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Latest & greatest articles for atrial fibrillation
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Dynamic Changes of CHA2DS2-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study 29723875 2018 07 02 2567-689X 118 7 2018 Jul Thrombosis and haemostasis Thromb. Haemost. Dynamic Changes of CHA2DS2-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study. 1296-1304 10.1055/s-0038-1651482 Stroke risk in atrial fibrillation (AF) is often assessed at initial presentation, and risk (...) the Korea National Health Insurance Service database, a total of 167,262 oral anticoagulant-naive non-valvular AFpatients aged ≥ 18 years old were enrolled between January 1, 2002, and December 31, 2005. These patients were followed up until December 31, 2015. At baseline, the proportions of subjects categorized as 'low', 'intermediate' or 'high risk' by CHA 2 DS 2 -VASc score were 15.4, 10.6 and 74.0%, respectively. Mean CHA 2 DS 2 -VASc score increased annually by 0.14, particularly due to age
Regional Dominant Frequency: A New Tool for Wave Break Identification During Atrial Fibrillation 29988509 2018 11 14 2297-055X 5 2018 Frontiers in cardiovascular medicine Front Cardiovasc Med Regional Dominant Frequency: A New Tool for Wave Break Identification During Atrial Fibrillation. 79 10.3389/fcvm.2018.00079 Cardiac mapping systems are based on the time/frequency feature analyses of intracardiac electrograms recorded from individual bipolar/unipolar electrodes. Signals from each (...) electrode are processed independently. Such approaches fail to investigate the interrelationship between simultaneously recorded channels of any given mapping catheter during atrial fibrillation (AF). We introduce a novel signal processing technique that reflects regional dominant frequency (RDF) components. We show that RDF can be used to identify and characterize variation and disorganization in wavefront propagation- wave breaks. The intracardiac electrograms from the left atrium of 15 patients were
Features of atrial fibrillation in wildâ€type transthyretin cardiac amyloidosis: a systematic review and clinical experience 29916559 2018 11 29 2055-5822 5 5 2018 10 ESC heart failure ESC Heart Fail Features of atrial fibrillation in wild-type transthyretin cardiac amyloidosis: a systematic review and clinical experience. 772-779 10.1002/ehf2.12308 Wild-type transthyretin (ATTRwt) cardiac amyloidosis has emerged as an important cause of heart failure in the elderly. Atrial fibrillation (AF (...) ) commonly affects older adults with heart failure and is associated with reduced survival, but its role in ATTRwt is unclear. We sought to explore the clinical impact of AFin ATTRwt. Patients with biopsy-proven ATTRwt cardiac amyloidosis (n = 146) were retrospectively identified, and clinical, echocardiographic, and biochemical data were collected. Patients were classified as AFor non-AFand followed for survival for a median of 41.4 ± 27.1 months. Means testing, univariable, and multivariable
Indexed Left Atrial Adipose Tissue Area Is Associated With Severity of Atrial Fibrillation and Atrial Fibrillation Recurrence Among Patients Undergoing Catheter Ablation 29971239 2018 11 14 2297-055X 5 2018 Frontiers in cardiovascular medicine Front Cardiovasc Med Indexed Left Atrial Adipose Tissue Area Is Associated With Severity of Atrial Fibrillation and Atrial Fibrillation Recurrence Among Patients Undergoing Catheter Ablation. 76 10.3389/fcvm.2018.00076 Background: Epicardial adipose (...) tissue (EAT) has been associated with adverse left atrial (LA) remodeling and atrial fibrillation (AF) outcomes, possibly because of paracrine signaling. Objectives: We examined factors associated with a novel measure of EAT i.e., indexed LAEAT (iLAEAT) and its prognostic significance after catheter ablation (CA) of atrial fibrillation (AF). Methods: We performed a retrospective analysis of 274 participants with AFreferred for CA. LAEAT area was measured from a single pre-ablation CT image
Treatment of Atrial Fibrillation in Patients with Co-existing Heart Failure and Reduced Ejection Fraction: Time to Revisit the Management Guidelines? 29967680 2018 11 14 2050-3369 7 2 2018 Jun Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Treatment of Atrial Fibrillation in Patients with Co-existing Heart Failure and Reduced Ejection Fraction: Time to Revisit the Management Guidelines? 91-94 10.15420/aer.2018.17.2 AFin patients with heart failure and reduced ejection (...) fraction (HFrEF) is common and is associated with an increased risk of stroke, heart failure hospitalisation and all-cause mortality. Rhythm control of AFin this population has been traditionally limited to the use of antiarrhythmic drugs. Clinical trials assessing superiority of pharmacological rhythm control over rate control have been largely disappointing. Catheter ablation has emerged as a viable alternative to pharmacological rhythm control in symptomatic AFand has enjoyed significant
Atrial Fibrillation Ablation in Patients with Heart Failure: One Size Does Not Fit All 29967679 2018 11 14 2050-3369 7 2 2018 Jun Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Atrial Fibrillation Ablation in Patients with Heart Failure: One Size Does Not Fit All. 84-90 10.15420/aer.2018.11.3 Atrial fibrillation (AF) is common in patients with heart failure and is associated with poorer clinical outcomes compared with patients with heart failure alone. Recent evidence has (...) strategies. This state-of-the-art review explores the evidence from these trials and examines the need for tailored, patient-specific strategies for AFablation in patients with heart failure. Mukherjee Rahul K RK King's College London London, UK. Williams Steven E SE King's College London London, UK. Guy's and St Thomas' NHS Foundation Trust London, UK. Niederer Steven A SA King's College London London, UK. O'Neill Mark D MD King's College London London, UK. Guy's and St Thomas' NHS Foundation Trust
Risk Factor Management in Atrial Fibrillation 29967684 2018 11 14 2050-3369 7 2 2018 Jun Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Risk Factor Management in Atrial Fibrillation. 118-127 10.15420/aer.2018.18.2 Atrial fibrillation (AF) is the most common clinical arrhythmia and is associated with increased morbidity and mortality. There is growing evidence that numerous cardiovascular diseases and risk factors are associated with incident AFand that lone AFis rare (...) . Beyond oral anticoagulant therapy, rate and rhythm control, therapy targeting risk factors and underlying conditions is an emerging AFmanagement strategy that warrants better implementation in clinical practice. This review describes current evidence regarding the association between known modifiable risk factors and underlying conditions and the development and progression of AF. It discusses evidence for the early management of underlying conditions to improve AFoutcomes. It also provides
Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association | Circulation Search for this keyword Search Search for this keyword Search Header Publisher Menu AHA Scientific Statement Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific (...) , 2018 Lin Y. Chen Mina K. Chung Larry A. Allen Michael Ezekowitz Karen L. Furie Pamela McCabe Peter A. Noseworthy Marco V. Perez Mintu P. Turakhia Jump to Abstract Our understanding of the risk factors and complications of atrial fibrillation (AF) is based mostly on studies that have evaluated AFin a binary fashion (present or absent) and have not investigated AFburden. This scientific statement discusses the published literature and knowledge gaps related to methods of defining and measuring AF
Association of Burden of Atrial Fibrillation With Risk of Ischemic Stroke in Adults With Paroxysmal Atrial Fibrillation: The KP-RHYTHM Study 29799942 2018 11 14 2380-6591 3 7 2018 Jul 01 JAMA cardiology JAMA Cardiol Association of Burden of Atrial Fibrillation With Risk of Ischemic Stroke in Adults With Paroxysmal Atrial Fibrillation: The KP-RHYTHM Study. 601-608 10.1001/jamacardio.2018.1176 Atrial fibrillation is a potent risk factor for stroke, but whether the burden of atrial fibrillation (...) in patients with paroxysmal atrial fibrillation independently influences the risk of thromboembolism remains controversial. To determine if the burden of atrial fibrillation characterized using noninvasive, continuous ambulatory monitoring is associated with the risk of ischemic stroke or arterial thromboembolism in adults with paroxysmal atrial fibrillation. This retrospective cohort study conducted from October 2011 and October 2016 at 2 large integrated health care delivery systems used an extended
Model-based meta-analysis to evaluate optimal doses of direct oral factor Xa inhibitors in atrial fibrillation patients 29760204 2018 11 14 2473-9537 2 10 2018 May 22 Blood advances Blood Adv Model-based meta-analysis to evaluate optimal doses of direct oral factor Xa inhibitors in atrial fibrillation patients. 1066-1075 10.1182/bloodadvances.2017013805 The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrial fibrillation were
Risk of stroke and transient ischaemic attack in patients with a diagnosis of resolved atrial fibrillation: retrospective cohort studies. OBJECTIVES: To determine rates of stroke or transient ischaemic attack (TIA) and all cause mortality in patients with a diagnosis of "resolved" atrial fibrillation compared to patients with unresolved atrial fibrillation and without atrial fibrillation. DESIGN: Two retrospective cohort studies. SETTING: General practices contributing to The Health Improvement (...) Network, 1 January 2000 to 15 May 2016. PARTICIPANTS: Adults aged 18 years or more with no previous stroke or TIA: 11 159 with resolved atrial fibrillation, 15 059 controls with atrial fibrillation, and 22 266 controls without atrial fibrillation. MAIN OUTCOME MEASURES: Primary outcome was incidence of stroke or TIA. Secondary outcome was all cause mortality. RESULTS: Adjusted incidence rate ratios for stroke or TIA in patients with resolved atrial fibrillation were 0.76 (95% confidence interval 0.67
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis. Importance: Vasopressin is an alternative to catecholamine vasopressors for patients with distributive shock-a condition due to excessive vasodilation, most frequently from severe infection. Blood pressure support with a noncatecholamine vasopressor may reduce stimulation of adrenergic receptors and decrease (...) myocardial oxygen demand. Atrial fibrillation is common with catecholamines and is associated with adverse events, including mortality and increased length of stay (LOS). Objectives: To determine whether treatment with vasopressin + catecholamine vasopressors compared with catecholamine vasopressors alone was associated with reductions in the risk of adverse events. Data Sources: MEDLINE, EMBASE, and CENTRAL were searched from inception to February 2018. Experts were asked and meta-registries searched
Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials 29668889 2018 05 17 1522-9645 39 19 2018 May 14 European heart journal Eur. Heart J. Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis (...) of randomized clinical trials. 1726-1735a 10.1093/eurheartj/ehy162 Of patients with atrial fibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population. A systematic review and meta-analysis was conducted using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and relevant meeting abstracts for Phase 3, randomized trials that compared DAT vs. TAT in patients
Incident Risk Factors and Major Bleeding in Patients with Atrial Fibrillation Treated with Oral Anticoagulants: A Comparison of Baseline, Follow-up and Delta HAS-BLED Scores with an Approach Focused on Modifiable Bleeding Risk Factors 29510426 2018 04 04 2567-689X 118 4 2018 Apr Thrombosis and haemostasis Thromb. Haemost. Incident Risk Factors and Major Bleeding in Patients with Atrial Fibrillation Treated with Oral Anticoagulants: A Comparison of Baseline, Follow-up and Delta HAS-BLED Scores (...) with an Approach Focused on Modifiable Bleeding Risk Factors. 768-777 10.1055/s-0038-1636534 When assessing bleeding risk in patients with atrial fibrillation (AF), risk stratification is often based on the baseline risks. We aimed to investigate changes in bleeding risk factors and alterations in the HAS-BLED score in AFpatients. We hypothesized that a follow-up HAS-BLED score and the 'delta HAS-BLED score' (reflecting the change in score between baseline and follow-up) would be more predictive of major
Atrial fibrillation and venous thromboembolism: evidence of bidirectionality in the Atherosclerosis Risk in Communities Study 29431904 2018 04 12 1538-7836 16 4 2018 Apr Journal of thrombosis and haemostasis : JTH J. Thromb. Haemost. Atrial fibrillation and venous thromboembolism: evidence of bidirectionality in the Atherosclerosis Risk in Communities Study. 670-679 10.1111/jth.13974 Essentials Atrial fibrillation (AF) may increase risk of venous thromboembolism (VTE), and vice versa (...) . Bidirectionality was assessed prospectively via data from 15 129 black and white individuals. AFwas associated with greater risk of developing VTE, and VTE with greater risk of AF. Associations were strongest among blacks and in the first 6 months after initial diagnosis. Background Atrial fibrillation (AF) and venous thromboembolism (VTE) frequently co-occur. These conditions have shared risk factors and are accompanied by coagulation abnormalities. Furthermore, mechanistic pathways may directly link
Lifestyle Therapy for the Management of Atrial Fibrillation 29650239 2018 04 30 1879-1913 121 9 2018 May 01 The American journal of cardiology Am. J. Cardiol. Lifestyle Therapy for the Management of Atrial Fibrillation. 1112-1117 S0002-9149(18)30165-6 10.1016/j.amjcard.2018.01.023 Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AFburden (...) . The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016. All studies were graded for quality using the Oxford Centre
Apixaban compared to heparin/vitamin K antagonist in patients with atrial fibrillation scheduled for cardioversion: the EMANATE trial 29659797 2018 04 16 1522-9645 2018 Apr 06 European heart journal Eur. Heart J. Apixaban compared to heparin/vitamin K antagonist in patients with atrial fibrillation scheduled for cardioversion: the EMANATE trial. 10.1093/eurheartj/ehy148 The primary objective was to compare apixaban to heparin/vitamin K antagonist (VKA) in patients with atrial fibrillation (AF (...) 0.19-54.00; nominal P > 0.999). In the safety population, there were 3/735 vs. 6/721 major (RR 0.49; 95% CI 0.10-2.07; nominal P = 0.338) and 11 vs. 13 CRNM bleeding events (RR 0.83; 95% CI 0.34-1.89; nominal P = 0.685). On imaging, 60/61 with thrombi continued randomized treatment; all (61) were without outcome events. Rates of strokes, systemic emboli, deaths, and bleeds were low for both apixaban and heparin/VKA treated AFpatients undergoing cardioversion. NCT02100228. Ezekowitz Michael D MD
A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AFstudy) 29534063 2018 03 25 1549-1676 15 3 2018 Mar PLoS medicine PLoS Med. A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary (...) care setting (the CDS-AFstudy). e1002528 10.1371/journal.pmed.1002528 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 significant undertreatment. The main aim of the current study was to investigate whether a clinical decision support tool (CDS) for stroke prevention integrated in the electronic health record could improve adherence to guidelines for stroke prevention