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atrial fibrillation recurrence risk factors

Douglas L Packer, Daniel B Mark, Richard A Robb, Kristi H Monahan, Tristram D Bahnson, Jeanne E Poole, Peter A Noseworthy, Yves D Rosenberg, Neal Jeffries, L Brent Mitchell, Greg C Flaker, Evgeny Pokushalov, Alexander Romanov, T Jared Bunch, Georg Noelker, Andrey Ardashev, Amiran Revishvili, David J Wilber, Riccardo Cappato, Karl-Heinz Kuck, Gerhard Hindricks, D Wyn Davies, Peter R Kowey, Gerald V Naccarelli, James A Reiffel, Jonathan P Piccini, Adam P Silverstein, Hussein R Al-Khalidi, Kerry L Lee
Importance: Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain. Objective: To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF. Design, Setting, and Participants: The Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is an investigator-initiated, open-label, multicenter, randomized trial involving 126 centers in 10 countries...
March 15, 2019: JAMA: the Journal of the American Medical Association
George Lazaros, Alexios S Antonopoulos, Massimo Imazio, Eirini Solomou, Emilia Lazarou, Dimitrios Vassilopoulos, Yehuda Adler, Christodoulos Stefanadis, Dimitris Tousoulis
The clinical significance of pleural effusions (PLEs) in the setting of acute pericarditis remains poorly investigated. We sought to identify predictive factors for PLEs and their association with the short- and long-term prognosis of patients with acute pericarditis. We enrolled 177 patients hospitalized with a first episode of acute pericarditis. In all cases an extensive clinical, biochemical, and diagnostic work-up to detect PLEs and establish etiological diagnosis was performed. All patients included were prospectively followed for a maximum of 18 months (median 12, range 1-18) and complications were recorded...
March 13, 2019: Internal and Emergency Medicine
Jae Hyun Kim, Woo Sung Jang, Jae-Bum Kim, Sook Jin Lee
Background: An enlarged left atrium (LA) is a well-known risk factor for ablation failure of atrial fibrillation (AF). We analyzed the result of concomitant AF ablation in patients with a giant LA and evaluated the effect of LA volume reduction. Methods: Between 2000 and 2011, 116 patients with a giant LA (antero-posterior dimension ≥70 mm) who underwent surgical AF ablation during MV surgery were retrospectively reviewed. Among these, 28 patients received aggressive LA volume reduction procedure (reduction group) while the other 88 patients received the surgery without LA volume reduction (non-reduction group)...
January 2019: Journal of Thoracic Disease
Eduardo Thadeu de Oliveira Correia, Letícia Mara Dos Santos Barbetta, Othon Moura Pereira da Silva, Evandro Tinoco Mesquita
BACKGROUND: Radiofrequency catheter ablation (RFCA) is a standard procedure for patients with atrial fibrillation (AF) not responsive to previous treatments, that has been increasingly considered as a first-line therapy. In this context, perioperative screening for risk factors has become important. A previous study showed that a high left atrial (LA) pressure is associated with AF recurrence after ablation, which may be secondary to a stiff left atrium. OBJECTIVE: To investigate, through a systematic review and meta-analysis, if LA stiffness could be a predictor of AF recurrence after RFCA, and to discuss its clinical use...
March 7, 2019: Arquivos Brasileiros de Cardiologia
Takashi Kakuta, Satsuki Fukushima, Kimito Minami, Yusuke Shimahara, Takuma Yamasaki, Yorihiko Matsumoto, Kizuku Yamashita, Naonori Kawamoto, Naoki Tadokoro, Daijiro Kabata, Junjiro Kobayashi, Tomoyuki Fujita
OBJECTIVES: As an institutional strategy, the CryoMaze procedure has been established for treating atrial fibrillation (AF) since 2001. In this study, we aimed to analyse the contemporary outcomes of the CryoMaze procedure and to examine the predictive factors of successful sinus rhythm conversion. METHODS: Between January 2009 and March 2018, we performed 352 CryoMaze procedures. The contemporary outcomes of the CryoMaze procedure concomitant with other cardiac procedures were analysed by the Kaplan-Meier method...
February 28, 2019: Interactive Cardiovascular and Thoracic Surgery
Ying Zhang, Yalin Guan, Yajing Zhang, Shuling Liu, Man Zheng, Min Wang, Wenhua Su, Hao Wu
Small artery occlusion (SAO) is responsible for 31.3% of all ischemic strokes in China. However, reports regarding the recurrence rate of SAO in China are rare. We aimed to assess the recurrence rate and factors associated with SAO in China. All consecutive patients with SAO hospitalized at Tianjin Huanhu Hospital from 2005 to 2014 were recruited. We assessed the association between stroke subtype, severity, and disease history with recurrence at 3, 12, and 36 months of onset using multivariate logistic regression analysis...
February 26, 2019: Scientific Reports
Won Seok Choe, Jun Hyuk Kang, Eue Keun Choi, Seung Yong Shin, Steven A Lubitz, Patrick T Ellinor, Seil Oh, Hong Euy Lim
BACKGROUND AND OBJECTIVES: The association of susceptibility loci for atrial fibrillation (AF) with AF recurrence after ablation has been reported, although with controversial results. In this prospective cohort analysis, we aimed to investigate whether a genetic risk score (GRS) can predict the rhythm outcomes after catheter ablation of AF. METHODS: We determined the association between 20 AF-susceptible single nucleotide polymorphisms (SNPs) and AF recurrence after catheter ablation in 746 patients (74% males; age, 59±11 years; 56% paroxysmal AF)...
December 17, 2018: Korean Circulation Journal
Yubing Wang, Yanping Xu, Zhiyu Ling, Weijie Chen, Li Su, Huaan Du, Peilin Xiao, Zengzhang Liu, Yuehui Yin
OBJECTIVE: This study was performed to observe the effect of radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF) and to explore the risk factors for late recurrence of atrial fibrillation (LRAF) after a single RFCA session. METHODS: In this retrospective study, 243 patients with PAF underwent RFCA and were followed up regularly. RESULTS: At a median follow-up of 37 months after a single procedure, 60...
February 26, 2019: Journal of International Medical Research
Yusuke Ebana, Tetsushi Furukawa
Atrial fibrillation (AF) can be initiated from arrhythmogenic foci within the muscular sleeves that extend not only into the pulmonary veins but also into both vena cavae. Patients with SVC-derived AF have the common clinical and genetic risk factors. Bayesian network analysis is a probabilistic model in which a qualitative dependency relationship among random variables is represented by a graph structure and a quantitative relationship between individual variables is expressed by a conditional probability...
March 2019: IJC Heart & Vasculature
Rose Mary Ferreira Lisboa Da Silva, Cláudia Madeira Miranda, Tong Liu, Gary Tse, Leonardo Roever
Atrial fibrillation (AF) is one of the cardiovascular risk factors for dementia. Several longitudinal studies have reported an association between AF and dementia independently of stroke history. Although the mechanisms underlying this association are not fully understood, proposed mechanisms include cerebral hypoperfusion, inflammation, genetic factors, cerebral microbleeds, and recurrent silent cerebral ischemia. Oral anticoagulation can be used to minimize risk of cognitive decline and dementia, given that brain insults can be caused by chronic microemboli or microbleeds...
2019: Frontiers in Neuroscience
Vincent A Pallazola, Rishi K Kapoor, Karan Kapoor, John W McEvoy, Roger S Blumenthal, Ty J Gluckman
Non-valvular atrial fibrillation and venous thromboembolism anticoagulation risk assessment tools have been increasingly utilized to guide implementation and duration of anticoagulant therapy. Anticoagulation significantly reduces stroke and recurrent venous thromboembolism risk, but comes at the cost of increased risk of major and clinically relevant non-major bleeding. The decision for anticoagulation in high-risk patients is complicated by the fact that many risk factors associated with increased thromboembolic risk are simultaneously associated with increased bleeding risk...
February 12, 2019: Vascular Medicine
Julia Miguel Leitão, Fernanda Maria Dutra Spagnuolo Moreira, Ingrid Eyng Thiel, Isadora Yasbick Spricido, Rômulo Henrique Malaquias Silva, Viviane Flumignan Zétola
OBJECTIVE: Large population campaigns have been conducted in Brazil to improve knowledge about the signs and symptoms of stroke and the importance of time to care. Parallel to these important actions, we aimed to evaluate the lay knowledge of patients with atrial fibrillation, a well-recognized etiology of stroke, adequate treatment and management of which can prevent up to 30% of cerebrovascular events. METHODS: We questioned 143 patients with atrial fibrillation about the risks associated with the disease...
December 2018: Arquivos de Neuro-psiquiatria
Glaucylara Reis Geovanini, Geraldo Lorenzi-Filho
Obstructive sleep apnea (OSA) is common among patients with cardiac rhythm disorders. OSA may contribute to arrhythmias due to acute mechanisms, such as generation of negative intrathoracic pressure during futile efforts to breath, intermittent hypoxia, and surges in sympathetic activity. In addition, OSA may lead to heart remodeling and increases arrhythmia susceptibility. Atrial distension and remodeling, that has been shown to be associated with OSA, is a well-known anatomical substrate for atrial fibrillation (AF)...
December 2018: Journal of Thoracic Disease
Hai Deng, Alena Shantsila, Pi Guo, Tatjana S Potpara, Xianzhang Zhan, Xianhong Fang, Hongtao Liao, Yang Liu, Wei Wei, Lu Fu, Yumei Xue, Shulin Wu, Gregory Y H Lip
BACKGROUND: Female sex has been linked with worse prognosis in patients with atrial fibrillation (AF). Clinical risk stratification of women with AF may help decision-making before catheter ablation (CA). AIM: To evaluate arrhythmia outcomes and the predictive value of clinical scores for arrhythmia recurrence in a large cohort of Chinese patients with AF undergoing CA. METHODS: A total 1410 of patients (68.1% men) who underwent AF ablation with scheduled follow-up were analysed retrospectively...
January 22, 2019: Archives of Cardiovascular Diseases
Li-Li Jin, Ling You, Rui-Qin Xie
Backgroud: Recent studies have demonstrated that cystatin C is a valuable risk marker for cardiovascular disease morbidity and mortality. Therefore, we hypothesized that the pre-ablation cystatin C level was associated with post-ablation atrial fibrillation (AF) recurrence. Methods: 207 patients were enrolled and completed in this prospective observational study. Patients with AF scheduled for receive radiofrequency catheter ablation (RFCA) therapy were screened for the study...
December 2018: Journal of Geriatric Cardiology: JGC
Xiao-Xi Zhao, Ku-Lin Li, Ru-Xing Wang, Jie Zheng, Xiao-Yu Liu, Shi-Peng Dang, Zhi-Ming Yu, Chang-Ying Zhang, Xiang-Jun Yang
BACKGROUND: No data exist on comparisons of efficacy, safety and recurrence risk factors of paroxysmal and persistent atrial fibrillation (AF) ablation using robotic magnetic navigation system (MNS) respectively. METHODS: 151 AF patients were prospectively enrolled and divided into paroxysmal AF group (n=102) and persistent AF group (n=49). Circumferential pulmonary vein antrum isolation (CPVI) were performed in all patients. Linear ablation at the left atrial roof and mitral isthmus was performed in patients with persistent AF in addition to CPVI...
January 16, 2019: Clinical Cardiology
Yen-Ju Lung, Wei-Chieh Weng, Chia-Lun Wu, Wen-Yi Huang
BACKGROUND: Aggressive lipid-lowering treatment reduces the risk of cardiovascular events, but remains controversial in stroke patients. We investigate the influence of total cholesterol level on 5-year outcomes of ischemic stroke patients with high-grade internal carotid artery (ICA) stenosis and poststroke functional dependence. METHODS: One-hundred and ninety-six acute ischemic stroke patients with high-grade ICA stenosis and modified Rankin Scale score ≥ 3 upon discharge were enrolled and prospectively observed for 5 years...
January 11, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hao Wang, Cheng Wang, Jindong Chen, Liang Zhao, Xin Pan
PURPOSE: This study aimed to evaluate efficacy, safety, and long-term outcome of radiofrequency catheter ablation (RFCA) for atrial tachyarrhythmia (ATa) in patients with atrial septal defect (ASD). METHODS: Seventy-five ASD patients with ATa (52% atrial fibrillation, AF) were enrolled. Electrophysiological study and RFCA were performed, with endpoints of index and multiple procedures as follows: (a) atrial tachycardia/atrial flutter (AT/AFL), absence of inducibility of any atrial arrhythmia and (b) AF, circumferential pulmonary vein ablation (CPVA, paroxysmal AF), bidirectional block of lines, and disappearance of complex fractionated atrial electrograms (persistent and long-standing persistent (LSP)-AF)...
January 3, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Francesco Vitali, Matteo Serenelli, Juhani Airaksinen, Rita Pavasini, Anna Tomaszuk-Kazberuk, Elzbieta Mlodawska, Samuli Jaakkola, Cristina Balla, Lorenzo Falsetti, Nicola Tarquinio, Roberto Ferrari, Angelo Squeri, Gianluca Campo, Matteo Bertini
BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge. HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion. METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines. INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score...
December 30, 2018: Clinical Cardiology
Jaime Masjuan, Luisa Salido, Alicia DeFelipe, Rosana Hernández-Antolín, Covadonga Fernández-Golfín, Antonio Cruz-Culebras, Consuelo Matute, Rocío Vera, Paula Pérez-Torre, José Luis Zamorano
BACKGROUND: There are no recommendations regarding how to treat cardioembolic recurrent strokes when patients are well anticoagulated. We evaluated the safety and efficacy of combining oral anticoagulation (OAC) with percutaneous left atrial appendage closure (LAAC) in well anticoagulated atrial fibrillation (AF) patients with recurrent strokes. METHODS: In an explorative, prospective, observational study, LAAC was performed in AF patients with at least 2 ischemic strokes in the previous year, despite good anticoagulation using the Amplatzer Cardiac Plug or Amulet device...
December 26, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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