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Source: Europace
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Total 183 results found since Jan 2013.
Electrophysiological effects of non-vitamin K antagonist oral anticoagulants on atrial repolarizing potassium channels
Conclusion Apixaban, dabigatran, edoxaban, and rivaroxaban did not exhibit direct functional interactions with human atrial K+ channels underlyingIKr,IKur,Ito,IK1, andIK2P currents that could account for beneficial clinical outcome associated with the drugs. Indirect or chronic effects and potential underlying signalling mechanisms remain to be investigated.
Source: Europace - July 17, 2020 Category: Cardiology Source Type: research
How to estimate the potential clinical benefit associated with left atrial appendage closure? Authors ’ reply
In response to the letter by Fauchier et al.,1 we wish to highlight numerous erroneous statements they have made with regards the data and analysis in our published article2 Firstly Fauchieret al. claim that ‘8% of patients still had oral anticoagulation (OAC) at 2-year follow-up, with no information on OAC use in the preceding follow-up visits’. However, the article states that 94% of patients stopped OAC at the first follow-up visit (2–3 months post-procedure) and patients who were recommenced on OAC during follow-up are individually described in the results leading to 8% of patients taking OAC at the end of 2-ye...
Source: Europace - July 16, 2020 Category: Cardiology Source Type: research
How to estimate the potential clinical benefit associated with left atrial appendage closure?
We read the article by Phillipset al. about combined left atrial appendage (LAA) closure and catheter ablation for atrial fibrillation (AF) and its related editorial.1,2 The rate of ischaemic stroke was 0.36% per year which would represent a 93% relative risk reduction (RRR) vs. predicted rate by the CHA2DS2-VASc score without oral anticoagulation (OAC). For non-procedural major bleeding rate, estimated RRR was 70% when compared to the expected bleeding risk on warfarin according to the HAS-BLED score.
Source: Europace - July 2, 2020 Category: Cardiology Source Type: research
Sex-related differences in risk factors, outcome, and quality of life in patients with permanent atrial fibrillation: results from the RACE II study
ConclusionIn this permanent AF population, women had more accumulation of AF risk factors than men. The observed higher cardiovascular event rate in women was no longer significant after adjusting for the number of risk factors. Further, QoL was negatively influenced by the higher number of risk factors in women. This suggests that sex differences may be driven by the greater risk factor burden in women.
Source: Europace - November 20, 2019 Category: Cardiology Source Type: research
Atrial high-rate episodes: prevalence, stroke risk, implications for management, and clinical gaps in evidence
AbstractSelf-terminating atrial arrhythmias are commonly detected on continuous rhythm monitoring, e.g. by pacemakers or defibrillators. It is unclear whether the presence of these arrhythmias has therapeutic consequences. We sought to summarize evidence on the prevalence of atrial high-rate episodes (AHREs) and their impact on risk of stroke. We performed a comprehensive, tabulated review of published literature on the prevalence of AHRE. In patients with AHRE, but without atrial fibrillation (AF), we reviewed the stroke risk and the potential risk/benefit of oral anticoagulation. Atrial high-rate episodes are found in 10...
Source: Europace - August 3, 2019 Category: Cardiology Source Type: research
Sex-related differences in catheter ablation of atrial fibrillation: a systematic review and meta-analysis
ConclusionsWomen who underwent catheter ablation of AF might experience lower efficacy and a higher risk of stroke/TIA and major complications than men. The reasons for these sex-related differences need to be further studied.
Source: Europace - July 8, 2019 Category: Cardiology Source Type: research
Apixaban enhances endogenous fibrinolysis in patients with atrial fibrillation
ConclusionApixaban enhances endogenous fibrinolysis, with maximal effect in those with impaired fibrinolysis pre-treatment. Apixaban-treated patients exhibit more favourable fibrinolysis profiles than those taking warfarin or aspirin. Whether apixaban may confer additional thrombotic risk reduction in NVAF patients with impaired fibrinolysis, compared to warfarin, merits further study.
Source: Europace - June 25, 2019 Category: Cardiology Source Type: research
Thromboembolism after electrical isolation of the left atrial appendage: a new indication for interventional closure?
ConclusionAfter electrical LAAI for rhythm control in AF patients, interventional LAAC was associated with fewer thromboembolic complications when compared with OAC.
Source: Europace - June 23, 2019 Category: Cardiology Source Type: research
Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: the FAI Project
ConclusionsOur findings indicate a high burden of AF in coming decades, especially among the oldest-old, who carry the higher AF-related risk of stroke and medical complications.
Source: Europace - June 6, 2019 Category: Cardiology Source Type: research
Oesophageal injury following magnetically guided single-catheter ablation for atrial fibrillation: insights from the MAGNA-AF registry
ConclusionMagnetically guided CA for AF with careful energy titration at the posterior LA wall and no oesophageal temperature monitoring is not associated with an increased incidence of oesophageal thermal injury. The routine use of periprocedural TOE may cause a low rate of mechanical oesophageal lesions but reliably prevents major complications like transient ischaemic attack, stroke, or cardiac tamponade. An observed high prevalence of upper digestive system inflammation (63%) may further support the recommendation for a routine post-interventional treatment with a proton-pump-inhibitor.
Source: Europace - May 1, 2018 Category: Cardiology Source Type: research
Thoracoscopic left atrial appendage clipping as novel treatment option for peri-device leakage
A 69-year-old woman known with symptomatic antiarrhythmic drug refractory paroxysmal atrial fibrillation (AF), stroke (CHA2DS2-VASc score 5), and therapy-resistant epilepsy resulting in collapses with risk for head trauma (HAS-BLED score 3), underwent catheter ablation and transcatheter left atrial appendage (LAA) occlusion (WATCHMANTM 24 mm, Boston Scientific, Natick, MA, USA). Computed tomography (CT) scan revealed significant peri-device leakage (4–5 mm). Due to the absolute contra-indication for oral anticoagulation therapy, the patient was referred for thoracoscopic LAA-clipping (Atriclip PRO 145, AtriCure Inc....
Source: Europace - January 12, 2018 Category: Cardiology Source Type: research
Integrating new approaches to atrial fibrillation management: the 6th AFNET/EHRA Consensus Conference
AbstractThere are major challenges ahead for clinicians treating patients with atrial fibrillation (AF). The population with AF is expected to expand considerably and yet, apart from anticoagulation, therapies used in AF have not been shown to consistently impact on mortality or reduce adverse cardiovascular events. New approaches to AF management, including the use of novel technologies and structured, integrated care, have the potential to enhance clinical phenotyping or result in better treatment selection and stratified therapy. Here, we report the outcomes of the 6th Consensus Conference of the Atrial Fibrillation Net...
Source: Europace - January 2, 2018 Category: Cardiology Source Type: research
Age, sex and the quantity of atrial fibrosis before AF ablation: what about systematic bias and confounding factors?
I read the article by Akoumet al. (1) with great interest. Their observational cohort study included a total of 939 consecutive patients with atrial fibrillation (AF) undergoing catheter ablation and 15 non-AF control group in whom late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) for atrial fibrosis quantification has been performed. As a result of the study analysis, women with AF revealed older age, higher previous history of stroke and higher left atrial fibrosis as compared to men. Female sex, persistent AF, time from AF diagnosis, and higher left atrium volume index (LAVI) were found to be independen...
Source: Europace - November 16, 2017 Category: Cardiology Source Type: research
Does CHA2DS2-VASc score predict ischaemic stroke in chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease (COPD) is associated with a high risk of ischaemic stroke.1 CHA2DS2-VASc score is recommended and is widely used for stroke risk stratification in atrial fibrillation (AF) patients,2 but it has been shown to be an independent predictor of thrombo-embolic events in patients without AF, as well.3 In this issue ofEuropace, Huet al. performed a retrospective cohort study in a very big case sample (1492 COPD patients with AF and 50 343 COPD patients without AF), and reported that COPD patients with a higher CHA2DS2-VASc score were more likely to develop ischaemic stroke whether or not AF...
Source: Europace - October 17, 2017 Category: Cardiology Source Type: research
