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115 Anticoagulation in atrial fibrillation – a single-centre audit on patient education, stroke and bleeding risk assessments and use of direct oral anticoagulants (DOACs)
Objective: To assess adherence to the National Institute of Health and Care Excellence (NICE) guidelines on management of atrial fibrillation in adults, specifically the provision of a personalised package of care and information to patients, and stroke and bleeding risk assessments. To assess the frequency of use of DOACs as the anticoagulant of choice.
Source: Europace - October 5, 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

Shifting to a non-vitamin K antagonist oral anticoagulation agent from vitamin K antagonist in atrial fibrillation
ConclusionIn a contemporary setting among VKA-experienced NVAF patients; VKA is still prevalent although about 30% by December 2015 had shifted to a NOAC.
Source: Europace - June 28, 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

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

Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation
Conclusion Combined CB ablation and LAA closure using different devices appears to be feasible in patients with non-valvular AF associated with high risk of stroke or contraindication to antithrombotic treatment.
Source: Europace - November 1, 2016 Category: Cardiology Authors: Fassini, G., Conti, S., Moltrasio, M., Maltagliati, A., Tundo, F., Riva, S., Dello Russo, A., Casella, M., Majocchi, B., Zucchetti, M., Russo, E., Marino, V., Pepi, M., Tondo, C. Tags: Ablation for atrial fibrillation 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

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

Long-term evaluation of dabigatran 150 vs. 110 mg twice a day in patients with non-valvular atrial fibrillation
Conclusion Annualized rates of all outcomes were constant with better efficacy of D150, less major bleeding with D110, and low intracerebral haemorrhage rates for both doses. There were no additional safety concerns. This is the longest continuous randomized experience of a novel anticoagulant.
Source: Europace - June 28, 2016 Category: Cardiology Authors: Ezekowitz, M. D., Eikelboom, J., Oldgren, J., Reilly, P. A., Brueckmann, M., Kent, A. P., Pogue, J., Spahr, J., Clemens, A., Noack, H., Diener, H.-C., Wallentin, L., Yusuf, S., Connolly, S. J. Tags: Atrial fibrillation Source Type: research

Role of insertable cardiac monitors in anticoagulation therapy in patients with atrial fibrillation at high risk of bleeding
Conclusion In AF patients with high bleeding risk, ICM-guided rhythm control with AADs and assessment of AF burden may allow safe discontinuation of OACs.
Source: Europace - June 12, 2016 Category: Cardiology Authors: Mascarenhas, D. A. N., Farooq, M. U., Ziegler, P. D., Kantharia, B. K. Tags: Atrial fibrillation Source Type: research

Self-reported physical activity and major adverse events in patients with atrial fibrillation: a report from the EURObservational Research Programme Pilot Survey on Atrial Fibrillation (EORP-AF) General Registry
Conclusion</div>Atrial fibrillation patients taking regular exercise were associated with a lower risk of all-cause death, even when we considered various subgroups, including gender, elderly age, symptomatic status, and stroke risk class. Efforts to increase physical activity among AF patients may improve outcomes in these patients.</span>
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

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