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Atrial fibrilation guidelines

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https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#1
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28698895/using-anatomical-landmark-to-avoid-phrenic-nerve-injury-during-balloon-based-procedures-in-atrial-fibrillation-patients
#2
Nicolina M Smith, Larry Segars, Travis Kauffman, Anthony B Olinger
PURPOSE: Atrial fibrillation (AF) is an arrhythmia which affects as many as 2.7 million Americans. AF should be treated, because it can lead to a four-to-fivefold increased risk of experiencing a stroke. The American College of Cardiology/American Heart Association guidelines for the treatment of drug refractory and symptomatic paroxysmal AF denote catheter ablation as the standard of care. The newest ablation treatment, cryoballoon, uses a cold balloon tip. The biggest risk factor associated with the cryoballoon ablation is phrenic nerve injury (PNI)...
July 11, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28694186/the-role-of-exercise-in-atrial-fibrillation-prevention-and-promotion-finding-optimal-ranges-for-health
#3
Adrian D Elliott, Benjamin Maatman, Michael S Emery, Prashanthan Sanders
The cardiovascular benefits of regular exercise have been well described, including a significant reduction in cardiovascular morbidity and mortality for those meeting recommended guidelines. Yet the impact of physical activity on the incidence of atrial fibrillation (AF) has been less clear. This review seeks to define the optimal dose and duration for the prevention and treatment of AF. In doing so, we review the evidence that supports a decline in AF risk for those who achieve a weekly physical activity dose slightly above the current recommended guidelines...
July 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28692548/comparison-of-vernakalant-and-ranolazine-in-atrial-fibrillation
#4
Gerrit Frommeyer, Magdalena Sterneberg, Dirk G Dechering, Simon Kochhäuser, Nils Bögeholz, Michael Fehr, Lars Eckardt
BACKGROUND: Current guidelines recommend vernakalant for pharmacologic cardioversion of recent-onset atrial fibrillation. However, this drug is not established as chronic therapy. METHODS AND RESULTS: In total, 15 rabbit hearts were Langendorff-perfused. A burst pacing protocol-induced atrial fibrillation in 7 of 15 hearts at baseline (10 episodes). Subsequently, a combination of acetylcholine and isoproterenol (ACH/ISO) has been administered to increase occurrence of atrial fibrillation resulting in a reduction of atrial action potential duration (-25 ms, P < 0...
July 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28692216/-digoxin-and-atrial-fibrillation-in-2016
#5
Sarah Théone, Sebastian Carballo, David Carballo, Christophe Marti
Various properties of digoxin have been exploited for decades, amongst which are its positive inotropy used in the treatment of heart failure, and its vagotonic effect used to slow ventricular response to atrial fibrillation. Pharmacologic properties of digoxin are however characterised by a narrow therapeutic interval, and recent observational studies suggest a potential association with increased mortality in patients with atrial fibrillation. As a result and because of available alternative therapeutic strategies, current guidelines do not recommend digoxin as first line treatment of atrial fibrillation...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28688009/comparing-volume-clamp-method-and-intra-arterial-blood-pressure-measurements-in-patients-with-atrial-fibrillation-admitted-to-the-intensive-or-medium-care-unit
#6
G F N Berkelmans, S Kuipers, B E Westerhof, A M E Spoelstra-de Man, Y M Smulders
International guidelines highlight the importance of blood pressure (BP) in patients with atrial fibrillation (AF). However, BP measurement in AF is complicated by beat-to-beat fluctuation. Automated BP measurement devices are not validated for patients with AF and no consensus exists on how to measure BP in AF manually. Beat-to-beat BP measurement using the volume-clamp method (VCM) could represent a non-invasive method to accurately assess BP, but has not been validated in AF. 31 admitted patients with sustained AF and 10 control patients with sinus rhythm underwent simultaneous intra-arterial and non-invasive BP measurement using a VCM monitor (Nexfin(®), BMEYE, Amsterdam, The Netherlands)...
July 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28687831/risk-of-intraocular-bleeding-with-novel-oral-anticoagulants-compared-with-warfarin-a-systematic-review-and-meta-analysis
#7
Michelle T Sun, Megan K Wood, WengOnn Chan, Dinesh Selva, Prashanthan Sanders, Robert J Casson, Christopher X Wong
Importance: It is unclear if the risk of intraocular bleeding with novel oral anticoagulants differs compared with warfarin. Objective: To characterize the risk of intraocular bleeding with novel oral anticoagulants compared with warfarin. Data Sources: A systematic review and meta-analysis was undertaken in an academic medical setting. MEDLINE and ClinicalTrials.gov were searched for randomized clinical trials published up until August 2016...
July 6, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28685644/summary-of-2016-esc-guidelines-on-heart-failure-atrial-fibrillation-dyslipidaemia-and-cardiovascular-prevention
#8
Marc J Claeys, Wilfried Mullens, Yves Vandekerckhove, Mattias Duytschaever, Catherine De Maeyer, Agnes Pasquet
During the ESC congress in September 2016 in Rome, the new ESC guidelines were presented and are now available on the ESC website ( http://www.escardio.org/guidelines ). The new guidelines cover management recommendations on following cardiovascular items: Heart failure, atrial fibrillation, dyslipidemia and cardiovascular prevention. The present document gives a summary of these guidelines and highlights the most important recommendations and changes in the management of these diseases. It will help to increase awareness about the new guidelines and may stimulate to consult the full document for specific items...
July 7, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28680466/atrial-fibrillation-with-a-structurally-normal-heart-in-pregnancy-an-international-survey-on-current-practice
#9
Annabelle Cumyn, Nadine Sauvé, Évelyne Rey
BACKGROUND: Little evidence exists for the optimal management of atrial fibrillation with a structurally normal heart in pregnancy. METHODS: A survey was sent to members of two associations to obtain input on optimal management of atrial fibrillation in pregnancy. The survey presented four cases with respect to (1) baseline investigations; (2) rate versus rhythm control; (3) chemical versus electrical cardioversion; and (4) anticoagulation. RESULTS: Sixty-one responders from 11 countries participated...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28679859/secondary-versus-primary-stroke-prevention-in-atrial-fibrillation-insights-from-the-darlington-atrial-fibrillation-registry
#10
Michał Mazurek, Eduard Shantsila, Deirdre A Lane, Andreas Wolff, Marco Proietti, Gregory Y H Lip
BACKGROUND AND PURPOSE: Although patients with atrial fibrillation (AF) who experienced an acute stroke are at high risk for recurrence, many patients are untreated or treated suboptimally for stroke prevention. The objective of this study is to compare clinical outcomes of AF patients with versus without previous stroke in relation to guideline-adherent antithrombotic treatment in a contemporary primary care population. METHODS: Community cohort of 105 000 patients from 11 general practices in Darlington, England, was used to assess AF stroke prevention strategies against 2014 National Institute for Health and Care Excellence guidelines...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28679020/a-cross-study-analysis-evaluating-the-effects-of-food-on-the-pharmacokinetics-of-rivaroxaban-in-clinical-studies
#11
Liping Zhang, Gary Peters, Lloyd Haskell, Purve Patel, Partha Nandy, Kenneth Todd Moore
US prescribing guidelines recommend that 15- and 20-mg doses of rivaroxaban be administered with food for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and for reduction in the risk of recurrence of DVT and PE. In addition, the US prescribing guidelines recommend these doses be administered with an evening meal to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). The purpose of this model-based cross-study comparison was to examine the impact of food, with regard to both meal timing and content, on the pharmacokinetics (PK) of rivaroxaban, using data collected during its clinical development...
July 5, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28678553/non-vitamin-k-antagonist-oral-anticoagulants-impact-of-non-adherence-and-discontinuation
#12
José Miguel Rivera-Caravaca, María Asunción Esteve-Pastor, Vanessa Roldán, Francisco Marín, Gregory Y H Lip
Non-Vitamin K Oral Anticoagulants (NOACs) are at least as effective as vitamin K antagonists (VKAs) reducing thromboembolism and mortality in atrial fibrillation (AF). These "fixed-dose regimen" drugs are characterized by not requiring routine monitoring or dosage adjustment. Stroke prevention with OAC is indicated in AF patients with CHA2DS2-VASc ≥2 (≥3 in females) and NOACs are recommended in preference to VKAs. However, underuse, premature discontinuation of treatment and non-adherence to guidelines is common, and independently associated with higher stroke risk and all-cause mortality...
July 5, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28666577/use-of-evidence-based-therapy-for-cardiovascular-risk-factors-in-canadian-outpatients-with-atrial-fibrillation-from-the-facilitating-review-and-education-to-optimize-stroke-prevention-in-atrial-fibrillation-freedom-af-and-co-ordinated-national-network-to-engage
#13
Alexandra Silberberg, Mary K Tan, Andrew T Yan, Paul Angaran, Paul Dorian, Claudia Bucci, Jean C Gregoire, Alan D Bell, David J Gladstone, Martin S Green, Peter L Gross, Allan Skanes, Andrew M Demchuk, Charles R Kerr, L Brent Mitchell, Jafna L Cox, Mario Talajic, Vidal Essebag, Brett Heilbron, Krishnan Ramanathan, Carl Fournier, Bruce H Wheeler, Peter J Lin, Murray Berall, Anatoly Langer, Lianne Goldin, Shaun G Goodman
Using data collected from 2 national atrial fibrillation (AF) primary care physician chart audits (Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation [FREEDOM AF] and Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation [CONNECT AF]), we evaluated the frequency of, and factors associated with, the use of cardiovascular (CV) evidence-based therapies in Canadian AF outpatients with at least 1 CV risk factor or co-morbidity...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28664799/dabigatran-versus-warfarin-in-patients-with-atrial-fibrillation
#14
Ruth Sander
Atrial fibrillation is associated with an increased risk of ischaemic stroke and mortality. Guidelines recommend non-vitamin K antagonist oral anticoagulants, or novel oral anticoagulants, as first choice of drug. While they do not require the meticulous dose adjustments that are required for warfarin, a clinical evaluation of appropriate dose is still necessary. Age and chronic kidney disease in patients with atrial fibrillation increase the risk of bleeding during anti-thrombotic treatment.
June 30, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28660415/-new-onset-atrial-fibrillation-in-patients-with-sepsis
#15
REVIEW
M Keller, R Meierhenrich
BACKGROUND: Atrial fibrillation is the most common new onset arrhythmia in patients hospitalized with sepsis; however, there are no specific treatment guidelines and the ideal therapeutic approaches still remain unclear. OBJECTIVES: To begin with the current state of knowledge concerning the underling mechanisms, the incidence and prognostic impact of new onset atrial fibrillation during sepsis are presented. Then a possible therapeutic algorithm for the special situation of sepsis is derived with respect to the currently existing atrial fibrillation guidelines...
June 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28660151/nonalcoholic-fatty-liver-disease-nafld-and-risk-of-cardiac-arrhythmias-a-new-aspect-of-the-liver-heart-axis
#16
REVIEW
Alessandro Mantovani
Nonalcoholic fatty liver disease (NAFLD) is a pathologic condition frequently observed in clinical practice. To date, the prevalence of NAFLD is approximately 25-30% among adults of the general population in Western countries but increases to approximately 70-75% among patients with type 2 diabetes mellitus. In the last decade, accumulating evidence has clearly demonstrated that patients with NAFLD have not only an increased liver-related morbidity and mortality but also an increased risk of fatal and non-fatal cardiovascular events...
June 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28656545/is-it-reasonable-to-use-a-lower-doac-dose-in-some-patients-with-vte-no
#17
Francesco Dentali, Chiara Fantoni
The international guidelines recommend the use of direct oral anticoagulants (DOACs) over vitamin K antagonists for anticoagulation long-term therapy in patients diagnosed with venous thromboembolism (VTE), and for stroke prevention in patients with non-valvular atrial fibrillation (AF). Efficacy and safety of DOACS have been extensively evaluated in large phase III trials. According to the product label, dose reductions of DOACs are recommended for patients with AF and renal impairment, low body weight and concomitant use of interfering medications...
August 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28648320/cost-effectiveness-of-edoxaban-vs-warfarin-in-patients-with-atrial-fibrillation-based-on-results-of-the-engage-af-timi-48-trial-taiwanese-perspective
#18
Katherine A Vilain, Ming Chin Yang, Elise Chia Hui Tan, Kaijun Wang, Haiyan Li, Wan Hsuan Hsu, Robert P Giugliano, David J Cohen, Elizabeth A Magnuson
BACKGROUND: Novel anticoagulants, such as factor Xa inhibitors, have entered clinical practice as alternatives to warfarin for the prevention of stroke and systemic embolic event (SEE) in patients with atrial fibrillation (AF). It is not known whether edoxaban, the fourth-to-market factor Xa inhibitor approved for this indication, will be cost-effective in Taiwan, where the cost of warfarin monitoring is prohibitive. METHODS: A Markov model projecting lifetime results of edoxaban 60 mg/30 mg dose-reduced versus warfarin in patients with nonvalvular AF, based on the ENGAGE AF - TIMI 48 trial, found edoxaban to be of high value relative to warfarin, from the perspective of the US health care system...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#19
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28642017/patterns-of-care-and-temporal-trends-in-ischemic-stroke-management-a-brazilian-perspective
#20
Monique Bueno Alves, Gisele Sampaio Silva, Renata Carolina Acri Miranda, Rodrigo Meireles Massaud, Andreia Maria Heins Vaccari, Miguel Cendoroglo-Neto, Solange Diccini
BACKGROUND AND PURPOSE: Demonstration of an improvement process of quality indicators in stroke care is essential to obtain certification as a primary stroke center (PSC). Our aim was to evaluate factors that influence temporal trends in quality indicators of ischemic stroke (IS) in a Brazilian hospital. METHODS: We evaluated patients discharged with IS from a tertiary hospital from January 2009 to December 2013. Ten predefined performance measures selected by the Get With the Guidelines-Stroke program were assessed...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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