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2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment
We have read with keen interest the updated practical guide by Steffelet al.1 For safer decision-making, we share the authors ’ view on the need for rapid assessment of anticoagulation in patients under non-vitamin K antagonist oral anticoagulant (NOAC) during emergencies such as bleeding and urgent surgical intervention. Our group has been involved in studies on point-of-care coagulation testing (POCT) in acute stroke p atients where rapid decision-making with respect to thrombolysis and anticoagulation reversal is vital.
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research

Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study
ConclusionAmong hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities.
Source: Europace - July 23, 2021 Category: Cardiology Source Type: research

Real-world experience with the insertion of a new implantable cardiac monitor
ConclusionThe new BM III was inserted in typically less than 5 minutes until wound closure. A relevant number of insertions took place in a consultation room. Prophylactic antibiotics may be unnecessary, because no pocket infections were reported, although no antibiotic prophylaxis was used in one half of all cases (N = 229). In summary, the insertion with the new tool is fast and has a low risk of complications.
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Predictive value of early AF recurrence after cryoballoon ablation
ConclusionERAF during blanking period predicts long-term sucess of patients undergoing cryoPVI. Prospective studies addressing outcome optimisation in this particular cohort of patients are needed. Abstract Figure.
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Comparative data on left atrial appendage occlusion efficacy and clinical outcomes by age group in the Amplatzer ™ Amulet™ Occluder Observational Study
ConclusionsDespite the increased risk for ischaemic stroke with increasing age in AF patients, LAAO reduced the risk for ischaemic stroke compared with the predicted rate across all age groups without differences in procedural SAEs.
Source: Europace - December 6, 2020 Category: Cardiology Source Type: research

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

Utilization and procedural adverse outcomes associated with Watchman device implantation
Conclusion  Percutaneous LAAO with the Watchman device in the USA is associated with low in-hospital complications and a similar safety profile to a recently published EWOLUTION cohort. The complication rates were lower than those reported in the major randomized clinical trials (RCTs). We report the frequency of peri-procedural complications of the LAAO using the Watchman device from the NIS database. We also compare the frequency of peri-procedural complications with the previously published RCTs and EWOLUTION cohort. Our findings are in concordance with findings from EWOLUTION cohort and compare favourably with RCTs.
Source: Europace - September 14, 2020 Category: Cardiology Source Type: research

Sex-related differences in risk factors, outcome, and quality of life in patients with permanent atrial fibrillation: results from the RACE II study
ConclusionIn this permanent AF population, women had more accumulation of AF risk factors than men. The observed higher cardiovascular event rate in women was no longer significant after adjusting for the number of risk factors. Further, QoL was negatively influenced by the higher number of risk factors in women. This suggests that sex differences may be driven by the greater risk factor burden in women.
Source: Europace - November 20, 2019 Category: Cardiology Source Type: research

Sex-related differences in catheter ablation of atrial fibrillation: a systematic review and meta-analysis
ConclusionsWomen who underwent catheter ablation of AF might experience lower efficacy and a higher risk of stroke/TIA and major complications than men. The reasons for these sex-related differences need to be further studied.
Source: Europace - July 8, 2019 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

Alcohol-related hospitalization is associated with increased risk of ischaemic stroke among low-risk patients with atrial fibrillation
ConclusionThe presence of a previous hospitalization with an alcohol-related disease was associated with a small but significant increase in the risk of stroke among low-risk AF patients. More research about relation between alcohol use and ischaemic stroke in AF patients is warranted.
Source: Europace - February 23, 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

Rationale and design of AXAFA-AFNET 5: an investigator-initiated, randomized, open, blinded outcome assessment, multi-centre trial to comparing continuous apixaban to vitamin K antagonists in patients undergoing atrial fibrillation catheter ablation
Conclusion</div>The results of AXAFA-AFNET 5 will provide evidence informing about the safety of apixaban in ablation patients and on its efficacy including effects on silent brain lesions. AXAFA – AFNET 5 is an investigator-initiated trial sponsored by AFNET. The trial is supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research) and by Bristol-Myers Squibb/Pfizer Alliance.</span>
Source: Europace - October 13, 2016 Category: Cardiology Source Type: research

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