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atrial fibrillation heart failure ablation

Shilpkumar Arora, Sopan Lahewala, Byomesh Tripathi, Varshil Mehta, Varun Kumar, Divya Chandramohan, Alejandro Lemor, Mihir Dave, Nileshkumar Patel, Nilay V Patel, Ghanshyam Palamaner Subash Shantha, Juan Viles-Gonzalez, Abhishek Deshmukh
BACKGROUND: Reducing readmission after catheter ablation (CA) in atrial fibrillation (AF) is important. METHODS AND RESULTS: We utilized National Readmission Data (NRD) 2010-2014. AF was identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) diagnostic code 427.31 in the primary field, while first CA of AF was identified via ICD-9 -procedure code 37.34. Any admission within 30 or 90 days of index admission was considered a readmission...
June 15, 2018: Journal of the American Heart Association
Peter Magnusson, Fredrik Gadler, Stellan Mörner
Hypertrophic cardiomyopathy is the most common cardiogenetic disease affecting 1/500-1/1 000 individuals. Dyspnea is common but chest pain, dizziness or fainting may also cause considerable limitation for the patient. The diagnosis can be suspected from ECG. Echocardiography confirms hypertrophy of at least 15 mm, usually in the septum. If the obstruction of the outflow tract is severe, myectomy or alcohol ablation can relieve symptoms. Genetic evaluation of family members is advisable. To reduce symptoms, betablockers are used; verapamil or disopyramide are alternatives...
June 11, 2018: Läkartidningen
Jackson J Liang, David J Callans
AF and heart failure with reduced ejection fraction (HFrEF) frequently coexist. Catheter ablation is an increasingly utilised treatment strategy for patients with AF and can be safely performed and is effective in achieving sinus rhythm for patients with HFrEF. Successful ablation may result in improved LV function, clinical heart failure status, quality of life and possibly even mortality. This review summarises the literature analysing efficacy, safety and outcomes of AF ablation for patients with HFrEF.
May 2018: Cardiac Failure Review
Hee Tae Yu, Pil-Sung Yang, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
BACKGROUND: Catheter ablation is a good treatment option for atrial fibrillation (AF) in young symptomatic patients. However, there is little information on the efficacy of catheter ablation of early-onset AF between sexes.Methods and Results:This study included 1,060 patients under the age 60 years old (837 men, 49.8±7.7 years old, 70.8% paroxysmal AF) who underwent catheter ablation for AF. Sex differences in clinical presentation and ablation outcomes were compared with and without propensity score-matching...
June 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Sérgio Barra, Jakub Baran, Kumar Narayanan, Serge Boveda, Simon Fynn, Patrick Heck, Andrew Grace, Sharad Agarwal, João Primo, Eloi Marijon, Rui Providência
BACKGROUND: Maintenance of sinus rhythm has been associated with lower mortality, but whether atrial fibrillation (AF) ablation per se benefits hard outcomes such as mortality and stroke is still debated. OBJECTIVE: To determine whether AF ablation is associated with a reduction in all-cause mortality and stroke compared with medical therapy alone. METHODS: Literature search looking for both randomized and observational studies comparing AF catheter ablation vs...
September 1, 2018: International Journal of Cardiology
Parag Goyal, Zaid I Almarzooq, Jim Cheung, Hooman Kamel, Udhay Krishnan, Dmitriy N Feldman, Evelyn M Horn, Luke K Kim
BACKGROUND: Atrial fibrillation (AF) and heart failure often occur concomitantly, representing a clinical phenotype at high-risk for poor outcomes. Differences in the characteristics, management, and in-hospital outcomes of AF among those with heart failure with preserved ejection fraction (HFpEF) and those with heart failure with reduced ejection fraction (HFrEF) are not well characterized. METHODS AND RESULTS: Using the National Inpatient Sample, we identified hospitalizations in 2008-2012 for HFpEF and for HFrEF, with and without AF based on ICD-9-CM codes...
September 1, 2018: International Journal of Cardiology
Samuel Sossalla, Dirk Vollmann
BACKGROUND: Heart failure affects 1-2% of the population and is associated with elevated morbidity and mortality. Cardiacarrhythmias are often a result of heart failure, but they can cause left-ventricular systolic dysfunction (LVSD) as an arrhythmiainducedcardiomyopathy (AIC). This causal relationship should be borne in mind by the physician treating a patient with systolicheart failure in association with cardiac arrhythmia. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed (1987-2017) and on therecommendations in current guidelines...
May 11, 2018: Deutsches Ärzteblatt International
Rizwan Ali, Arooj Tahir, Kanna V Posina
Hyperthyroidism is a common metabolic disorder with many cardiovascular manifestations. In rare cases, untreated hyperthyroidism can lead to thyrotoxic cardiomyopathy with severe left ventricular (LV) dysfunction. This case report aims to discuss the pathogenesis of heart failure in hyperthyroidism and the available treatment options. A 51-year-old male with a past history of untreated hyperthyroidism presented to our hospital for the evaluation of shortness of breath and dysphagia. Workup revealed atrial flutter and severe biventricular dilated cardiomyopathy...
April 2, 2018: Curēus
Nassir F Marrouche, Mobin Kheirkhahan, Johannes Brachmann
In the last two decades, catheter ablation of atrial fibrillation (AF) has evolved into a procedure with both efficacy in reduction of AF burden and safety. This has led to changes in guidelines from ESC, AHA/ACC and HRS1, 2 now recommending a catheter ablation procedure as a viable first line treatment option for patients suffering from AF with and without heart failure (HF). Current recommendations are based on relief of symptoms and not prevention of mortality and morbidity.
May 30, 2018: Circulation
Milton Packer, Peter R Kowey
Atrial fibrillation is part of the medical history in >30% of patients with heart failure and a reduced ejection fraction and in >50% of those with a preserved ejection fraction. In general, the arrhythmia does not cause heart failure; but does it contribute to progression of the disease? The treatment of atrial fibrillation has advanced over the past 20 years, as we have moved from antiarrhythmic drugs to catheter ablation. Yet, is intervention beneficial? It is important to relieve disabling symptoms due to paroxysms of the arrhythmia, but this is a valid goal whether heart failure exists or not...
May 30, 2018: Circulation
Stanley Nattel
No abstract text is available yet for this article.
June 1, 2018: Cardiovascular Research
Peter M Kistler, Aleksandr Voskoboinik
No abstract text is available yet for this article.
May 2018: JACC. Clinical Electrophysiology
Safi U Khan, Hammad Rahman, Swapna Talluri, Edo Kaluski
OBJECTIVES: This study sought to compare the efficacy and safety of catheter ablation (CA) with those of medical therapy (MT) for the treatment of atrial fibrillation (AF). BACKGROUND: The preferred therapeutic strategy for subjects with AF remains unclear. METHODS: A total of 17 randomized controlled trials were selected using Medline, EMBASE, and CENTRAL (September 1998 to 2 February 2018). The analysis was stratified at the trial level according to the following: 1) patients with AF and heart failure (HF); and 2) patients with AF without HF...
May 2018: JACC. Clinical Electrophysiology
Yoshimori An, Masahiro Esato, Mitsuru Ishii, Moritake Iguchi, Nobutoyo Masunaga, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Gregory Y H Lip, Masaharu Akao
Management of atrial fibrillation (AF) with current rhythm-control therapy has an uncertain impact on outcomes. Among 3731 patients in the Fushimi AF Registry, a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, we investigated the characteristics and outcomes in 478 patients receiving rhythm-control therapy (anti-arrhythmic drug and/or catheter ablation) alone, with 1279 patients receiving rate-control therapy (beta-blockers, calcium channel blockers, and digoxin) alone serving as a reference...
May 24, 2018: Heart and Vessels
Mauricio Scanavacca, Edimar Alcides Bocchi
No abstract text is available yet for this article.
April 2018: Arquivos Brasileiros de Cardiologia
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
Douglas L Packer, Daniel B Mark, Richard A Robb, Kristi H Monahan, Tristram D Bahnson, Kathleen Moretz, Jeanne E Poole, Alice Mascette, Yves Rosenberg, Neal Jeffries, Hussein R Al-Khalidi, Kerry L Lee
The Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA,NCT00911508)(1) trial is testing the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of eliminating atrial fibrillation (AF) is superior to current state-of-the-art pharmacologic therapy. This international 140-center clinical trial was designed to randomize 2200 patients to a strategy of catheter ablation versus state-of-the-art rate or rhythm control drug therapy. Inclusion criteria include: 1) age> 65, or ≤65 with≥ 1 risk factor for stroke, 2) documented AF warranting treatment, and 3) eligibility for both catheter ablation and≥ 2 anti-arrhythmic or≥ 2 rate control drugs...
May 2018: American Heart Journal
Jinhee Ahn, Hyun Jung Kim, Jeong Cheon Choe, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Kwang Soo Cha, Taek Jong Hong, Young-Hoon Kim
BACKGROUND: Atrial fibrillation (AF) frequently coexists with heart failure (HF) with reduced ejection fraction (EF). This meta-analysis compared AF control strategies, that is, rhythm vs. rate, and catheter ablation (CA) vs. anti-arrhythmic drugs (AAD) in patients with AF combined with HF.Methods and Results:The MEDLINE, EMBASE, and CENTRAL databases were searched, and 13 articles from 11 randomized controlled trials with 5,256 patients were included in this meta-analysis. The outcomes were echocardiographic parameters (left ventricular EF, LVEF), left atrial (LA) size, and left ventricular end-systolic volume, LVESV), clinical outcomes (mortality, hospitalization, and thromboembolism), exercise capacity, and quality of life (QOL)...
April 27, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Takafumi Oka, Koichi Inoue, Koji Tanaka, Yuichi Ninomiya, Yuko Hirao, Nobuaki Tanaka, Masato Okada, Hiroyuki Inoue, Ryo Nakamaru, Yasushi Koyama, Atsunori Okamura, Katsuomi Iwakura, Yasushi Sakata, Kenshi Fujii
The efficacy of catheter ablation (CA) of nonparoxysmal atrial fibrillation (PAF) in patients with left ventricular systolic dysfunction is controversial. We investigated the outcomes of CA for non-PAF in patients with reduced left ventricular ejection fraction (LVEF) and the impact of early left atrial (LA) reverse remodeling on these outcomes. A total of 251 consecutive patients who underwent CA for non-PAF were divided into 2 groups (reduced: preoperative LVEF ≤55%, LVEF: 46.5 ± 8.7%, n = 63; normal: >55%, 65...
March 29, 2018: American Journal of Cardiology
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