Latest & greatest articles for atrial fibrillation

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Top results for atrial fibrillation

801. Management of newly detected atrial fibrillation: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians.

Management of newly detected atrial fibrillation: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. The Joint Panel of the American Academy of Family Physicians and the American College of Physicians, in collaboration with the Johns Hopkins Evidence-based Practice Center, systematically reviewed the available evidence on the management of newly detected atrial fibrillation and developed recommendations for adult patients (...) with first-detected atrial fibrillation. The recommendations do not apply to patients with postoperative or post-myocardial infarction atrial fibrillation, patients with class IV heart failure, patients already taking antiarrhythmic drugs, or patients with valvular disease. The target physician audience is internists and family physicians dedicated to primary care. The recommendations are as follows: RECOMMENDATION 1: Rate control with chronic anticoagulation is the recommended strategy for the majority

Annals of Internal Medicine2003

802. Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography.

Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. PURPOSE: This review summarizes the available evidence regarding the efficacy of medications used for ventricular rate control, stroke prevention, acute conversion, and maintenance of sinus rhythm, as well as the efficacy of electrical cardioversion and the use of echocardiography in patients with atrial fibrillation. DATA SOURCES: The Cochrane (...) Collaboration's database of controlled clinical trials and MEDLINE. STUDY SELECTION: Primarily randomized, controlled trials of medications. DATA EXTRACTION: Paired reviewers obtained data on efficacy and safety. Strength of evidence was assessed. DATA SYNTHESIS: Recent clinical trial results showed that most patients with atrial fibrillation have similar outcomes with strategies for controlling ventricular rate compared with strategies for restoring sinus rhythm. For efficacy of primary stroke prevention

Annals of Internal Medicine2003

803. Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation.

Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation. BACKGROUND: The incidence of stroke in patients with atrial fibrillation is greatly reduced by oral anticoagulation, with the full effect seen at international normalized ratio (INR) values of 2.0 or greater. The effect of the intensity of oral anticoagulation on the severity of atrial fibrillation-related stroke is not known but is central to the choice of the target INR. METHODS: We studied (...) incident ischemic strokes in a cohort of 13,559 patients with nonvalvular atrial fibrillation. Strokes were identified through hospitalization data bases and validated on the basis of medical records, which also provided information on the use of warfarin or aspirin, the INR at admission, and coexisting illnesses. The severity of stroke was graded according to a modified Rankin scale. Thirty-day mortality was ascertained from hospitalization and mortality files. RESULTS: Of 596 ischemic strokes, 32

NEJM2003

804. A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study.

A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. CONTEXT: Prior risk stratification schemes for atrial fibrillation (AF) have been based on randomized trial cohorts or Medicare administrative databases, have included patients with established AF, and have focused on stroke as the principal outcome. OBJECTIVE: To derive risk scores for stroke alone and stroke or death in community-based individuals (...) with new-onset AF. DESIGN, SETTING, AND PARTICIPANTS: Prospective, community-based, observational cohort in Framingham, Mass. We identified 868 participants with new-onset AF, 705 of whom were not treated with warfarin at baseline. Risk scores for stroke (ischemic or hemorrhagic) and stroke or death were developed with censoring when warfarin initiation occurred during follow-up. Event rates were examined in low-risk individuals, as defined by the risk score and 4 previously published risk schemes

JAMA2003

805. Lessons from the Stroke Prevention in Atrial Fibrillation trials.

Lessons from the Stroke Prevention in Atrial Fibrillation trials. Atrial fibrillation predisposes to left atrial thrombus formation and carries a sixfold increased risk for stroke. Antithrombotic therapies are the mainstay for stroke prevention. The National Institute of Neurological Disorders and Stroke-sponsored Stroke Prevention in Atrial Fibrillation (SPAF) studies assessed the value of warfarin, aspirin, and their combination for preventing stroke in six multicenter trials involving 3950 (...) participants. This review presents the major results and implications, which offer unique perspectives on antithrombotic therapies for stroke prevention in atrial fibrillation. Warfarin and aspirin reduce stroke. Anticoagulation substantially benefits high-risk patients with atrial fibrillation, while many younger patients with atrial fibrillation have a low stroke rate when given aspirin. Pathogenetic and transesophageal echocardiographic correlations shed light on mechanisms by which antithrombotic

Annals of Internal Medicine2003

806. Pulmonary vein stenosis after catheter ablation of atrial fibrillation: emergence of a new clinical syndrome.

Pulmonary vein stenosis after catheter ablation of atrial fibrillation: emergence of a new clinical syndrome. BACKGROUND: Pulmonary vein isolation is a new, effective curative procedure for selected patients with atrial fibrillation. Pulmonary vein stenosis is a potential complication and may lead to symptoms that are often underrecognized. OBJECTIVE: To describe the clinical course and symptoms associated with pulmonary vein stenosis developing after ablation in the pulmonary veins. DESIGN (...) : Retrospective study. SETTING: Tertiary care referral center. PATIENTS: 335 patients referred for catheter ablation of drug-refractory atrial fibrillation. INTERVENTION: Pulmonary vein electrical isolation using radiofrequency catheter ablation. MEASUREMENTS: Three months after ablation, patients underwent routine screening for pulmonary vein stenosis with spiral computed tomography. Screening was considered earlier if symptoms suggestive of stenosis developed and was repeated at 6 and 12 months if any

Annals of Internal Medicine2003

807. Temporary atrial epicardial pacing as prophylaxis against atrial fibrillation after heart surgery: a meta-analysis

Temporary atrial epicardial pacing as prophylaxis against atrial fibrillation after heart surgery: a meta-analysis Temporary atrial epicardial pacing as prophylaxis against atrial fibrillation after heart surgery: a meta-analysis Temporary atrial epicardial pacing as prophylaxis against atrial fibrillation after heart surgery: a meta-analysis Daoud E G, Snow R, Hummel J D, Kalbfleisch S J, Weiss R, Augostini R CRD summary This review assessed the short-term use of pacemakers to prevent (...) atrial fibrillation after heart surgery. The authors concluded that evidence supports the use of pacemakers. The review had a limited search, review methods were not always reported and there was some confusion about numerical values in the paper. These factors make it difficult to assess the reliability of the conclusions. Authors' objectives To assess the effect of pacing therapies for the prevention of new-onset atrial fibrillation following cardiac surgery. Searching MEDLINE, bibliographies of identified

DARE.2003

808. Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis

Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis Chevalier P, Durand-Dubief A, Burri H, Cucherat M, Kirkorian G, Touboul P CRD summary This well reported review compared amiodarone with placebo (...) or class Ic drugs for the cardioversion of recent-onset atrial fibrillation (AF). Even though the onset of conversion was delayed, the efficacy of amiodarone was similar at 24 hours compared with class Ic drugs. The conclusions reached by the authors seem valid and the limited generalisability of the findings was acknowledged. Authors' objectives To conduct a meta-analysis comparing amiodarone with placebo or class Ic drugs for the cardioversion of recent-onset atrial fibrillation (AF). Searching

DARE.2003

809. Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis

Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis Letelier L M, Udol K, Ena J, Weaver B, Guyatt G H CRD summary This review assessed the effectiveness of amiodarone in treating atrial fibrillation (AF). In this thorough and well-conducted review (...) , the authors concluded that amiodarone is effective in treating AF in a wide range of patients. However, as information on adverse events was limited, further studies are required. Authors' objectives To assess the effect of amiodarone in converting atrial fibrillation (AF) to sinus rhythm. Searching MEDLINE (January 1966 to February 2001), EMBASE (January 1980 to September 2000), the Cochrane Controlled Trials Register (Issue 3, 2000) and Best Evidence (January 1991 to September 2000) were searched using

DARE.2003

810. Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources

Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources Goldberg A, Menen M, Mickelsen S, MacIndoe C, Binder M, Nawman R, West G, Kusumoto F M Record Status (...) . Study population The study population comprised patients referred for radiofrequency catheter ablation for drug refractory atrial fibrillation. Setting The setting was secondary care. The economic study was carried out in Albuquerque, USA. Dates to which data relate The effectiveness data were collected for patients referred to the medical centre between June 1996 and June 1997. The cost information was collected for the same time period. The price year was 2001. Source of effectiveness data

NHS Economic Evaluation Database.2003

811. Effectiveness and costs of chemical versus electrical cardioversion of atrial fibrillation

Effectiveness and costs of chemical versus electrical cardioversion of atrial fibrillation Effectiveness and costs of chemical versus electrical cardioversion of atrial fibrillation Effectiveness and costs of chemical versus electrical cardioversion of atrial fibrillation De Paola A A, Figueiredo E, Sesso R, Veloso H H, Nascimento L O Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The study compared the use of chemical versus electrical cardioversion as an initial treatment to convert atrial fibrillation (AF) to sinus rhythm in patients with persistent AF of less than 6 months. The authors not only compared the initial strategies, but they also evaluated whether a strategy that started with either method followed

NHS Economic Evaluation Database.2003

812. Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection

Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection Lanza L A, Visbal A I, DeValeria P A, Zinsmeister A R, Diehl N N, Trastek V F Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of low-dose oral amiodarone (LDOA) as prophylactic treatment for atrial fibrillation (AF) after pulmonary resection. LDOA comprised 200 mg by mouth every 8 hours. Treatment was started after recovery from general anaesthesia and was discontinued at dismissal. Type of intervention Secondary prevention. Economic study type

NHS Economic Evaluation Database.2003

813. Rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation

Rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation Rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation Rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation Institute for Clinical Systems Improvement Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database (...) . Citation Institute for Clinical Systems Improvement. Rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation. Bloomington MN: Institute for Clinical Systems Improvement (ICSI) 2003 Authors' objectives This review aims to assess the available evidence on rhythm therapy versus rate control for long-term management of recurrent atrial fibrillation (AF). Authors' conclusions With regard to rhythm therapy versus rate control for long-term management of recurrent

Health Technology Assessment (HTA) Database.2003

814. Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial.

Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial. 14643116 2003 12 03 2004 02 04 2015 06 16 1474-547X 362 9397 2003 Nov 22 Lancet (London, England) Lancet Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial. 1691-8 Warfarin (...) prevents ischaemic stroke in patients with non-valvular atrial fibrillation, but dose adjustment, coagulation monitoring, and bleeding risk limit its use. The oral direct thrombin inhibitor ximelagatran represents a potential alternative. We aimed to establish whether ximelagatran is non-inferior to warfarin, within a margin of 2% per year, for prevention of stroke and systemic embolism. We randomised 3410 patients with atrial fibrillation and one or more stroke risk factors to open-label warfarin

Lancet2003

815. Atrial fibrillation: strategies to control, combat, and cure.

Atrial fibrillation: strategies to control, combat, and cure. Atrial fibrillation is the commonest clinical arrhythmia, is increasing in incidence and prevalence, and is associated with substantial morbidity and mortality. The arrhythmia may be paroxysmal (self-limiting), persistent (amenable to cardioversion), or permanent. Especially in its paroxysmal form, atrial fibrillation may be initiated by rapidly firing foci, generally located in the proximal pulmonary veins. Sustained (...) atrial fibrillation is maintained by an atrial tissue substrate capable of accommodating many meandering wavelets. With continuing arrhythmia, the electrophysiological properties of the atria change and further facilitate continuing fibrillation. Treatment is aimed at prevention of thromboembolic complications, restoration and maintenance of sinus rhythm, and control of ventricular rate during atrial fibrillation. With greater understanding of the arrhythmia mechanisms, it is becoming possible to offer targeted

Lancet2002

816. Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials

Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials Hilleman D E, Spinler S A Authors' objectives To evaluate the efficacy and safety of intravenous amiodarone for conversion (...) of recent-onset atrial fibrillation (AF). Searching MEDLINE was searched from January 1975 to March 2001 for studies published in the English language. The search terms were 'atrial fibrillation', 'amiodarone' and 'cardioversion'. Pertinent review articles and the reference lists in the identified studies were examined for additional studies. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were eligible. Specific interventions included

DARE.2002

817. Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation

Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation Nichol G, McAlister F, Pham B (...) , Laupacis A, Shea B, Green M, Tang A, Wells G Authors' objectives To assess the effectiveness of anti-arrhythmic drugs at promoting sinus rhythm in patients with atrial fibrillation by conducting a meta-analysis of randomised controlled trials (RCTs). Searching MEDLINE was searched for trials for which results were available by August 2001; the search terms were reported. The bibliographies of relevant articles were examined. Only articles published in the English language were sought. Unpublished

DARE.2002

818. Amiodarone vs sotalol as prophylaxis against atrial fibrillation/flutter after heart surgery: a meta-analysis

Amiodarone vs sotalol as prophylaxis against atrial fibrillation/flutter after heart surgery: a meta-analysis Amiodarone vs sotalol as prophylaxis against atrial fibrillation/flutter after heart surgery: a meta-analysis Amiodarone vs sotalol as prophylaxis against atrial fibrillation/flutter after heart surgery: a meta-analysis Wurdeman R L, Mooss A N, Mohiuddin S M, Lenz T L Authors' objectives To compare the efficiency of sotalol versus amiodarone in preventing the occurrence (...) of atrial fibrillation or flutter (AFF) after coronary artery bypass graft (CABG) surgery. Searching MEDLINE was searched from 1985 to 2000 for publications in the English language, using the terms 'coronary artery bypass', 'atrial fibrillation', 'atrial flutter' and 'supraventricular arrhythmias'. The reference lists from the retrieved articles were also examined. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were eligible for inclusion in the review

DARE.2002

819. Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis

Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Desbiens N A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The health intervention examined in the study was anticoagulation treatment with warfarin in patients with nonrheumatic atrial fibrillation (AF). Type of intervention Treatment. Economic study type Cost-utility analysis. Study population The study population comprised patients aged 65 to 100 years with nonrheumatic AF. Setting

NHS Economic Evaluation Database.2002

820. Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial

Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial Lumer G B, Roy D, Talajic M, Couturier A, Lambert J, Frasure-Smith N, Thibault B, Dubuc M, Gagne P, Nattel S Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Low-dose amiodarone was compared with other first-line therapy (sotalol or propafenone) for the treatment of atrial fibrillation (AF). Type of intervention Primary prevention. Economic study type Cost-effectiveness analysis. Study population The study population

NHS Economic Evaluation Database.2002