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Fibrilation atrial guidelines

Tilmann Kramer, Daniel Dumitrescu, Felix Gerhardt, Kristina Orlova, Henrik Ten Freyhaus, Martin Hellmich, Stephan Baldus, Stephan Rosenkranz
OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is frequently associated with pulmonary hypertension (PH), which substantially impacts survival. Based on pulmonary vascular resistance (PVR) and the diastolic pressure gradient (DPG), current guidelines distinguish between isolated post-capillary PH (IpcPH) and combined post- and pre-capillary PH (CpcPH). However, the therapeutic consequences of this sub-classification remain entirely unclear. We specifically investigated the efficacy and safety of PDE5i in patients with HFpEF and CpcPH...
January 4, 2019: International Journal of Cardiology
Stefan H Hohnloser, Marat Fudim, John H Alexander, Daniel M Wojdyla, Justin A Ezekowitz, Michael Hanna, Dan Atar, Ziad Hijazi, M Cecilia Bahit, Sana M Al-Khatib, Jose Luis Lopez-Sendon, Lars Wallentin, Christopher B Granger, Renato D Lopes
BACKGROUND: Guidelines caution against the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with extremely high (>120 kg) or low (≤60 kg) body weight due to lack of data in these populations. METHODS: In a post-hoc analysis of ARISTOTLE (n=18,201), a randomized trial comparing apixaban with warfarin for the prevention of stroke in patients with AF, we estimated the randomized treatment effect (apixaban vs. warfarin) stratified by body weight (≤60, >60-120, >120 kg) using a Cox regression model and tested the interaction between body weight and randomized treatment...
February 18, 2019: Circulation
David Pilecky, Mate Vamos, Peter Bogyi, Balazs Muk, Dora Stauder, Hajnalka Racz, Noemi Nyolczas, Gabor Z Duray, Gabor Zacher, Endre Zima
OBJECTIVE: Patients with electrical injury are considered to be at high risk of cardiac arrhythmias. Due to the small number of studies, there is no widely accepted guideline regarding the risk assessment and management of arrhythmic complications after electrical accident (EA). Our retrospective observational study was designed to determine the prevalence of ECG abnormalities and cardiac arrhythmias after EA, to evaluate the predictive value of cardiac biomarkers for this condition and to assess in-hospital and 30-day mortality...
February 15, 2019: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Stefan H Hohnloser, Edin Basic, Michael Nabauer
BACKGROUND: Underuse of oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF) results in thousands of preventable strokes in Germany each year. This study aimed to assess changes in antithrombotic therapy in AF patients after increased use of direct oral anticoagulants (DOACs) in Germany and to evaluate whether the adoption of DOAC therapy was associated with changes in AF-related stroke and bleeding over time. METHODS: Analyses were carried out on a large claims-based dataset of 4 million health-insured Germans...
February 15, 2019: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Pierluigi Merella, Gavino Casu, Patrizio Mazzone, Giovanni Lorenzoni, Giuseppe D'Angelo, Simonetta Genovesi
Non-valvular atrial fibrillation (AF) is the most frequent arrhythmia in the general population and its prevalence increases with age. The prevalence and incidence of AF is high in patients with chronic kidney failure (CKD). The most important complication associated with AF, both in the general population and in that with CKD, is thromboembolic stroke. For this reason, in patients with AF, the Guidelines indicate oral anticoagulant therapy (OAT) with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for thromboembolic risk prevention...
February 2019: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Alexander Wutzler, Christos Krogias, Anna Grau, Roland Veltkamp, Peter U Heuschmann, Karl Georg Haeusler
BACKGROUND: Atrial fibrillation (AF) is present in 15-20% of patients with acute ischemic stroke. Oral anticoagulation reduces the risk of AF-related recurrent stroke but clinical guideline recommendations are rather vague regarding its use in the acute phase of stroke. We aimed to assess the current clinical practice of medical stroke prevention in AF patients during the acute phase of ischemic stroke. METHODS: In April 2017, a standardized anonymous questionnaire was sent to clinical leads of all 298 certified stroke units in Germany...
February 12, 2019: BMC Neurology
Charles M Pearman, James Redfern, Emmanuel A Williams, Richard L Snowdon, Paul Modi, Mark C S Hall, Simon Modi, Johan E P Waktare, Saagar Mahida, Derick M Todd, Neeraj Mediratta, Dhiraj Gupta
Aims: Video-assisted thoracoscopic surgery (VATS) ablation has been advocated as a treatment option for non-paroxysmal atrial fibrillation (AF) in recent guidelines. Real-life data on its safety and efficacy during a centre's early experience are sparse. Methods and results: Thirty patients (28 persistent/longstanding persistent AF) underwent standalone VATS ablation for AF by an experienced thoracoscopic surgeon, with the first 20 cases proctored by external surgeons...
February 6, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hai-Di Wu, Hong-Yan Cao, Zi-Kai Song, Shuo Yang, Ming-Long Tang, Yang Liu, Ling Qin
BACKGROUND: Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that does not require coagulation monitoring based on current recommendations. Our goal is to explore whether routine coagulation monitoring should not be required for all patients receiving oral rivaroxaban, what relationship between routine coagulation abnormalities and bleeding, and how to deal with the above clinical situations through our case and review of the literature. CASE SUMMARY: We report a 67-year-old woman with a history of atrial fibrillation who presented to the hospital with worsening dyspnea and cough...
February 6, 2019: World Journal of Clinical Cases
Monique Young
The purpose of this article is to educate staff nurses and advanced practice nurses the importance of identifying, diagnosing, and making appropriate clinical decisions when treating patients with atrial fibrillation. Atrial fibrillation is a supraventricular arrhythmia characterized by uncoordinated, chaotic electrical activity and deterioration of proper atrial mechanical function, with an irregular ventricular response. Poorly controlled or undiagnosed atrial fibrillation increases the risk of mortality and may decrease quality of life...
March 2019: Critical Care Nursing Clinics of North America
Lucas Van Hoof, Kristof De Brabandere, Steffen Fieuws, Bernard Stockman, Herbert Gutermann, Filip Rega
BACKGROUND: The Belgian 'National Institute for Health and Disability Insurance (RIZIV-INAMI)' requested prospective collection of data on all ablations in Belgium to determine the outcomes of surgical ablation of atrial fibrillation (AF) during concomitant cardiac surgery. METHODS: 890 patients undergoing concomitant ablation for AF between 2011 and 2016 were prospectively followed. Freedom from AF with and without anti-arrhythmic drugs was calculated for 817 patients with follow-up beyond the 3-month blanking period and for 574 patients with sufficient rhythm-related follow-up consisting of at least one Holter registration or a skipped Holter due to AF being evident on ECG...
February 8, 2019: Acta Cardiologica
Shinya Goto, Pantep Angchaisuksiri, Jean-Pierre Bassand, A John Camm, Helena Dominguez, Laura Illingworth, Harry Gibbs, Samuel Z Goldhaber, Shinichi Goto, Zhi-Cheng Jing, Sylvia Haas, Gloria Kayani, Yukihiro Koretsune, Toon Wei Lim, Seil Oh, Jitendra P S Sawhney, Alexander G G Turpie, Martin van Eickels, Freek W A Verheugt, Ajay K Kakkar
Background Using data from the GARFIELD - AF (Global Anticoagulant Registry in the FIELD -Atrial Fibrillation), we evaluated the impact of chronic kidney disease ( CKD ) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation ( AF ). Methods and Results GARFIELD - AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013-2016) were classified with no, mild, or moderate-to-severe CKD , based on the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines...
February 5, 2019: Journal of the American Heart Association
Sharan Prakash Sharma, Mohit Turagam, Donita Atkins, Sudha Bommana, Courtney Jeffrey, Diana Newton, Cheri Nydegger, Heidi Carroll, Rakesh Gopinathannair, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: Dofetilide is a commonly used class III anti-arrhythmic drug for atrial fibrillation. Drug guidelines mandates waiting for 3-month prior to initiating dofetilide after amiodarone use. It is not known if patients with implantable cardioverter defibrillator (ICD) can be rapidly switched from amiodarone to dofetilide. OBJECTIVE: We aimed to evaluate if rapid switching of amiodarone to dofetilide is safe in atrial fibrillation patients with ICD. METHODS: In this retrospective observational study, we assessed the feasibility as well as short- and long-term safety of rapid switching from amiodarone to dofetilide in hospitalized patients with atrial fibrillation with an ICD...
January 30, 2019: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Kelly Arps, Vincent A Pallazola, Rhanderson Cardoso, Joseph Meyer, Richard Jones, Jacqueline Latina, Ty J Gluckman, Neil J Stone, Roger S Blumenthal, John W McEvoy
Efforts to better control risk factors for cardiovascular disease and prevent the development of subsequent events are crucial to maintaining healthy populations. In today's busy practice environment and with the overwhelming pace of new research findings, ensuring appropriate emphasis and implementation of evidence-based preventive cardiovascular care can be challenging. The ABCDEF approach to cardiovascular disease prevention is intended to improve dissemination of contemporary best practices and facilitate the implementation of comprehensive preventive strategies for clinicians...
January 30, 2019: American Journal of Medicine
Sahereh Mirzaei, Patricia E Hershberger, Holli A DeVon
BACKGROUND: Bleeding is a serious complication of coronary artery bypass grafting that often leads to blood transfusion. Approximately 50% of patients who have the surgery receive blood products, and blood transfusions play a role in adverse outcomes after the surgery. OBJECTIVE: To examine the association between perioperative blood transfusion and postoperative adverse outcomes in patients undergoing coronary artery bypass grafting. METHODS: A systematic review of the literature, via the matrix method of quality evaluation, was conducted...
February 2019: Critical Care Nurse
Mark Steven Link
No abstract text is available yet for this article.
February 1, 2019: Circulation
Daniele Pastori, John W Eikelboom, Sonia S Anand, Manesh Raman Patel, Jean-Francois Tanguay, Jean-Baptiste Ricco, Eike Sebastian Debus, Lucia Mazzolai, Rupert Bauersachs, Peter Verhamme, Jackie Bosch, Sigrid Nikol, Mark Nehler, Victor Aboyans, Francesco Violi
The most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events...
January 31, 2019: Thrombosis and Haemostasis
Craig T January, L Samuel Wann, Hugh Calkins, Michael E Field, Lin Y Chen, Karen L Furie, Joaquin E Cigarroa, Paul A Heidenreich, Joseph C Cleveland, Katherine T Murray, Patrick T Ellinor, Julie B Shea, Michael D Ezekowitz, Cynthia M Tracy, Clyde W Yancy
No abstract text is available yet for this article.
January 23, 2019: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Craig T January, L Samuel Wann, Hugh Calkins, Lin Y Chen, Joaquin E Cigarroa, Joseph C Cleveland, Patrick T Ellinor, Michael D Ezekowitz, Michael E Field, Karen L Furie, Paul A Heidenreich, Katherine T Murray, Julie B Shea, Cynthia M Tracy, Clyde W Yancy
No abstract text is available yet for this article.
January 21, 2019: Journal of the American College of Cardiology
Marco Ferlini, Silvia Mauri, Roberta Rossini
Current guidelines recommend a three- to six-months dual antiplatelet therapy (DAPT) in patients undergoing transcatheter aortic valve replacement (TAVR) or to continue with oral anticoagulant agents (OAC) if already indicated before procedure. However, recent studies showed that treatment with aspirin has the same efficacy of DAPT but it was associated with a significant reduction of major bleeding. Furthermore, half of cerebrovascular events, occurring >24 h after procedure, may be related to new onset of atrial fibrillation or to subclinical leaflets thrombosis and they may be prevented by use of OAC rather than antiplatelet therapy...
January 23, 2019: International Journal of Cardiology
Jonathan P Piccini, Haolin Xu, Margueritte Cox, Roland A Matsouaka, Gregg C Fonarow, Javed Butler, Anne B Curtis, Nihar Desai, Margaret Fang, Pamela J McCabe, Robert L Page, Mintu Turakhia, Andrea M Russo, Bradley P Knight, Mandeep Sidhu, Jodie L Hurwitz, Kenneth A Ellenbogen, William R Lewis
BACKGROUND: Efforts to improve oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) have had limited success in improving guideline adherence. METHODS: We evaluated adherence to the ACC/AHA performance measures for OAC in eligible patients with a CHA2DS2-VASc≥2 and trends in prescription over time in the American Heart Association's Get With The Guidelines (GWTG) AFIB registry. Adjusted associations with in-hospital outcomes were also determined...
January 31, 2019: Circulation
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