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Source: Heart Rhythm

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Total 406 results found since Jan 2013.

Predictors of ischemic stroke for low-risk patients with atrial fibrillation: A matched case-control study
The predictors of ischemic stroke in ‘low-risk’ patients with atrial fibrillation (AF) (CHA2DS2-VASc score 0 in men or 1 in women) are debated.
Source: Heart Rhythm - January 19, 2021 Category: Cardiology Authors: Soonil Kwon, Tae Jung Kim, Eue-Keun Choi, Hyo-Jeong Ahn, Euijae Lee, So-Ryoung Lee, Sang-Bae Ko, Seil Oh, Gregory Y.H. Lip Source Type: research

Connexin45 (GJC1) loss-of-function mutation contributes to familial atrial fibrillation and conduction disease
Atrial fibrillation (AF) represents the most common clinical cardiac arrhythmia and substantially increases the risk for cerebral stroke, heart failure and death. Although causative genes for AF have been identified, the genetic determinants for AF remain largely unclear.
Source: Heart Rhythm - January 8, 2021 Category: Cardiology Authors: Ruo-Gu Li, Ying-Jia Xu, Willy G. Ye, Yan-Jie Li, Honghong Chen, Xing-Biao Qiu, Yi-Qing Yang, Donglin Bai Source Type: research

The Decrease in Peak Atrial Longitudinal Strain in Patients with Atrial Fibrillation as a Practical Parameter for Stroke Risk Stratification
Decreased peak atrial longitudinal strain (LA strain) derived from two-dimensional speckle tracking is frequently observed in patients with atrial fibrillation (AF) and associated with the risk of ischemic stroke.
Source: Heart Rhythm - December 28, 2020 Category: Cardiology Authors: Jo-Nan Liao, Tze-Fan Chao, Chung-Lieh Hung, Shih-Ann Chen Source Type: research

Cardiac implantable electronic device-detected atrial fibrillation —“To anticoagulate or not to anticoagulate, that is the question”: The noble or ignoble choice?
Atrial fibrillation (AF) detected during interrogation of a cardiovascular implantable electronic device (CIED) is a common event,1 with available studies suggesting that it is associated with an increased risk of stroke.2,3 While current guidelines recommend oral anticoagulant (OAC) therapy for patients with AF and an elevated CHA2DS2-VASc score,4 controversy exists about whether the various components of CIED-detected AF (eg, duration, burden, and CHA2DS2-VASc score) predict stroke and, if effective as predictors, which characteristics best define that risk.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Thomas F. Deering, Faiez Zannad Tags: Editorial Commentary Source Type: research

Cardiac Implantable Electronic Device-Detected Atrial Fibrillation - “To anticoagulate or not to anticoagulate, that is the question”: The Noble or Ignoble Choice?
Atrial fibrillation (AF) detected during interrogation of a cardiovascular implantable electronic device (CIED) is a common event1 with available studies suggesting that it is associated with an increased risk of stroke.2,3 While current guidelines recommend oral anticoagulant (OAC) therapy for AF patients with an elevated CHA2DS2-VASc score,4 controversy exists about whether the various components of CIED-detected AF (e.g. duration, burden, CHA2DS2-VASc score, etc.) predict stroke and, if effective as predictors, which characteristics best define that risk.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Thomas F. Deering, Faiez Zannad Source Type: research

EP News: Quality Improvement and Outcomes
In this issue of Heart Rhythm, we summarize key publications of relevance to the electrophysiology community regarding the use of systems-based processes to improve heart rhythm care and outcomes for patients with atrial fibrillation (AF). The featured research highlights challenges in improving the rate of guideline-directed anticoagulation to prevent stroke for high risk AF patients, including the benefits and limitations of the use of shared decision-making tools. This summary also reports on efforts to identify additional quality indicators to measure AF care and outcomes.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Chirag R. Barbhaiya Source Type: research

EP News: Clinical
Okumura et  al (N Engl J Med 2020;383:1735–1745, PMID 32865374) conducted a multicenter, randomized, double-blind, placebo-controlled trial comparing a once-daily, 15-mg dose of edoxaban (E) with placebo in elderly patients (age ≥80 years) with nonvalvular atrial fibrillation (AF) who were not candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy endpoint was the composite of stroke or systemic embolism. A total of 984 patients were randomly assigned in a 1:1 ratio to receive a daily dose of 15 mg of E (n = 492) or placebo (n = 492).
Source: Heart Rhythm - November 4, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: Ep News Source Type: research

EP News Clinical November 2020
Okumura and colleagues (N Eng J Med 2020 Oct 29;383(18):1735-1745. PMID: 32865374) conducted a multicenter, randomized, double-blind, placebo-controlled, trial to compare a once-daily 15-mg dose of edoxaban (E) with placebo in elderly patients ( ≥80 years of age) with nonvalvular atrial fibrillation who were not candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy end point was the composite of stroke or systemic embolism. A total of 984 patients were randomly assigned in a 1:1 ratio to r eceive a daily dose of 15 mg of E (492 patients) or placebo (492 patients).
Source: Heart Rhythm - November 4, 2020 Category: Cardiology Authors: N. A. Mark Estes Source Type: research

Relationship between Device-detected Burden and Duration of Atrial Fibrillation and Risk of Ischemic Stroke
Wider availability of continuous rhythm monitoring has made it feasible to incorporate metrics of atrial fibrillation burden and duration into the decision to initiate anticoagulation. However, the relationship between thresholds of burden and duration and underlying risk factors at which anticoagulation should be considered remains unclear.
Source: Heart Rhythm - October 23, 2020 Category: Cardiology Authors: Mounir Al-Gibbawi, Hakeem O. Ayinde, Neal K. Bhatia, Mikhael F. El-Chami, Stacy B. Westerman, Angel R. Leon, Anand D. Shah, Anshul M. Patel, David B. De Lurgio, Christine M. Tompkins, Michael S. Lloyd, Faisal M. Merchant, Soroosh Kiani Source Type: research

EP News Clinical October 2020
Kirchhof and colleagues et al. (N Engl J Med. 2020;383(14):1305-1316 PMID: 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first-primary-outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0...
Source: Heart Rhythm - October 10, 2020 Category: Cardiology Authors: N A Mark Estes Source Type: research

EP News: Clinical
Kirchhof et  al (N Engl J Med 2020;383:1305, PMID 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first primary outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0/100 person-years) ( P = .005).
Source: Heart Rhythm - October 10, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

Anticoagulation for Stroke Prevention in Patients With Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Review
Atrial fibrillation is the most common arrhythmia in patients with hypertrophic cardiomyopathy with a prevalence and incidence of 23% and 3.1% respectively. The risk of thromboembolism is high in patients with hypertrophic cardiomyopathy regardless of the CHADS2VASC score. This review includes five observational studies that focused on prevention of thromboembolism in patients with hypertrophic cardiomyopathy and atrial fibrillation. These papers evaluated and compared outcomes between patients on either warfarin or direct oral anticoagulants.
Source: Heart Rhythm - October 2, 2020 Category: Cardiology Authors: M. Farhan Nasser, Sanjay Gandhi, Robert J. Siegel, Florian Rader Source Type: research

Atrial Fibrillation Ablation in the 21st Century: Almost No Stroke Risk?
Atrial fibrillation ablation (AFabl) emerged at the end of the 20th century as an exciting alternative for physicians who were disappointed with antiarrhythmic drug outcomes1. However, numerous critics expressed skepticism at the long-term outcomes and benefits of the procedure and risks of serious complications2.
Source: Heart Rhythm - August 11, 2020 Category: Cardiology Authors: Koonlawee Nademanee Source Type: research

Is Transesophageal Echocardiography Necessary In Patients Undergoing Ablation Of Atrial Fibrillation On An Uninterrupted Direct Oral Anticoagulant Regimen? Results From A Prospective Multicenter Registry
Thromboembolic stroke is a rare but devastating consequence of atrial fibrillation (AF) ablation. Transesopheageal echocardiography (TEE) is recommended to rule out left atrial appendage thrombus (LAA); however, its utilization is variable.
Source: Heart Rhythm - July 14, 2020 Category: Cardiology Authors: Kavisha Patel, Andrea Natale, Ruike Yang, Chintan Trivedi, Jorge Romero, David Briceno, Sanghamitra Mohanty, Isabella Alviz, Veronica Natale, Javier Sanchez, Domenico G. Della Rocca, Nicola Tarantino, Xiao-Dong Zhang, Prasant Mohanty, Rodney Horton, David Source Type: research

EP News: Allied Professionals
In this paper, the authors (Poole et al J Am Coll Cardiol. 2020;75:3105-3118. PMID 32586583) provide expanded results of an important secondary endpoint of the CABANA (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial, the recurrence of atrial fibrillation (AF). In the CABANA trial, 2204 patients with symptomatic AF and risk factors for stroke were randomized to catheter ablation or drug therapy with a primary endpoint was a composite of death, stroke, major bleeding or cardiac arrest during 5 years of follow-up.
Source: Heart Rhythm - July 7, 2020 Category: Cardiology Authors: Erica S. Zado Source Type: research