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Condition: Atrial Fibrillation
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Total 257 results found since Jan 2013.

Antithrombotic therapy for chronic coronary syndrome and atrial fibrillation: less might be more
AbstractThe best strategy in atrial fibrillation (AF) after  >  12 months after an acute coronary syndrome or in patients with chronic coronary syndrome without an indication for interventional revascularization remains unclear. European guidelines generally recommend therapy with oral anticoagulation (OAC) alone, whereas North American guidelines advise com bination therapy consisting of OAC plus antiplatelet therapy in some patients. We performed a meta-analysis of available trials comparing these treatment strategies. The primary endpoint was major adverse cardiac events (MACE), secondary endpoints included maj...
Source: Journal of Thrombosis and Thrombolysis - December 2, 2019 Category: Hematology Source Type: research

Should This Patient Be Screened for Atrial Fibrillation?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2019 Dec 03;171(11):828-836 Authors: Burns RB, Zimetbaum P, Lubitz SA, Smetana GW Abstract Atrial fibrillation (AFib) is the most common type of cardiac arrhythmia, affecting 2.7 million to 6.1 million persons in the United States. Although some persons with AFib have no symptoms, others do. For those without symptoms, AFib may be detected by 12-lead electrocardiogram (ECG), single-lead monitors (such as ambulatory blood pressure monitors and pulse oximeters), or consumer devices (such as wearable monitors and smartphones). Pulse pa...
Source: Annals of Internal Medicine - December 2, 2019 Category: Internal Medicine Authors: Burns RB, Zimetbaum P, Lubitz SA, Smetana GW Tags: Ann Intern Med Source Type: research

Assessing patient preferences for switching from warfarin to direct oral anticoagulants
This study assessed patient preference for warfarin or DOAC based on a willingness to pay more for potential DOAC benefits. Current warfarin patients with atrial fibrillation or venous thromboembolism enrolled in the University of Utah Health Thrombosis Service were given a one-time electronic survey that assessed preferences between warfarin and DOACs using scenarios comparing effectiveness, safety, and convenience. When DOACs were preferred, patients were asked how much more they would be willing to pay monthly for the perceived advantages associated with DOACs. With 123 completed surveys, 68% of patients preferred to st...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2019 Category: Hematology Source Type: research

Incidence and Causes of In-hospital Outcomes and 30-day Readmissions After Percutaneous Left Atrial Appendage Closure: A United States Nationwide Retrospective Cohort Study Using Claims Data
Percutaneous left atrial appendage closure (p-LAAC) emerged as an option for stroke prevention in atrial fibrillation (AF) patients ’ ineligible for long-term anticoagulation.Real-world data on its in-hospital and 30-day readmission measures are limited.
Source: Heart Rhythm - September 16, 2019 Category: Cardiology Authors: Venkat L.K. Vuddanda, Mohit K. Turagam, Nikita A. Umale, Zubair Shah, Dhanunjaya R. Lakkireddy, Krzysztof Bartus, Finnian R. McCausland, Poonam Velagapudi, Moussa Mansour, E. Kevin Heist Source Type: research

Use of insertable cardiac monitors for the detection of atrial fibrillation in patients with cryptogenic stroke in the United States is cost-effective.
Authors: Maervoet J, Bossers N, Borge RP, Thompson Hilpert S, van Engen A, Smala A Abstract Atrial fibrillation (AF) is the most common arrhythmia and a major marker of stroke risk. Early detection is crucial and, once diagnosed, anticoagulation therapy can be initiated to reduce stroke risk. The aim of this study was to assess the cost-effectiveness of employing an insertable cardiac monitor (ICM), BIOMONITOR, for the detection of AF compared to standard of care (SoC) ECG and Holter monitoring in patients with cryptogenic stroke, that is, stroke of unknown origin and where paroxysmal, silent AF is suspected. A Mar...
Source: Journal of Medical Economics - September 6, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Age-Dependence of Flow Homeostasis in the Left Ventricle
Conclusions: In average, blood spends 1 to 3 beats inside the LV with very low shear stress rates. The apical region is the most prone to blood stasis, particularly in mid-aged adults. The washout of blood in the normal LV is age-dependent due to physiological changes in the degree of apical penetration of the filling waves. Introduction Cardioembolic stroke is a major source of mortality and disability worldwide and blood stasis one of its major determinants (Adams et al., 1986). Left ventricular (LV) function has evolved to maximize mechanical efficiency and ensure organ perfusion at a low cost of energy and fill...
Source: Frontiers in Physiology - April 25, 2019 Category: Physiology Source Type: research

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1 β Deficient Murine Hearts
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health pro...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Effect of Warfarin on Ischemic Stroke, Bleeding, and Mortality in Patients with Atrial Fibrillation Receiving Peritoneal Dialysis
ConclusionThere is no significant association between warfarin treatment with risks of mortality, ischemic stroke or bleeding in patients with atrial fibrillation receiving peritoneal dialysis.
Source: American Journal of Cardiovascular Drugs - April 22, 2019 Category: Cardiology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Angiographical Identification of Intracranial, Atherosclerosis-Related, Large Vessel Occlusion in Endovascular Treatment
Conclusions Among only a few identification methods, the ICAS-LVO can be feasibly identified by angiographical findings. The identification of ICAS-LVO based on based on occlusion type, is a reliable and practical identification method for ICAS-LVO. Procedural details by occlusion type and its predictability to endovascular results were reported. Furthermore, occlusion type can be determined before or in the early stages of the procedure, which may be most helpful in setting up an optimal endovascular treatment strategy. Author Contributions J-HB established the study idea, designed the manuscript structure, acquired an...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment
Conclusion In this study, reduced CBF and FA and increased MD in the inner NAWM layers for both PVWMH and DWMH suggested extensive WM alterations beyond the visible WM lesions commonly observed on clinical MRI of svMCI subjects. CBF penumbras cover more extensive WM at risk than DTI penumbras, suggesting the likelihood that compromised CBF precedes white matter integrity changes, and CBF penumbras may be a potential target for the prevention of further microstructural white matter damage. The imaging parameters investigated, however, did not correlate to cognition. Author Contributions YZ, QX, and XG conceived and desig...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Screening for Atrial Fibrillation using a Mobile, Single-Lead Electrocardiogram in Canadian Primary Care Clinics
ConclusionPreviously undiagnosed AF is common in older individuals attending primary care clinics. The Kardia Mobile ECG device appears to be an effective screening tool for AF with high physician acceptability. More research on the feasibility of such novel technologies is warranted for future consideration of integration in population-based screening programs.
Source: Canadian Journal of Cardiology - April 6, 2019 Category: Cardiology Source Type: research