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Atrial fibrilation stroke

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https://www.readbyqxmd.com/read/29156015/european-prospective-multicentre-study-of-hybrid-thoracoscopic-and-transcatheter-ablation-of-persistent-atrial-fibrillation-the-historic-af-trial
#1
Claudio Muneretto, Gianluigi Bisleri, Fabrizio Rosati, Ralf Krakor, Laura Giroletti, Lorenzo Di Bacco, Alberto Repossini, Massimo Moltrasio, Antonio Curnis, Claudio Tondo, Gianluca Polvani
OBJECTIVES: The HISTORIC-AF trial is a prospective, multicentre, single-arm study designed to evaluate the outcomes of a staged endoscopic and transcatheter ablation in patients with stand-alone, persistent or long-standing persistent atrial fibrillation (AF). METHODS: From 2012 to 2015, 100 consecutive patients were enrolled and underwent thoracoscopic left atrial epicardial isolation ('box lesion') followed by transcatheter ablation in case of AF recurrency. The safety end point was the composite outcome of freedom from major adverse events at 30-days, while efficacy end points were: (i) primary: freedom from AF and stable sinus rhythm following isolated thoracospic ablation >60% and (ii) secondary: freedom from AF and stable sinus rhythm >80% following hybrid ablation (as per HRS criteria)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155884/the-importance-of-mean-time-in-therapeutic-range-for-complication-rates-in-warfarin-therapy-of-patients-with-atrial-fibrillation-a-systematic-review-and-meta-regression-analysis
#2
Anne Sig Vestergaard, Flemming Skjøth, Torben Bjerregaard Larsen, Lars Holger Ehlers
BACKGROUND: \Anticoagulation is used for stroke prophylaxis in non-valvular atrial fibrillation, amongst other by use of the vitamin K antagonist, warfarin. Quality in warfarin therapy is often summarized by the time patients spend within the therapeutic range (percent time in therapeutic range, TTR). The correlation between TTR and the occurrence of complications during warfarin therapy has been established, but the influence of patient characteristics in that respect remains undetermined...
2017: PloS One
https://www.readbyqxmd.com/read/29153576/coronary-artery-calcium-and-long-term%C3%A2-risk-of-death-myocardial%C3%A2-infarction-and-stroke-the-walter-reed-cohort-study
#3
Joshua D Mitchell, Robert Paisley, Patrick Moon, Eric Novak, Todd C Villines
OBJECTIVES: This study aimed to assess the long-term risk of death and atherosclerotic cardiovascular disease (ASCVD) outcomes, including stroke, in a real-world cohort that underwent coronary artery calcium (CAC) scoring. BACKGROUND: Large-scale, long-term studies assessing the independent relationship of CAC for prediction of ASCVD events, to include stroke, in young, low-risk patients are uncommon outside of the clinical trial setting. METHODS: A total of 23,637 consecutive subjects without ASCVD who underwent CAC scoring from 1997 to 2009 were studied...
November 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29153246/usefulness-of-the-american-heart-association-s-life-simple-7-to-predict-the-risk-of-atrial-fibrillation-from-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-study
#4
Parveen K Garg, Wesley T O'Neal, Adedotun Ogunsua, Evan L Thacker, George Howard, Elsayed Z Soliman, Mary Cushman
The American Heart Association has identified metrics of ideal cardiovascular (CV) health known as Life's Simple 7 (LS7). We determined the prospective relationship between the LS7 and the incident atrial fibrillation (AF) in a biracial cohort. The REasons for Geographic And Racial Differences in Stroke (REGARDS) study enrolled non-Hispanic black and white adults 45 years or older. This analysis included 9,576 REGARDS participants (mean age 63 ± 8.4 years; 57% women; 30% black) who were free of AF at baseline and completed a follow-up examination 9...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#5
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#6
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29149516/feasibility-of-percutaneous-left-atrial-appendage-closure-using-a-novel-lambre-occluder-in-patients-with-atrial-fibrillation-initial-results-from-a-prospective-cohort-registry-study
#7
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Takahiko Nagase, Nikolaos Tsianakas, Laura Perrotta, K R Julian Chun
BACKGROUND: The LAmbreۛ occluder is a novel device for percutaneous left atrial appendage closure (LAAC). The presented study aimed to report the initial experience in implantation of the novel LAmbre for LAAC in patients with non-valvular AF. METHODS: We conducted a prospective, observational, cohort registry study to evaluate the feasibility of percutaneous LAAC using the LAmbre occlude. RESULTS: Thirty patients (15 female, mean age 77...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29148592/oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#8
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
#9
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/29148038/visual-field-defect-after-ischemic-stroke-impact-on-mortality
#10
K M Sand, H Naess, L Thomassen, J M Hoff
OBJECTIVES: We aimed to investigate the impact of visual field defects (VFD) on mortality in ischemic stroke patients. MATERIALS AND METHODS: All patients with acute infarction and a clinically detected VFD from February 2006 to December 2013 in the NORSTROKE Registry (n = 506) were included and compared with ischemic stroke patients with normal visual fields (n = 2041). A record of patients who had died per ultimo April 2015 was obtained from the central registry at Haukeland University Hospital...
November 17, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#11
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/29146875/risk-of-stroke-in-patients-with-short-run-atrial-tachyarrhythmia
#12
Shinya Yamada, Chin-Yu Lin, Shih-Lin Chang, Tze-Fan Chao, Yenn-Jiang Lin, Li-Wei Lo, Fa-Po Chung, Yu-Feng Hu, Ta-Chuan Tuan, Jo-Nan Liao, Abigail Louise D Te, Yao-Ting Chang, Ting-Yung Chang, Cheng-I Wu, Satoshi Higa, Shih-Ann Chen
BACKGROUND AND PURPOSE: The risk of stroke in patients with short-run atrial tachyarrhythmia (AT) remains unclear. This study aimed to investigate the relationship between short-run AT and the stroke and the use of the CHA2DS2-VASc score for the risk stratification. METHODS: From the registry of 24-hour Holter monitoring, 5342 subjects without known atrial fibrillation or stroke were enrolled. Short-run AT was defined as episodes of supraventricular ectopic beats <5 seconds...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29146668/percutaneous-left-atrial-appendage-closure-current-devices-and-clinical-outcomes
#13
REVIEW
Lluis Asmarats, Josep Rodés-Cabau
Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29145948/type-of-atrial-fibrillation-and-outcomes-in%C3%A2-patients-with-heart-failure-and-reduced%C3%A2-ejection%C3%A2-fraction
#14
Ulrik M Mogensen, Pardeep S Jhund, William T Abraham, Akshay S Desai, Kenneth Dickstein, Milton Packer, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Michael R Zile, Lars Køber, John J V McMurray
BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), but the outcome by type of AF is largely unknown. OBJECTIVES: This study investigated outcomes related to type of AF (paroxysmal, persistent or permanent, or new onset) in 2 recent large trials in patients with HF with reduced ejection fraction. METHODS: The study analyzed patients in the PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure) trials...
November 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29145634/risk-profiles-for-acute-health-events-after-incident-atrial-fibrillation-in-patients-with-end-stage-renal-disease-on-hemodialysis
#15
Medha Airy, Tara I Chang, Victoria Y Ding, Benjamin A Goldstein, Nisha Bansal, Jingbo Niu, Sankar D Navaneethan, Mintu P Turakhia, Wolfgang C Winkelmayer
Background: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). Methods: We studied older US patients who newly initiated HD for ESRD (2006-11) and who had not previously been diagnosed with AF, stroke, myocardial infarction (MI) or hip fracture. We used Cox regression with AF as a time-varying covariate, adjusted for socio-demographic characteristics and comorbidities to estimate hazard ratios [HRs (95% confidence intervals)] for the events of ischemic stroke, MI and death...
November 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29144514/catheter-ablation-of-atrial-fibrillation-in-elderly-population
#16
Josef Kautzner, Petr Peichl, Marek Sramko, Robert Cihak, Bashar Aldhoon, Dan Wichterle
Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#17
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/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
#18
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/29141778/pathophysiology-and-risk-of-atrial-fibrillation-detected-after-ischemic-stroke-paradise-a-translational-integrated-and-transdisciplinary-approach
#19
Maryse Paquet, Joshua O Cerasuolo, Victoria Thorburn, Sebastian Fridman, Rasha Alsubaie, Renato D Lopes, Lauren E Cipriano, Paula Salamone, C W James Melling, Ali R Khan, Lucas Sedeño, Jiming Fang, Maria Drangova, Manuel Montero-Odasso, Jennifer Mandzia, Alexander V Khaw, Juan M Racosta, Justin Paturel, Lucy Samoilov, Devin Stirling, Brittany Balint, Victoria Jaremek, Marlys L Koschinsky, Michael B Boffa, Kelly Summers, Agustín Ibañez, Marko Mrkobrada, Gustavo Saposnik, Kurt Kimpinski, Shawn N Whitehead, Luciano A Sposato
BACKGROUND: It has been hypothesized that ischemic stroke can cause atrial fibrillation. By elucidating the mechanisms of neurogenically mediated paroxysmal atrial fibrillation, novel therapeutic strategies could be developed to prevent atrial fibrillation occurrence and perpetuation after stroke. This could result in fewer recurrent strokes and deaths, a reduction or delay in dementia onset, and in the lessening of the functional, structural, and metabolic consequences of atrial fibrillation on the heart...
November 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#20
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
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