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Source: Medicine
Condition: Atrial Fibrillation

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Total 92 results found since Jan 2013.

Utility of Duranta, a wireless patch-type electrocardiographic monitoring system developed in Japan, in detecting covert atrial fibrillation in patients with cryptogenic stroke: A case report
Rationale: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life. A Duranta device was used to detect covert AF in patien...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Comparison of the effects of left atrial appendage closure and oral anticoagulants in preventing stroke in patients with non-valvular atrial fibrillation: A protocol for systematic review and meta-analysis
Conclusion: This study will give the best treatment strategy to prevent stroke in patients with NVAF, and provide some reference for clinical medical staff. OSF registration number: DOI 10.17605/OSF.IO/2UXPA (https://osf.io/2uxpa).
Source: Medicine - September 17, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Predicting Hemorrhagic Transformation of Acute Ischemic Stroke: Prospective Validation of the HeRS Score
Abstract: Hemorrhagic transformation (HT) increases the morbidity and mortality of ischemic stroke. Anticoagulation is often indicated in patients with atrial fibrillation, low ejection fraction, or mechanical valves who are hospitalized with acute stroke, but increases the risk of HT. Risk quantification would be useful. Prior studies have investigated risk of systemic hemorrhage in anticoagulated patients, but none looked specifically at HT. In our previously published work, age, infarct volume, and estimated glomerular filtration rate (eGFR) significantly predicted HT. We created the hemorrhage risk stratification (HeRS...
Source: Medicine - January 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Stroke risks and patterns of warfarin therapy among atrial fibrillation patients post radiofrequency ablation: A real-world experience
In this study, we analyzed the stroke risks of patients who had undergone RFA for AF at our hospital between March 2014 and June 2016 using the CHADS2, CHADS2-VASc, and Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years) (HAS-BLED) scoring systems. We retrieved medications, co-morbidities, and initial warfarin dosage data. The primary outcome was the percentage of patients initiated with warfarin therapy for stroke prophylaxis in AF who had a CHADS2-VASc score of 0. Totally, 309 patients were initiated with warfarin therapy ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Thrombolysis in an acute ischemic stroke patient with rivaroxaban anticoagulation: A case report
Rationale: Whether intravenous recombinant tissue plasminogen activator (r-TPA) therapy can be administered in acute ischemic stroke patients treated with novel oral anticoagulants (NOACs), including rivaroxaban, remains controversial. Patient concerns: A 76-year-old woman with nonvalvular atrial fibrillation, who had been receiving 15 mg rivaroxaban once daily, was brought to the emergency department with right-side hemiparesis and aphasia. The onset of neurological deficits occurred 8 hours after the last dose of rivaroxaban administration. Diagnosis: The patient was diagnosed with acute ischemic stroke. Int...
Source: Medicine - February 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Predictive value of CHA2DS2-VASc scores regarding the risk of stroke and all-cause mortality in patients with atrial fibrillation (CONSORT compliant)
Background: Patients with atrial fibrillation (AF) have a higher risk of fatal complications (e.g., stroke). This investigation was performed as an observational retrospective cohort study includes 137 patients (age 61 ± 15; 34.3% women) with a primary diagnosis of AF (paroxysmal, persistent, and permanent). Methods: We collected information about the drug therapy, comorbidities and survival of AF patients and determined their congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA2DS2-VASc) scores. Statistical analysis ident...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous thrombolysis: A meta-analysis
Conclusion: The systematic review showed that male, age, diabetes, NIHSS, OTT, atrial fibrillation, post stroke, infarct size, and ischemic signs of CT were significantly correlated with hemorrhagic transformation (HT). PROSPERO Registration number: CRD42019127499.
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Do NOACs Improve Antithrombotic Therapy in Secondary Stroke Prevention in Nonvalvular Atrial Fibrillation?
Abstract: Guidelines recommended oral anticoagulant (OAC) for ischemic stroke patients related to atrial fibrillation (AF). But, underprescription or underdose of warfarin was observed worldwide. We aimed to explore if the use of antithrombotic therapy in nonvalvular AF (NVAF) ischemic stroke patients improved after novel oral anticoagulants (NOACs) became available. Between January 2011 to December 2013, 360 acute ischemic stroke patients related to NVAF were recruited. Patients were categorized into 2 groups based on the date (July 2012) of NOACs’ availability. There were 184 patients recruited before July 2012, and wh...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Global longitudinal strain predicts incident atrial fibrillation and stroke occurrence after acute myocardial infarction
Abstract: Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients. The study comprised of 373 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections. The endpoint was ...
Source: Medicine - November 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

A new clinical decision support tool for improving the adequacy of anticoagulant therapy and reducing the incidence of stroke in nonvalvular atrial fibrillation: A randomized clinical trial in primary care
This study protocol was approved by the Ethical Committee of Clinical Investigation of the Institut Universitari d’Investigació en Atenció Primària Jordi Gol (code P17/091). Articles will be published in scientific journals.Trial registration:Clinical-Trials.gov: NCT03367325. Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke 4 to 5-fold. The first choice of anticoagulant therapy (AT) is the vitamin K antagonist (VKA). Contraindication to VKA or poor control of the International Normalized Ratio leads to the administration of direct-acting oral an...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Relationship of cardiac biomarkers with white matter hyperintensities in cardioembolic stroke due to atrial fibrillation and/or rheumatic heart disease
White matter hyperintensities (WMHs), which are common in elderly people and contribute to age-related disability, can coexist with cardiac injury. It remains unclear whether cardiac biomarkers are associated with WMHs. To investigate this question, we prospectively recruited patients with cardioembolic stroke due to atrial fibrillation (AF) and/or rheumatic heart disease (RHD). Four cardiac biomarkers were measured: myoglobin, high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB, and terminal pro-brain natriuretic peptide. WMHs in periventricular and deep white matter were assessed separately. In the entire...
Source: Medicine - August 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Is intravenous thrombolysis safe for acute ischemic stroke patients taking warfarin with INR 1.9?: A case report
Conclusion: The clinical guidelines are still the main reference for guiding clinical practice, and the main thrombolytic standards and contraindications for treatment still need to be conformed. On this basis, for individualized patients, clinicians must accurately judge the cause of acute stroke, to make optimal choice, reduce disability and mortality, and improve quality of life of patients.
Source: Medicine - March 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Stroke severity modified the effect of chronic atrial fibrillation on the outcome of thrombolytic therapy
This study was designed to identify high-risk patients with chronic AF who had undergone thrombolysis treatment and to explore whether the baseline National Institutes of Health Stroke Scale (NIHSS) could be used to distinguish poor clinical outcomes in thrombolyzed patients.
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Atrial Fibrillation is Associated With Poor Outcomes in Thrombolyzed Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Abstract: The influence of atrial fibrillation (AF) on the clinical outcomes of patients with ischemic stroke (IS) has not been completely determined. We aimed to perform a systematic review and meta-analysis to assess the relationship between AF and adverse events in patients with acute IS treated with thrombolysis. PubMed, EMBASE, and the Cochrane Library were searched for relevant studies regarding the association between AF and the outcomes of patients with IS treated with thrombolysis. Random and fixed effect models were used for pooling data. Twelve cohort studies involving 14,801 patients with acute IS were includ...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research

Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage. Patient concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU). Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma. Interventions: The patient was treated with Idarucizumab ...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research