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Dual potential embolic source detected in left atrium during hyperacute stroke
Clinical introduction A woman in her late 60s with a medical history of hypertension presented to the emergency department with symptoms of a stroke which began 40 min prior. Brain MRI was performed (figure 1A). Hyperacute CT angiography of the head and neck did not find any atherosclerosis. ECG is shown (figure 1B), and subsequent transthoracic echocardiography showed left atrium enlargement and left-to-right flow at the region of the fossa ovalis (figure 1C). Figure 1Brain MRI of diffusion-weighted image sequence (A), ECG (B), and transthoracic echocardiogram (C). Question Which of the following is the most likely mechan...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Fu, Z., Xu, C., Gao, L. Tags: Image challenges Source Type: research

Bradyarrhythmias in patients with atrial fibrillation
The increasing burden of atrial fibrillation (AF) and significant morbidity/mortality associated with this arrhythmia encourage screening it in clinical practice, as recommended in current guidelines. It means opportunistic screening (in patients over 65 years) or systematic screening (in people above 75 years) by using clinical examination, followed by an ECG, 24-hour ECG monitoring or continuous rhythm monitoring by a screening tool (including mobile or wearable device). In screen-positive cases, a definitive diagnosis of AF should always be obtained before providing an appropriate management.1 Symptomatic or asymptomati...
Source: Heart - August 11, 2023 Category: Cardiology Authors: Floria, M., Tanase, D. M. Tags: Editorials Source Type: research

Heartbeat: prediction of atrial fibrillation risk
One of the challenges in prevention of stroke is identification of patients at risk of atrial fibrillation (AF) shortly before the onset of the arrhythmia so that prevention therapies can be promptly instituted. In this issue of Heart, Nadarajah and colleagues1 report the development and validation of an algorithm based on data from the UK Clinical Practice Research Datalink GOLD dataset that included 2 081 139 individuals of whom 7386 developed AF within 6 months. This new algorithm-- Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF) – identified a high-risk cohort with a 20-fold higher 6 month ...
Source: Heart - June 26, 2023 Category: Cardiology Authors: Otto, C. M. Tags: Highlights from this issue Source Type: research

Prediction of short-term atrial fibrillation risk using primary care electronic health records
Conclusions FIND-AF, a machine learning algorithm applicable at scale in routinely collected primary care data, identifies people at higher risk of short-term AF.
Source: Heart - June 26, 2023 Category: Cardiology Authors: Nadarajah, R., Wu, J., Hogg, D., Raveendra, K., Nakao, Y. M., Nakao, K., Arbel, R., Haim, M., Zahger, D., Parry, J., Bates, C., Cowan, C., Gale, C. P. Tags: Open access, Editor's choice Arrhythmias and sudden death Source Type: research

Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer
Conclusions Cancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.
Source: Heart - June 14, 2023 Category: Cardiology Authors: Raisi-Estabragh, Z., Cooper, J., McCracken, C., Crosbie, E. J., Walter, F. M., Manisty, C. H., Robson, J., Mamas, M. A., Harvey, N. C., Neubauer, S., Petersen, S. E. Tags: Open access, Editor's choice, Press releases Cardiac risk factors and prevention Source Type: research

Impact of pre-existing left atrial appendage occluder on catheter ablation of atrial fibrillation
Conclusions This pioneer study first showed impacts of LAAO on LA substrate and PVI procedure.
Source: Heart - May 26, 2023 Category: Cardiology Authors: Chen, J.-J., Chiu, F.-C., Chang, S.-N., Cheng, H.-L., Huang, P.-s., Wu, C.-K., Wang, Y.-C., Hwang, J.-J., Tsai, C.-T. Tags: Arrhythmias and sudden death Source Type: research

Prediction of incident atrial fibrillation with cardiac biomarkers and left atrial volumes
Conclusions In the general population, echocardiographic left atrial volumetric indices and NT-proBNP, but not cTnT and GDF-15, associate with prevalent atrial fibrillation and with risk of incident atrial fibrillation. cTnT and NT-proBNP provide incremental prognostic information to echocardiography.
Source: Heart - February 14, 2023 Category: Cardiology Authors: Lyngbakken, M. N., Ronningen, P. S., Solberg, M. G., Berge, T., Brynildsen, J., Aagaard, E. N., Kvisvik, B., Rosjo, H., Steine, K., Tveit, A., Omland, T. Tags: Arrhythmias and sudden death Source Type: research

Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter
Conclusion Cryoballoon PVI as first-line treatment for AFL is equally effective compared with standard CTI ablation for preventing recurrence of atrial arrhythmia and better at preventing new-onset AF. Trial registration number NCT03401099.
Source: Heart - February 14, 2023 Category: Cardiology Authors: Gupta, D., Ding, W. Y., Calvert, P., Williams, E., Das, M., Tovmassian, L., Tayebjee, M. H., Haywood, G., Martin, C. A., Rajappan, K., Bates, M. G. D., Temple, I. P., Reichlin, T., Chen, Z., Balasubramaniam, R. N., Ronayne, C., Clarkson, N., Morgan, M., B Tags: Arrhythmias and sudden death Source Type: research

Emergent readmission and long-term mortality risk after incident atrial fibrillation hospitalisation
Conclusion This study highlights the large burden of unplanned all-cause and cardiovascular-specific readmissions within 2 years after being hospitalised for incident AF and their associated adverse impact on mortality. Concomitant comorbidities are independently associated with unplanned hospitalisations and mortality, which supports integrated multidisciplinary management of comorbidities, along with AF-targeted treatments, to improve long-term outcomes in patients with AF.
Source: Heart - February 14, 2023 Category: Cardiology Authors: Weber, C., Hung, J., Hickling, S., Li, I., Murray, K., Briffa, T. Tags: Cardiac risk factors and prevention Source Type: research

Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis
Conclusions Our analysis suggests that off-label underdosing of NOACs does not reduce bleeding outcomes. Patients prescribed off-label NOAC doses are at an increased risk of all-cause mortality. These data underscore the importance of prescriber adherence to NOAC dosing guidelines to achieve optimal clinical outcomes for patients with AF. PROSPERO registration number CRD42020219844.
Source: Heart - January 11, 2023 Category: Cardiology Authors: Caso, V., de Groot, J. R., Sanmartin Fernandez, M., Segura, T., Blomström-Lundqvist, C., Hargroves, D., Antoniou, S., Williams, H., Worsley, A., Harris, J., Caleyachetty, A., Vardar, B., Field, P., Ruff, C. T. Tags: Open access Systematic review Source Type: research

Heartbeat: hospitalisation for COVID-19 is associated with an increased risk of subsequent adverse cardiovascular events
In order to assess whether previous COVID-19 infection might be associated with a higher risk of subsequent adverse cardiovascular disease (CVD) events, Raisi-Estabragh and colleagues1 analysed incident CVD events in 17 871 UK Biobank cases with prospective follow-up from March 2020 to March 2021. Hospitalisation for COVID-19 was associated with an increased risk of several adverse CVD events, including myocardial infarction, stroke, heart failure, atrial fibrillation, venous thromboembolism and mortality (figure 1). Risk was highest in the first 30 days after infection, but remained higher than matched controls over an av...
Source: Heart - December 22, 2022 Category: Cardiology Authors: Otto, C. M. Tags: COVID-19 Highlights from this issue Source Type: research

Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank
Conclusions Individuals hospitalised with COVID-19 have increased risk of incident cardiovascular events across a range of disease and mortality outcomes. The risk of most events is highest in the early postinfection period. Individuals not requiring hospitalisation have increased risk of VTE, but not of other cardiovascular-specific outcomes.
Source: Heart - December 22, 2022 Category: Cardiology Authors: Raisi-Estabragh, Z., Cooper, J., Salih, A., Raman, B., Lee, A. M., Neubauer, S., Harvey, N. C., Petersen, S. E. Tags: Open access, Editor's choice, Press releases, COVID-19 Cardiac risk factors and prevention Source Type: research

Left atrial appendage preservation versus closure during surgical ablation of atrial fibrillation
Conclusions LAA preservation during surgical AF ablation was not associated with an increased risk of stroke or mortality. Postoperative LA transport functions were more favourable with LAA preservation than with LAA closure.
Source: Heart - November 10, 2022 Category: Cardiology Authors: Kim, H. J., Chang, D.-H., Kim, S.-O., Kim, J. K., Kim, K., Jung, S.-H., Lee, J. W., Kim, J. B. Tags: Arrhythmias and sudden death Source Type: research

Eligibility for early rhythm control in patients with atrial fibrillation in the UK Biobank
Conclusion Around 80% of participants diagnosed with AF in the UK population are eligible for early rhythm-control. Early rhythm-control therapy was safe in routine care.
Source: Heart - November 10, 2022 Category: Cardiology Authors: Kany, S., Cardoso, V. R., Bravo, L., Williams, J. A., Schnabel, R., Fabritz, L., Gkoutos, G. V., Kirchhof, P. Tags: Open access Arrhythmias and sudden death Source Type: research

Sex-specific differences in adverse outcome events among patients with atrial fibrillation
Conclusion In this large study of patients with established AF, women had a lower risk of death than men, but there were no sex-specific differences in other adverse outcomes.
Source: Heart - August 25, 2022 Category: Cardiology Authors: Evers-Dörpfeld, S., Aeschbacher, S., Hennings, E., Eken, C., Coslovsky, M., Rodondi, N., Beer, J. H., Moschovitis, G., Ammann, P., Kobza, R., Ceylan, S., Krempke, M., Meyer-Zürn, C. S., Moutzouri, E., Springer, A., Sticherling, C., Bonati, Tags: Arrhythmias and sudden death Source Type: research

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