika Gawałko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Aldona Babiarz, Aleksandra Bodys, Robert Uliński, Maciej Żochowski, Michał Peller, Piotr Scisło, Janusz Kochanowski, Krzysztof J Filipiak, Grzegorz Opolski
INTRODUCTION    Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). OBJECTIVES    The aim of the study was to assess the incidence of left atrial appendage (LAA) thrombus and dense spontaneous echo contrast (SEC), as well as to compare the clinical characteristics of patients with AF treated with different anticoagulant regimens. PATIENTS AND METHODS    We studied 1033 consecutive patients with AF, who underwent transesophageal echocardiography (TEE) before AF ablation or cardioversion...
December 22, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28955382/atrial-fibrillation-in-heart-failure-a-therapeutic-challenge-of-our-times
#16
REVIEW
Syeda Atiqa Batul, Rakesh Gopinathannair
Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of "atrial kick" translates into poorer quality of life and increased mortality...
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28935034/persistence-with-dabigatran-therapy-at-2%C3%A2-years-in-patients-with-atrial-fibrillation
#17
Miney Paquette, Lionel Riou França, Christine Teutsch, Hans-Christoph Diener, Shihai Lu, Sergio J Dubner, Chang Sheng Ma, Kenneth J Rothman, Kristina Zint, Jonathan L Halperin, Menno V Huisman, Gregory Y H Lip, Robby Nieuwlaat
BACKGROUND: Guidelines recommend long-term oral anticoagulation therapy for stroke prevention in patients with atrial fibrillation (AF). Treatment discontinuation rates in vitamin K antagonist (VKA)-treated patients are high but may be lower with non-VKA oral anticoagulant agents. OBJECTIVES: The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up. METHODS: Consecutive patients newly diagnosed with AF and ≥1 stroke risk factor were followed up for 2 years...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28867157/-fine-tuning-of-antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-the-afinva-register
#18
Daniela Dubois Marques, Vicente Mora Llabata, Julián Pacheco Arroyo, Salvador Gasull Insertis, Manuela Vicente Cañizares, Ildefonso Roldán Torres
OBJECTIVE: To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines. DESIGN: Prospective observational study. LOCATION: Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain. PARTICIPANTS: A total of 505 patients with nonvalvular atrial fibrillation were included in the study...
August 31, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28858739/spontaneous-non-traumatic-mediastinal-hematoma-associated-with-oral-anticoagulant-therapy-a-case-report-and-literature-review
#19
Masashi Mikubo, Dai Sonoda, Hirotsugu Yamazaki, Masahito Naito, Yoshio Matsui, Kazu Shiomi, Yukitoshi Satoh
INTRODUCTION: Mediastinal hematoma is usually caused by thoracic trauma or a ruptured aortic aneurysm. Spontaneous non-traumatic mediastinal hematomas are rare but potentially life-threatening conditions that can occur in patients taking anticoagulants. PRESENTATION OF CASE: We report a case of 72-year-old man with a massive mediastinal hematoma associated with anticoagulant therapy. He had complained of acute chest discomfort and subsequent tarry diarrhea. Because he had been taking warfarin for paroxysmal atrial fibrillation, an upper gastrointestinal hemorrhage was initially suspected, but no bleeding was detected by upper endoscopy...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28853765/pulmonary-embolism-four-days-after-interruption-of-therapy-with-rivaroxaban
#20
Gabor Göndör, Claudia Stöllberger
Thrombosis after cessation of anticoagulation, also named rebound thrombosis, is a matter of concern and controversy. There are only few published data about occurrence of rebound thrombosis associated with non-vitamin K-antagonist oral anticoagulant drugs (NOACs). We report on a 58-year-old male with paroxysmal atrial fibrillation (AF) with a CHA2 DS2 VASC score of 4 who developed central pulmonary embolism four days after interruption of rivaroxaban because of parotid surgery. He had received 40 mg enoxaparin/d...
October 26, 2017: Hämostaseologie
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