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Atrial fibrilation guidelines

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https://www.readbyqxmd.com/read/28511557/impact-of-a-perioperative-prophylaxis-guideline-on-post-cardiothoracic-surgery-atrial-fibrillation
#1
Rosanna Li, C Michael White, Jola Mehmeti, Spencer T Martin, Laura C Hobbs
BACKGROUND: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). OBJECTIVE: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. METHODS: Data were retrospectively collected on 400 adults (200 patients pre-guideline implementation and 200 patients post-guideline implementation) with a CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28509773/perioperative-management-of-antithrombotic-therapies
#2
Timur Yurttas, Patrick M Wanner, Miodrag Filipovic
PURPOSE OF REVIEW: Perioperative coagulation management is becoming increasingly frequent in the daily routine of the anesthesiologist and with the plethora of new substances on the market also increasingly complex. The perioperative setting poses unique challenges requiring an individualized evaluation and management of antithrombotic therapy. This review shall summarize the newest developments in this domain. RECENT FINDINGS: New data in patients with atrial fibrillation have led to a paradigm change in the perioperative management of antithrombotics...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509703/pathway-for-the-management-of-atrial-fibrillation-and-atrial-flutter
#3
Eyal Herzog, Edgar Argulian, Steven B Levy, Emad F Aziz
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance encountered in clinical practice, and its prevalence is increasing as the population ages. The American College of Cardiology, the American Heart Association, and the European Society of Cardiology established guidelines for the management of patients with AF. Atrial flutter (Afl) is less common and is often associated with or preceded by AF or occurs in an isolated pattern. A major limitation of the currently published guidelines for the management of patients with AF and Afl is their complexity, the fact that official guidelines are published separately for each of these arrhythmias, and that they were published several years ago...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28506981/contemporary-trends-in-oral-anticoagulant-prescription-in-atrial-fibrillation-patients-at-low-to-moderate-risk-of-stroke-after-guideline-recommended-change-in-use-of-the-chads2-to-the-cha2ds2-vasc-score-for-thromboembolic-risk-assessment-analysis-from-the-national
#4
David F Katz, Thomas M Maddox, Mintu Turakhia, Anil Gehi, Emily C O'Brien, Steven A Lubitz, Alexander Turchin, Gheorghe Doros, Lanyu Lei, Paul Varosy, Lucas Marzec, Jonathan C Hsu
BACKGROUND: Use of the CHA2DS2-VASc score instead of the CHADS2 score for thromboembolic risk stratification and initiation of oral anticoagulation (OAC) was recommended in the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines. We sought to define the proportion of patients with AF qualifying for and receiving OAC in contemporary practice by applying the CHA2DS2-VASc score to patients with a low CHADS2 score. METHODS AND RESULTS: Among patients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's outpatient Practice Innovation and Clinical Excellence registry (2008-2014) CHADS2 score of 0 or 1, we calculated the impact of adoption of the CHA2DS2-VASc score on the proportion of patients with an indication for OAC...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#5
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28500480/-pulmonary-vein-isolation-for-atrial-fibrillation-findings-from-long-term-follow-up
#6
C-H Heeger, K-H Kuck, F Ouyang
Atrial fibrillation is by far the most common cardiac arrhythmia in humans. The incidence of atrial fibrillation increases with age and will increase even more in the future due to the demographic changes in the population. Therefore, this arrhythmia will have a growing clinical and socioeconomic impact. Although there are established pharmaceutical treatment options, atrial fibrillation is one of the major causes of stroke, heart failure and cardiovascular morbidity and mortality. The latest guidelines recommend the invasive procedure of circumferential pulmonary vein isolation (PVI) as an effective treatment of paroxysmal and persistent atrial fibrillation...
May 12, 2017: Herz
https://www.readbyqxmd.com/read/28483832/screening-for-atrial-fibrillation-a-report-of-the-af-screen-international-collaboration
#7
REVIEW
Ben Freedman, John Camm, Hugh Calkins, Jeffrey S Healey, Mårten Rosenqvist, Jiguang Wang, Christine M Albert, Craig S Anderson, Sotiris Antoniou, Emelia J Benjamin, Giuseppe Boriani, Johannes Brachmann, Axel Brandes, Tze-Fan Chao, David Conen, Johan Engdahl, Laurent Fauchier, David A Fitzmaurice, Leif Friberg, Bernard J Gersh, David J Gladstone, Taya V Glotzer, Kylie Gwynne, Graeme J Hankey, Joseph Harbison, Graham S Hillis, Mellanie T Hills, Hooman Kamel, Paulus Kirchhof, Peter R Kowey, Derk Krieger, Vivian W Y Lee, Lars-Åke Levin, Gregory Y H Lip, Trudie Lobban, Nicole Lowres, Georges H Mairesse, Carlos Martinez, Lis Neubeck, Jessica Orchard, Jonathan P Piccini, Katrina Poppe, Tatjana S Potpara, Helmut Puererfellner, Michiel Rienstra, Roopinder K Sandhu, Renate B Schnabel, Chung-Wah Siu, Steven Steinhubl, Jesper H Svendsen, Emma Svennberg, Sakis Themistoclakis, Robert G Tieleman, Mintu P Turakhia, Arnljot Tveit, Steven B Uittenbogaart, Isabelle C Van Gelder, Atul Verma, Rolf Wachter, Bryan P Yan
Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document...
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28475278/anticoagulation-bridge-therapy-in-patients-with-atrial-fibrillation-recent-updates-providing-a-rebalance-of-risk-and-benefit
#8
Candice L Garwood, Bianca Korkis, Domenico Grande, Claudia Hanni, Amy Morin, Lynette R Moser
In 2011, we provided a review of clinical updates and controversies surrounding anticoagulation bridge therapy in patients with atrial fibrillation. Since then, options for oral anticoagulation have expanded with the addition of four direct oral anticoagulant (DOAC) agents available in the United States. Nonetheless, vitamin K antagonist (VKA) therapy continues to be the treatment of choice for patients who are poor candidates for a DOAC and for whom bridge therapy remains a therapeutic dilemma. However, bridge therapy for patients taking a VKA remains a therapeutic dilemma...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28472091/patients-with-atrial-fibrillation-and-outcomes-of-cerebral-infarction-in-those-with-treatment-of-warfarin-versus-no-warfarin-with-references-to-cha2ds2-vasc-score-age-and-sex-a-swedish-nationwide-observational-study-with-48-433-patients
#9
Tommy Andersson, Anders Magnuson, Ing-Liss Bryngelsson, Ole Frøbert, Karin M Henriksson, Nils Edvardsson, Dritan Poçi
AIMS: There is controversy in the guidelines as to whether patients with atrial fibrillation and a low risk of stroke should be treated with anticoagulation, especially those with a CHA2DS2-VASc score of 1 point. METHODS: In a retrospective, nationwide cohort study, we used the Swedish National Patient Registry, the National Prescribed Drugs Registry, the Swedish Registry of Education and the Population and Housing Census Registry. 48 433 patients were identified between 1 January 2006 and 31 December 2008 with incident atrial fibrillation who were divided in age categories, sex and a CHA2DS2-VASc score of 0, 1, 2 and ≥3 and they were included in a time-varying analysis of warfarin treatment versus no treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#10
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28461140/laa-occluder-device-for-stroke-prevention-data-on-watchman-and-other-laa-occluders
#11
REVIEW
Martin W Bergmann
NOAC therapy has become the standard for stroke prevention in patients with atrial fibrillation. Yet some patients suffer extracranial bleeding events or have other reasons to seek non-pharmacologic stroke protection. LAA occlusion with the WATCHMAN device has been proven safe and effective for such patients and is now recommended in current guidelines for this patient group; other devices also seek approval.
March 24, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28455320/cha2ds2-vasc-score-congestive-heart-failure-hypertension-age-%C3%A2-75-doubled-diabetes-mellitus-prior-stroke-or-transient-ischemic-attack-doubled-vascular-disease-age-65-74-female-for-stroke-in-asian-patients-with-atrial-fibrillation-a-korean-nationwide-sample
#12
Tae-Hoon Kim, Pil-Sung Yang, Jae-Sun Uhm, Jong-Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y H Lip
BACKGROUND AND PURPOSE: The CHA2DS2-VASc stroke score (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65-74, female) is used in most guidelines for risk stratification in atrial fibrillation (AF), but most data for this score have been derived in Western populations. Ethnic differences in stroke risk may be present. Our objective was to investigate risk factors for stroke in AF and application of the CHA2DS2-VASc score in an Asian AF population from Korea...
April 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28454807/clinical-decision-support-for-stroke-prevention-in-atrial-fibrillation-cds-af-rationale-and-design-of-a-cluster-randomized-trial-in-the-primary-care-setting
#13
Lars O Karlsson, Staffan Nilsson, Emmanouil Charitakis, Magnus Bång, Gustav Johansson, Lennart Nilsson, Magnus Janzon
BACKGROUND: Atrial fibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains a significant undertreatment. The main aim of the current study is to investigate whether a clinical decision support tool for stroke prevention (CDS) integrated in the electronic health record can improve adherence to guidelines for stroke prevention in patients with AF. METHODS: We will conduct a cluster randomized trial where 43 primary care clinics in the county of Östergötland, Sweden (population 444,347), will be randomized to be part of the CDS intervention or serve as controls...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28454796/atrial-fibrillation-detected-by-continuous-electrocardiographic-monitoring-using-implantable-loop-recorder-to-prevent-stroke-in-individuals-at-risk-the-loop-study-rationale-and-design-of-a-large-randomized-controlled-trial
#14
Søren Zöga Diederichsen, Ketil Jørgen Haugan, Lars Køber, Søren Højberg, Axel Brandes, Christian Kronborg, Claus Graff, Anders Gaarsdal Holst, Jonas Bille Nielsen, Derk Krieger, Jesper Hastrup Svendsen
Atrial fibrillation (AF) increases the rate of stroke 5-fold, and AF-related strokes have a poorer prognosis compared with non-AF-related strokes. Atrial fibrillation and stroke constitute an intensifying challenge, and health care organizations are calling for awareness on the topic. Previous studies have demonstrated that AF is often asymptomatic and consequently undiagnosed. The implantable loop recorder (ILR) allows for continuous, long-term electrocardiographic monitoring with daily transmission of arrhythmia information, potentially leading to improvement in AF detection and stroke prevention...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28453809/in-patients-undergoing-lung-resection-is-it-safe-to-administer-amiodarone-either-as-prophylaxis-or-treatment-of-atrial-fibrillation
#15
Styliani Maria Kolokotroni, Levon Toufektzian, Leanne Harling, Andrea Billè
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether the administration of amiodarone is safe in patients undergoing lung resection either for prophylaxis or treatment of de novo postoperative atrial fibrillation (POAF). A total of 30 papers were identified, of which 13 represented the best evidence to answer the clinical question. The authors, journal, date, study type, country of publication, patient demographics, relevant outcomes and results were tabulated...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28439617/-stroke-prophylaxis-in-atrial-fibrillation-when-how-and-for-whom
#16
T Maurer, C Sohns
In patients suffering from atrial fibrillation (AF), modern antithrombotic therapy and anticoagulation strategies should be individualized based on shared decision making including patient preferences and the absolute and relative risks of stroke and bleeding. Estimation of the individual risk for stroke is still based on the CHA2DS2-VASc score. Based on the most recent guidelines for the management of AF, oral anticoagulation therapy should be considered for men with a CHA2DS2-VASc score ≥1 and women with a score ≥2, balancing the expected stroke reduction, risk of bleeding and patient preference...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28424890/left-atrial-electromechanical-conduction-time-predicts-atrial-fibrillation-in-patients-with-mitral-stenosis-a-5-year-follow-up-speckle-tracking-echocardiography-study
#17
Ozkan Candan, Cetin Gecmen, Arzu Kalayci, Cem Dogan, Emrah Bayam, Mehmet Ozkan
Prolonged left atrial electromechanical conduction time is related with atrial electrical remodeling, and is predictive of the development of atrial fibrillation. The aim of our study was to examine whether left atrial electromechanical conduction time (EMT) and left atrial strain as measured by speckle tracking echocardiography (STE) are predictors for the development of atrial fibrillation (AF) in patients with mitral stenosis (MS) at 5-year follow-up. A total of 81 patients (61% females; mean age 38.1 ± 12...
April 19, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#18
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#19
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28413184/risk-of-ischemic-stroke-in-patients-with-non-valvular-atrial-fibrillation-not-receiving-oral-anticoagulants%C3%A3-korean-nationwide-population-based-study
#20
Si-Hyuck Kang, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Myung-Jin Cha, Youngjin Cho, Il-Young Oh, Seil Oh
BACKGROUND: Atrial fibrillation, the most common cardiac arrhythmia, is associated with an elevated thromboembolic risk, including ischemic stroke. Guidelines recommend the stratification of individual stroke risk and tailored antithrombotic therapy. This study investigated the demographics, comorbidities, and prognosis of non-valvular AF (NVAF) in Korean patients.Methods and Results:We extracted data on 10,846 patients with newly diagnosed NVAF who were naïve to oral anticoagulants from the National Health Insurance Service-National Sample Cohort...
April 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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