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Insomnia and Cardiovascular Health: Exploring the Link Between Sleep Disorders and Cardiac Arrhythmias
AbstractCardiovascular diseases (CVDs), driven by modern lifestyles, have increased, with atrial fibrillation (AF) being a major concern linked to heart failure and stroke. Insomnia affects a large population, especially younger individuals, males, and menopausal women, decreasing the quality of life and potentially causing autonomic disturbances and cardiac arrhythmias.Purpose of ReviewThis review explores the link between insomnia and cardiac arrhythmias, particularly AF, and its impact on cardiovascular health and emphasizes the need to address insomnia in individuals with cardiac arrhythmias by tailored strategies for ...
Source: Current Cardiology Reports - September 1, 2023 Category: Cardiology Source Type: research

Left Atrial Appendage Closure with Watchman vs Amulet Devices: Similarities and Differences
AbstractPurpose of ReviewLeft atrial appendage closure (LAAC) has shown to be non-inferior to oral anticoagulation (OAC) for non-valvular atrial fibrillation (AF). LAAC is now becoming a leading method for stroke prophylaxis in patients who have atrial fibrillation and are unable to tolerate OAC. There are currently two FDA-approved endocardial closure devices, namely, the Watchman FLX and Amplatzer Amulet.Recent FindingsCurrent data highlights that both devices offer similar efficacy and safety for LAAC. While the two devices differ in terms of intraprocedural complication rates, they offer similar short- to long-term out...
Source: Current Cardiology Reports - August 16, 2023 Category: Cardiology Source Type: research

Sex Differences in Atrial Fibrillation
AbstractPurpose of ReviewAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The estimated lifetime risk of developing AF is higher in men; however, due to differences in life expectancy, the overall prevalence is higher among women, particularly in the older age group. Sex differences play an important role in the pathophysiology, presentation, and clinical outcomes of AF. Awareness of these differences minimizes the potential for disparities in AF management. Our review summarizes the current literature on sex differences in AF, including the epidemiology, pathophysiology, risk factors, clinical sym...
Source: Current Cardiology Reports - July 28, 2023 Category: Cardiology Source Type: research

Incidence and Prevalence of Atrial Fibrillation in Latinos: What ’s New Since the Study in Latinos (SOL)?
AbstractPurpose of ReviewTo assess contemporary epidemiological trends in AF incidence and prevalence in the LatinX population after the Hispanic Community Health Study/Study of Latinos.Recent FindingsAtrial fibrillation (AF) remains the most abnormal heart rhythm condition globally and disproportionately impacts morbidity and mortality of communities that have been historically disadvantaged. The incidence and prevalence of AF is lower in the LatinX population compared to White individuals despite a higher burden of classic risk factors associated with AF. Since the Hispanic Community Health Study/Study of Latinos study o...
Source: Current Cardiology Reports - July 8, 2023 Category: Cardiology Source Type: research

Is There a Role for Vitamin K Antagonist in the Management of Atrial Fibrillation in 2023?
AbstractPurpose of ReviewTo address the following question: Are vitamin K antagonists (VKA) obsolete as stroke prevention therapy for patients with atrial fibrillation (AF) and thromboembolic risk factors?Recent FindingsA patient-level meta-analysis of the pivotal phase III randomized trials confirmed the favorable treatment effect of direct oral anticoagulants (DOAC) over VKA in multiple key patient subgroups. Among patients with AF and rheumatic heart disease (85% of whom had mitral stenosis), a randomized trial showed that rivaroxaban was not superior to VKA for stroke prevention. Caution should be exercised when prescr...
Source: Current Cardiology Reports - March 30, 2023 Category: Cardiology Source Type: research

Stroke in Atrial Fibrillation and Other Atrial Dysrhythmias
AbstractPurpose of ReviewAtrial fibrillation (AF) is a major risk factor for systemic embolism and ischaemic stroke. Furthermore, AF-related strokes are associated with higher mortality, greater disability, longer hospital stays and lower rates of hospital discharge than strokes caused by other reasons. The aim of this review to summarise the existing evidence on the association of AF with ischemic stroke and provide insights on the pathophysiological mechanisms and the clinical management of patients with AF in order to reduce the burden of ischemic stroke.Recent FindingsBeyond Virchow ’s triad, several pathophysiologic...
Source: Current Cardiology Reports - March 28, 2023 Category: Cardiology Source Type: research

Stroke and Noninfective Native Valvular Disease
AbstractPurpose of ReviewEmbolic stroke of undetermined source is a challenging clinical entity. While less common than atrial fibrillation and endocarditis, many noninfective heart valve lesions have been associated with stroke and may be considered as culprits for cerebral infarcts when other more common causes are excluded. This review discusses the epidemiology, pathophysiology, and management of noninfective valvular diseases that are commonly associated with stroke.Recent FindingsCalcific debris from degenerating aortic and mitral valves may embolize to the cerebral vasculature causing small- or large-vessel ischemia...
Source: Current Cardiology Reports - March 27, 2023 Category: Cardiology Source Type: research

Stroke Prevention in Atrial Fibrillation
AbstractPurpose of ReviewAtrial fibrillation is associated with a significant increase in stroke and systemic embolism. This review explores the areas of stroke prevention.Recent FindingsIn the last decade, NOAC has overtaken warfarin as the anticoagulant of choice for stroke prevention in AF. For patients unable to take anticoagulation, LAA closure has proven to be a valid option. The use of digital devices has led to widespread consumer-directed AF screening. It remains to be determined if all device detect AF pose the same amount of risk as recent studies have shown that short and infrequent episodes of AF may not benef...
Source: Current Cardiology Reports - September 22, 2022 Category: Cardiology Source Type: research

Concomitant Surgical Left Atrial Appendage Occlusion: a Review
AbstractPurpose of ReviewIn this review, we discuss some of the observational studies that examined the impact of left atrial appendage occlusion on stroke, the Left Atrial Appendage Occlusion Study (LAAOS) III research program that provided definitive evidence for the benefit of surgical left atrial appendage occlusion on ischemic stroke, and high priority studies in the field that should be pursued by the surgical community.Recent FindingsAtrial fibrillation is common in patients undergoing cardiac surgery. Oral anticoagulants are effective at preventing strokes related to atrial fibrillation; they have been the standard...
Source: Current Cardiology Reports - April 30, 2022 Category: Cardiology Source Type: research

Outcomes of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease
AbstractPurpose of ReviewDirect oral anticoagulants (DOACs) are increasingly used for the treatment and prevention of thromboembolic events in patients with non-valvular atrial fibrillation (AF). Evidence regarding their role in patients with AF and concurrent valvular heart disease (VHD) continues to evolve.Recent FindingsPost hoc analyses of randomized clinical trials suggest that DOACs are non-inferior to warfarin for the prevention of stroke or systemic embolism in patients with AF and VHD. Emerging evidence from observational data showed a favorable benefit-risk profile for DOACs compared to warfarin in patients with ...
Source: Current Cardiology Reports - April 23, 2022 Category: Cardiology Source Type: research

Use of Prolonged Cardiac Rhythm Monitoring to Identify Atrial Fibrillation After Cryptogenic Stroke
AbstractPurpose of ReviewProlonged cardiac monitoring (PCM) improves detection of atrial fibrillation (AF) after cryptogenic stroke. We summarize current research supporting the use of PCM as part of the cryptogenic stroke evaluation, while highlighting areas that require more investigation.Recent FindingsDespite increased AF detection with longer durations of PCM, more definitive research is needed to demonstrate how PCM improves clinical outcomes. The optimal type, timing, and length of cardiac monitoring after cryptogenic stoke remains unknown. Clinical calculators will be important to risk stratify which cryptogenic st...
Source: Current Cardiology Reports - February 16, 2022 Category: Cardiology Source Type: research

Stroke Prevention After Cryptogenic Stroke
AbstractPurpose of ReviewCryptogenic stroke represents a heterogenous but clinically important collection of stroke etiologies for which our understanding continues to grow. Here, we review our current knowledge and most recent recommendations on secondary prevention for common causes of cryptogenic stroke including paroxysmal atrial fibrillation, atrial cardiopathy, patent foramen ovale, and substenotic atherosclerotic disease as well as the under-recognized mechanisms of occult malignancy, heart failure, and, most recently, infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).Recent FindingsThe res...
Source: Current Cardiology Reports - October 16, 2021 Category: Cardiology Source Type: research

Stroke Prevention After Intracerebral Hemorrhage: Where Are We Now?
The objective of this article is to review the current guidelines on stroke prevention measures after ICH as well as the new findings and controversies for future guidance.Recent FindingsIntensive blood pressure reduction might benefit ICH survivors significantly. Cholesterol levels and the risk of ICH have an inverse relationship, but statin therapy after ICH might be still beneficial. Anticoagulation in atrial fibrillation after ICH specifically with novel oral anticoagulants may be associated with better long-term outcomes. Left atrial appendage occlusion may be an alternative for stroke prevention in ICH survivors with...
Source: Current Cardiology Reports - October 1, 2021 Category: Cardiology Source Type: research

Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling in the Community
AbstractPurpose of ReviewEchocardiography is a noninvasive tool of choice for evaluating cardiac structure and function in numerous cardiac conditions ranging from congenital heart disease, myocardial diseases, coronary artery disease (CAD), valvulopathies, arrhythmias, and pericardial disorders. We review the prognostic significance of echocardiographic indices of cardiac remodeling in the general population.Recent FindingsRecent meta-analyses have confirmed the prognostic significance of echocardiographic measurements (left ventricular mass/hypertrophy, systolic and diastolic dysfunction, left atrial dimensions and funct...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

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