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By Pramod Reddy I am a board certified cardiologist practicing cardiology for 21 years. It would be very helpful to have ready access to the latest information in managing pts.
Julian L Wichmann, Richard W Katzberg, Sheldon E Litwin, Peter L Zwerner, Carlo N De Cecco, Thomas J Vogl, Philip Costello, U Joseph Schoepf
No abstract text is available yet for this article.
November 17, 2015: Circulation
Henrik Vadmann, Peter Brønnum Nielsen, Søren Pihlkjær Hjortshøj, Sam Riahi, Lars Hvilsted Rasmussen, Gregory Y H Lip, Torben Bjerregaard Larsen
Atrial flutter confers a thromboembolic risk, but contrary to atrial fibrillation the relationship has only been addressed in few studies. This study performs an up to date systematic review of the literature to investigate the association between atrial flutter and thromboembolic events. Articles were found by MEDLINE, EMBASE search and a manual search of references list in included articles. International guidelines, meta-analyses, reviews, case reports, studies reporting thromboembolic events in relation to ablation, or cardioversion procedures, echocardiography, and observational studies were found eligible in this review...
September 2015: Heart: Official Journal of the British Cardiac Society
Michael Schepke
No abstract text is available yet for this article.
September 2007: Nephrology, Dialysis, Transplantation
Denis Roy, Mario Talajic, Stanley Nattel, D George Wyse, Paul Dorian, Kerry L Lee, Martial G Bourassa, J Malcolm O Arnold, Alfred E Buxton, A John Camm, Stuart J Connolly, Marc Dubuc, Anique Ducharme, Peter G Guerra, Stefan H Hohnloser, Jean Lambert, Jean-Yves Le Heuzey, Gilles O'Hara, Ole Dyg Pedersen, Jean-Lucien Rouleau, Bramah N Singh, Lynne Warner Stevenson, William G Stevenson, Bernard Thibault, Albert L Waldo
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure and suggesting that the suppression of atrial fibrillation may favorably affect the outcome. However, the benefits and risks of this approach have not been adequately studied. METHODS: We conducted a multicenter, randomized trial comparing the maintenance of sinus rhythm (rhythm control) with control of the ventricular rate (rate control) in patients with a left ventricular ejection fraction of 35% or less, symptoms of congestive heart failure, and a history of atrial fibrillation...
June 19, 2008: New England Journal of Medicine
Mathew G Wilson, Georgina M Ellison, N Tim Cable
Cardiorespiratory fitness is a strong predictor of cardiovascular (CV) disease and all-cause mortality, with increases in cardiorespiratory fitness associated with corresponding decreases in CV disease risk. The effects of exercise upon the myocardium and vascular system are dependent upon the frequency, intensity and duration of the exercise itself. Following a prolonged period (≥6 months) of regular intensive exercise in previously untrained individuals, resting and submaximal exercising heart rates are typically 5-20 beats lower, with an increase in stroke volume of ∼20% and enhanced myocardial contractility...
May 15, 2015: Heart: Official Journal of the British Cardiac Society
Freek W A Verheugt, Christopher B Granger
In patients with non-valvular atrial fibrillation, oral anticoagulation with vitamin K antagonists reduces the risk of stroke by more than 60%. But vitamin K antagonists have limitations, including causing serious bleeding such as intracranial haemorrhage and the need for anticoagulation monitoring. In part related to these limitations, they are used in only about half of patients who should be treated according to guideline recommendations. In the past decade, oral agents have been developed that directly block the activity of thrombin (factor IIa), as well as drugs that directly inhibit activated factor X (Xa), which is the first protein in the final common pathway to the activation of thrombin...
July 18, 2015: Lancet
Jeroen J Bax, Victoria Delgado
Chronic heart failure is a major public-health problem with a high prevalence, complex treatment, and high mortality. A careful and comprehensive analysis is needed to provide optimal (and personalized) therapy to heart failure patients. The main 4 non-invasive imaging techniques (echocardiography, magnetic resonance imaging, multi-detector-computed tomography, and nuclear imaging) provide information on cardiovascular anatomy and function, which form the basis of the assessment of the pathophysiology underlying heart failure...
April 2015: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Jeffrey B Washam, Charles A Herzog, Amber L Beitelshees, Mauricio G Cohen, Timothy D Henry, Navin K Kapur, Jessica L Mega, Venu Menon, Robert L Page, L Kristin Newby
No abstract text is available yet for this article.
March 24, 2015: Circulation
Lauren E Odum, Kelly A Cochran, Daniel S Aistrope, Kathleen A Snella
The association of atrial fibrillation and resultant thromboembolic stroke is readily recognized in the published literature. However, the identification and weight of other risk factors that increase stroke risk are varied. To predict which patients are at greatest risk for thromboembolic stroke, numerous risk stratification schemas have been developed to guide thromboprophylactic treatment decisions. The well-known CHADS(2) scoring system incorporates risk factors such as congestive heart failure, hypertension, age 75 years or older, diabetes mellitus, and previous stroke or transient ischemic attack...
March 2012: Pharmacotherapy
Jonas Bjerring Olesen, Christian Torp-Pedersen, Morten Lock Hansen, Gregory Y H Lip
North American and European guidelines on atrial fibrillation (AF) are conflicting regarding the classification of patients at low/intermediate risk of stroke. We aimed to investigate if the CHA2DS2-VASc score improved risk stratification of AF patients with a CHADS2 score of 0-1. Using individual-level-linkage of nationwide Danish registries 1997-2008, we identified patients discharged with AF having a CHADS2 score of 0-1 and not treated with vitamin K antagonist or heparin. In patients with a CHADS2 score of 0, 1, and 0-1, rates of stroke/ thromboembolism were determined according to CHA2DS2-VASc score, and the risk associated with increasing CHA2DS2-VASc score was estimated in Cox regression models adjusted for year of inclusion and antiplatelet therapy...
June 2012: Thrombosis and Haemostasis
S Apostolakis, D A Lane, H Buller, G Y H Lip
Many of the risk factors for stroke in atrial fibrillation (AF) are also important risk factors for bleeding. Wetested the hypothesis that the CHADS2 and CHA2DS2-VASc scores (used for stroke risk assessment) could be used to predict serious bleeding, and that these scores would compare well against the HAS-BLED score, which is a specific risk score designed for bleeding risk assessment. From the AMADEUS trial, we focused on the trial's primary safety outcome for serious bleeding, which was "any clinically relevant bleeding"...
November 2013: Thrombosis and Haemostasis
Lakshmi Kannan, Vincent M Figueredo
A 31-year-old male smoker with diabetes mellitus presented to the emergency department with intermittent, exertional chest pain of 4 days' duration. Electrocardiography performed on arrival (Panel A) revealed anterolateral T-wave inversions with biphasic lateral T waves, which raised concern about..
January 1, 2015: New England Journal of Medicine
Daniel S Chertow, Christian Kleine, Jeffrey K Edwards, Roberto Scaini, Ruggero Giuliani, Armand Sprecher
In resource-limited areas, isolation of the sick from the population at large has been the cornerstone of control of Ebola virus disease (EVD) since the virus was discovered in 1976. Although this strategy by itself may be effective in controlling small outbreaks in remote settings, it has offered..
November 27, 2014: New England Journal of Medicine
Henry M Wu, Jessica K Fairley, James Steinberg, Phyllis Kozarsky
No abstract text is available yet for this article.
January 6, 2015: Annals of Internal Medicine
Riccardo Cappato, Michael D Ezekowitz, Allan L Klein, A John Camm, Chang-Sheng Ma, Jean-Yves Le Heuzey, Mario Talajic, Maurício Scanavacca, Panos E Vardas, Paulus Kirchhof, Melanie Hemmrich, Vivian Lanius, Isabelle Ling Meng, Peter Wildgoose, Martin van Eickels, Stefan H Hohnloser
AIMS: X-VeRT is the first prospective randomized trial of a novel oral anticoagulant in patients with atrial fibrillation undergoing elective cardioversion. METHODS AND RESULTS: We assigned 1504 patients to rivaroxaban (20 mg once daily, 15 mg if creatinine clearance was between 30 and 49 mL/min) or dose-adjusted vitamin K antagonists (VKAs) in a 2:1 ratio. Investigators selected either an early (target period of 1-5 days after randomization) or delayed (3-8 weeks) cardioversion strategy...
December 14, 2014: European Heart Journal
Gerald C Kaye, Nicholas J Linker, Thomas H Marwick, Lucy Pollock, Laura Graham, Erika Pouliot, Jan Poloniecki, Michael Gammage
AIM: Chronic right ventricle (RV) apical (RVA) pacing is standard treatment for an atrioventricular (AV) block but may be deleterious to left ventricle (LV) systolic function. Previous clinical studies of non-apical pacing have produced conflicting results. The aim of this randomized, prospective, international, multicentre trial was to compare change in LV ejection fraction (LVEF) between right ventricular apical and high septal (RVHS) pacing over a 2-year study period. METHODS AND RESULTS: We randomized 240 patients (age 74 ± 11 years, 67% male) with a high-grade AV block requiring >90% ventricular pacing and preserved baseline LVEF >50%, to receive pacing at the RVA (n = 120) or RVHS (n = 120)...
April 7, 2015: European Heart Journal
Bernard De Bruyne, William F Fearon, Nico H J Pijls, Emanuele Barbato, Pim Tonino, Zsolt Piroth, Nikola Jagic, Sven Mobius-Winckler, Gilles Rioufol, Nils Witt, Petr Kala, Philip MacCarthy, Thomas Engström, Keith Oldroyd, Kreton Mavromatis, Ganesh Manoharan, Peter Verlee, Ole Frobert, Nick Curzen, Jane B Johnson, Andreas Limacher, Eveline Nüesch, Peter Jüni
BACKGROUND: We hypothesized that in patients with stable coronary artery disease and stenosis, percutaneous coronary intervention (PCI) performed on the basis of the fractional flow reserve (FFR) would be superior to medical therapy. METHODS: In 1220 patients with stable coronary artery disease, we assessed the FFR in all stenoses that were visible on angiography. Patients who had at least one stenosis with an FFR of 0.80 or less were randomly assigned to undergo FFR-guided PCI plus medical therapy or to receive medical therapy alone...
September 25, 2014: New England Journal of Medicine
Michael L LeFevre
DESCRIPTION: Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA). METHODS: The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) screen-detected AAAs. POPULATION: These recommendations apply to asymptomatic adults aged 50 years or older. RECOMMENDATION: The USPSTF recommends 1-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked...
August 19, 2014: Annals of Internal Medicine
Anthony S Fauci
An outbreak of Ebola virus disease (EVD) has jolted West Africa, claiming more than 1000 lives since the virus emerged in Guinea in early 2014 (see figure). The rapidly increasing numbers of cases in the African countries of Guinea, Liberia, and Sierra Leone have had public health authorities on..
September 18, 2014: New England Journal of Medicine
Florian Prüller, Eva-Christine Weiss, Reinhard B Raggam, Mila Cervar-Zivkovic, Wilfried Renner, Jasmin Wagner, Simon Michaelis, Winfried März, Harald Mangge
The authors suggest that functional testing for activated protein C resistance is cheaper and more clinically relevant than genetic testing to detect a factor V Leiden mutation in identifying persons who are at risk for thromboembolism.
August 14, 2014: New England Journal of Medicine
2014-08-16 17:41:30
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