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Latest & greatest articles for atrial fibrillation
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on atrial fibrillation or other clinical topics then use Trip today.
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Digoxin and Mortality in Patients With AtrialFibrillation Digoxin is widely used in patients with atrialfibrillation (AF).The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration.The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users
Apixaban in patients at risk of stroke undergoing atrialfibrillation ablation It is recommended to perform atrialfibrillation ablation with continuous anticoagulation. Continuous apixaban has not been tested.We compared continuous apixaban (5 mg b.i.d.) to vitamin K antagonists (VKA, international normalized ratio 2-3) in atrialfibrillation patients at risk of stroke a prospective, open, multi-centre study with blinded outcome assessment. Primary outcome was a composite of death, stroke (...) , or bleeding (Bleeding Academic Research Consortium 2-5). A high-resolution brain magnetic resonance imaging (MRI) sub-study quantified acute brain lesions. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) at baseline and at end of follow-up. Overall, 674 patients (median age 64 years, 33% female, 42% non-paroxysmal atrialfibrillation, 49 sites) were randomized; 633 received study drug and underwent ablation; 335 undertook MRI (25 sites, 323 analysable scans). The primary outcome
How to Prevent, Detect and Manage Complications Caused by Cryoballoon Ablation of AtrialFibrillationAtrialfibrillation is the most common cardiac arrhythmia and the prevalence is increasing every year. Patients who fail to maintain sinus rhythm with use of anti-arrhythmic drug therapy are referred for catheter ablation. Cryoballoon (CB) ablation has emerged as an effective and alternative treatment option to traditional point-by-point radiofrequency ablation, but there can be complications (...) . This article reviews the incidence, presentation, risk factors, management and preventative strategies of three major complications associated with CB ablation: phrenic nerve injury, atrial oesophageal fistula and bronchial injury. Although these complications are rare, electrophysiologists should institute measures to identify high-risk patients, implement best-practice techniques to minimise risks and maintain a high index of suspicion to recognise the complications quickly and implement correct
Drivers of AtrialFibrillation: Theoretical Considerations and Practical Concerns Understanding the mechanisms responsible for driving AF is key to improving the procedural success for AF ablation. In this review, we look at some of the proposed drivers of AF, the disagreement between experts and the challenges confronted in attempting to map AF. Defining a 'driver' is also controversial, but for the purposes of this review we will consider an AF driver to be either a focal or localised source
Authorsâ€™ Reply: Hybrid Approach for AtrialFibrillation Ablation: the Jury is Still Out 29686873 2018 11 14 2050-3369 7 1 2018 Mar Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Authors' Reply: Hybrid Approach for AtrialFibrillation Ablation: the Jury is Still Out. 65-66 10.15420/aer.2017.7.1.L3.R3 Pearman Charles M CM Liverpool Heart and Chest Hospital, Liverpool and Manchester Academic Health Science Centre, University of Manchester Manchester, UK. Liverpool Heart
Hybrid Approach for AtrialFibrillation Ablation: the Jury is Still Out 29636976 2018 11 14 2050-3369 7 1 2018 Mar Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Hybrid Approach for AtrialFibrillation Ablation: the Jury is Still Out. 65 10.15420/aer.2017.7.1.L3 Giannopoulos Georgios G Yale School of MedicineNew Haven, CT, USA. Deftereos Spyridon S Yale School of MedicineNew Haven, CT, USA. eng Journal Article England Arrhythm Electrophysiol Rev 101637930 2050-3369 2018 4 12
Systematic Screening for AtrialFibrillation in the Community: Evidence and Obstacles With an ageing population globally, the burden of atrialfibrillation (AF) and its consequent complication of stroke and risk of mortality will continue to increase. Although opportunistic screening for AF by pulse check or ECG rhythm strip for people >65 years of age is currently recommended, data are now emerging that demonstrate the possible benefits of systematic community screening. Such screening
Stroke Risk in Patients With Reduced Ejection Fraction After Myocardial Infarction Without AtrialFibrillation Stroke can occur after myocardial infarction (MI) in the absence of atrialfibrillation (AF).This study sought to identify risk factors (excluding AF) for the occurrence of stroke and to develop a calibrated and validated stroke risk score in patients with MI and heart failure (HF) and/or systolic dysfunction.The datasets included in this pooling initiative were derived from 4 trials
New-Onset AtrialFibrillation After PCI or CABG for Left Main Disease: The EXCEL Trial There is limited information on the incidence and prognostic impact of new-onset atrialfibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD).This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes.In the EXCEL (Evaluation (...) of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization.Among 1,812 patients without atrialfibrillation on presentation, NOAF developed at a mean of 2.7 ± 2.5 days after revascularization in 162 patients
Female Sex Is a Risk Modifier Rather Than a Risk Factor for Stroke in AtrialFibrillation: Should We Use a CHA2DS2-VA Score Rather Than CHA2DS2-VASc? Stroke risk in atrialfibrillation is assessed by using the CHA2DS2-VASc score. Sex category (Sc, ie, female sex) confers 1 point on CHA2DS2-VASc. We hypothesized that female sex is a stroke risk modifier, rather than an overall risk factor, when added to a CHA2DS2-VA (sex-independent thromboembolism risk) score scale.Using 3 nationwide registries (...) , we identified patients with incident nonvalvular atrialfibrillation from January 1, 1997, through December 31, 2015. Patients receiving oral anticoagulant treatment at baseline were excluded, and person-time was censored at the time of treatment initiation (if any). CHA2DS2-VA scores were calculated for men and women, and were followed for up to 1 year in the Danish National Patient Registry. The primary outcome was a primary hospital code for ischemic stroke or systemic embolism
Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrialfibrillation: results of the RACE 3 trial Atrialfibrillation (AF) is a progressive disease. Targeted therapy of underlying conditions refers to interventions aiming to modify risk factors in order to prevent AF. We hypothesised that targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent AF.We randomized patients with early persistent AF
Lifetime Risks, Projected Numbers, and Adverse Outcomes in Asian Patients With AtrialFibrillation: A Report From the Taiwan Nationwide AF Cohort Study Most data on the clinical epidemiology of atrialfibrillation (AF) come from Western populations, and data for Asians are limited. We investigated the lifetime risk and projected number of AF among Asians. The annual risks of adverse events among patients with AF, time trends, and the risks compared with patients without AF were analyzed.Between
In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrialfibrillation Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrialfibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these patients, compare
Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrialfibrillation: a population based study from UK primary care. To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrialfibrillation and chronic kidney disease.Propensity matched, population based, retrospective cohort analysis from January 2006 through (...) December 2016.The Royal College of General Practitioners Research and Surveillance Centre database population of almost 2.73 million patients from 110 general practices across England and Wales.Patients aged 65 years and over with a new diagnosis of atrialfibrillation and estimated glomerular filtration rate (eGFR) of <50 mL/min/1.73m2, calculated using the chronic kidney disease epidemiology collaboration creatinine equation. Patients with a previous diagnosis of atrialfibrillation or receiving
Reveal LINQ insertable cardiac monitor to detect atrialfibrillation after cryptogenic stroke Re Rev veal LINQ insertable cardiac monitor to detect eal LINQ insertable cardiac monitor to detect atrialfibrillation after cryptogenic strok atrialfibrillation after cryptogenic stroke e Medtech innovation briefing Published: 16 February 2018 nice.org.uk/guidance/mib141 pathways Summary Summary The technology technology described in this briefing is Reveal LINQ insertable cardiac monitor (ICM (...) ) with CareLink service for detecting suspected asymptomatic atrialfibrillation (AF) after cryptogenic stroke. The inno innovativ vative aspects e aspects are: a proprietary AF detection algorithm, which is designed to reduce false positive detections; small device size, which allows insertion outside a catheterisation lab; and memory capacity offering sufficient recording time to establish symptom–rhythm correlations. The intended place in ther intended place in therap apy y is in addition to standard care
Prediction of Incident AtrialFibrillation According to Gender in Patients With Ischemic Stroke From a Nationwide Cohort The CHA2DS2-VASc score may identify patients at higher risk of atrialfibrillation (AF) following ischemic stroke (IS) in patients without known AF. We compared gender-related differences in items from CHA2DS2-VASc score and their relation with AF occurrence after IS. This French cohort study was based on the database covering hospital care from 2009 to 2012 for the entire
Predictors of Mortality in Patients With AtrialFibrillation (from the AtrialFibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events [ACTIVE A]) The mortality rate of most patients with atrialfibrillation (AF) exceeds the stroke rate, but predictors of mortality have not been well defined. The AtrialFibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE A) recruited patients with AF who were unsuitable to receive vitamin K
[Trancatheter ablation with cryoballoon for the treatment of atrialfibrillation. A rapid assessment] Ablazione transcatetere mediante criopallone per il trattamento della fibrillazione atriale. Valutazione rapida [Trancatheter ablation with cryoballoon for the treatment of atrialfibrillation. A rapid assessment] Ablazione transcatetere mediante criopallone per il trattamento della fibrillazione atriale. Valutazione rapida [Trancatheter ablation with cryoballoon for the treatment of atrial (...) fibrillation. A rapid assessment] Negro A, Maltoni S, Pecoraro V, Camerlingo M, Falasca G, Lauretti F. Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Negro A, Maltoni S, Pecoraro V, Camerlingo M, Falasca G, Lauretti F.. Ablazione transcatetere mediante criopallone per il trattamento della fibrillazione atriale. Valutazione rapida. [Trancatheter
Catheter Ablation for AtrialFibrillation with Heart Failure. Mortality and morbidity are higher among patients with atrialfibrillation and heart failure than among those with heart failure alone. Catheter ablation for atrialfibrillation has been proposed as a means of improving outcomes among patients with heart failure who are otherwise receiving appropriate treatment.We randomly assigned patients with symptomatic paroxysmal or persistent atrialfibrillation who did not have a response (...) to antiarrhythmic drugs, had unacceptable side effects, or were unwilling to take these drugs to undergo either catheter ablation (179 patients) or medical therapy (rate or rhythm control) (184 patients) for atrialfibrillation in addition to guidelines-based therapy for heart failure. All the patients had New York Heart Association class II, III, or IV heart failure, a left ventricular ejection fraction of 35% or less, and an implanted defibrillator. The primary end point was a composite of death from any
Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrialfibrillation Randomized clinical trials comparing direct oral anticoagulants (DOACs) to warfarin in cancer patients have not been performed. We evaluated the effectiveness and associated risk of DOACs vs warfarin, as well as comparisons of DOACs, in a large population of cancer patients with nonvalvular atrialfibrillation (AF). Using the MarketScan databases, we identified 16 096 AF patients