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Source: Heart Rhythm
Condition: Atrial Fibrillation

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Total 356 results found since Jan 2013.

EWOLUTION —The next evolution in appendage closure?
Oral anticoagulation (OAC) is a class I indication for patients with nonvalvular atrial fibrillation (AF) and ≥2 risk factors for stroke.1 However, many patients with AF are ineligible for OAC because of prohibitive bleeding. Subsequently, as a result of the pivotal role of the left atrial appendage (LAA) in the formation of thrombi, an alternative strategy to OAC is occlusion of the LAA.2 The WATCHMAN de vice (Boston Scientific Corporation, Marlborough, MA) is the only US Food and Drug Administration (FDA)–approved LAA occlusion product that has been studied in randomized control trials (RCTs) (Table).
Source: Heart Rhythm - June 22, 2017 Category: Cardiology Authors: Muhammad R. Afzal, Emile G. Daoud Tags: Editorial Commentary Source Type: research

The who, how, and why of screening patients for atrial fibrillation: More questions than answers
An estimated 100,000 –125,000 of the 610,000 strokes per year in the United States are associated with atrial fibrillation (AF).1 AF-related strokes cause larger cortical loss, disability, cost, and mortality compared with strokes not related to AF. In a pooled trial analysis, oral anticoagulation with warfarin lowere d AF stroke incidence by 64%.2 However, many AF patients have minimal to no symptoms and remain undiagnosed until complications occur. Given the devastating consequences of stroke and the high prevalence of AF, the value of screening to detect asymptomatic AF for the purpose of initiating anticoagul ation p...
Source: Heart Rhythm - June 17, 2017 Category: Cardiology Authors: Anne B. Curtis, Alexander Hattoum Tags: Editorial Commentary Source Type: research

PREdicting Determinants of Atrial Fibrillation for Therapy Elucidation in Patients at Risk for Thromboembolic Events (PREDATE AF) Study
AF is the most common, clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke and OAC has been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long term outcomes but the optimal patient population and screening intensity are unknown.
Source: Heart Rhythm - May 12, 2017 Category: Cardiology Authors: Javed M. Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater Source Type: research

Predicting Determinants of Atrial Fibrillation or Flutter for Therapy Elucidation in Patients at Risk for Thromboembolic Events (PREDATE AF) Study
Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown.
Source: Heart Rhythm - May 12, 2017 Category: Cardiology Authors: Javed M. Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater Source Type: research

Preventing Heart Failure in Atrial Fibrillation: In the Middle of Difficulty Lies Opportunity
Atrial fibrillation increases the risk of several adverse cardiovascular events. While a great deal of attention is focused on the prevention of stroke, relatively little attention is paid to the prevention of heart failure in patients with atrial fibrillation (AF) despite the fact that heart failure (HF) complicates AF more often than stroke does. The risk of developing heart failure is 3-4 times greater in patients with AF1 and as many as half of all patients with long-standing persistent AF have HF.
Source: Heart Rhythm - February 22, 2017 Category: Cardiology Authors: Jonathan P. Piccini, Benjamin A. Steinberg Source Type: research

Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established, and in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1,2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation, possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors and to the increased...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Tags: Editorial Commentary Source Type: research

Editorial Commentary: Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established and, in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1, 2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors as well as the incre...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Source Type: research

Atrial fibrillation ablation, stroke and mortality. Evaluating the effects of therapy in the era of big data
Atrial fibrillation (AF) is associated with an increased stroke and mortality risk. The logical extension of this is that if AF is controlled or eliminated then patient outcomes with respect to stroke and mortality should improve. The AFFIRM trial comparing rate and rhythm control strategies unfortunately did not demonstrate an improvement in either of these endpoints in the rhythm control population (1). An interesting sub-analysis of the AFFIRM trial did however indicate that patients who were in sinus rhythm more often at the time of their follow-up had a reduced mortality (2).
Source: Heart Rhythm - February 9, 2017 Category: Cardiology Authors: Steven J. Kalbfleisch Source Type: research

Atrial fibrillation ablation, stroke, and mortality: Evaluating the effects of therapy in the era of big data
Atrial fibrillation (AF) is associated with an increased stroke and mortality risk. The logical extension of this is that if AF is controlled or eliminated then patient outcomes with respect to stroke and mortality should improve. The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial1 comparing rate and rhythm control strategies unfortunately did not demonstrate an improvement in either of these end points in the rhythm control population. An interesting subanalysis of the AFFIRM trial2 did, however, indicate that patients who were in sinus rhythm more often at the time of their follow-up had a reduced mortality.
Source: Heart Rhythm - February 9, 2017 Category: Cardiology Authors: Steven J. Kalbfleisch Tags: Editorial Commentary Source Type: research

Catheter ablation of atrial fibrillation is associated with reduced risk of stroke and mortality: A propensity-matched analysis
Catheter ablation reduces recurrence of atrial fibrillation and improves quality of life. Only few studies have assessed the effect of catheter ablation on long-term outcomes.
Source: Heart Rhythm - February 7, 2017 Category: Cardiology Authors: Walid Saliba, Jorge E. Schliamser, Idit Lavi, Ofra Barnett-Griness, Naomi Gronich, Gad Rennert Source Type: research

Percutaneous left atrial appendage closure improves left atrial mechanical function through Frank –Starling mechanism
Modifications in left atrial (LA) flow velocities after left atrial appendage (LAA) exclusion have been shown in animal and ex  vivo models. In a substudy of PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation), an objective improvement in quality of life was observed after LAA closure.
Source: Heart Rhythm - February 6, 2017 Category: Cardiology Authors: Augustin Coisne, Rosario Pilato, Fran çois Brigadeau, Didier Klug, Christelle Marquie, Zouheir Souissi, Marjorie Richardson, Stéphanie Mouton, Anne-Sophie Polge, Patrizio Lancellotti, Dominique Lacroix, David Montaigne Source Type: research

Warfarin Use and the Risk of Mortality, Stroke, and Bleeding in Hemodialysis Patients with Atrial Fibrillation
The optimal management of stroke prophylaxis in hemodialysis patients with atrial fibrillation is controversial.
Source: Heart Rhythm - February 5, 2017 Category: Cardiology Authors: Brandon Kai, Yuliya Bogorad, Leigh-Ann N. Nguyen, Su-Jau Yang, Wansu Chen, Hillard T. Spencer, Albert Y.-J. Shen, Ming-Sum Lee Source Type: research

Benefits of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation go beyond stroke prevention
Source: Heart Rhythm - January 15, 2017 Category: Cardiology Authors: Jay A. Montgomery, Gregory F. Michaud Source Type: research

Benefits of non –vitamin K antagonist oral anticoagulants in patients with atrial fibrillation go beyond stroke prevention
The last decade has produced a large body of robust randomized controlled trial (RCT) data investigating the use of non –vitamin K antagonist oral anticoagulants (NOACs) in nonvalvular atrial fibrillation (AF).1–4 Compared with warfarin, dabigatran and apixaban have been found to reduce the combined outcome of stroke and systemic embolism. In addition, apixaban and edoxaban significantly reduce major bleeding. Fu rthermore, a pooled meta-analysis has demonstrated superior efficacy and overall safety of the NOACs.
Source: Heart Rhythm - January 15, 2017 Category: Cardiology Authors: Jay A. Montgomery, Gregory F. Michaud Tags: Editorial Commentary Source Type: research

Extracranial arterial and venous thromboembolism in patients with atrial fibrillation: A meta-analysis of randomized controlled trials
Thromboembolism prevention is central to atrial fibrillation (AF) management. Randomized controlled trials (RCTs) have primarily focused on stroke prevention. Detailed analyses of extracranial thromboembolic events, particularly in patients with low dose non-vitamin K antagonist oral anticoagulants (NOACs), are scarce.
Source: Heart Rhythm - January 2, 2017 Category: Cardiology Authors: Kang-Ling Wang, Harry R. B üller, Shinya Goto, Chun-Yi Lin, En-Yu Lai, Chun-Chih Chiu, Chern-En Chiang, Robert P. Giugliano Source Type: research