Dose adjustment based on the plasma level measurement used anti-FXa chromogenic assay on the use of non-vitamin K antagonist oral anticoagulants (NOACs) improved the overall benefit of NOACs dosing in patients with atrial fibrillation: Authors ’ reply
We thank the authors for alerting us to their recently published article on non-vitamin K antagonist oral anticoagulant (NOAC) plasma level assessments.1 Indeed, despite extensive literature review, this interesting and important article has slipped our attention.2 We like to congratulate the authors for their detailed and well-represented work. Based on our 2018 EHRA Practical Guide ’s recommendations,3 Suwaet al. measured plasma levels in both patients on rivaroxaban and apixaban and found acceptable peak plasma levels even in a substantial proportion of patients with off-label dose reductions. Especially in patients w...
Source: Europace - September 22, 2021 Category: Cardiology Source Type: research
Dose adjustment based on the plasma level measurement used anti-FXa chromogenic assay on the use of non-vitamin K antagonist oral anticoagulants (NOACs) improved the overall benefit of NOACs dosing in patients with atrial fibrillation
This article indicates that anti-FXa chromogenic assays are available to measure plasma concentration of the FXa inhibitors using validated calibrators. In the section of ‘Potential indications for NOAC plasma level measurements’ of this article, the authors say that no studies have investigated if measurement of drug levels and dose adjustment based on laboratory coagulation parameters, e.g. by dose reduction in case of higher than expected levels or by dose inc rease in case of lower than expected levels, improve the overall benefit of non-vitamin K antagonist oral anticoagulants during long-term treatment in patient...
Source: Europace - September 22, 2021 Category: Cardiology Source Type: research
2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment
We have read with keen interest the updated practical guide by Steffelet al.1 For safer decision-making, we share the authors ’ view on the need for rapid assessment of anticoagulation in patients under non-vitamin K antagonist oral anticoagulant (NOAC) during emergencies such as bleeding and urgent surgical intervention. Our group has been involved in studies on point-of-care coagulation testing (POCT) in acute stroke p atients where rapid decision-making with respect to thrombolysis and anticoagulation reversal is vital. (Source: Europace)
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research
2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment —Authors’ reply
We thank the authors for addressing this important issue.1 Indeed, the assessment of NOAC plasma levels —or potential alternatives—in special situations may represent an important element in the further refinement of non-vitamin K antagonist oral anticoagulant (NOAC) therapy. In their letter, Mbroh and Poli make a case for using point-of-care coagulation tests (POCT) to more rapidly assess the lev el of anticoagulant in patients’ blood samples. In the 2021 EHRA Practical Guide on the use of NOACs, we suggest to consider NOAC plamsa level assessment in two different types of scenarios: emergency situations (e.g. acute...
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research
Prompt recognition and successful aspiration of a left atrial thrombus under intracardiac echocardiography guidance during radiofrequency catheter ablation for atrial tachycardia
We present a case of an 80-year-old woman with persistent atrial tachycardia who underwent catheter ablation, during which continuous intracardiac echocardiography (ICE)-based monitoring of the ablation site revealed an RFA-related thrombus. (Source: Europace)
Source: Europace - September 3, 2021 Category: Cardiology Source Type: research
Outcomes after catheter ablation of ventricular tachycardia without implantable cardioverter-defibrillator in selected patients with arrhythmogenic right ventricular cardiomyopathy
Conclusion In patients with ARVC, well-tolerated MVT without a back-up ICD did not lead to fatal arrhythmic event after RCA despite VT recurrences in some. Our data suggest that RCA may be an alternative to ICD in selected ARVC patients. (Source: Europace)
Source: Europace - August 24, 2021 Category: Cardiology Source Type: research
Corrigendum to: Complications in pulmonary vein isolation in the Netherlands Heart Registration differ with sex and ablation technique
[Europace 2020; doi:10.1093/europace/euaa255] (Source: Europace)
Source: Europace - August 6, 2021 Category: Cardiology Source Type: research
Underdiagnosis of phrenic nerve palsy caused by cryoballoon ablation for atrial fibrillation with upright position chest radiography: usefulness of supine position dynamic chest radiography
A 77-year-old man with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using a 28 mm 4th-generation cryoballoon. Despite the immediate termination of cryoablation of the right superior PV upon weakened diaphragmatic motion detection, right phrenic nerve palsy (PNP) was observed fluoroscopically. (Source: Europace)
Source: Europace - August 5, 2021 Category: Cardiology Source Type: research
In Memoriam Prof. Dr sc. med. Joachim Witte (1936 –2021)
On 18th January 2021, Prof. Dr sc. med. Joachim Witte, a pioneer of pacemaker therapy in the former German Democratic Republic (GDR), dies after a brief serious illness. (Source: Europace)
Source: Europace - August 4, 2021 Category: Cardiology Source Type: research
Corrigendum to: Arrhythmogenic potential of myocardial disarray in hypertrophic cardiomyopathy: genetic basis, functional consequences and relation to sudden cardiac death [Europace 2021; doi:10.1093/europace/euaa348]
Upon the original publication of this article, the following sentence and accompanying reference were inadvertently omitted from the end of the legend of Figure 5: “Figure adapted from Arigaet al. ”. This error has now been corrected. (Source: Europace)
Source: Europace - July 30, 2021 Category: Cardiology Source Type: research
Leadless left ventricular endocardial pacing for CRT upgrades in previously failed and high-risk patients in comparison with coronary sinus CRT upgrades
ConclusionDespite prior failed upgrades and high-risk patients with more comorbidities, WiSE-CRT upgrades had high rates of procedural success and similar improvements in CCS and LV remodelling with CS upgrades. (Source: Europace)
Source: Europace - July 28, 2021 Category: Cardiology Source Type: research
Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study
ConclusionAmong hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities. (Source: Europace)
Source: Europace - July 23, 2021 Category: Cardiology Source Type: research
How simple ideas forged in the fire of adversity can change healthcare: telehealth for atrial fibrillation during the COVID 19 pandemic
This editorial refers to ‘The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences.’ by D. Gawalkoet al. on pages 23(7):1003--15. (Source: Europace)
Source: Europace - July 22, 2021 Category: Cardiology Source Type: research
A meta-analysis of clinical risk factors for stroke in anticoagulant-na ïve patients with atrial fibrillation
ConclusionThis study confirms age and prior stroke as the strongest predictors of stroke or systemic embolism in anticoagulant-naive AF patients. Other predictors include hypertension, diabetes, heart failure, and vascular disease. Female sex seems not to be universally associated with stroke or systemic embolism. (Source: Europace)
Source: Europace - July 19, 2021 Category: Cardiology Source Type: research
Brugada syndrome and syncope: a practical approach for diagnosis and treatment
AbstractSyncope in patients with Brugada electrocardiogram pattern may represent a conundrum in the decision algorithm because incidental benign forms, especially neurally mediated syncope, are very frequent in this syndrome similarly to the general population. Arrhythmic syncope in Brugada syndrome typically results from a self-terminating sustained ventricular tachycardia or paroxysmal ventricular fibrillation, potentially leading to sudden cardiac death. Distinguishing syncope due to malignant arrhythmias from a benign form is often difficult unless an electrocardiogram is recorded during the episode. We performed a rev...
Source: Europace - July 15, 2021 Category: Cardiology Source Type: research
