Ischemic Stroke or Systemic Embolism After Transseptal Ablation of Arrhythmias in Patients With Cardiac Implantable Electronic Devices Arrhythmia and Electrophysiology

We examined risk of ischemic stroke, transient ischemic attack (TIA), or systemic embolism after transseptal ablation in patients with and without CIEDs. Methods and Results Using a national administrative claims database, 31 720 patients who underwent a transseptal catheter ablation between January 2004 and September 2014 were identified. Two propensity-matched cohorts were created by matching demographic variables, administrative variables, Charlson Comorbidity Index, CHA2DS2-Vasc score, and year and indication for ablation (5533 and 11 300 patients with and without CIEDs). Incidence rates and Cox proportional hazards models were used to estimate risk of ischemic stroke, TIA, or systemic embolism for patients with and without CIEDs. Impact of oral anticoagulation (OAC) use on the endpoint was examined. Over a mean follow-up of 2.1 years, the incidence of the combined endpoint was 1.9 per 100 person-years in patients with CIEDs and 1.5 per 100 person-years in patients without CIEDs (P=0.03). Among patients not on OAC, presence of a cardiac device was associated with an increased risk (hazard ratio [HR], 1.71 [1.24–2.35]; P
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Arrhythmias, Catheter Ablation and Implantable Cardioverter-Defibrillator, Atrial Fibrillation, Ischemic Stroke, Transient Ischemic Attack (TIA) Arrhythmia and Electrophysiology Source Type: research

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ConclusionThe combination of catheter ablation and LAAC under ICE guidance was safe and effective in AF patients with high stroke risk. ICE with our novel protocol was technically feasible for comprehensive and systematic assessment of device implantation.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Stroke remains one of the leading causes of death globally. 1 In Mexico, it represents the 6th cause of death2 and contributes with 688.19 DALYs per 100,000 people,3 constituting a major cause of burden of disease in the country. Heart rhythm dysfunctions following acute ischemic strokes (AIS) have been previously reported,4 –9 and it is expected that 25-30% of patients will be diagnosed with any type of arrhythmia after stroke.6,9 Kallmünze et al. reported the incidence of several post-stroke arrhythmias, such as atrial fibrillation (AF), focal atrial tachycardia, undetermined supraventricular tachycardia,...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Objective To investigate the association of mitral regurgitation (MR) on thromboembolic risk of patients with non-valvular atrial fibrillation (NVAF) undergoing transoesophageal echocardiography (TEE)-guided cardioversion. Methods Data for consecutive patients who underwent TEE-guided cardioversion for NVAF between 2000 and 2012 were analysed. MR severity was assessed by Doppler echocardiography and classified as ≤mild, moderate or severe. Left atrial appendage emptying velocities were averaged for five consecutive cycles. Multivariable regression models were used to identify independent predictors of left atrial appen...
Source: Heart - Category: Cardiology Authors: Tags: Arrhythmias and sudden death Source Type: research
Atrial fibrillation (AF) is established as the most prevalent clinical arrhythmia, and a major risk factor for stroke, death, heart failure, cognitive decline, and hospitalisation [1]. Ranking these complications is difficult, however ischemic stroke caused by AF is posing a significant burden to patients, their next of kin, to physicians and to the health care system. The stroke risk in AF patients can be markedly lowered by oral anticoagulation (OAC) treatment [2], but many patients with AF have few or no symptoms [3], hence health care contacts and arrhythmia detection might be lacking [4].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Atrial fibrillation (AF) is the most common arrhythmia in adults and it is responsible for about one-third of all ischemic strokes.1 Although prior studies have found more frequently detected AF following stroke with longer duration of monitoring, ambiguity remains regarding the optimal duration of ambulatory cardiac monitoring.1 Therefore, we conducted a meta-analysis of solely randomized clinical trials (RCTs) to evaluate the efficacy and safety of implantable loop recorder (ILR) in AF detection, and subsequent reduction of recurrent strokes in patients with recent ischemic strokes.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Eur J Intern Med. 2021 Nov 8:S0953-6205(21)00361-7. doi: 10.1016/j.ejim.2021.10.022. Online ahead of print.ABSTRACTSepsis can lead to cardiac arrhythmias, of which the most common is atrial fibrillation (AF). Sepsis is associated with up to a six-fold higher risk of developing AF, where it occurs most commonly in the first 3 days of hospital admission. In many patients, AF detected during sepsis is the first documented episode of AF, either as an unmasking of sub-clinical AF or as a newly developed arrhythmia. In the short term, sepsis that is complicated by AF leads to longer hospital stays and an increased risk of inpati...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Source Type: research
Recent evidence has shown that the pathogenesis of ischaemic stroke associated with atrial fibrillation (AF) is complex and involves other factors in addition to arrhythmias. The purpose of this study was to i...
Source: BMC Cardiovascular Disorders - Category: Cardiology Authors: Tags: Research article Source Type: research
ConclusionNOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Our Meta-analysis suggests that it is independently associated with poor outcome. In view of these findings there is a need for better quality observational studies, because reliable identification of patients with sepsis who are prone for the development of AF may allow for early pharmacological interventions to prevent this complication.
Source: QJM - Category: Internal Medicine Source Type: research
ConclusionThe current study found that low ejection fraction, dilated left atrium, hypertension, smoking, old age, male gender, prolonged bypass time, prolonged cross clamping time, renal impairment, previous myocardial infarction, ungrafted dominant right coronary artery, low temperatures on bypass, early ischemic changes postoperative, hypokalemia, use of adrenaline and nor adrenaline, all of these factors were a significant predictors for development of atrial fibrillation after cardiac surgery.
Source: QJM - Category: Internal Medicine Source Type: research
Rev Cardiovasc Med. 2021 Sep 24;22(3):635-648. doi: 10.31083/j.rcm2203074.ABSTRACTAtrial fibrillation (AF) represents the most prevalent supraventricular arrhythmia in adults population and up to 15% of AF patients undergo percutaneous coronary intervention (PCI) for coronary artery disease (CAD) during their life. While oral anticoagulants (OACs) exert a protective effect in the setting of stroke prevention and systemic embolization in AF patients, patients undergoing PCI are recommended to receive dual antiplatelet therapy (DAPT) to reduce the risk of cardiovascular death, recurrent myocardial infarction and stent thromb...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Authors: Source Type: research
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