Patterns of Anticoagulation Use and Cardioembolic Risk After Catheter Ablation for Atrial Fibrillation Arrhythmia and Electrophysiology

Background There is significant practice variation in oral anticoagulation (OAC) use following catheter ablation for atrial fibrillation. It is not clear whether the risk of cardioembolism increases after discontinuation of OAC following catheter ablation. Methods and Results We identified 6886 patients within a large national administrative claims database who underwent catheter ablation for atrial fibrillation between January 1, 2005, and September 30, 2014. We assessed the effect of time off of OAC by CHA2DS2-VASc score (after adjusting for other comorbidities) on risk of cardioembolism, using Cox proportional hazards models. There was an increase in the use of non–vitamin K OAC after ablation from 0% in 2005 to 69.8% in 2014. OAC discontinuation was high, with only 60.5% and 31.3% of patients remaining on OAC at 3 and 12 months, respectively. The rate of discontinuation was higher in low-risk patients (82% versus 62.5% at 12 months for CHA2DS2-VASc 0–1 versus ≥2, respectively; P
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Arrhythmia and Electrophysiology Source Type: research

Related Links:

AbstractPurpose of reviewAtrial fibrillation is the commonest sustained arrhythmia in rheumatic heart disease and is associated with significant morbidity and mortality. In this review, we discuss its epidemiology, natural course and management with special emphasis on recent developments in understanding and treatment of atrial fibrillation in rheumatic heart disease.Recent findingsUse of direct oral anticoagulants appears promising, especially in developing countries where regular coagulation monitoring is a challenge. Also, restoration and maintenance of sinus rhythm in rheumatic atrial fibrillation appear feasible and ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Atrial fibrillation (AF) is a frequently identified arrhythmia during the course of sepsis. The aim of this narrative review is to assess the characteristics of patients with new-onset AF related to sepsis and the risk of stroke and death, to understand if there is a need for anticoagulation. We searched for studies on AF and sepsis on PubMed, the Cochrane database, and Web of Science, and 17 studies were included. The mean incidence of new-onset AF in patients with sepsis was 20.6% (14.7% in retrospective studies and 31.6% in prospective). Risk factors for new-onset AF included advanced age, white race, male sex, obesity,...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
Authors: Gheini A, Pourya A, Pooria A Abstract Cardiac arrhythmias are associated with several cardiac diseases and are prevalent in people with or without structural and valvular abnormalities. Ventricular arrhythmias (VA) can be life threating and its onset requires immediate medical attention. Similarly, atrial fibrillation and flutter lead to stroke, heart failure and even death. Optimal treatment of VA is very variable and depends on the medical condition associated with the rhythm disorder (which includes reversible causes such as myocardial ischemia or pro-arrhythmic drugs). While an implanted cardioverter d...
Source: Cardiovascular and Hematological Disorders Drug Targets - Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research
Atrial fibrillation is the most common arrhythmia in patients with hypertrophic cardiomyopathy with a prevalence and incidence of 23% and 3.1% respectively. The risk of thromboembolism is high in patients with hypertrophic cardiomyopathy regardless of the CHADS2VASC score. This review includes five observational studies that focused on prevention of thromboembolism in patients with hypertrophic cardiomyopathy and atrial fibrillation. These papers evaluated and compared outcomes between patients on either warfarin or direct oral anticoagulants.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
AbstractPurpose of ReviewWith the aging population, atrial fibrillation (AF) associations with both stroke and dementia have become a priority for the healthcare system. The purpose of this paper is to review the emerging role of clinical scores and biomarkers in the risk stratification of AF patients for risk of stroke and risk of dementia.Recent FindingsAF is the most common arrhythmia in the aging population and a common comorbidity in atherosclerotic disease and heart failure. In this review, we identified 34 most relevant papers that specifically address the role of biomarkers in risk-stratifying patients with AF with...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
CONCLUSIONS: RM is effective for atrial arrhythmia detection in patients using wearable devices and for reducing the risk of stroke in patients with CIED. PMID: 33012748 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Atrial fibrillation (AF) is the most common arrhythmia, with a substantial rise in global incidence and prevalence. Ischemic stroke is a frequent complication of AF, since AF perfectly fulfills Virchow's triad of blood stasis, vascular damage and hypercoagulation, making oral anticoagulation (OAC) obligatory for stroke prevention. Direct oral anticoagulants (DOAC), such as dabigatran, which inhibits thrombin, and apixaban, edoxaban and rivaroxaban, which block the activated coagulation factor X (FXa), have some advantages and are largely replacing coumarin-based OAC.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
In conclusion, SZV-270 with its combined Class I/B and III effects can prevent re-entry arrhythmias with reduced risk of provoking drug-induced Torsades de Pointes. PMID: 32970956 [PubMed - as supplied by publisher]
Source: Canadian Journal of Physiology and Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Can J Physiol Pharmacol Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0040-1714400Atrial fibrillation (AF) is a frequently identified arrhythmia during the course of sepsis. The aim of this narrative review is to assess the characteristics of patients with new-onset AF related to sepsis and the risk of stroke and death, to understand if there is a need for anticoagulation. We searched for studies on AF and sepsis on PubMed, the Cochrane database, and Web of Science, and 17 studies were included. The mean incidence of new-onset AF in patients with sepsis was 20.6% (14.7% in retrospective studies and 31.6% in prospective). Risk factors for new-onset AF includ...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
Abstract Many widely used medications may cause or exacerbate a variety of arrhythmias. Numerous antiarrhythmic agents, antimicrobial drugs, psychotropic medications, and methadone, as well as a growing list of drugs from other therapeutic classes (neurological drugs, anticancer agents, and many others), can prolong the QT interval and provoke torsades de pointes. Perhaps less familiar to clinicians is the fact that drugs can also trigger other arrhythmias, including bradyarrhythmias, atrial fibrillation/atrial flutter, atrial tachycardia, atrioventricular nodal reentrant tachycardia, monomorphic ventricular tachy...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
More News: Arrhythmia | Atrial Fibrillation | Cardiology | Databases & Libraries | Heart | Stroke | Study | Vitamins