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Screening over 100 000 patients in 39 general practices in the Netherlands for anticoagulation underprescription in atrial fibrillation: a descriptive, cross-sectional study
Conclusions In this large Dutch study among GPs, we observed 9.8% underprescription of OAC in AF patients. In 76% of the AF patients lacking a prescription for OAC, no documentation for deviating from the guidelines was found. Only in a minority of cases detection of OAC underprescription lead to OAC initiation.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Voorhout, L., Pisters, R., Geurts, C. H. P. H., Oostindjer, A., van Doorn, S., Rila, H., Fuijkschot, W. W., Verheugt, F., Hemels, M. E. W. Tags: Open access, Cardiovascular medicine Source Type: research

Improving outcomes of AF ablation by integrated personalized lifestyle interventions: rationale and design of the prevention to improve outcomes of PVI (POP) trial
This study is a prospective, 1:1 randomized, single centre, investigator-initiated clinical trial in 150 patients with paroxysmal or persistent AF referred for a first pulmonary vein isolation (PVI). Prior to the ablation, patients in the intervention group receive a personalized risk factor treatment programme in a specialized, protocolized, nurse-led outpatient clinic. Patient education and durable lifestyle management is promoted with an e-health platform. Patients in the control group receive standard care by cardiologists before ablation. The primary endpoint is the number of hospitalizations for re-ablation and cardi...
Source: Clinical Research in Cardiology - March 31, 2023 Category: Cardiology Source Type: research

Safety and effectiveness of rivaroxaban for prevention of stroke in patients with nonvalvular atrial fibrillation: analysis of routine clinical data from four countries
CONCLUSIONS: Incidences of intracranial bleeding were generally lower with rivaroxaban than with SOC, whereas incidences of gastrointestinal and urogenital bleeding were generally higher. The safety profile of rivaroxaban for NVAF in routine practice is consistent with findings from randomized controlled trials and other studies.PMID:36795067 | DOI:10.1080/14740338.2023.2181334
Source: Expert Opinion on Drug Safety - February 16, 2023 Category: Drugs & Pharmacology Authors: Luis Alberto Garc ía-Rodríguez Ana Ruig ómez Tania Schink Annemarie Voss Elisabeth Smits Karin M A Swart Yanina Balabanova Kiliana Suzart-Woischnik Gunnar Brobert Ron M C Herings Source Type: research

How is atrial fibrillation detected in everyday healthcare? Results of a  Dutch cohort study
CONCLUSION: Diagnosing AF is a multidisciplinary process. The irregular heartbeat was most often detected by the GP, but cardiologists diagnosed most cases. One-third of all newly diagnosed AF was silent.PMID:36048351 | DOI:10.1007/s12471-022-01719-2
Source: Netherlands Heart Journal - September 1, 2022 Category: Cardiology Authors: N Verbiest-van Gurp S B Uittenbogaart S C M van de Moosdijk U F van Sprang J A Knottnerus H E J H Stoffers W A M Lucassen Source Type: research

The WOEST  2 registry : A prospective registry on antithrombotic therapy in atrial fibrillation patients undergoing percutaneous coronary intervention
CONCLUSIONS: Patients on combined oral anticoagulation and antiplatelet therapy undergoing PCI are elderly and have both a high bleeding and ischaemic risk. Over time, a NOAC plus clopidogrel became the preferred treatment. The rate of thrombotic and bleeding events was not significantly different between patients on triple or dual therapy or between those on VKAs versus NOACs.PMID:35230636 | DOI:10.1007/s12471-022-01664-0
Source: Netherlands Heart Journal - March 1, 2022 Category: Cardiology Authors: A J W M de Veer N Bennaghmouch W L Bor J P R Herrman M Vrolix M Meuwissen T Vandendriessche T Adriaenssens B de Bruyne M Magro W J M Dewilde J M Ten Berg Source Type: research

Cost-effectiveness of a photopethysmographic procedure for screening for atrial fibrillation in 6 European countries
ConclusionThe model results showed a strong dependence of the results on the country-specific costs for stroke treatment. The use of the investigated screening method is close to cost-neutral or cost-reducing in the Western European countries and Greece. In countries with low price levels, higher cost increases due to AF screening are to be expected. Lower costs of anticoagulation, which are expected due to the upcoming patent expiry of direct anticoagulants, have a positive effect on the cost result.
Source: Health Economics Review - February 26, 2022 Category: International Medicine & Public Health Source Type: research

Validating risk models versus age alone for atrial fibrillation in a young Dutch population cohort: should atrial fibrillation risk prediction be expanded to younger community members?
Conclusion Multivariable models accurately discriminate for 5-year and 10-year AF risk among young European community-dwelling individuals. However, their additional discriminatory value over age alone was limited. Selection strategies for primary AF screening using multivariable models should not be expanded to younger individuals.
Source: BMJ Open - February 16, 2022 Category: General Medicine Authors: Himmelreich, J. C. L., Harskamp, R. E., Geelhoed, B., Virdone, S., Lucassen, W. A. M., Gansevoort, R. T., Rienstra, M. Tags: Open access, Cardiovascular medicine Source Type: research

Smoking Does Not Alter Treatment Effect of Intravenous Thrombolysis in Mild to Moderate Acute Ischemic Stroke —A Dutch String-of-Pearls Institute (PSI) Stroke Study
Conclusions: In patients with mild to moderate AIS admitted within 12 h of symptom onset, smoking did not modify treatment effect of thrombolysis.
Source: Frontiers in Neurology - July 30, 2020 Category: Neurology Source Type: research

Reasons for discontinuation of novel oral anticoagulant therapy in patients with atrial fibrillation.
Conclusion: DOAC discontinuation rates varied significantly and appeared related to drug-specific side effects, patient-initiated discontinuation, and bleeding. We observed longer-term administration of apixaban, suggesting that this drug is better tolerated than dabigatran or rivaroxaban. PMID: 32011180 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - February 5, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research

ICDs Have Come a Long Way in 40 Years
Michel Mirowski and his colleagues gave the field of implantable cardioverter-defibrillators (ICDs) a pretty good start, but what's more impressive is how far the technology has advanced since that first human ICD implant in February 1980. In the past 40 years we've seen ICDs become dramatically smaller, longer lasting, more capable, more personalized, subcutaneous (non-transvenous), and even MRI-firendly. And that's not to mention the advanced data connectivity and monitoring capabilities that the latest technologies offer. So without further ado, let's take a look at the current ICD landscape and the companie...
Source: MDDI - February 4, 2020 Category: Medical Devices Authors: Amanda Pedersen Tags: Implants Source Type: news

Opportunistic screening versus usual care for diagnosing atrial fibrillation in general practice: a cluster randomised controlled trial.
CONCLUSION: Opportunistic screening with a single-lead ECG at the discretion of the GP did not result in a higher yield of newly detected cases of AF in patients aged ≥65 years in the community than usual care. For higher participation rates in future studies, more rigorous screening methods are needed. PMID: 31988084 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - January 26, 2020 Category: Primary Care Authors: Kaasenbrood F, Hollander M, de Bruijn SH, Dolmans CP, Tieleman RG, Hoes AW, Rutten FH Tags: Br J Gen Pract Source Type: research

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