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Source: The American Journal of Cardiology
Condition: Atrial Fibrillation
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Total 336 results found since Jan 2013.
Effectiveness of Only Aspirin or Clopidogrel Following Percutaneous Left Atrial Appendage Closure
Percutaneous left atrial appendage closure (LAAC) offers a feasible option for stroke prevention in patients with atrial fibrillation (AF), but the optimal antithrombotic treatment strategy for patients with strict contraindications to oral anticoagulation (OAC) remains uncertain. We sought to evaluate short- and long-term outcome after percutaneous LAAC in these very patients discharged on single antiplatelet therapy (SAPT) alone. All consenting AF patients who underwent LAAC from February 2009 to August 2018 in Turku University Hospital, Finland, were enrolled into a prospectively maintained registry.
Source: The American Journal of Cardiology - September 25, 2019 Category: Cardiology Authors: Jussi-Pekka Pouru, Samuli Jaakkola, Juha Lund, Fausto Biancari, Antti Saraste, K. E. Juhani Airaksinen Source Type: research
The Interaction Among Atrial Thromboembolism, Atrial Fibrillation, and Atrial Cardiomyopathy
I read with interest the timely paper titled “Thromboembolism in the Absence of Atrial Fibrillation” by Smietana et al1 that discusses several highly important but underappreciated contributors to ischemic stroke in patients with and without atrial fibrillation (AF). Several are worthy of further emphasis and/or expansion for your readers, both investigators and clinicians. First is the recognition of the concept of atrial cardiomyopathy.2 Atrial cardiomyopathy may be a cause and/or consequence of AF; can vary with the etiology, duration, number, and severity of associated comorbidities as well as the amount of AF pres...
Source: The American Journal of Cardiology - August 1, 2019 Category: Cardiology Authors: James A. Reiffel Source Type: research
Meta-Analysis Evaluating Outcomes of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery
Surgical left atrial appendage occlusion (S-LAAO) has become a common procedure performed in patients undergoing cardiac surgery; however, evidence to support this procedure remains inconclusive. This meta-analysis aims to assess the efficacy of S-LAAO in terms of ischemic stroke, postoperative atrial fibrillation (AF), and all-cause mortality. A thorough literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We identified ten relevant studies for our meta-analysis.
Source: The American Journal of Cardiology - July 31, 2019 Category: Cardiology Authors: Abdisamad M Ibrahim, Nitin Tandan, Cameron Koester, Mohammad Al-Akchar, Bishal Bhandari, Albert Botchway, Jumana Abdelkarim, Ruby Maini, Mohamed Labedi Source Type: research
Usefulness of CHA2DS2-VASc Score to Predict Stroke Risk Independent of Atrial
We examined whether a CHA2DS2-VASc score predicts stroke risk among individuals without hospital-diagnosed AF and quantified the magnitude of the association in comparison to AF patients. We used data from population-based medical registries (1995 –2005) covering all Danish hospitals to identify patients diagnosed with AF (n=122,980). We matched ≤5 non-AF individuals (n=612,723) to each AF patient on the individual risk factors included in the CHA2DS2-VASc score.
Source: The American Journal of Cardiology - July 14, 2019 Category: Cardiology Authors: Anne Gulbech Ording, Erzs ébet Horváth-Puhó, Paolo Prandoni, Michelle Zippora Leisner, Dóra Körmendiné Farkas, Flemming Hald Steffensen, Morten Olsen, Henrik Toft Sørensen, Morten Schmidt Source Type: research
Usefulness of CHA2DS2-VASc Score to Predict Stroke Risk Independent of Atrial Fibrillation
We examined whether a CHA2DS2-VASc score predicts stroke risk among individuals without hospital-diagnosed AF and quantified the magnitude of the association in comparison to AF patients. We used data from population-based medical registries (1995 to 2005) covering all Danish hospitals to identify patients diagnosed with AF (n = 122,980). We matched ≤5 non-AF individuals (n = 612,723) to each AF patient on the individual risk factors included in the CHA2DS2-VASc score.
Source: The American Journal of Cardiology - July 14, 2019 Category: Cardiology Authors: Anne Gulbech Ording, Erzs ébet Horváth-Puhó, Paolo Prandoni, Michelle Zippora Leisner, Dóra Körmendiné Farkas, Flemming Hald Steffensen, Morten Olsen, Henrik Toft Sørensen, Morten Schmidt Source Type: research
Changes in Management Following Detection of Previously Unknown Atrial Fibrillation by an Insertable Cardiac Monitor (From the REVEAL AF Study)
The REVEAL AF study demonstrated a high incidence of previously undetected atrial fibrillation (AF) using insertable cardiac monitors (ICMs) in patients with risk factors for AF and stroke. This analysis evaluated whether ICM monitoring led to changes in clinical management following AF detection. Patients with CHADS2 scores ≥3 (or =2 with ≥1 additional AF risk factor) but no history of AF received an ICM and were followed 18-30 months. Physicians recorded changes in clinical management in response to AF detection at scheduled (every 6 months) and unscheduled follow-up visits.
Source: The American Journal of Cardiology - June 23, 2019 Category: Cardiology Authors: Atul Verma, Rolf Wachter, Peter R. Kowey, Jonathan L. Halperin, Bernard J. Gersh, Mitchell S.V. Elkind, Rachelle E. Kaplon, Paul D. Ziegler, Lou Sherfesee, James A. Reiffel Source Type: research
Thromboembolism In The Absence Of Atrial Fibrillation
Atrial fibrillation (AF) is associated with thrombus formation in the left atrial appendage (LAA) and systemic embolic events including ischemic stroke. Cardiogenic thromboembolism can also occur in the absence of clinical AF as a result of various pathological conditions affecting the endocardium. The inconsistent temporal relation between AF and ischemic events has stimulated exploration for factors other than clinical AF that contribute to thromboembolism. These include sub-clinical AF, a thrombogenic atrial cardiomyopathy, LAA dysfunction and embolism from other sources.
Source: The American Journal of Cardiology - April 23, 2019 Category: Cardiology Authors: Jeffrey Smietana, Anna Plitt, Jonathan L. Halperin Source Type: research
Reader's Comments: Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang et al1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type is truly im...
Source: The American Journal of Cardiology - April 8, 2019 Category: Cardiology Authors: James A. Reiffel Source Type: research
Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism
I read with great interest the paper by Zhang and colleagues1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al.2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al.1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type ...
Source: The American Journal of Cardiology - April 8, 2019 Category: Cardiology Authors: James A. Reiffel Tags: Reader's Comments Source Type: research
Discriminative Ability of CHA2DS2-VASc and HAS-BLED Score in Whites and Nonwhites
The CHA2DS2-VASc and HAS-BLED scoring systems are used in patients with atrial fibrillation (AF) to estimate risk of stroke and bleeding, respectively. Both were developed in minimally diverse European populations and these scores have not yet been extensively studied in US whites and nonwhites. In a retrospective cohort study, we included patients with AF who received inpatient or outpatient care in a large integrated academic health system from 2011 to 2017. Cox proportional hazards were used to analyze associations between stroke and CHA2DS2-VASc score in AF patients not prescribed anticoagulation and between incident b...
Source: The American Journal of Cardiology - March 18, 2019 Category: Cardiology Authors: Sarah M. Schwartz, Yacob G. Tedla, Philip Greenland, Ajay Yadlapati, Rod S. Passman Source Type: research
Discriminative Ability of CHA2DS2-VASc and HAS-BLED Score in Whites and Non-Whites
The CHA2DS2-VASc and HAS-BLED scoring systems are used in patients with atrial fibrillation (AF) to estimate risk of stroke and bleeding, respectively. Both were developed in minimally diverse European populations and these scores have not yet been extensively studied in US whites and non-whites. In a retrospective cohort study, we included patients with AF who received inpatient or outpatient care in a large integrated academic health system from 2011 to 2017. Cox proportional hazards were used to analyze associations between stroke and CHA2DS2-VASc score in AF patients not prescribed anticoagulation and between incident ...
Source: The American Journal of Cardiology - March 18, 2019 Category: Cardiology Authors: Sarah M Schwartz, Yacob G Tedla, Philip Greenland, Ajay Yadlapati, Rod Passman Source Type: research
Prevalence and Significance of Interatrial Block in Takotsubo Syndrome (From the RETAKO Registry)
Interatrial block (IAB) represents a conduction delay between right and left atria and is associated with an increased risk of atrial fibrillation and stroke. IAB has not been previously assessed in patients with Takotsubo syndrome (TS). Our aim was to describe the prevalence and prognostic significance of IAB in patients with TS. Data come from the Spanish National prospective registry of patients with definitive TS diagnosis. IAB was defined as a P-wave ≥ 120 milliseconds and was considered partial when the P-wave was positive in inferior leads and advanced when it was biphasic (+/-).
Source: The American Journal of Cardiology - March 17, 2019 Category: Cardiology Authors: Irene Mart ín-Demiguel, Iván J. Núñez-Gil, Alberto Pérez-Castellanos, Oscar Vedia, Aitor Uribarri, Albert Duran-Cambra, Agustín Martín-García, Miguel Corbí-Pascual, Marta Guillén Marzo, Manuel Martínez-Selles Source Type: research
Comparison of Stroke Risk Stratification Scores for Atrial Fibrillation
Several stroke risk stratification scores have been developed to guide clinical decision making in patients with non valvular atrial fibrillation (AF). The aim of this study was to compare the performance of the CHADS2, CHA2DS2-VASc and R2CHADS2 risk scores to predict stroke.This retrospective cohort study was based on electronic medical records from Clalit Health Services (CHS), the largest payer provider healthcare organization in Israel. Data of CHS members with AF diagnosis between 2004- 2015 were extracted.
Source: The American Journal of Cardiology - March 12, 2019 Category: Cardiology Authors: Meytal Avgil Tsadok, Adi Berliner Senderey, Orna Reges, Morton Leibowitz, Maya Leventer-Roberts, Moshe Hoshen, Moti Haim Source Type: research
Impact of Heart Failure Type on Thromboembolic and Bleeding Risk in Patients with Atrial Fibrillation on Oral Anticoagulation
Heart failure (HF) increases stroke risk in atrial fibrillation (AF) patients. Differential impact of HF category on thromboembolic and bleeding risk in AF patients on oral anticoagulation (OAC) is unknown. We used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The primary endpoint of admission for ischemic stroke was evaluated using Cox proportional hazards regression models that controlled for patient demographics, comorbidities (including CHA2DS2-VASc and HASBLED score...
Source: The American Journal of Cardiology - February 28, 2019 Category: Cardiology Authors: Amgad Mentias, Alexandros Briasoulis, Ghanshyam Shantha, Paulino Alvarez, Mary Vaughan-Sarrazin Source Type: research
Relation of Obesity to Outcomes of Hospitalizations for Atrial Fibrillation
Obesity has been linked with increased incidence of atrial fibrillation (AF), but impact of presence of obesity on outcomes of hospitalizations for AF has not been investigated. We used the National Inpatient Sample (NIS) database 2010-2014 to identify all adult hospitalizations aged ≥18 years with a primary diagnosis of AF. Obese patients were identified using the co-morbidity variable for obesity, as defined in NIS databases. Multivariable logistic regression was used to compare in-hospital outcomes (mortality, acute stroke events) between obese and non-obese patients with A F.
Source: The American Journal of Cardiology - February 14, 2019 Category: Cardiology Authors: Manyoo A. Agarwal, Lohit Garg, Mahek Shah, Brijesh Patel, Nidhi Jain, Sameer Jain, Rajesh Kabra, Csaba Kovesdy, Guy L. Reed, Carl J. Lavie Source Type: research
