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subclinical atrial fibrillation and risk of stroke

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https://www.readbyqxmd.com/read/27793994/genetic-risk-prediction-of-atrial-fibrillation
#1
Steven A Lubitz, Xiaoyan Yin, Henry Lin, Matthew Kolek, J Gustav Smith, Stella Trompet, Michiel Rienstra, Natalia S Rost, Pedro Teixeira, Peter Almgren, Christopher D Anderson, Lin Y Chen, Gunnar Engström, Ian Ford, Karen L Furie, Xiuqing Guo, Martin G Larson, Kathryn Lunetta, Peter W Macfarlane, Bruce M Psaty, Elsayed Z Soliman, Nona Sotoodehnia, David J Stott, Kent D Taylor, Lu-Chen Weng, Jie Yao, Bastiaan Geelhoed, Niek Verweij, Joylene E Siland, Sekar Kathiresan, Carolina Roselli, Dan M Roden, Pim van der Harst, Dawood Darbar, J Wouter Jukema, Olle Melander, Jonathan Rosand, Jerome I Rotter, Susan R Heckbert, Patrick T Ellinor, Alvaro Alonso, Emelia J Benjamin
BACKGROUND: -Atrial fibrillation (AF) has a substantial genetic basis. Identification of individuals at greatest AF risk could minimize the incidence of cardioembolic stroke. METHODS: -To determine whether genetic data can stratify risk for development of AF, we examined associations between AF genetic risk scores and incident AF in five prospective studies comprising 18,919 individuals of European ancestry. We examined associations between AF genetic risk scores and ischemic stroke in a separate study of 509 ischemic stroke cases (202 cardioembolic [40%]) and 3,028 referents...
October 28, 2016: Circulation
https://www.readbyqxmd.com/read/27702868/atrial-high-rate-episodes-and-stroke-prevention
#2
A John Camm, Emmanuel Simantirakis, Andreas Goette, Gregory Y H Lip, Panos Vardas, Melanie Calvert, Gregory Chlouverakis, Hans-Christoph Diener, Paulus Kirchhof
While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high-rate episodes (AHRE) recorded on a cardiac implantable electronic device, sometimes also called subclinical AF, and lasting for at least 6 min in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and transient ischaemic attack...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27637962/cerebrovascular-disease
#3
M L P Portegies, P J Koudstaal, M A Ikram
With 16.9 million people who suffered a first-ever stroke in 2010 worldwide, stroke is a very common vascular disease. Epidemiologic studies have played an essential role in assessing this burden and in detecting the risk factors for stroke. Primary prevention of these risk factors, primarily hypertension, smoking, diabetes, and atrial fibrillation, has reduced the incidence in high-income countries. However, stroke remains a major cause of death and disability, and therefore research should be continued. Subarachnoid hemorrhages are less prevalent than strokes but have an even higher risk of death...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27554422/subclinical-atrial-fibrillation-a-new-entity-and-what-it-means
#4
Peter Ott
New device technologies allow for detection of clinically silent atrial fibrillation. This new entity has been associated with increased risk for stroke, even if detected for only relatively brief time periods. Current practice guidelines do not provide recommendations on how to approach this new clinical entity.
August 5, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27344417/prognostic-implications-of-lv-strain-risk%C3%A2-score%C3%A2-in%C3%A2-asymptomatic-patients-with%C3%A2-hypertensive-heart-disease
#5
Makoto Saito, Faisal Khan, Ted Stoklosa, Andrea Iannaccone, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to investigate the associations of left ventricular (LV) strain and its serial change with major adverse cardiac events (MACE) in hypertensive heart disease, independent of and incremental to clinical and LV geometric parameters. BACKGROUND: In patients with hypertensive heart disease, MACE are associated with abnormal LV morphology, but their association with subclinical LV dysfunction is unclear. METHODS: We retrospectively studied 388 asymptomatic nonischemic patients with hypertension who had abnormal LV geometry at a baseline echocardiogram between 2005 and 2014...
August 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27297859/atrial-fibrillation-without-comorbidities-prevalence-incidence-and-prognosis-from-the-framingham-heart-study
#6
Eun-Jeong Kim, Xiaoyan Yin, João D Fontes, Jared W Magnani, Steve A Lubitz, David D McManus, Sudha Seshadri, Ramachandran S Vasan, Patrick T Ellinor, Martin G Larson, Emelia J Benjamin, Michiel Rienstra
BACKGROUND: The epidemiology of atrial fibrillation (AF) without comorbidities, known as 'lone AF', is uncertain. Although it has been considered a benign condition, we hypothesized that it confers a worse prognosis compared with a matched sample without AF. METHODS: We described the proportion of AF without comorbidities (clinical, subclinical cardiovascular disease and triggers) among the entire AF sample in Framingham Heart Study (FHS). We compared AF without comorbidities with typical AF, and age-, sex- and cohort-matched individuals without AF, using Cox proportional hazards analysis in relation to combined cardiovascular events (stroke, heart failure, myocardial infarction), and mortality...
July 2016: American Heart Journal
https://www.readbyqxmd.com/read/27196706/atrial-fibrillation-burden-and-atrial-fibrillation-type-clinical-significance-and-impact-on-the-risk-of-stroke-and-decision-making-for-long-term-anticoagulation
#7
REVIEW
Giuseppe Boriani, Daniele Pettorelli
Atrial fibrillation (AF) is a common arrhythmia increasing the risk of morbidity and adverse outcomes (stroke, heart failure, death). AF is found in 1-2% of the general population, with increasing prevalence with aging. Its exact epidemiological profile is incomplete and underestimated, because 10-40% of AF patients (particularly the elderly) can be asymptomatic ("clinically silent or subclinical AF"), with occasional electrocardiographic diagnosis. The research interest on silent AF has increased by the evidence that its outcome is no less severe, in terms of risks of stroke and death, than that for symptomatic patients...
August 2016: Vascular Pharmacology
https://www.readbyqxmd.com/read/27060297/high-incidence-of-de-novo-and-subclinical-atrial-fibrillation-in-patients-with-hypertrophic-cardiomyopathy-and-cardiac-rhythm-management-device
#8
Iris Wilke, Katrin Witzel, Julia Münch, Simon Pecha, Stephan Blankenberg, Hermann Reichenspurner, Stephan Willems, Monica Patten, Ali Aydin
INTRODUCTION: Atrial fibrillation (AF) is an important prognostic parameter in patients with hypertrophic cardiomyopathy (HCM). Though cardiac rhythm management (CRM) devices (e.g., ICD, pacemaker or implantable loop recorder) can detect subclinical AF, data describing the incidence of AF are rare. We therefore investigated the incidence and clinical impact of de novo and subclinical AF detected by CRM devices in patients with HCM. METHODS AND RESULTS: In our retrospective single-center study, we included patients with HCM and need for CRM devices...
July 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/26962746/subclinical-atrial-fibrillation-and-the-risk-of-stroke
#9
(no author information available yet)
No abstract text is available yet for this article.
March 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26941260/stroke-and-embolic-events-in-hypertrophic-cardiomyopathy-risk-stratification-in-patients-without-atrial-fibrillation
#10
Shintaro Haruki, Yuichiro Minami, Nobuhisa Hagiwara
BACKGROUND AND PURPOSE: Stroke and systemic embolic events are known to occur as complications of hypertrophic cardiomyopathy (HCM), and these complications are more common in patients with accompanying atrial fibrillation (AF). The diagnosis of AF is sometimes difficult, however, and it is possible that subclinical asymptomatic paroxysmal episodes or a first episode of AF in patients without previously documented AF may lead to embolic events. We investigated the prevalence of embolic events in patients with HCM and evaluated risk factors for these events in patients without documented AF...
April 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/26842114/subclinical-atrial-fibrillation-and-stroke-insights-from-continuous-monitoring-by-implanted-cardiac-electronic-devices
#11
REVIEW
Chu-Pak Lau, Chung-Wah Siu, Kai-Hang Yiu, Kathy Lai-Fun Lee, Yap-Hang Chan, Hung-Fat Tse
Nearly one out of five strokes is associated with atrial fibrillation (AF). Atrial fibrillation is often intermittent and asymptomatic. Detection of AF after cryptogenic stroke will likely change therapy from antiplatelet to oral anticoagulation agents for secondary stroke prevention. A critical step is to convert 'covert' AF into electrocardiogram documented AF. External rhythm recording devices have registered a high incidence of AF to occur after a cryptogenic stroke, but are limited by short duration of continuous recordings...
October 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/26835031/relevance-of-monitoring-atrial-fibrillation-in-clinical-practice
#12
Thorsten Lewalter, Giuseppe Boriani
The monitoring of atrial fibrillation (AF) is performed using a variety of tools, ranging from the conventional Holter electrocardiogram to modern implantable loop recording with remote data exchange. The main clinical areas in AF where monitoring is crucial for decision-making are catheter and surgical ablation, as well as anticoagulation to prevent strokes. Identifying the patient cohort at risk - e.g., those with subclinical silent AF - is a challenge. In addition, the interaction of AF with implanted devices - e...
September 2012: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/26599225/silent-brain-infarcts-in-high-blood-pressure-patients-with-cardiac-implantable-electronic-devices-unmasking-silent-atrial-fibrillation
#13
Juan Benezet-Mazuecos, José Antonio Iglesias, Marcelino Cortes, Juan José De La Vieja, José Manuel Rubio, Pepa Sanchez-Borque, Jerónimo Farre
BACKGROUND: Hypertensive patients present a higher risk for developing atrial fibrillation and its complications. Cardiac implantable electronic devices (CIEDs) have shown reliable atrial fibrillation detection as atrial high-rate episodes (AHREs). The presence of AHRE more than 5 min has been related to increased risk of stroke, but a high proportion of ischemic brain lesions (IBLs) could be subclinical and thromboembolic risk underestimated. METHODS: We included hypertensive patients with CIED and we analyzed the incidence of AHRE and the presence of IBL on computed tomography (CT) scan...
February 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/26486510/paroxysmal-atrial-fibrillation-in-cryptogenic-stroke-an-overlooked-explanation
#14
REVIEW
Cen Zhang, Scott E Kasner
Approximately one third of ischemic strokes are labeled cryptogenic because the etiology is unknown despite a thorough evaluation. Paroxysmal atrial fibrillation carries the same risk of ischemic stroke as persistent atrial fibrillation and has increasingly gained attention as a potential source of cryptogenic stroke. Recent trials utilizing long-term cardiac monitoring devices have demonstrated high rates of previously undetected paroxysmal atrial fibrillation in patients with cryptogenic stroke. Newly detected atrial fibrillation has subsequently changed treatment and increased the use of oral anticoagulation in these studies...
December 2015: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/26409719/predictors-of-ischemic-stroke-in-rheumatic-heart-disease
#15
Anirban Gupta, Rohit Bhatia, Gautam Sharma, Kameshwar Prasad, Mamta Bhushan Singh, Deepti Vibha
BACKGROUND: Studies on predictors of ischemic strokes caused by rheumatic heart disease (RHD) are sparse and extremely important for identifying high-risk cases to direct future therapeutic trials for prevention of ischemic stroke in this population. OBJECTIVE: The aim of the present study was to study the predictors of ischemic stroke in patients with RHD and to observe outcome of patients with ischemic stroke at 3 months' follow-up using modified Rankin scale...
December 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/26304531/management-of-device-detected-atrial-high-rate-episodes
#16
REVIEW
Todd T Tomson, Rod Passman
Atrial tachyarrhythmias are common in patients with cardiac implantable electronic devices (CIEDs) with atrial leads. These atrial tachyarrhythmias are detected as atrial high-rate episodes (AHREs) by the CIED. AHREs may be brief, infrequent, and asymptomatic, and may be detected before clinical arrhythmia is apparent. These subclinical device-detected AHREs are associated with an increased stroke risk, similar to, but to a lesser degree than, clinically apparent atrial fibrillation detected by routine methods...
September 2015: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/26279110/prevalence-and-implications-of-subclinical-coronary-artery-disease-in-patients-with-atrial-fibrillation
#17
Kongkiat Chaikriangkrai, Miguel Valderrabano, Sayf Khaleel Bala, Sama Alchalabi, Edward A Graviss, Faisal Nabi, John Mahmarian, Su Min Chang
The objective of this study was to examine prevalence and clinical implications of subclinical coronary artery disease (CAD) detected by coronary artery calcium score (CACS) testing in patients with atrial fibrillation (AF). CACS was assessed in patients without history of CAD undergoing catheter ablation of AF. Age- and gender-matched patients with normal sinus rhythm (NSR) presenting with chest pain served as controls. Predicted arterial age using the Multi-Ethnic Study of Atherosclerosis registry was also compared to the chronologic age...
October 15, 2015: American Journal of Cardiology
https://www.readbyqxmd.com/read/26227434/incidence-outcome-risk-factors-and-long-term-prognosis-of-cryptogenic-transient-ischaemic-attack-and-ischaemic-stroke-a-population-based-study
#18
Linxin Li, Gabriel S Yiin, Olivia C Geraghty, Ursula G Schulz, Wilhelm Kuker, Ziyah Mehta, Peter M Rothwell
BACKGROUND: A third of transient ischaemic attacks (TIAs) and ischaemic strokes are of undetermined cause (ie, cryptogenic), potentially undermining secondary prevention. If these events are due to occult atheroma, the risk-factor profile and coronary prognosis should resemble that of overt large artery events. If they have a cardioembolic cause, the risk of future cardioembolic events should be increased. We aimed to assess the burden, outcome, risk factors, and long-term prognosis of cryptogenic TIA and stroke...
September 2015: Lancet Neurology
https://www.readbyqxmd.com/read/26141019/associations-between-calcium-and-vitamin-d-supplement-use-as-well-as-their-serum-concentrations-and-subclinical-cardiovascular-disease-phenotypes
#19
Inke Thiele, Jakob Linseisen, Christa Meisinger, Sigrid Schwab, Cornelia Huth, Annette Peters, Siegfried Perz, Thomas Meitinger, Florian Kronenberg, Claudia Lamina, Joachim Thiery, Wolfgang Koenig, Wolfgang Rathmann, Stefan Kääb, Cornelia Then, Jochen Seissler, Barbara Thorand
BACKGROUND: Supplementation of calcium (Ca) and vitamin D for the prevention of osteoporosis is frequently found in Western countries. Recent re-analyses of clinical trials observed a higher risk of myocardial infarction and stroke in subjects taking Ca (+vitamin D) supplements, although the underlying mechanisms are not clear. OBJECTIVE: Thus, we analyzed the associations between Ca and vitamin D supplementation as well as serum concentrations of Ca and 25-hydroxyvitamin D (25(OH)D) and subclinical cardiovascular disease (CVD) phenotypes, namely intima-media thickness, ankle-brachial-index (ABI), intermittent claudication, and atrial fibrillation (AF)...
August 2015: Atherosclerosis
https://www.readbyqxmd.com/read/26100203/left-atrial-appendage-morphology-and-physiology-the-missing-piece-in-the-puzzle
#20
Jorge Romero, Andrea Natale, Luigi DI Biase
No abstract text is available yet for this article.
June 23, 2015: Journal of Cardiovascular Electrophysiology
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