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Alcohol-related hospitalization is associated with increased risk of ischaemic stroke among low-risk patients with atrial fibrillation
ConclusionThe presence of a previous hospitalization with an alcohol-related disease was associated with a small but significant increase in the risk of stroke among low-risk AF patients. More research about relation between alcohol use and ischaemic stroke in AF patients is warranted.
Source: Europace - February 23, 2017 Category: Cardiology Source Type: research

The budget impact of left atrial appendage closure compared with adjusted-dose warfarin and dabigatran etexilate for stroke prevention in atrial fibrillation
Conclusion The majority of LAAC costs are borne in the first year, while costs for pharmaceutical strategies continue to accrue year on year. Thus, LAAC represents an opportunity for savings to healthcare systems in the long term. This is an important consideration for payers in evaluating lifetime treatment strategies in AF.
Source: Europace - July 29, 2014 Category: Cardiology Authors: Amorosi, S. L., Armstrong, S., Da Deppo, L., Garfield, S., Stein, K. Tags: Atrial fibrillation Source Type: research

Stroke and bleeding with non-vitamin K antagonist oral anticoagulant or warfarin treatment in patients with non-valvular atrial fibrillation: a population-based cohort study
ConclusionThis population-based cohort study of routine care indicates similar or better effectiveness and safety with NOAC compared with warfarin treatment. NOACs were associated with fewer intracranial bleeds, but more gastrointestinal bleeds.
Source: Europace - February 10, 2017 Category: Cardiology Source Type: research

Challenges in comparing the non-vitamin K antagonist oral anticoagulants for atrial fibrillation-related stroke prevention
AbstractThe aim of this review is to provide context for meta-analyses interpreting data from phase III stroke prevention studies of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (NVAF). Differences between the four phase III NOAC stroke prevention studies in patients with NVAF (ROCKET AF, ARISTOTLE, RE-LY, and ENGAGE AF), their potential impact on outcomes, and inter-study differences were evaluated, as well as the potential role of real-world evidence in evaluating NOACs in this setting. Study design differences included blinding strategy, dose-reduction options, a...
Source: Europace - October 13, 2017 Category: Cardiology Source Type: research

Atrial fibrillation patients do not benefit from acetylsalicylic acid
Conclusion Acetylsalicylic acid as monotherapy in stroke prevention of atrial fibrillation has no discernable protective effect against stroke, and may even increase the risk of ischaemic stroke in elderly patients. Thus, our data support the new European guidelines recommendation that ASA as monotherapy should not be used as stroke prevention in atrial fibrillation.
Source: Europace - May 5, 2014 Category: Cardiology Authors: Sjalander, S., Sjalander, A., Svensson, P. J., Friberg, L. Tags: Atrial fibrillation Source Type: research

Left atrial or left atrial appendage thrombus as a cardiac source of embolus: that is the question or Faust bargain for left atrial appendage closure? —Authors’ reply
We thank Yakutet al. for their comments on our Point of view ‘Where are clots in atrial fibrillation? Did we have the wrong assumptions over the last decades?’. In the manuscript, we addressed how in the old literature the frequency of left atrial cavity thrombi is probably largely overestimated.1 In fact, based on an accurate review, and on our experience, the real frequency of atrial thrombi located outside the left appendage (LAA) is extremely low, and it might be an important rationale for LAA occlusion interventions. The aim of this last sentence was to give evidence to procedures focusing on LAA, not promoting LA...
Source: Europace - November 30, 2020 Category: Cardiology Source Type: research

Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world patients with atrial fibrillation
Conclusion In ‘real-world’ patients with AF, dabigatran appears to be as effective, but significantly safer than acenocoumarol.
Source: Europace - August 30, 2016 Category: Cardiology Authors: Korenstra, J., Wijtvliet, E. P. J., Veeger, N. J. G. M., Geluk, C. A., Bartels, G. L., Posma, J. L., Piersma-Wichers, M., Van Gelder, I. C., Rienstra, M., Tieleman, R. G. Tags: Atrial fibrillation Source Type: research

Sex-related differences in catheter ablation of atrial fibrillation: a systematic review and meta-analysis
ConclusionsWomen who underwent catheter ablation of AF might experience lower efficacy and a higher risk of stroke/TIA and major complications than men. The reasons for these sex-related differences need to be further studied.
Source: Europace - July 8, 2019 Category: Cardiology Source Type: research

Comparative data on left atrial appendage occlusion efficacy and clinical outcomes by age group in the Amplatzer ™ Amulet™ Occluder Observational Study
ConclusionsDespite the increased risk for ischaemic stroke with increasing age in AF patients, LAAO reduced the risk for ischaemic stroke compared with the predicted rate across all age groups without differences in procedural SAEs.
Source: Europace - December 6, 2020 Category: Cardiology Source Type: research

Novel oral anticoagulants in a real-world cohort of patients undergoing catheter ablation of atrial fibrillation
Conclusion In this prospective observational study, anticoagulation with NOACs following AF catheter ablation was safe and effective at long-term follow-up. Fast onset of action makes NOACs especially attractive in patients without effective anticoagulation on admission and in patients following periprocedural complications.
Source: Europace - October 29, 2013 Category: Cardiology Authors: Eitel, C., Koch, J., Sommer, P., John, S., Kircher, S., Bollmann, A., Arya, A., Piorkowski, C., Hindricks, G. Tags: Ablation for atrial fibrillation Source Type: research

Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF
Conclusion Nearly 1 in 7 of the moderate-to-high-risk patients with AF enrolled in this trial was hospitalized within 2 years, and both AF and bleeding were rare causes of hospitalization. Further research is needed to determine whether care pathways directed at comorbid conditions among AF patients could reduce the need for and costs associated with hospitalization.
Source: Europace - August 4, 2016 Category: Cardiology Authors: DeVore, A. D., Hellkamp, A. S., Becker, R. C., Berkowitz, S. D., Breithardt, G., Hacke, W., Halperin, J. L., Hankey, G. J., Mahaffey, K. W., Nessel, C. C., Singer, D. E., Fox, K. A. A., Patel, M. R., Piccini, J. P., on behalf of the ROCKET AF Steering Com Tags: Atrial fibrillation Source Type: research

Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis
ConclusionThe use of real-time 2D ultrasound guidance for femoral vein cannulation decreases access-related bleeding rates and life-threatening vascular complications.
Source: Europace - May 20, 2016 Category: Cardiology Source Type: research

Utilization and procedural adverse outcomes associated with Watchman device implantation
Conclusion  Percutaneous LAAO with the Watchman device in the USA is associated with low in-hospital complications and a similar safety profile to a recently published EWOLUTION cohort. The complication rates were lower than those reported in the major randomized clinical trials (RCTs). We report the frequency of peri-procedural complications of the LAAO using the Watchman device from the NIS database. We also compare the frequency of peri-procedural complications with the previously published RCTs and EWOLUTION cohort. Our findings are in concordance with findings from EWOLUTION cohort and compare favourably with RCTs.
Source: Europace - September 14, 2020 Category: Cardiology Source Type: research

Major bleeding in patients with atrial fibrillation receiving vitamin K antagonists: a systematic review of randomized and observational studies
Conclusion The median rate of major bleeding in observational studies and RCTs is similar. The larger heterogeneity in bleeding rates observed in a real-life setting could reflect a high variability in standard of care of patients on VKAs and/or methodological differences between observational studies and/or variability in data sources.
Source: Europace - May 24, 2013 Category: Cardiology Authors: Roskell, N. S., Samuel, M., Noack, H., Monz, B. U. Tags: Atrial Fibrillation Source Type: research

Rationale and design of AXAFA-AFNET 5: an investigator-initiated, randomized, open, blinded outcome assessment, multi-centre trial to comparing continuous apixaban to vitamin K antagonists in patients undergoing atrial fibrillation catheter ablation
Conclusion</div>The results of AXAFA-AFNET 5 will provide evidence informing about the safety of apixaban in ablation patients and on its efficacy including effects on silent brain lesions. AXAFA – AFNET 5 is an investigator-initiated trial sponsored by AFNET. The trial is supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research) and by Bristol-Myers Squibb/Pfizer Alliance.</span>
Source: Europace - October 13, 2016 Category: Cardiology Source Type: research

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