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CHA2DS2-VASc score for ischaemic stroke risk stratification in patients with chronic obstructive pulmonary disease with and without atrial fibrillation: a nationwide cohort study
ConclusionsOur study is the first to show that the performance of CHA2DS2-VASc score in predicting ischaemic stroke is better for COPD patients without AF than for COPD patients with AF.
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

Does atrial fibrillation cause cognitive decline and dementia?
AbstractAtrial fibrillation (AF) and dementia are both frequent diseases with substantial socioeconomic impact. While AF has been associated with cognitive dysfunction and dementia, we currently lack an exact understanding of the complex association between AF and cognitive decline. Based on an extended literature search we summarize key publications focusing on AF-related cognitive decline and dementia. Moreover, ongoing trials and potential therapeutic implications are discussed. While further prospective studies using a standardized definition of AF and cognitive decline are urgently needed, growing evidence supports th...
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

The unfinished issue of ischaemic stroke and embolic events during catheter ablation of atrial fibrillation
We have read with interest the paper by Liuet al.,1 who report a very low incidence of ischaemic stroke (0.36%; 7 patients) in 1946 consecutive procedures of catheter ablation of atrial fibrillation (AF). Although these findings are noteworthy, we would like to comment on two aspects of the study that deserve reflection.
Source: Europace - March 17, 2017 Category: Cardiology Source Type: research

The unfinished issue of ischaemic stroke and embolic events during ablation for atrial fibrillation: the authors' reply
We thank Dr. Providenciaet al.1 for the concern and comments on our article.2 We agree with them that discontinuation of warfarin before catheter ablation for atrial fibrillation (AF) is likely associated with increased risk of periprocedural thrombo-embolic events. We cannot comment on the effects of different periprocedural anticoagulation strategy used in our cohort on thrombo-embolic events during AF ablation because of only a small minority of patients who were anti-coagulated with uninterrupted warfarin. Although several reports indicate that AF ablation can be performed safely with fewer stroke and bleeding complica...
Source: Europace - March 17, 2017 Category: Cardiology Source Type: research

Alcohol-related hospitalization is associated with increased risk of ischaemic stroke among low-risk patients with atrial fibrillation
ConclusionThe presence of a previous hospitalization with an alcohol-related disease was associated with a small but significant increase in the risk of stroke among low-risk AF patients. More research about relation between alcohol use and ischaemic stroke in AF patients is warranted.
Source: Europace - February 23, 2017 Category: Cardiology Source Type: research

Stroke and bleeding with non-vitamin K antagonist oral anticoagulant or warfarin treatment in patients with non-valvular atrial fibrillation: a population-based cohort study
ConclusionThis population-based cohort study of routine care indicates similar or better effectiveness and safety with NOAC compared with warfarin treatment. NOACs were associated with fewer intracranial bleeds, but more gastrointestinal bleeds.
Source: Europace - February 10, 2017 Category: Cardiology Source Type: research

Demographics, treatment and outcomes of atrial fibrillation in a developing country: the population-based TuRkish Atrial Fibrillation (TRAF) cohort
ConclusionThe TRAF cohort is the first population-based, whole-country cohort of AF epidemiology, quality of care and outcomes. It provides a unique opportunity to study the patterns, causes and impact of treatments on the incidence and outcomes of AF in a developing country.
Source: Europace - February 10, 2017 Category: Cardiology Source Type: research

Endocardial left ventricular pacing for cardiac resynchronization: systematic review and meta-analysis
ConclusionLV endocardial pacing appears to be a viable technique when conventional lead placement is not possible. Response rates were heterogeneous but comparable with conventional CRT. There is likely to be a small increase over expected rates of stroke, although included patients were high risk.
Source: Europace - January 10, 2017 Category: Cardiology Source Type: research

Single lead atrial vs. dual chamber pacing in sick sinus syndrome: extended register-based follow-up in the DANPACE trial
ConclusionThis register-based long-term follow-up study indicates that there is no difference in mortality among patients with SSS randomized to AAIR or DDDR pacing, even with very long follow-up. Nor is there any difference in risk of AF hospitalization, stroke or HF. The higher rate of pacing mode-change to DDDR in the AAIR group suggests a different management of patients with an AAIR PM after the DANPACE trial.
Source: Europace - December 24, 2016 Category: Cardiology Source Type: research

Catheter ablation of atrial fibrillation in very young adults: a 5-year follow-up study
ConclusionIn the majority of very young adults catheter ablation for AF is effective, and associated with an acceptable complication rate. SHD and obesity are predictors for AF recurrence in this population.
Source: Europace - December 24, 2016 Category: Cardiology Source Type: research

New insights from a computational model on the relation between pacing site and CRT response
Conclusions</div>In these model simulations, the best cardiac function was obtained when pacing the mid-basal LV lateral wall, because of fastest recruitment of LV activation. This study illustrates how computer modeling can shed new light on optimizing pacing therapies for CRT. The results from this study may help to design new clinical studies to further investigate the importance of the pacing site for CRT response.</span>
Source: Europace - December 22, 2016 Category: Cardiology Source Type: research

The increased risk of stroke/transient ischemic attack in women with a cardiac implantable electronic device is not associated with a higher atrial fibrillation burden
ConclusionsAmong patients implanted with a CIED, an AF burden of at least 5  min is a common finding, (44% of patients). Female patients have a risk of stroke and TIAs that is around two-fold that of male patients, but this increased risk cannot be ascribed to a higher burden of AF or to differences in the evolution to permanent AF.Clinical Trial RegistrationClinicalTrials.gov Identifier: NCT01007474
Source: Europace - December 22, 2016 Category: Cardiology Source Type: research

Adverse outcomes in patients with atrial fibrillation and peripheral arterial disease: a report from the EURObservational research programme pilot survey on atrial fibrillation
ConclusionPeripheral arterial disease is prevalent in 11% of AF patients and related to various atherosclerotic risk factors. Even if PAD is associated with higher risk of all-cause death on univariate analysis, this risk was significantly lowered and was no longer evident after adjusting for the use of CV prevention drugs.
Source: Europace - December 9, 2016 Category: Cardiology Source Type: research

Atrial fibrillation and risk of stroke: a nationwide cohort study
Conclusions Stroke/TE/TIA risk was particularly increased when prior stroke/TE/TIA was present. Atrial fibrillation is associated with an increase in risk of stroke/TE/TIA in the absence of other risk factors but only a moderate increase in risk when other risk factors are present.
Source: Europace - November 1, 2016 Category: Cardiology Authors: Christiansen, C. B., Gerds, T. A., Olesen, J. B., Kristensen, S. L., Lamberts, M., Lip, G. Y. H., Gislason, G. H., Kober, L., Torp-Pedersen, C. Tags: Atrial fibrillation Source Type: research

Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation
Conclusion Combined CB ablation and LAA closure using different devices appears to be feasible in patients with non-valvular AF associated with high risk of stroke or contraindication to antithrombotic treatment.
Source: Europace - November 1, 2016 Category: Cardiology Authors: Fassini, G., Conti, S., Moltrasio, M., Maltagliati, A., Tundo, F., Riva, S., Dello Russo, A., Casella, M., Majocchi, B., Zucchetti, M., Russo, E., Marino, V., Pepi, M., Tondo, C. Tags: Ablation for atrial fibrillation Source Type: research

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