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Source: Europace
Condition: Bleeding
Drug: Warfarin

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Total 17 results found since Jan 2013.

Left atrial or left atrial appendage thrombus as a cardiac source of embolus: that is the question or Faust bargain for left atrial appendage closure? —Authors’ reply
We thank Yakutet al. for their comments on our Point of view ‘Where are clots in atrial fibrillation? Did we have the wrong assumptions over the last decades?’. In the manuscript, we addressed how in the old literature the frequency of left atrial cavity thrombi is probably largely overestimated.1 In fact, based on an accurate review, and on our experience, the real frequency of atrial thrombi located outside the left appendage (LAA) is extremely low, and it might be an important rationale for LAA occlusion interventions. The aim of this last sentence was to give evidence to procedures focusing on LAA, not promoting LA...
Source: Europace - November 30, 2020 Category: Cardiology Source Type: research

How to estimate the potential clinical benefit associated with left atrial appendage closure?
We read the article by Phillipset al. about combined left atrial appendage (LAA) closure and catheter ablation for atrial fibrillation (AF) and its related editorial.1,2 The rate of ischaemic stroke was 0.36% per year which would represent a 93% relative risk reduction (RRR) vs. predicted rate by the CHA2DS2-VASc score without oral anticoagulation (OAC). For non-procedural major bleeding rate, estimated RRR was 70% when compared to the expected bleeding risk on warfarin according to the HAS-BLED score.
Source: Europace - July 2, 2020 Category: Cardiology Source Type: research

Challenges in comparing the non-vitamin K antagonist oral anticoagulants for atrial fibrillation-related stroke prevention
AbstractThe aim of this review is to provide context for meta-analyses interpreting data from phase III stroke prevention studies of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (NVAF). Differences between the four phase III NOAC stroke prevention studies in patients with NVAF (ROCKET AF, ARISTOTLE, RE-LY, and ENGAGE AF), their potential impact on outcomes, and inter-study differences were evaluated, as well as the potential role of real-world evidence in evaluating NOACs in this setting. Study design differences included blinding strategy, dose-reduction options, a...
Source: Europace - October 13, 2017 Category: Cardiology Source Type: research

124 GP-led anticoagulation counselling for non-valvular atrial fibrillation (AF) in the community is neither comprehensive nor accurate: Results from a service improvement project.
Background: Stroke risk in NVAF can be reduced significantly by anticoagulation with either warfarin or the non- vitamin K antagonist (NOACs). NICE recommendations state that NOACs are as efficacious but also associated with significantly less intracranial bleeding compared to Warfarin and in this sense are safer than warfarin. Additionally NOACs do not require regular monitoring of their anticoagulant effects and therefore offer convenience to the patient. However they are not as tried and tested as warfarin and at the time of our study, did not have an available agent to reverse their effects in the event of a bleeding c...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

Non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients undergoing elective cardioversion
ConclusionThrombotic and bleeding complications related to NOACs were uncommon (<0.5%) in real life AF patients undergoing elective cardioversion.
Source: Europace - July 10, 2017 Category: Cardiology Source Type: research

Combining Watchman left atrial appendage closure and catheter ablation for atrial fibrillation: multicentre registry results of feasibility and safety during implant and 30 days follow-up
ConclusionThe outcomes from these international, multicentre registries support the feasibility and safety of performing combined procedures of ablation and Watchman LAAC for patients with non-valvular AF and high stroke risk. Further data are needed on long-term outcomes for the hybrid technique on all-cause stroke and mortality.
Source: Europace - July 3, 2017 Category: Cardiology Source Type: research

The unfinished issue of ischaemic stroke and embolic events during ablation for atrial fibrillation: the authors' reply
We thank Dr. Providenciaet al.1 for the concern and comments on our article.2 We agree with them that discontinuation of warfarin before catheter ablation for atrial fibrillation (AF) is likely associated with increased risk of periprocedural thrombo-embolic events. We cannot comment on the effects of different periprocedural anticoagulation strategy used in our cohort on thrombo-embolic events during AF ablation because of only a small minority of patients who were anti-coagulated with uninterrupted warfarin. Although several reports indicate that AF ablation can be performed safely with fewer stroke and bleeding complica...
Source: Europace - March 17, 2017 Category: Cardiology Source Type: research

Stroke and bleeding with non-vitamin K antagonist oral anticoagulant or warfarin treatment in patients with non-valvular atrial fibrillation: a population-based cohort study
ConclusionThis population-based cohort study of routine care indicates similar or better effectiveness and safety with NOAC compared with warfarin treatment. NOACs were associated with fewer intracranial bleeds, but more gastrointestinal bleeds.
Source: Europace - February 10, 2017 Category: Cardiology Source Type: research

Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world patients with atrial fibrillation
Conclusion In ‘real-world’ patients with AF, dabigatran appears to be as effective, but significantly safer than acenocoumarol.
Source: Europace - August 30, 2016 Category: Cardiology Authors: Korenstra, J., Wijtvliet, E. P. J., Veeger, N. J. G. M., Geluk, C. A., Bartels, G. L., Posma, J. L., Piersma-Wichers, M., Van Gelder, I. C., Rienstra, M., Tieleman, R. G. Tags: Atrial fibrillation Source Type: research

Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF
Conclusion Nearly 1 in 7 of the moderate-to-high-risk patients with AF enrolled in this trial was hospitalized within 2 years, and both AF and bleeding were rare causes of hospitalization. Further research is needed to determine whether care pathways directed at comorbid conditions among AF patients could reduce the need for and costs associated with hospitalization.
Source: Europace - August 4, 2016 Category: Cardiology Authors: DeVore, A. D., Hellkamp, A. S., Becker, R. C., Berkowitz, S. D., Breithardt, G., Hacke, W., Halperin, J. L., Hankey, G. J., Mahaffey, K. W., Nessel, C. C., Singer, D. E., Fox, K. A. A., Patel, M. R., Piccini, J. P., on behalf of the ROCKET AF Steering Com Tags: Atrial fibrillation Source Type: research

Cost effectiveness of LAA closure in patients with AF and contraindications to warfarin: comment
This study evaluated the costs of percutaneous left atrial appendage closure (LAAC) using the Watchman device (Boston Scientific, Marlborough, MA). As pointed out by the authors, procedures to implement percutaneous devices are associated with a 6.7% short-term risk of major complications (air embolism, major bleeding, and pericardial effusion). Moreover, the device and technical platform necessary for the procedure come at a significant cost (€9136). Despite these downsides, assuming a willingness-to-pay threshold of€30 000 per quality-adjusted life-year gained, the authors found that relative to both aspirin and apix...
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey
This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21–30 and 11–20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a struc...
Source: Europace - February 26, 2015 Category: Cardiology Authors: Potpara, T. S., Pison, L., Larsen, T. B., Estner, H., Madrid, A., Blomstrom-Lundqvist, C., Conducted by the Scientific Initiatives Committee, and European Heart Rhythm Association, Conducted by the Scientific Initiatives Committee, and European Heart Rhyt Tags: EP WIRE Source Type: research

Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naive atrial fibrillation patients: Danish nationwide descriptive data 2011-2013
Conclusion Among oral anticoagulation-naïve AF patients initiated on oral anticoagulation in Denmark, warfarin initiation has declined since the introduction of dabigatran in August 2011. Dabigatran is the most frequently used alternative option to warfarin; however, use of rivaroxaban and apixaban is increasing. Patients initiated with rivaroxaban or apixaban in general have a higher predicted stroke and bleeding risks compared with warfarin or dabigatran initiators.
Source: Europace - January 29, 2015 Category: Cardiology Authors: Olesen, J. B., Sorensen, R., Hansen, M. L., Lamberts, M., Weeke, P., Mikkelsen, A. P., Kober, L., Gislason, G. H., Torp-Pedersen, C., Fosbol, E. L. Tags: Atrial fibrillation Source Type: research

Peri-procedural interrupted oral anticoagulation for atrial fibrillation ablation: comparison of aspirin, warfarin, dabigatran, and rivaroxaban
Conclusion Using interrupted OAC, low target intraprocedural ACT, and irrigated-tip RF, the rate of peri-procedural groin, haemorrhagic, and thromboembolic complications was extremely low. There were only minimal differences between OACs. Low-risk patients may remain on aspirin/no OAC pre-ablation. There are no problems changing from one OAC pre-ablation to another post-ablation.
Source: Europace - September 29, 2014 Category: Cardiology Authors: Winkle, R. A., Mead, R. H., Engel, G., Kong, M. H., Patrawala, R. A. Tags: Ablation for atrial fibrillation Source Type: research

The budget impact of left atrial appendage closure compared with adjusted-dose warfarin and dabigatran etexilate for stroke prevention in atrial fibrillation
Conclusion The majority of LAAC costs are borne in the first year, while costs for pharmaceutical strategies continue to accrue year on year. Thus, LAAC represents an opportunity for savings to healthcare systems in the long term. This is an important consideration for payers in evaluating lifetime treatment strategies in AF.
Source: Europace - July 29, 2014 Category: Cardiology Authors: Amorosi, S. L., Armstrong, S., Da Deppo, L., Garfield, S., Stein, K. Tags: Atrial fibrillation Source Type: research