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Source: Heart Rhythm
Condition: Atrial Fibrillation
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Total 356 results found since Jan 2013.
Cardiac implantable electronic device-detected atrial fibrillation —“To anticoagulate or not to anticoagulate, that is the question”: The noble or ignoble choice?
Atrial fibrillation (AF) detected during interrogation of a cardiovascular implantable electronic device (CIED) is a common event,1 with available studies suggesting that it is associated with an increased risk of stroke.2,3 While current guidelines recommend oral anticoagulant (OAC) therapy for patients with AF and an elevated CHA2DS2-VASc score,4 controversy exists about whether the various components of CIED-detected AF (eg, duration, burden, and CHA2DS2-VASc score) predict stroke and, if effective as predictors, which characteristics best define that risk.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Thomas F. Deering, Faiez Zannad Tags: Editorial Commentary Source Type: research
EP News: Quality Improvement and Outcomes: Defining and Measuring Atrial Fibrillation Quality Indicators in Canada
In 2016, the Working Group published an initial report identifying and defining priority QIs in 3 distinct categories: access to care, treatment, and outcomes (Can J Cardiol 2016;32:1566, PMID 27297003). An iterative process resulted in the selection of 3 priority QIs: (i) proportion of AF patients at high risk of stroke receiving an oral anticoagulant, (ii) annual rate of stroke, (iii) annual rate of major hemorrhage. A feasibility assessment followed, which determined that none of the QIs as defined could be adequately measured with existing data sources.
Source: Heart Rhythm - April 26, 2021 Category: Cardiology Authors: Roopinder K. Sandhu, Stephen B. Wilton, Anne Marie Smith, Paul Dorian Source Type: research
EP News: Clinical
Bernstein et al (JAMA 2021;325:2169–2177; PMID: 34061145) evaluated whether long-term monitoring with an implantable cardiac monitor (ICM) is more effective than usual care for atrial fibrillation (AF) detection in patients with stroke from large- or small-vessel disease. Overall, 242 patients were randomize d to ICM insertion within 10 days of the index stroke. Patients in the control group (n = 250) received site-specific usual care with external cardiac monitoring, such as 12-lead electrocardiograms, Holter monitoring, telemetry, or event recorders.
Source: Heart Rhythm - July 7, 2021 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
B-po04-077 heart rate variability and left atrial hemodynamics in atrial fibrillation measured with 4d flow mri
Atrial fibrillation (AF) can lead to stroke due to thrombus formation in the left atrium (LA) or left atrial appendage (LAA). Altered LA hemodynamics in the presence of AF may be predictive of thrombus and stroke risk. Previous 4D flow MRI studies found increased stasis and decreased peak velocity in patients with AF. However, the impact of variable R-R intervals on LA velocity and stasis measurement has not been investigated.
Source: Heart Rhythm - July 28, 2021 Category: Cardiology Authors: Amanda DiCarlo, Justin Baraboo, Mitchell A. Collins, Maurice Pradella, Patrick M. McCarthy, Philip Greenland, Rishi Arora, Daniel C. Lee, Daniel Kim, Michael Markl, Rod S. Passman Source Type: research
EP News: Clinical
Lakkireddy et al (Circulation 2021;144:1543, PMID 34459659) evaluated the safety and effectiveness of the Amulet left atrial appendage occluder (A) compared with the Watchman device (W). Patients with nonvalvular atrial fibrillation at an increased risk of stroke were randomly assigned (1:1) to A or W. The prim ary end points included safety (composite of procedure-related complications, death, or major bleeding at 12 months) and effectiveness (composite of ischemic stroke or systemic embolism at 18 months).
Source: Heart Rhythm - December 7, 2021 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
Po-701-04 outcomes of left atrial appendage closure in patients with atrial fibrillation and end-stage renal disease on dialysis
Oral anticoagulation (OAC) therapy is the mainstay of treatment for stroke-risk reduction in patients with atrial fibrillation (AF). However, OAC use in patients with end-stage renal disease (ESRD) on dialysis is associated with a significantly increased risk of bleeding and an uncertain benefit in stroke reduction. In these patients, left atrial appendage closure (LAAC) could be alternative.
Source: Heart Rhythm - April 29, 2022 Category: Cardiology Authors: Jorge Romero, Juan C. Diaz, Sutopa Purkayastha, Jorge Marin, Julian M. Aristizabal, Daniel Rodriguez, Isabella Alviz, Mauricio Duque, Mohamed Gabr, Maria Gamero, Jose Matias, Marta Lorente-Ros, Luis Ernesto Cerna, Dhanunjaya R. Lakkireddy, Rishi Charate, Source Type: research
Po-701-01 nine month readmission rates and clinical outcomes of anticoagulation versus watchman device in octogenarians
Atrial Fibrillation (AF), the most common arrhythmia in older adults, is fraught with an increased risk of stroke. Studies which have demonstrated non-inferiority of Left atrial appendage occlusion (LAAO) with a watchman device compared to oral anticoagulation for stroke risk reduction in AF did not include patients greater than 80 years of age, making it difficult to generalize these results to this population.
Source: Heart Rhythm - April 29, 2022 Category: Cardiology Authors: Varun Victor, Mahmoud Khalil, Dilanthy Annappah, Ahmed Mohamed, Kirolos Barssoum Source Type: research
Performing Transcatheter Left Atrial Appendage Closure: Techniques and Challenges
The left atrial appendage (LAA) has been demonstrated to be the major source of thromboemboli in patients with atrial fibrillation (AF).1 The rationale of LAA closure is based on eliminating LAA continuity with the left atrium thereby reducing stroke risk. Indeed, left atrial appendage occlusion (LAAO) procedures play an important role in anticoagulation-intolerant patients at risk for AF-related stroke. Based on the PROTECT-AF2 and PREVAIL3 studies, the Food and Drug Administration (FDA) approved use of the Watchman (Boston Scientific, MA) device in 2015, with an updated generation of device subsequently ratified in 2020 ...
Source: Heart Rhythm - August 6, 2022 Category: Cardiology Authors: Ammar M. Killu, Mohamad A. Alkhouli Source Type: research
Contemporary Trends in Utilization and Outcomes of Percutaneous Left Atrial Appendage Occlusion in the United States from 2016 to 2019
Atrial fibrillation is a major cause of stroke and thromboembolism and oral anticoagulation is the mainstay of prevention. In patients who are poor candidates for long-term anticoagulation, percutaneous left atrial appendage occlusion (pLAAO) emerged as an alternative stroke prevention strategy and was approved by the US FDA in 2015. We aimed to examine trends in procedural volume, resource utilization, and clinical outcomes of pLAAO from a nationally representative cohort.
Source: Heart Rhythm - October 14, 2022 Category: Cardiology Authors: Mohak Gupta, Abdul Mannan Khan Minhas, Sachin S. Goel, Sourbha S. Dani, Mahboob Alam, Salik Nazir, Safi U. Khan, Wilbert Aronow, Vardhmaan Jain Source Type: research
Po-02-134 real world clinical management after surgical left atrial appendage excision
Surgical left atrial appendage (LAA) closure is an increasingly utilized approach to mitigate the risk of cardioembolic stroke in patients with atrial fibrillation (AF). Optimal stroke prevention management after surgical LAA management with respect to imaging and continuation of oral anticoagulation (OAC) is not well understood.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Karanpreet Dhaliwal, Matthew Singleton, Karl Richardson, Lauren Ehrhardt-Humbert, David Coffman, Prashant D. Bhave Source Type: research
Po-03-061 utility of implantable loop recorders for cryptogenic strokes to detect arrhythmias other than atrial fibrillation
Implantable loop recorders (ILR) are recommended to detect atrial fibrillation (AF) in cases of cryptogenic stroke (CS). However, the utilization of loop recorders for the diagnosis of other arrhythmias in patients with a history of cryptogenic stroke is limited.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Taqi A. Rizvi, Shahkar Khan, Nnedindu Asogwa, Hai Xu, Valay K. Parikh, Philippe Akhrass, Rina R. Shah, Marcin Kowalski Source Type: research
Po-03-135 left atrial appendage occlusion versus standard of care in patients with atrial fibrillation and a prior thrombo-embolic event despite oral anticoagulant therapy: a propensity score matched comparison
Patients with atrial fibrillation (AF) that suffer from ischemic stroke despite oral anticoagulant (OAC) therapy have a very high risk of recurrent stroke and better prevention strategies are needed. Left atrial appendage occlusion (LAAO) is a promising secondary prevention strategy that may provide mechanical protection. However, evidence showing effectiveness of LAAO in this population is scarce and the current international guidelines only consider LAAO in patients with a contra-indication for OAC.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Moniek Maarse, David Seiffge, Errol Aarnink, Nicolai Fierro, Patrizio Mazzone, Alessandro Beneduce, Alessio Gasperetti, Claudio Tondo, Radek Pracon, Marcin Demkow, Kamil Zielinski, Ole de Backer, Kasper Korsholm, Jens Erik Nielsen-Kudsk, Rodrigo Estevez-L Source Type: research
I left my smartphone at home and can’t tell if I’m in atrial fibrillation
The enormous impact of atrial fibrillation (AF) on human suffering, health-care utilization, and physician resources is clear to the readers of HeartRhythm. Recent publications have developed 3 alarming trends: (1) the incidence of AF is increasing, perhaps fueled by the obesity epidemic; (2) our ability to treat AF is not improving, at least as assessed by age-adjusted mortality rates postdiagnosis; and (3) health-care costs for treatment of AF are growing exponentially. In reaction to these depressing facts, the tendency to want to learn more about our enemy is only natural. Improvements in bioengineering technology and ...
Source: Heart Rhythm - January 28, 2013 Category: Cardiology Authors: David J. Callans Tags: Editorial Commentary Source Type: research
Toward permanent pulmonary vein isolation: The use of adenosine to unmask dormant conduction
Atrial fibrillation (AF) remains the most common sustained cardiac arrhythmia and continues to be a major cause of stroke and hospitalizations worldwide. Seminal observations by Haïssaguerre et al in 1998 on the role of pulmonary vein (PV) triggers in AF led to the development of PV isolation as the cornerstone of ablation for AF. However, this initial enthusiasm has been dampened by the high frequency of PV reconnection, resulting in recurrent AF. Therefore, permanent PV isolation remains the “holy grail” for electrophysiologists. The quest for permanent PV isolation has resulted in the development of numerous techno...
Source: Heart Rhythm - February 4, 2013 Category: Cardiology Authors: Kim H. Chan, Raymond W. Sy Tags: Editorial Commentary Source Type: research
