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Source: Heart Rhythm
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Total 406 results found since Jan 2013.
EP News: Clinical
Osmancik and colleagues (J Am Coll Cardiol 2020;75:3122 –3135, PMID 32586585) compared left atrial appendage closure (LAAC) with direct oral anticoagulants (DOAC) in a multicenter, randomized, noninferiority trial. A high-risk patient cohort (CHA2DS2-VASc: 4.7 ± 1.5) was randomized to receive LAAC (n = 201) or DOAC (n = 201). At 19.9 months of follow- up, the annual rates of the primary outcome were 10.99% with LAAC and 13.42% with DOAC (d ratio [HR]: 0.84; P = .44; P = .004 for noninferiority). There were no differences between groups for the components of the composite endpoint: all-stroke/transient ischemic attack (H...
Source: Heart Rhythm - July 3, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
EP News Clinical July 1, 2020
Osmancik and colleagues (J Am Coll Cardiol. 2020; 75:3122-3135. PMID: 32586585) compared left atrial appendage closure (LAAC) with direct oral anticoagulants in a multicenter, randomized, noninferiority trial. A high-risk patient cohort (CHA2DS2-VASc: 4.7 ± 1.5) was randomized to receive LAAC (n = 201) or DOAC (n = 201). At 19.9 months of follow-up, the annual rates of the primary outcome were 10.99% with LAAC and 13.42% with DOAC (HR: 0.84; p = 0.44; p = 0.004 for noninferiority). There were no differences between groups for the components of the c omposite endpoint: all-stroke/TIA (HR: 1.00), clinically significant blee...
Source: Heart Rhythm - July 3, 2020 Category: Cardiology Authors: N. A. Mark Estes Source Type: research
HRS white paper on atrial fibrillation centers of excellence: Rationale, considerations, and goals
Atrial fibrillation (AF) remains an important global problem.1 –3 AF continues to lead to poor health outcomes, including reduced quality of life (QoL) and increased risks of heart failure, cognitive impairment, stroke, and death.4,5 Moreover, it has a significant financial impact on health care systems and their associated economies.6–8 In order to improve care for patients with AF, there is an increasing recognition that current care must evolve. Health care organizations should move from a system of siloed outpatient and inpatient clinicians and health care facilities to a system of integrated, coordinated, and pati...
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Jonathan P. Piccini, James Allred, T. Jared Bunch, Thomas F. Deering, Luigi Di Biase, Ayman A. Hussein, William R. Lewis, Suneet Mittal, Andrea Natale, Jose Osorio, Douglas L. Packer, Christian Ruff, Andrea M. Russo, Prashanthan Sanders, Amber Seiler, Dav Source Type: research
Rationale, considerations, and goals for atrial fibrillation centers of excellence: A Heart Rhythm Society perspective
Atrial fibrillation (AF) remains an important global problem.1 –3 AF continues to lead to poor health outcomes, including reduced quality of life (QoL) and increased risks of heart failure, cognitive impairment, stroke, and death.4,5 Moreover, it has a significant financial impact on health care systems and their associated economies.6–8 In order to improve care for patients with AF, there is an increasing recognition that current care must evolve. Health care organizations should move from a system of siloed outpatient and inpatient clinicians and health care facilities to a system of integrated, coordinated, and pati...
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Jonathan P. Piccini, James Allred, T. Jared Bunch, Thomas F. Deering, Luigi Di Biase, Ayman A. Hussein, William R. Lewis, Suneet Mittal, Andrea Natale, Jose Osorio, Douglas L. Packer, Christian Ruff, Andrea M. Russo, Prashanthan Sanders, Amber Seiler, Dav Source Type: research
EP News: Allied Professionals
Using data from implantable loop recorders (ILRs) inserted in patients with risk factors for stroke but without history of atrial fibrillation (AF), Diederichsen et al (Circulation 2020; DOI 10.1161/CIRCULATIONAHA.119.044407; PMID 32114796) used simulation techniques to assess how often various rhythm monitors would pick up episodes of AF during regular screening. The patients were part of the LOOP trial (Atrial Fibrillation Detected by Continuous ECG Monitor ing; ClinicalTrials.gov Identifier: NCT02036450).
Source: Heart Rhythm - March 20, 2020 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research
EP News: Case Reports
Detection of atrial fibrillation (AF) in patients with cryptogenic stroke is critical and impacts treatment approaches. Multiple tools now are available that can detect AF with high sensitivity and specificity. However, continuous monitors often are required to detect subclinical, short, or infrequent AF episodes. Implantable cardiac monitors are expensive, require surgical insertion, and monitor for 2 –3 years on average. These limitations and the lack of broad availability of monitors prompt the need to consider novel approaches to AF risk assessment in patients post cryptogenic stroke.
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research
Pacing in vasovagal syncope: physiology, pacemaker sensors and recent clinical trials. Precise patient selection and measurable benefit.
The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients that benefit from dual-chamber pacing are typically older with highly symptomatic, late-onset, frequent and severe syncope with short/no prodrome and documented severe cardioinhibition. Tilt-testing is of value in patients with recurrent unexplained syncope to identify important hypotensive susceptibility stemming from reduced venous return and stroke volume.
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Richard Sutton, Jelle SY. de Jong, Julian M. Stewart, Artur Fedorowski, Frederik J. de Lange Source Type: research
EP News: Clinical
Diederichsen et al (J Am Coll Cardiol 2019;74:2771, PMID 31779791) evaluated the natural history of subclinical atrial fibrillation (AF) in at-risk patients from the general population. The authors studied 590 individuals ≥70 years of age with ≥1 of hypertension, diabetes, previous stroke, or heart failure; w ithout a history of AF; and with long-term implantable loop recorder monitoring. End points included AF burden, AF progression, symptoms, and heart rate during AF. In a total of 685,445 monitoring days, AF lasting ≥6 minutes was detected in 205 participants (35%).
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
Impact of atrial fibrillation/flutter on the in-hospital mortality of ischemic stroke patients
Stroke is the second leading cause of death worldwide. Ischemic strokes, which are caused by atrial fibrillation/flutter (AF) may be more devastating than those without AF.
Source: Heart Rhythm - October 3, 2019 Category: Cardiology Authors: Karsten Keller, Lukas Hobohm, Philip Wenzel, Thomas M ünzel, Christine Espinola-Klein, Mir A. Ostad Source Type: research
Pacing in vasovagal syncope: a physiological paradox?
CThe physiological principles underlying pacemaker treatment in patients with vasovagal syncope (VVS) have never been reviewed. Current knowledge suggests that pacing the right heart is unlikely to correct blood pressure (BP) during a vasovagal reaction. In adults, the reason for this is that stroke volume (SV) is dictated by central blood volume (CBV) contained in the cardiopulmonary vessels within the chest (i.e. left ventricular preload). Preceding posture-triggered VVS, there is a significant fall in CBV and therefore in SV and cardiac output (CO) long before the onset of bradycardia.
Source: Heart Rhythm - September 23, 2019 Category: Cardiology Authors: Jelle SY. de Jong, David L. Jardine, Jacques WM. Lenders, Wouter Wieling 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
EP News: Allied Professionals
Di Biase et al (J Am Coll Cardiol 2019;74:1019, PMID 31439209) sought to assess the incidence of thromboembolic (TE) events such as stroke and transient ischemic attack (TIA) in patients with atrial fibrillation (AF) undergoing ablation for AF that included left atrial appendage (LAA) isolation (LAAI). The st udy group comprised all patients who underwent LAAI as part of their ablation strategy and who were without AF 6 months after ablation. All patients were continued on oral anticoagulation (OAC) with either warfarin or direct oral anticoagulant (DOAC) for the first 6 months.
Source: Heart Rhythm - September 15, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research
Thromboembolic, Bleeding, and Mortality Risks among Patients with Nonvalvular Atrial Fibrillation Treated with Dual Antiplatelet Therapy versus Oral Anticoagulants: A Population-Based Study
Dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel is used for stroke prevention in patients with atrial fibrillation (AF) when patients refuse to use oral anticoagulants (OAC) in clinical practice. However, there are limited clinical data comparing these treatments.
Source: Heart Rhythm - July 31, 2019 Category: Cardiology Authors: Wallis C.Y. Lau, Ian J. Douglas, Ian C.K. Wong, Liam Smeeth, Gregory Y.H. Lip, Wai K. Leung, Chung-Wah Siu, Bernard M.Y. Cheung, Michael T.C. Mok, Esther W. Chan Source Type: research
Left Atrial Appendage Closure Device Implantation in Patients at Very High Risk for Stroke
Little is known about the role of left atrial appendage closure using Watchman ™ device in patients who are at very high risk for stroke.
Source: Heart Rhythm - July 11, 2019 Category: Cardiology Authors: Erika Hutt, Oussama M. Wazni, Simrat Kaur, Walid I. Saliba, Khaldoun G. Tarakji, Samir Kapadia, Jose Aguilera, Amr F. Barakat, Mouin Abdallah, Wael Jaber, Peter Rasmussen, Shazam Hussain, Ken Uchino, Dolora Wisco, Bruce D. Lindsay, Mohamed Kanj, Ayman A. Source Type: research
