Catheter ablation of atrial fibrillation: current and evolving indications

Publication date: Available online 24 January 2020Source: Canadian Journal of CardiologyAuthor(s): Ahmed AlTurki, Jacqueline Joza, Martin L. Bernier, Riccardo Proietti, Vidal EssebagAbstractCatheter ablation (CA) was developed as a potentially curative procedure through electrical isolation of the pulmonary veins to isolate the main triggers of atrial fibrillation (AF). When successful, CA has clearly been shown to decrease AF recurrence and symptoms as well as improve quality of life. With advancing technology, increased procedural success, and lower complication risk, CA is being utilized at much higher rates, with broader indications and in a diverse AF population. Symptomatic paroxysmal AF that is refractory to antiarrhythmic drugs (AAD) is currently the indication for CA with the best evidence. CA for AF as first-line therapy is reserved for highly selected symptomatic patients with paroxysmal AF. Current studies have not shown an improvement in mortality or quality of life with CA as first line therapy. In patients with persistent AF who are symptomatic despite medical therapy, catheter ablation is a reasonable therapeutic option. Though recent trials have suggested that CA reduced mortality and hospitalizations in patients with heart failure and reduced ejection fraction, the evidence is not conclusive. Therefore, current guidelines recommend CA for similar indications to patients without heart failure, but large trials comparing CA to strict rate control will be repor...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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Type 2 diabetes (T2D) is a metabolic disorder of insulin resistance — a reduced sensitivity to the action of insulin — which leads to high blood sugar, or hyperglycemia. Approximately 12% of American adults have T2D, and more than one-third of Americans have prediabetes, a precursor to T2D. This is a major public health concern, as T2D dramatically increases risk for heart disease, including heart attacks, atrial fibrillation, and heart failure. The development and progression of T2D is affected by many factors. Some, such as a person’s race/ethnicity, age, and gender cannot be modified. Others, including...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Exercise and Fitness Healthy Eating Heart Health Source Type: blogs
Publication date: Available online 14 February 2020Source: American Heart JournalAuthor(s): Bao-Oanh Nguyen, Michiel Rienstra, Anne H. Hobbelt, Jan G.P. Tijssen, Marcelle D. Smit, Robert G. Tieleman, Bastiaan Geelhoed, Dirk J. Van Veldhuisen, Harry J.G.M. Crijns, Isabelle C. Van Gelder, RACE 3 InvestigatorsAbstractAtrial fibrillation (AF) is a progressive disease, and maintenance of sinus rhythm is cumbersome. In this analysis of the Routine versus Aggressive risk factor driven upstream rhythm Control for prevention of Early atrial fibrillation in heart failure (RACE 3) trial we aimed to determine whether optimal treatment...
Source: American Heart Journal - Category: Cardiology Source Type: research
Peak left atrial longitudinal strain (PALS) can help identify left atrial appendage thrombus (LAAT) in patients with atrial fibrillation. Nevertheless, few studies have been performed in patients in sinus rhyt...
Source: Cardiovascular Ultrasound - Category: Radiology Authors: Tags: Research Source Type: research
Although ∼20% of the elderly develop atrial fibrillation (AF), little is known about the mechanisms. Heart failure with preserved ejection fraction (HFpEF), which is associated with AF, is more common in aged females than in males
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
Abstract BACKGROUND AND OBJECTIVES: The aim of this retrospective cohort study was to develop a new score (RA-CHADSV) (rheumatoid arthritis - congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack/thromboembolism, and vascular disease), modified from the CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years (doubled), diabetes mellitus, stroke/transient ischemic attack (doubled), vascular disease, age 65-74 years, and female), in predicting the risk of ischemic stroke in rheumatoid arthritis (RA) patients without atrial fibrillation (AF)...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Authors: Meireles MA, Golçalves J, Neves J Abstract INTRODUCTION: Heart failure frequently coexists with several comorbidities. Our aim is to evaluate the prognostic role of various comorbidities in the risk of acute heart failure development. MATERIAL AND METHODS: Comorbidities of patients with acute heart failure were, retrospectively, compared to a control group of patients with chronic heart failure admitted to an Internal Medicine unit in a 2-year period. Logistic regression models were constructed to determine their association with acute heart failure and to develop a comorbidome. ...
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
ConclusionsPatients with POAF after CABG had three times the incidence of long-term AF compared with both non-POAF patients and matched controls. POAF was associated with long-term ischemic stroke, heart failure, and corresponding mortality even after adjustment for AF during follow-up. The increased overall mortality was partly explained by morbidities associated with POAF.Graphic abstract
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Conclusion: Cancer patients carry a high burden of CVD-related comorbidities before the application of VEGF antagonists. HTN is the most prevalent comorbid condition, and cancer patients with HTN constitute substantial cardiovascular risks and a higher co-prevalence of other CVDs.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Epidemiology Source Type: research
ConclusionsOur experience suggests that sacubitril/valsartan is well tolerated and improves echocardiographic functional and structural parameters, N ‐terminal pro‐B‐type natriuretic peptide levels, and symptomatic status in patients with CTRCD.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Short Communication Source Type: research
Journal of Cardiovascular Electrophysiology, EarlyView.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: EDITORIAL ‐INVITED Source Type: research
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