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Source: The American Journal of Cardiology
Condition: Atrial Fibrillation
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Total 336 results found since Jan 2013.
Frequency, Trend, Predictors, and Impact of Gastrointestinal Bleeding in Atrial Fibrillation Hospitalizations
Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke 1. Anticoagulation alone or in combination with other treatment strategies are implemented to reduce the risk of stroke in patients with AF. Gastrointestinal bleeding (GIB) is a common complication of oral anticoagulation (OAC) with a prevalence of 1%-3% in patients on long term OAC2. GIB in AF patients leads to discontinuation of anticoagulation, which can increase the risk of ischemic stroke, subject patients to endoscopic procedures, blood transfusions, and related side effects.
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Mihir Dav, Ashish Kumar, Monil Majmundar, Devina Adalja, Mariam Shariff, Palak Shah, Rupak Desai, Krunalkumar Patel, Gowthami Sai Kogilathota Jagirdhar, Saraschandra Vallabhajosyula, Nageshwara Gullapalli, Rajkumar Doshi Source Type: research
A Commentary on “Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke”
Cryptogenic stroke, defined as acute ischemic stroke without a clear identifiable cause, accounts for approximately 1/3 of acute ischemic stroke cases. Undiagnosed atrial fibrillation (AF) is likely the leading underlying cause of such presentations; hence, cardiac rhythm monitoring is key to the diagnostic work-up. Commonly, long-term monitoring (LTM) using implantable cardiac monitors (ICMs) is indicated after a negative period of short-term monitoring (STM). However, the low diagnostic yield of STM prompts the question: would directly proceeding to LTM represent a more cost-effective approach?
Source: The American Journal of Cardiology - July 22, 2023 Category: Cardiology Authors: Michael Griffin, Gregory Y.H. Lip Tags: Editorial Source Type: research
Transesophageal Echocardiography for Cardiac Thromboembolic Risk Assessment in Patients With Severe, Symptomatic Aortic Valve Stenosis Referred for Potential Transcatheter Aortic Valve Implantation
Stroke is a devastating complication after transcatheter aortic valve implantation (TAVI) and might partially be related to cardiac embolization. The aim of this single-center prospective study was to determine the incidence of intracardiac thrombi and left atrial spontaneous echo contrast (SEC), both known predictors of cardiac embolic stroke, in patients referred for potential TAVI. One hundred four consecutive patients with severe symptomatic aortic valve stenosis and at high or very high risk for surgery were included and underwent transesophageal echocardiography. In 11 patients (10.6%), intracardiac thrombi were dete...
Source: The American Journal of Cardiology - February 25, 2013 Category: Cardiology Authors: Guy D. Lenders, Bernard P. Paelinck, Kristien Wouters, Marc J. Claeys, Inez E. Rodrigus, Paul L. Van Herck, Christiaan J. Vrints, Johan M. Bosmans Tags: Valvular Heart Disease Source Type: research
Dabigatran and Acute Coronary Syndromes
There has been considerable interest in the utility of newer oral anticoagulants for the secondary prevention of myocardial infarction (MI) and acute coronary syndromes (ACS). The direct thrombin inhibitor dabigatran has been approved for stroke prevention in patients with atrial fibrillation. However, as Verheugt discussed, when combined with dual antiplatelet therapy for secondary prevention in patients with ACS, no difference was found between the placebo and dabigatran groups for the composite end point of cardiovascular death, nonfatal MI, or stroke. However, it should also be noted that recent reports have actually ...
Source: The American Journal of Cardiology - May 1, 2013 Category: Cardiology Authors: John R. Kapoor Tags: Readers' Comments Source Type: research
Usefulness of Frequent Supraventricular Extrasystoles and a High CHADS2 Score to Predict First-Time Appearance of Atrial Fibrillation
Frequent supraventricular extrasystoles (SVEs) are associated with the subsequent first-time appearance of atrial fibrillation (AF) and ischemic stroke. The aim of this study was to investigate the combined role of SVEs and an AF-related risk score for ischemic stroke, the CHADS2 score, on the occurrence of new AF in patients in sinus rhythm. The Shinken Database 2004–2010 lists 3,263 patients who underwent 24-hour Holter monitoring. A total of 2,589 patients were analyzed, after excluding 674 patients previously diagnosed with AF. Frequent SVEs were defined as ≥102 beats/day (the top quartile) and the presence of a cl...
Source: The American Journal of Cardiology - March 18, 2013 Category: Cardiology Authors: Shinya Suzuki, Koichi Sagara, Takayuki Otsuka, Hiroto Kano, Shunsuke Matsuno, Hideaki Takai, Tokuhisa Uejima, Yuji Oikawa, Akira Koike, Kazuyuki Nagashima, Hajime Kirigaya, Junji Yajima, Hiroaki Tanabe, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita Tags: Arrhythmias and Conduction Disturbances Source Type: research
Effect of Dabigatran on Referrals to and Switching From Warfarin in Two Academic Anticoagulation Management Services
Dabigatran was expected to replace warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF) who are warfarin naive, difficult to maintain in therapeutic range, or at risk of warfarin-related bleeding complications. We hypothesized that the number of patients with nonvalvular AF referred to Anticoagulation Management Services would decrease sharply and that most would switch from warfarin to dabigatran. We evaluated the number of patients with nonvalvular AF referred to 2 large services, Anticoagulation Management Service 1 and Anticoagulation Management Service 2, 12 months before and after mark...
Source: The American Journal of Cardiology - May 6, 2013 Category: Cardiology Authors: Julie K. Atay, John Fanikos, Geoffrey D. Barnes, Michael Ehle, John Coatney, Gregory Piazza, James B. Froehlich, Samuel Z. Goldhaber Tags: Arrhythmias and Conduction Disturbances Source Type: research
Prognostic Usefulness of Left Ventricular Hypertrophy by Electrocardiography in Patients With Atrial Fibrillation (from the Randomized Evaluation of Long-Term Anticoagulant Therapy Study)
It is unknown whether left ventricular hypertrophy (LVH) diagnosis by electrocardiography improves risk stratification in patients with atrial fibrillation (AF). We investigated the prognostic impact of LVH diagnosis by electrocardiography in a large sample of anticoagulated patients with AF included in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Study. We defined electrographic LVH (ECG-LVH) by strain pattern or Cornell voltage (R wave in aVL plus S wave in V3)>2.0 mV (women) or>2.4 mV (men). LVH prevalence was 22.7%. During a median follow-up of 2.0 years, 303 patients developed a stroke, 778 d...
Source: The American Journal of Cardiology - November 25, 2013 Category: Cardiology Authors: Paolo Verdecchia, Gianpaolo Reboldi, Giuseppe Di Pasquale, Giovanni Mazzotta, Giuseppe Ambrosio, Sean Yang, Janice Pogue, Lars Wallentin, Michael D. Ezekowitz, Stuart J. Connolly, Salim Yusuf, RE-LY Study Investigators Tags: Arrhythmias and Conduction Disturbances Source Type: research
Unanswered Questions in Patients With Concurrent Atrial Fibrillation and Acute Coronary Syndrome
In conclusion, until the results of additional ongoing or planned randomized trials are known, clinicians must continue to rely on expert opinion and their own clinical judgment when treating these patients.
Source: The American Journal of Cardiology - December 16, 2013 Category: Cardiology Authors: Daniel S. Ice, Timothy A. Shapiro, Eric M. Gnall, Peter R. Kowey Tags: Review Source Type: research
Atrial Fibrillation and Heart Failure: A Bad Combination
Atrial fibrillation (AF) and heart failure (HF) commonly coexist and share similar risk factors such as hypertension, increasing age, valvular heart disease, previous ischemic cardiac event, and diabetes mellitus. Individually, AF and HF increase the risk of stroke and death, and the synergistic combination of AF and HF creates a prothrombotic state that results in worse stroke morbidity and mortality than the mere presence of either condition separately.
Source: The American Journal of Cardiology - January 17, 2014 Category: Cardiology Authors: Yee C. Lau, Deirdre A. Lane, Gregory Y.H. Lip Tags: Heart Failure Source Type: research
Comparison of Characteristics and Outcomes of Dabigatran versus Warfarin in Hypertensive Patients with Atrial Fibrillation (From the RE-LY® Trial)
Hypertension is frequent among patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg bid (D 110) and 150 mg bid (D 150) non-inferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D 110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed.
Source: The American Journal of Cardiology - July 28, 2015 Category: Cardiology Authors: Rangadham Nagarakanti, Lars Wallentin, Herbert Noack, Martina Brueckmann, Paul Reilly, Andreas Clemens, Stuart J. Connolly, Salim Yusuf, Michael D. Ezekowitz Source Type: research
Comparison of Characteristics and Outcomes of Versus in Hypertensive Patients With Atrial Fibrillation (from the RE-LY Trial)
Hypertension is frequent in patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg (D110) and 150 mg twice daily (D150) noninferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed.
Source: The American Journal of Cardiology - July 28, 2015 Category: Cardiology Authors: Rangadham Nagarakanti, Lars Wallentin, Herbert Noack, Martina Brueckmann, Paul Reilly, Andreas Clemens, Stuart J. Connolly, Salim Yusuf, Michael D. Ezekowitz Tags: Arrhythmias and Conduction Disturbances Source Type: research
Diagnosing Paroxysmal Atrial Fibrillation in Patients with Ischemic Strokes and Transient Ischemic Attacks using Echocardiographic Measures of Left Atrium Function
Twenty-five to thirty-five percent of stroke cases are cryptogenic and it has been demonstrated that paroxysmal atrial fibrillation is the causal agent in up to 25% of these incidents. The purpose of this study was to investigate if left atrial (LA) parameters have value for diagnosing paroxysmal AF in ischemic stroke (IS) and transient ischemic attack (TIA) patients. We retrospectively analyzed 219 patients who after acute IS or TIA underwent a transthoracic echocardiographic examination. Patients were designated as paroxysmal AF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination.
Source: The American Journal of Cardiology - October 16, 2015 Category: Cardiology Authors: Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Tor Biering-Sørensen Source Type: research
The Quandary of Oral Anticoagulation in Patients with Atrial Fibrillation and Chronic Kidney Disease
Compared to patients with normal renal function, the prevalence of atrial fibrillation (AF) in chronic kidney disease (CKD) is increased, as is consequently the stroke prevalence in these patients. This increased risk of stroke in CKD patients is caused not only by the increased prevalence of AF, but also by associated comorbidities, and inherent platelet and vascular dysfunction. Paradoxically, imbalance in the same factors also increases the bleeding risk, imposing a dilemma as to whether anticoagulation should be prescribed or deferred, particularly in patients with end stage renal disease (ESRD), in whom the bleeding d...
Source: The American Journal of Cardiology - November 18, 2015 Category: Cardiology Authors: Shmuel Schwartzenberg, Eli I. Lev, Alik Sagie, Asher Korzets, Ran Kornowski Source Type: research
Relation of Nonvalvular Atrial Fibrillation to Body Mass Index (from the SPORTIF Trials)
Obesity is well-established as a major cardiovascular (CV) risk factor. Obesity confers a greater risk for developing atrial fibrillation (AF), but the relation between obesity and established nonvalvular AF for stroke and all-cause death is still unclear. To ascertain the prevalence of overweight and obesity in patients with nonvalvular AF, their influence on adverse events, and the relation with anticoagulation control, we performed this post hoc analysis of the pooled Stroke Prevention using an Oral Thrombin Inhibitor in patients with atrial Fibrillation (SPORTIF) III and V data sets.
Source: The American Journal of Cardiology - April 19, 2016 Category: Cardiology Authors: Marco Proietti, Deirdre A. Lane, Gregory Y.H. Lip Tags: Arrhythmias and Conduction Source Type: research
Meta-Analysis of Anxiety as a Risk for Cardiovascular Disease
We examined the association of anxiety with cardiovascular mortality, major cardiovascular events (defined as the composite of cardiovascular death, stroke, coronary heart disease and heart failure), stroke, coronary heart disease, heart failure and atrial fibrillation.
Source: The American Journal of Cardiology - May 27, 2016 Category: Cardiology Authors: Connor A. Emdin, Ayodele Odutayo, Christopher X. Wong, Jenny Tran, Allan J. Hsiao, Benjamin HM. Hunn Source Type: research
