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Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n  = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients with Persistent Atrial Fibrillation
This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients of nonvalvular atrial fibrillation with LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups.
Source: The American Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Oh-Hyun Lee, Jung-Sun Kim, Hui-Nam Pak, Geu-Ru Hong, Chi Young Shim, Jae-Sun Uhm, In-Jeong Cho, Boyoung Joung, Cheol-Woong Yu, Hyun-Jong Lee, Woong-Chol Kang, Eun-Seok Shin, Rak-kyeong Choi, Do-Sun Lim, Yangsoo Jang Source Type: research

Real-Time Pathophysiologic Correlates of Left Atrial Appendage Thrombus in Patients Who Underwent Transesophageal-Guided Electrical Cardioversion for Atrial Fibrillation
Although current guidelines advocate using the CHA2DS2-VASc score to assess the risk of stroke in patients with atrial fibrillation (AF), compared with transesophageal echocardiography (TEE), its ability to predict left atrial appendage thrombus (LAAT) is limited. We studied 3,324 consecutive patients with sustained AF from our prospective registry of patients who underwent first-time TEE-guided electrical cardioversion (ECV) from May 2000 through March 2012. The association of CHA2DS2-VASc score or TEE risk factors with the occurrence of LAAT was analyzed.
Source: The American Journal of Cardiology - March 13, 2018 Category: Cardiology Authors: Rowlens M. Melduni, Bernard J. Gersh, Waldemar E. Wysokinski, Naser M. Ammash, Paul A. Friedman, David O. Hodge, Krishnaswamy Chandrasekaran, Jae K. Oh, Hon-Chi Lee Source Type: research

Real-Time Pathophysiologic Correlates of Left Atrial Appendage Thrombus in Patients Undergoing Transesophageal-Guided Electrical Cardioversion for Atrial Fibrillation
Although current guidelines advocate using the CHA2DS2-VASc score to assess the risk of stroke in patients with atrial fibrillation (AF), compared with transesophageal echocardiographic (TEE), its ability to predict left atrial appendage thrombus (LAAT) is limited. We studied 3,324 consecutive patients with sustained AF from our prospective registry of patients undergoing first-time TEE-guided electrical cardioversion (ECV) from May 2000 through March 2012. The association of CHA2DS2-VASc score or TEE risk factors with the occurrence of LAAT was analyzed.
Source: The American Journal of Cardiology - March 13, 2018 Category: Cardiology Authors: Rowlens M. Melduni, Bernard J. Gersh, Waldemar E. Wysokinski, Naser M. Ammash, Paul A. Friedman, David O. Hodge, Krishnaswamy Chandrasekaran, Jae K. Oh, Hon-Chi Lee Source Type: research

Anticoagulant Agents for Atrial Fibrillation in Cancer Patients
In a recent article in the journal, Patell et  al1 found CHADS2 (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism) and CHA2DS2VASC (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, prior stroke/transient ischemic attack/thromboembolism, vascular disease, age 65-74, sex category [i.e., female]) to predict risk of ischemic stroke in cancer patients with baseline atrial fibrillation (AF). Although only 36% of patients received anticoagulant therapy, the risk of stroke generally appeared to be lower than in cancer-free individuals.
Source: The American Journal of Cardiology - February 3, 2018 Category: Cardiology Authors: Marc Sorigue, Edurne Sarrate, Mireia Franch-Sarto, Mireia Santos-Gomez, Elisa Orna Source Type: research

Relation of Stroke and Bleeding Risk Profiles to Efficacy and Safety of Edoxaban for Cardioversion of Atrial Fibrillation (From the Edoxaban Versus Warfarin in Subjects Undergoing Cardioversion of Atrial Fibrillation ENSURE-AF Study)
In the ENSURE-AF study, edoxaban was compared to enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation, showing comparable low rates of bleeding and thromboembolism. This ancillary analysis investigated differences in relation to stroke and bleeding risk profiles. Secondly, we determined clinical risk profi les to quality of anticoagulation control in the warfarin arm. Primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular death) and safety (composite of major and clinically relevant nonmajor bleeding) outcomes and time to...
Source: The American Journal of Cardiology - October 26, 2017 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, G. Andrei Dan, Sakis Themistoclakis, Kenneth A. Ellenbogen, Raffaele De Caterina, Assen Goudev, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Usefulness of the 2MACE Score to Predicts Adverse Cardiovascular Events in Patients with Atrial Fibrillation.
We investigated the incidence of non-embolic adverse events in 2 cohorts of AF patients and validated the 2MACE score [(metabolic syndrome, age ≥75) [doubled]; (myocardial infarction (MI)/revascularization, congestive heart failure (HF) and stroke/TIA/thromboembolism)] as predictor of major adverse cardiovascular events (MACEs). We recruited 2630 AF patients from two different cohorts (Murcia AF and FANTASIIA). The 2MACE score was calcula ted and during a median of 7.2 years (Murcia AF cohort) and 1.01 years (FANTASIIA) of follow-up we recorded all non-embolic adverse events and MACEs (composite of non-fatal MI/revascula...
Source: The American Journal of Cardiology - September 18, 2017 Category: Cardiology Authors: Jos é Miguel Rivera-Caravaca, Francisco Marín, María Asunción Esteve-Pastor, Paula Raña-Míguez, Manuel Anguita, Javier Muñiz, Ángel Cequier, Vicente Bertomeu-Martínez, Mariano Valdés, Vicente Vicente, Gregory Yoke Hong Lip, Vanessa Roldán Source Type: research

Outcome of Patients Receiving Thrombolytic Therapy While on Rivaroxaban for Non-Valvular Atrial Fibrillation (From ROCKET AF)
The safety of intravenous thrombolysis in patients taking rivaroxaban has not been well established. We retrospectively analyzed the outcomes of all patients who received thrombolytic therapy in the ROCKET AF trial. Review of medical and adverse event records for patients receiving thrombolytic therapy while enrolled in ROCKET AF was performed to determine their baseline characteristics, indications for thrombolysis, and type of agent used. Safety endpoints were 30-day post-thrombolytic rates of stroke, bleeding, and mortality.
Source: The American Journal of Cardiology - August 7, 2017 Category: Cardiology Authors: Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, G ünter Breithardt, Keith AA Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel Source Type: research

Outcome of Patients Receiving Thrombolytic Therapy While on Rivaroxaban for Nonvalvular Atrial Fibrillation (from Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
The safety of intravenous thrombolysis in patients taking rivaroxaban has not been well established. We retrospectively analyzed the outcomes of all patients who received thrombolytic therapy in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). A review of medical and adverse event records for patients receiving thrombolytic therapy while enrolled in ROCKET AF was performed to determine their baseline characteristics, indications for thrombolysis, and type of agent used.
Source: The American Journal of Cardiology - August 7, 2017 Category: Cardiology Authors: Sean T. Chen, Anne S. Hellkamp, Richard C. Becker, Scott D. Berkowitz, G ünter Breithardt, Keith A.A. Fox, Werner Hacke, Jonathan L. Halperin, Graeme J. Hankey, Kenneth W. Mahaffey, Christopher C. Nessel, Jonathan P. Piccini, Daniel E. Singer, Manesh R. Source Type: research

Bleeding Risk Scores in Atrial Fibrillation and Venous Thromboembolism
Patients receiving oral anticoagulant (OAC) therapy for stroke prevention in atrial fibrillation (AF) and prevention of venous thromboembolism (VTE) face an increased risk of bleeding with OAC treatment. Clinicians need to weigh-up the benefits of OAC treatment against the risk of bleeding. To help formalise bleeding risk assessment, various bleeding risk scores have been developed to help predict the risk of bleeding in AF and VTE patients receiving anticoagulant therapy. This review summarises the literature involving original studies deriving bleeding risk scores and validation studies of these scores for stroke prevent...
Source: The American Journal of Cardiology - July 14, 2017 Category: Cardiology Authors: Hanis Zulkifly, Gregory Yoke Hong Lip, Deirdre Anne Lane Source Type: research

Usefulness of the CHA2DS2-VASc Score to Predict Mortality in Defibrillator Recipients
In this study, we examined data from 2,258 patients who underwent ICD device implantation at the hospitals of the University of Pittsburgh Medical Center from February 2002 to April 2014 (median follow up 5.1 years) and examined the impact of their CHA2DS2-VASC score at the time of device implantation on all-cause mortality.
Source: The American Journal of Cardiology - April 13, 2017 Category: Cardiology Authors: Christopher Hong, Krishna Alluri, Nasir Shariff, Furqan Khattak, Evan Adelstein, Sandeep Jain, Samir Saba Source Type: research

The Population-Based Long-Term Impact of Anticoagulant and Antiplatelet Therapies in Low-Risk Patients With Atrial Fibrillation
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoa gulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1 or 2 were studied.
Source: The American Journal of Cardiology - April 13, 2017 Category: Cardiology Authors: Anjani Golive, Heidi T. May, Tami L. Bair, Victoria Jacobs, Brian G. Crandall, Michael J. Cutler, John D. Day, Charles Mallender, Jeffrey S. Osborn, Scott M. Stevens, J. Peter Weiss, Scott C. Woller, T. Jared Bunch Source Type: research

Management of Major Bleeding in Patients With Atrial Fibrillation Treated With Non –Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice (from Phase II of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation ORBIT-AF II)
Non –vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed to assess the frequency, management, and outcomes of major blee ding in the setting of community use of NOACs. Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry, we analyzed rates of International Society on Thrombosis and Haemostasis major bleeding and subsequent outcomes in patients treated with NOACs versus warfarin.
Source: The American Journal of Cardiology - February 28, 2017 Category: Cardiology Authors: Benjamin A. Steinberg, DaJuanicia N. Simon, Laine Thomas, Jack Ansell, Gregg C. Fonarow, Bernard J. Gersh, Peter R. Kowey, Kenneth W. Mahaffey, Eric D. Peterson, Jonathan P. Piccini, Outcomes Registry for Better Informed Treatment of Atrial Fibrillation ( Tags: Arrhythmias and Conduction Disturbances Source Type: research

Economy Class Syndrome, patent foramen ovale and stroke
Whether or not air travel in a patient with patent foramen ovale (PFO) is a risk factor for cerebral embolism is unresolved. This is illustrated by a recent case report of the Massachusetts General Hospital in the New England Journal of Medicine of deep venous thrombosis and stroke associated with air travel. The discussant concluded that because of the relatively short flight “it seems unlikely that air travel was a major risk factor” 1. This may well be true for deep venous thrombosis per se, the risk of which has been shown to increase with duration of the flight 2.
Source: The American Journal of Cardiology - August 1, 2016 Category: Cardiology Authors: Franz H. Messerli, Stefano F. Rimoldi, Urs Scherrer Source Type: research

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