Atrial Fibrillation in Rheumatic Heart Disease

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 may predict better clinical outcomes.SummaryAtrial fibrillation in rheumatic heart disease is not only very frequent but also a clinical marker of worse outcomes. Increasing age and left atrial size are the most important predictors for its development. The risk of thromboembolism/disabling stroke is significantly elevated when compared with that with non-valvular atrial fibrillation. Anticoagulation with vitamin K antagonists and ventricular rate control are the mainstay of therapy. However, recent evidence predicts a promising future for direct oral anticoagulants and rhythm control strategies in rheumatic atrial fibrillation.
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research

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AbstractAdult patients with simple congenital heart disease (sACHD) represent an expanding population vulnerable to atrial arrhythmias (AA). CHA2DS2-VASc score estimates thromboembolic risk in non-valvular atrial fibrillation patients. We investigated the prognostic role of CHA2DS2-VASc score in a non-selected sACHD population regardless of cardiac rhythm. Between November 2009 and June 2018, 427 sACHD patients (377 in sinus rhythm, 50 in AA) were consecutively referred to our ACHD service. Cardiovascular hospitalization and/or all-cause death were considered as composite primary end-point. Patients were divided into group...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Batul SA, Gopinathannair R Abstract Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of "atrial kick" translates into poorer quality of life and increased mortality. In the absence of underlying struct...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
Conclusions:Approximately 1 in 6 patients who undergo percutaneous transcatheter closure of PFO after stroke or transient ischemic attack experience a serious complication or death within 5 years.Study Supported by:Dr. Gialdini is supported by the Feil Family Foundation.Dr. Navi is supported by NIH grant K23NS091395 and the Florence Gould Endowment for Discovery in Stroke.Dr. Iadecola is supported by NIH grants R37NS089323-02, R01NS034179-21, R01NS037853-19, and R01 NS073666-04.Dr. Kamel is supported by NIH grants K23NS082367 and R01NS097443 as well as the Michael Goldberg Research Fund.Disclosure: Dr. Merkler has nothing ...
Source: Neurology - Category: Neurology Authors: Tags: Cerebrovascular Disease and Interventional Neurology: Stroke Prevention and Translation Source Type: research
CONCLUSIONS: LAA thrombi were found in 2.7% of Japanese NVAF patients scheduled for procedures despite ongoing oral anticoagulation therapy. Incidence of thrombi was similar for patients on DOAC and on warfarin. PMID: 28179613 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Conclusions The prevalence of AF was low compared with other regions of the world and stroke prophylaxis was underused. A larger study is needed to confirm these findings. This study demonstrates that larger evaluations would be feasible using the community-based techniques employed here.
Source: Heart Asia - Category: Cardiology Authors: Tags: Original research Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 14. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 7. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rate...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
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