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Source: Heart Rhythm
Drug: Coumadin
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Total 21 results found since Jan 2013.
Po-713-05 ischemic stroke after prophylaxis with left atrial appendage closure vs non-warfarin oral anticoagulants: a “real-world” multicenter comparison of stroke severity
In randomized trials, strokes occurring in patients who have received left atrial appendage closure (LAAC) devices have been less severe than in patients receiving warfarin prophylaxis - an observation thought related to warfarin ’s higher rate of hemorrhagic stroke (which are known to have worse outcomes). Similar stroke rates have been described with LAAC vs NOACs (non-warfarin oral anticoagulants), but the low hemorrhagic stroke rate of NOACs raises the question of stroke severity between these two therapies.
Source: Heart Rhythm - April 29, 2022 Category: Cardiology Authors: Mohit K. Turagam, Iwanari Kawamura, Domenico G. Della Rocca, Pavel Hala, Thomas Flautt, Deji Adedokun, Moritoshi Funasako, Daniel Ross Musikantow, Srinivas R. Dukkipati, David H. Yoo, Petr Neuzil, Devi G. Nair, Douglas N. Gibson, Miguel Valderrabano, Andr Source Type: research
B-po03-155 outcomes of left atrial appendage occlusion with watchman in contemporary clinical practice compared with clinical trials: a pooled analysis of protect-af, prevail, and the ncdr laao registry
The PROTECT-AF and PREVAIL trials established Watchman left atrial appendage occlusion (LAAO) as an alternative to warfarin for stroke protection in atrial fibrillation. In clinical practice, LAAO is often performed in patients who cannot tolerate long-term anticoagulation and have more cardiac and non-cardiac comorbidities.
Source: Heart Rhythm - July 28, 2021 Category: Cardiology Authors: Daniel J. Friedman, Chengan Du, Yongfei Wang Vratika Agarwal, Paul D. Varosy, Frederick A. Masoudi, Jeptha P. Curtis, James Freeman Source Type: research
B-po05-154 an updated meta-analysis comparing left atrial appendage closure and oral anticoagulation
Left atrial appendage closure (LAAC) trials such as PREVAIL and PROTECT revealed non-inferiority of LAAC compared to warfarin. The recently published PRAGUE study showed that LAAC was non-inferior to direct oral anti-coagulants. Current guidelines give a IIb recommendation for LAAC in patients with non-valvular atrial fibrillation (NVAF) with increased risk of stroke and contraindication to long-term anticoagulation.
Source: Heart Rhythm - July 28, 2021 Category: Cardiology Authors: Sisir Siddamsetti, Arshad Muhammad Iqbal, Alexander Shinn, Sandeep Gautam 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
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
Left Atrial Appendage Closure Device Implantation in Patients with Atrial Fibrillation and Prior Intracranial Hemorrhage “No Man Left Behind”
Several LAA closure devices have been developed for patients with atrial fibrillation (AF) seeking an alternative to long-term oral anticoagulation (OAC). The PROTECT AF trial was the first multicenter randomized controlled trial (RCT) comparing LAA closure device vs. OAC with Warfarin. Primary safety events were statistically more frequent in the device group (7.4% vs. 4.4%). At a mean follow up of 3.8 years LAA closure device showed superiority for the primary efficacy endpoint (i.e., composite of stroke, cardiovascular death and systemic embolism), with a 34% relative risk reduction in total mortality1-3 However, with t...
Source: Heart Rhythm - January 14, 2019 Category: Cardiology Authors: Luigi Di Biase, Jorge Romero Source Type: research
A New Model to Predict Ischemic Stroke in Patients with Atrial Fibrillation Using Warfarin or Direct Oral Anticoagulants
Stroke risk stratification scores (e.g., CHA2DS2-VASc) are used to tailor therapeutic recommendations for patients with atrial fibrillation (AF) in different risk groups.
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: J ’Neka S. Claxton, Richard F. MacLehose, Pamela L. Lutsey, Faye L. Norby, Lin Y. Chen, Wesley T. O’Neal, Alanna M. Chamberlain, Lindsay G.S Bengtson, Alvaro Alonso Source Type: research
EP News: Allied Professionals
Using data from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial, Lopes et al (J Am Coll Cardiol 2018;71:1063, PMID 29519345) sought to determine the effect of digoxin on mortality in patients with atrial fibrillation (AF). ARISTOTLE is a pivotal trial involving ∼18,000 patients with AF and at least 1 risk factor for stroke with randomization to apixaban or warfarin. T he present study is a post hoc analysis of those patients who were on digoxin at baseline as compared with those not on digoxin as well as an analysis of patients taking digoxin during the cour...
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Erica S. Zado Source Type: research
Renal function and risk of stroke and bleeding in patients undergoing catheter ablation for atrial fibrillation: comparison between uninterrupted direct oral anticoagulants and warfarin administration
The effect of uninterrupted oral anticoagulant use in patients with chronic kidney disease (CKD) during catheter ablation for atrial fibrillation (AF) is not fully understood.
Source: Heart Rhythm - October 26, 2017 Category: Cardiology Authors: Satoshi Yanagisawa, Yasuya Inden, Aya Fujii, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara Source Type: research
Percutaneous Left Atrial Appendage Closure is Not Ready for Routine Clinical Use
Both Watchman and NOACs are treatment strategies designed to prevent stroke in patients with atrial fibrillation (AF). For practical reasons device trials cannot enroll as many patients as drug trials, however, a comparison of the Watchman and NOAC trials serves to highlight the challenge of predicting efficacy of a treatment when event rates are low. Four large noninferiority trials compared NOAC to warfarin therapy for stroke prevention in patients with AF. 1-4 We will focus on the RELY and ARISTOTLE trials because they enrolled patients with similar stroke-risk (age, CHADS2 score, etc.) to those in the Watchman trials.
Source: Heart Rhythm - October 10, 2017 Category: Cardiology Authors: John Mandrola, Andrew Foy, Gerald Naccarelli Source Type: research
Left Atrial Appendage Closure Devices: A Reasonable Therapeutic Alternative
Preventing stroke is arguably the most important goal in the management of atrial fibrillation (AF). For decades, oral anticoagulation (OAC) has been the therapeutic mainstay for stroke prophylaxis – initially warfarin, and more recently, non-warfarin oral anticoagulants (NOACs). However, many patients are poor candidates for lifelong OAC therapy. This clinical need prompted the emergence of the therapeutic alternative, left atrial appendage closure (LAAC). Herein, I discuss the clinical evi dence supporting LAAC’s role as a reasonable stroke prevention alternative.
Source: Heart Rhythm - October 10, 2017 Category: Cardiology Authors: Vivek Y. Reddy Source Type: research
The who, how, and why of screening patients for atrial fibrillation: More questions than answers
An estimated 100,000 –125,000 of the 610,000 strokes per year in the United States are associated with atrial fibrillation (AF).1 AF-related strokes cause larger cortical loss, disability, cost, and mortality compared with strokes not related to AF. In a pooled trial analysis, oral anticoagulation with warfarin lowere d AF stroke incidence by 64%.2 However, many AF patients have minimal to no symptoms and remain undiagnosed until complications occur. Given the devastating consequences of stroke and the high prevalence of AF, the value of screening to detect asymptomatic AF for the purpose of initiating anticoagul ation p...
Source: Heart Rhythm - June 17, 2017 Category: Cardiology Authors: Anne B. Curtis, Alexander Hattoum Tags: Editorial Commentary Source Type: research
Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established, and in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1,2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation, possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors and to the increased...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Tags: Editorial Commentary Source Type: research
Editorial Commentary: Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established and, in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1, 2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors as well as the incre...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Source Type: research
Percutaneous left atrial appendage closure improves left atrial mechanical function through Frank –Starling mechanism
Modifications in left atrial (LA) flow velocities after left atrial appendage (LAA) exclusion have been shown in animal and ex vivo models. In a substudy of PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation), an objective improvement in quality of life was observed after LAA closure.
Source: Heart Rhythm - February 6, 2017 Category: Cardiology Authors: Augustin Coisne, Rosario Pilato, Fran çois Brigadeau, Didier Klug, Christelle Marquie, Zouheir Souissi, Marjorie Richardson, Stéphanie Mouton, Anne-Sophie Polge, Patrizio Lancellotti, Dominique Lacroix, David Montaigne Source Type: research
