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Atrial fibrillation and exercise

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https://www.readbyqxmd.com/read/29433335/relationship-between-the-prognostic-value-of-ventilatory-efficiency-and-age-in-patients-with-heart-failure
#1
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Osamu Nagayama, Etsuko Hayama, Takuto Arita, Naoharu Yagi, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Yuji Oikawa, Takashi Kunihara, Junji Yajima, Takeshi Yamashita
Background Ventilatory efficiency decreases with age. This study aimed to investigate the prognostic significance and cut-off value of the minute ventilation/carbon dioxide production (VE/VCO 2 ) slope according to age in patients with heart failure. Methods and results We analysed 1501 patients with heart failure from our observational cohort who performed maximal symptom-limited cardiopulmonary exercise testing and separated them into three age groups (≤55 years, 56-70 years and ≥71 years) in total and according to the three ejection fraction categories defined by European Society of Cardiology guidelines...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29411631/the-ambiguity-of-physical-activity-exercise-and-atrial-fibrillation
#2
Bente Morseth, Maja-Lisa Løchen, Inger Ariansen, Marius Myrstad, Dag S Thelle
Although commonly associated with cardiovascular disease or other medical conditions, atrial fibrillation may also occur in individuals without any known underlying conditions. This manifestation of atrial fibrillation has been linked to extensive and long-term exercise, as prolonged endurance exercise has shown to increase prevalence and risk of atrial fibrillation. In contrast, more modest physical activity is associated with a decreased risk of atrial fibrillation, and current research indicates a J-shaped association between atrial fibrillation and the broad range of physical activity and exercise...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#3
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29411287/mechanisms-of-atrial-fibrillation-in-athletes-what-we-know-and-what-we-do-not-know
#4
REVIEW
E Guasch, L Mont, M Sitges
Exercise is an emerging cause of atrial fibrillation (AF) in young individuals without coexisting cardiovascular risk factors. The causes of exercise-induced atrial fibrillation remain largely unknown, and conclusions are jeopardised by apparently conflicting data. Some components of the athlete's heart are known to be arrhythmogenic in other settings. Bradycardia, atrial dilatation and, possibly, atrial premature beats are therefore biologically plausible contributors to exercise-induced AF. Challenging findings in an animal model suggest that exercise might also prompt the development of atrial fibrosis, possibly due to cumulative minor structural damage after each exercise bout...
February 6, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29405644/variations-in-subclinical-left-ventricular-dysfunction-functional-capacity-and-clinical-outcomes-in-different-heart-failure-aetiologies
#5
Ying Wang, Hong Yang, Mark Nolan, Faraz Pathan, Kazuaki Negishi, Thomas H Marwick
AIMS: Patients with heart failure (HF) risk factors are described as being in Stage A of this condition (SAHF). Management is directed towards prevention of HF progression, but to date, no evidence has been described to align the intensity of this intervention to HF risk. We sought to what extent SAHF of Type 2 diabetes mellitus (T2DM) and other HF risks showed differences in subclinical left ventricular function, exercise capacity, and prognosis. METHODS AND RESULTS: We recruited 551 elder asymptomatic SAHF patients (age 71 ± 5 years, 49% men, 290 T2DM) with at least one risk factor from a community-based population with preserved ejection fraction...
February 5, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29340805/cardiorespiratory-fitness-and-cardiovascular-disease-prevention-an-update
#6
REVIEW
Mouaz H Al-Mallah, Sherif Sakr, Ada Al-Qunaibet
PURPOSE OF REVIEW: Cardiovascular diseases account for nearly one third of all deaths globally. Improving exercise capacity and cardiorespiratory fitness (CRF) has been an important target to reduce cardiovascular events. In addition, the American Heart Association defined decreased physical activity as the fourth risk factor for coronary artery disease. Multiple large cohort studies have evaluated the impact of CRF on outcomes. In this review, we will discuss the role of CRF in reducing cardiovascular morbidity and mortality...
January 16, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#7
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29245366/catheter-ablation-versus-rate-control-in-patients-with-atrial-fibrillation-and-heart-failure-a-multicenter-study
#8
MULTICENTER STUDY
Jin Geng, Yanchun Zhang, Yanhan Wang, Lijuan Cao, Jie Song, Bingjian Wang, Wei Song, Ju Li, Wei Xu
Many trials have shown improvements in left ventricular function, exercise capacity, and quality of life after catheter ablation (CA) of atrial fibrillation (AF) in patients with heart failure (HF). We sought to evaluate the impact of CA on hard outcomes in a retrospective cohort study. AF patients with symptomatic HF from 3 hospitals were included. Our primary endpoint was major adverse cardiac events (MACEs), a composite of all-cause mortality, stroke, and unplanned hospitalization. In total, 90 patients underwent CA and 304 ones received rate control (RaC) were included...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29244075/the-athlete-s-heart-is-a-proarrhythmic-heart-and-what-that-means-for-clinical-decision-making
#9
Hein Heidbuchel
Recurring questions when dealing with arrhythmias in athletes are about the cause of the arrhythmia and, more importantly, about the eligibility of the athlete to continue sports activities. In essence, the relation between sports and arrhythmias can be understood along three lines: sports as arrhythmia trigger on top of an underlying problem, sports as arrhythmic substrate promotor, or sports as substrate inducer. Often, there is no sharp divider line between these entities. The athlete's heart, a heart that adapts so magically to cope with the demands of exercise, harbours many structural and functional changes that by themselves predispose to arrhythmia development, at the atrial, nodal and ventricular levels...
December 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29221502/impact-of-cardiorespiratory-fitness-on-frequency-of-atrial-fibrillation-stroke-and-all-cause-mortality
#10
Nasir Hussain, Bernard J Gersh, Karina Gonzalez Carta, Nóra Sydó, Francisco Lopez-Jimenez, Stephen L Kopecky, Randal J Thomas, Samuel J Asirvatham, Thomas G Allison
Benefits of cardiorespiratory fitness on cardiovascular health are well recognized, but the impact on incidence of atrial fibrillation (AF) and stroke, and, particularly, risk of stroke and mortality in patients with AF is less clear. From 1993 to 2010, patients referred for a treadmill exercise test (TMET) at the Mayo Clinic Rochester, MN, were retrospectively identified (N = 76,857). From this, 14,094 local residents were selected. Exclusions were age <18 years; history of heart failure, structural or valvular heart disease, AF or flutter, or stroke...
January 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29208632/right-ventricular-exercise-contractile-reserve-and-outcomes-after-early-surgery-for-primary-mitral-regurgitation
#11
Emilie Vitel, Elena Galli, Christophe Leclercq, Maxime Fournet, Christian Bosseau, Hervé Corbineau, Guillame Bouzille, Erwan Donal
OBJECTIVE: To assess if the lack of development of right ventricular (RV) contractile reserve during exercise echocardiography (ex-echo) might be a predictor of postoperative major adverse cardiovascular events (MACEs) in patients with primary mitral regurgitation (pMR) undergoing early surgery. METHODS: Comprehensive resting and ex-echo were performed in 142 asymptomatic patients (58±21 years, 68% men, New York Heart Association functional class ≤2) with isolated severe pMR and preserved left ventricular (LV) function (LV ejection >60%, LV end-systolic diameter <45 mm) undergoing mitral valve replacement (n=20) or repair...
December 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29178512/body-size-and-risk-of-atrial-fibrillation-a-cohort-study-of-1-1-million-young-men
#12
Kasper Andersen, Finn Rasmussen, Martin Neovius, Per Tynelius, Johan Sundström
BACKGROUND: While tall stature has been related to lower risk of vascular disease, it has been proposed as a risk factor for atrial fibrillation. Little is known about other anthropometric measures and their joint effects on risk for atrial fibrillation. OBJECTIVES: We aim to investigate associations and potential joint effects of height, weight, body surface area (BSA) and body mass index (BMI) with risk of atrial fibrillation. METHODS: In a cohort covering 1,153,151 18-years old men participating in the Swedish military conscription (1972-1995) Cox regression was used to investigate associations of height, weight, BSA and BMI with risk of atrial fibrillation...
November 27, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29161419/incidence-of-postoperative-atrial-fibrillation-recurrence-in-patients-discharged-in-sinus-rhythm-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#13
Nicole Lowres, Georgina Mulcahy, Kai Jin, Robyn Gallagher, Lis Neubeck, Ben Freedman
Postoperative atrial fibrillation (POAF) is associated with increased stroke risk and mortality post-discharge. POAF is often considered transient; however, recurrence is likely under-recognized as symptoms are an unreliable guide. Surveillance post-discharge may identify asymptomatic POAF recurrences in patients discharged in sinus rhythm. Therefore, we performed a systematic review and meta-analysis of studies investigating POAF recurrence post-discharge, in patients with new-onset POAF following cardiac surgery who reverted to sinus rhythm prior to discharge...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#14
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
https://www.readbyqxmd.com/read/29098615/the-benefits-of-exercise-training-on-aerobic-capacity-in-patients-with-heart-failure-and-preserved-ejection-fraction
#15
Danilo Marcelo Leite do Prado, Enéas Antônio Rocco
Heart failure with preserved ejection fraction (HFpEF) is defined as an inability of the ventricles to optimally accept blood from atria with blunted end- diastolic volume response by limiting the stroke volume and cardiac output. The HEpEF prevalence is higher in elderly and women and may be associated to hypertension, diabetes mellitus and atrial fibrillation. Severe exercise intolerance, manifested by dyspnea and fatigue during physical effort is the important chronic symptom in HFpEF patients, in which is the major determinant of their reduced quality of life...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29094875/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#16
REVIEW
John D Gazewood, Patrick L Turner
Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e.g., fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema) and signs (S3 heart sound, displaced apical pulse, and jugular venous distension) of chronic heart failure...
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29089343/impact-of-atrial-fibrillation-on-exercise-capacity-and-mortality-in-heart-failure-with-preserved-ejection-fraction-insights-from-cardiopulmonary-stress-testing
#17
Mohamed B Elshazly, Todd Senn, Yuping Wu, Bruce Lindsay, Walid Saliba, Oussama Wazni, Leslie Cho
BACKGROUND: Atrial fibrillation (AF) has been objectively associated with exercise intolerance in patients with heart failure with reduced ejection fraction; however, its impact in patients with heart failure with preserved ejection fraction has not been fully scrutinized. METHODS AND RESULTS: We identified 1744 patients with heart failure and ejection fraction ≥50% referred for cardiopulmonary stress testing at the Cleveland Clinic (Cleveland, OH), 239 of whom had AF...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29049041/the-impact-of-lifestyle-intervention-on-atrial-fibrillation
#18
Kathryn L Hong, Benedict M Glover
PURPOSE OF REVIEW: Atrial fibrillation is the most common sustained cardiac arrhythmia, attributable to several factors that may be amenable through lifestyle modification. There is emerging evidence to suggest that the successful management of several cardiovascular risk factors [obesity, hypertension (HTN), diabetes mellitus, and obstructive sleep apnea (OSA)] can lead to fewer complications and atrial fibrillation prevention. However, the long-term sustainability and reproducibility of these effects have yet to be explored in larger studies...
January 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29031455/does-permanent-atrial-fibrillation-modify-response-to-cardiac-resynchronization-therapy-in-heart-failure-patients
#19
Ana Abreu, Mário Oliveira, Pedro Silva Cunha, Helena Santa Clara, Guilherme Portugal, Inês Gonçalves Rodrigues, Vanessa Santos, Luís Morais, Mafalda Selas, Rui Soares, Luísa Branco, Rui Ferreira, Miguel Mota Carmo
INTRODUCTION: The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). METHODS: We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO2max) and ventilatory efficiency (VE/VCO2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29025686/-usefulness-of-spectral-tissue-doppler-e-e-ratio-in-the-management-of-patients-with-atrial-fibrillation
#20
S Arques, E Roux
Atrial fibrillation is the most common cardiac rhythm disorder encountered in daily clinical practice. It carries high morbidity and mortality rates, mainly related to sudden death, heart failure and stroke. Validation of noninvasive markers in the diagnosis of heart failure with preserved ejection fraction and risk stratification is therefore attractive in this clinical setting. The spectral tissue Doppler-derived E/e' ratio is a simple and user-friendly index which has been validated in the assessment of left ventricular diastolic pressures, regardless of rhythm...
November 2017: Annales de Cardiologie et D'angéiologie
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