Clinical analysis of antithrombotic treatment and occurrence of stroke in elderly patients with nonvalvular persistent atrial fibrillation

Clinical Cardiology, EarlyView.
Source: Clinical Cardiology - Category: Cardiology Authors: Source Type: research

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ConclusionsThis study is the largest European real-world study ever published on NOACs. It includes all Italian patients treated with NOACs since 2013 accounting for about 1/3 of subjects with AF. The enrolled population consisted of very elderly patients, at high risk of ischemic adverse events. The AIFA registries are consolidated tools that guarantee the appropriateness of prescription and provide important information for the governance of National Health System by collecting real-world data.
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Background: It is important to understand the risk of thromboembolism and bleeding in patients with nonvalvular atrial fibrillation (NVAF) receiving direct oral anticoagulants; however, data on risk factors in Japanese patients are limited. Methods: XAPASS (Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation) is a prospective observational study examining the safety and effectiveness of rivaroxaban in Japanese real-world clinical practice. We investigated risk factors for stroke/noncentral nervous system systemic embolism (non-CNS SE)/myocardial infarction (MI) and major ...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
ConclusionIn 20% of failing MT, thrombus cannot be reached/passed. Direct carotid puncture or surgical arterial access could be considered in these cases.In 80% of failing interventions, thrombus can be passed with the device, but the occluded vessel cannot be recanalized. Rescue techniques can be an option. Development of new devices and techniques is necessary to improve recanalization rates. Assessment of pre-existing illness could sensitize for occurring complications.
Source: Neurological Sciences - Category: Neurology Source Type: research
This study compared the risks of ischemic stroke/systemic embolism (ISSE) and major bleeding in patients with NVAF and stage IV-V CKD treated with rivaroxaban or warfarin.MethodsPatients with NVAF and stage IV-V CKD who initiated rivaroxaban or warfarin treatment between November 2011 and June 2018 were selected from the Optum® Deidentified EHR Database. Propensity score (PS)-matching was used to balance rivaroxaban and warfarin patients on 112 measured baseline covariates. ISSE and major bleeding events over two years following treatment initiation were ascertained with validated endpoint definitions. Outcomes were an...
Source: American Heart Journal - Category: Cardiology Source Type: research
She previously had Atrial fibrillation with LBBB.Here is her ED ECG:Does this reveal the etiology of her symptoms?This shows atrial fibrillation.  There is a regular, slow response.  The fact that the response is regular proves that the atrial fibrillation is NOT conducting.  When atrial fib conducts, the ventricular rate must always be irregular.This is atrial fibrillation with complete (3rd degree) AV block.The QRS morphology is RBBB with a vertical axis.  This suggests an LV escape rhythm, possibly from the left anterior fascicle.She previously had known LBBB, so she is lucky that her left sided esca...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Diederichsen et  al (J Am Coll Cardiol 2019;74:2771, PMID 31779791) evaluated the natural history of subclinical atrial fibrillation (AF) in at-risk patients from the general population. The authors studied 590 individuals ≥70 years of age with ≥1 of hypertension, diabetes, previous stroke, or heart failure; w ithout a history of AF; and with long-term implantable loop recorder monitoring. End points included AF burden, AF progression, symptoms, and heart rate during AF. In a total of 685,445 monitoring days, AF lasting ≥6 minutes was detected in 205 participants (35%).
Source: Heart Rhythm - Category: Cardiology Authors: Tags: EP News Source Type: research
Background: Paroxysmal atrial fibrillation (PAF) or flutter is prevalent among patients with cryptogenic stroke. The goal of this study was to investigate the feasibility of incorporating a fast-track, long term continuous heart monitoring (LTCM) program within a stroke clinic.Method: We designed and implemented a fast-track LTCM program in our stroke clinics. The instrument that we used for the study was the ZioXT® device from IRhythm™ Technologies. To implement the program, all clinic support staff received training on the skin preparation and proper placement of the device. We prospectively followed every pati...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
We present a 42 ‐year‐old male patient with familial transthyretin amyloidosis who suffered an embolic stroke that originated from a left atrial appendage thrombus in the absence of any documented atrial fibrillation. This case highlights atrial mechanical dysfunction in patients with cardiac amyloidosis and th e need to better stratify thrombotic risk in this population with integration of echocardiographic parameters and transesophageal echocardiography.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
Source: Core Evidence - Category: Drugs & Pharmacology Tags: Core Evidence Source Type: research
Clinical pharmacists have helped reduce the number of strokes by 22% following an atrial fibrillation pilot in Tameside and Glossop.
Source: The Pharmaceutical Journal - Category: Drugs & Pharmacology Source Type: research
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