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Source: Heart Rhythm
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Total 406 results found since Jan 2013.
Is Transesophageal Echocardiography Necessary In Patients Undergoing Ablation Of Atrial Fibrillation On An Uninterrupted Direct Oral Anticoagulant Regimen? Results From A Prospective Multicenter Registry
Thromboembolic stroke is a rare but devastating consequence of atrial fibrillation (AF) ablation. Transesopheageal echocardiography (TEE) is recommended to rule out left atrial appendage thrombus (LAA); however, its utilization is variable.
Source: Heart Rhythm - July 14, 2020 Category: Cardiology Authors: Kavisha Patel, Andrea Natale, Ruike Yang, Chintan Trivedi, Jorge Romero, David Briceno, Sanghamitra Mohanty, Isabella Alviz, Veronica Natale, Javier Sanchez, Domenico G. Della Rocca, Nicola Tarantino, Xiao-Dong Zhang, Prasant Mohanty, Rodney Horton, David Source Type: research
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
Atrial Fibrillation Ablation in the 21st Century: Almost No Stroke Risk?
Atrial fibrillation ablation (AFabl) emerged at the end of the 20th century as an exciting alternative for physicians who were disappointed with antiarrhythmic drug outcomes1. However, numerous critics expressed skepticism at the long-term outcomes and benefits of the procedure and risks of serious complications2.
Source: Heart Rhythm - August 11, 2020 Category: Cardiology Authors: Koonlawee Nademanee 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 Clinical October 2020
Kirchhof and colleagues et al. (N Engl J Med. 2020;383(14):1305-1316 PMID: 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first-primary-outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0...
Source: Heart Rhythm - October 10, 2020 Category: Cardiology Authors: N A Mark Estes Source Type: research
EP News: Clinical
Kirchhof et al (N Engl J Med 2020;383:1305, PMID 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first primary outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0/100 person-years) ( P = .005).
Source: Heart Rhythm - October 10, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
Relationship between Device-detected Burden and Duration of Atrial Fibrillation and Risk of Ischemic Stroke
Wider availability of continuous rhythm monitoring has made it feasible to incorporate metrics of atrial fibrillation burden and duration into the decision to initiate anticoagulation. However, the relationship between thresholds of burden and duration and underlying risk factors at which anticoagulation should be considered remains unclear.
Source: Heart Rhythm - October 23, 2020 Category: Cardiology Authors: Mounir Al-Gibbawi, Hakeem O. Ayinde, Neal K. Bhatia, Mikhael F. El-Chami, Stacy B. Westerman, Angel R. Leon, Anand D. Shah, Anshul M. Patel, David B. De Lurgio, Christine M. Tompkins, Michael S. Lloyd, Faisal M. Merchant, Soroosh Kiani Source Type: research
EP News: Quality Improvement and Outcomes
In this issue of Heart Rhythm, we summarize key publications of relevance to the electrophysiology community regarding the use of systems-based processes to improve heart rhythm care and outcomes for patients with atrial fibrillation (AF). The featured research highlights challenges in improving the rate of guideline-directed anticoagulation to prevent stroke for high risk AF patients, including the benefits and limitations of the use of shared decision-making tools. This summary also reports on efforts to identify additional quality indicators to measure AF care and outcomes.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Chirag R. Barbhaiya Source Type: research
Connexin45 (GJC1) loss-of-function mutation contributes to familial atrial fibrillation and conduction disease
Atrial fibrillation (AF) represents the most common clinical cardiac arrhythmia and substantially increases the risk for cerebral stroke, heart failure and death. Although causative genes for AF have been identified, the genetic determinants for AF remain largely unclear.
Source: Heart Rhythm - January 8, 2021 Category: Cardiology Authors: Ruo-Gu Li, Ying-Jia Xu, Willy G. Ye, Yan-Jie Li, Honghong Chen, Xing-Biao Qiu, Yi-Qing Yang, Donglin Bai Source Type: research
Who is at risk of atrial fibrillation?
Atrial fibrillation (AF) is a common cause of stroke, with prevalence increasing alongside the aging of our population [1]. Increasing age, hypertension, obesity, heart failure, sleep apnea, diabetes, coronary disease, chronic kidney disease and smoking account for much of the global risk of AF [2 3]. Incident AF is also predicted by both rare and common genetic variants, many of which encode for cardiac structural and electrical proteins, as well as by more complex heritable traits such as height, obesity and race [4-6].
Source: Heart Rhythm - February 24, 2021 Category: Cardiology Authors: Jeff S. Healey, Jason D. Roberts, Thalia S. Field Source Type: research
Anti-diabetic drugs for preventing atrial fibrillation: a new revolution?
Type 2 diabetes mellitus (DM) and atrial fibrillation (AF) are two of the great epidemics of our time. DM affects and estimated 8.5% of adults in the US1, and is associated with an increased risk of cardiovascular events, including AF.2 AF in turn affects an estimated up to 12.5% of adults over age 65 years in the US, decreases quality of life and increases the risks of heart failure, stroke and death 3,4. In 2015, the EMPA-REG OUTCOME randomized controlled trial (RCT), assessing a sodium glucose co-transporter 2 inhibitor (SGLT-2i), sparked interest in the therapeutic potential for oral anti-diabetic agents to reduce card...
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: William F. McIntyre, Jeff S. Healey Source Type: research
Strategies to balance stroke and bleeding risk in patients with atrial fibrillation and cancer
A 76-year-old female with obesity, hypertension, persistent atrial fibrillation, and heart failure with preserved ejection fraction is started on ibrutinib 420 mg once daily for Waldenstrom ’s macroglobulinemia. Due to concern for drug-drug interactions, her amiodarone is decreased from 200 to 100 mg daily, and she is continued on metoprolol succinate 100 mg daily and apixaban 5 mg twice daily. She presents to the clinic one month later with extensive superficial ecchymoses, and her apixaban dose is reduced to 2.5 mg twice daily due to concerns that this may reflect the combined antiplatelet effects of ibrutinib and anti...
Source: Heart Rhythm - April 27, 2021 Category: Cardiology Authors: Shiv Bagga, Sourbha S. Dani, Bruce G. Hook, Anju Nohria, Sarju Ganatra Source Type: research
Antidiabetic drugs for preventing atrial fibrillation: A new revolution?
Type 2 diabetes mellitus (DM) and atrial fibrillation (AF) are 2 of the great epidemics of our time. DM affects an estimated 8.5% of adults in the United States1 and is associated with an increased risk of cardiovascular events, including AF.2 AF in turn affects up to an estimated 12.5% of adults older than 65 years in the United States, decreases quality of life, and increases the risks of heart failure, stroke, and death.3,4 In 2015, the EMPA-REG OUTCOME (BI 10773 [Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) randomized controlled trial (RCT), which assessed the sodium glucose c...
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: William F. McIntyre, Jeff S. Healey Tags: Editorial Commentary Source Type: research
The Combination of Coronary Sinus Ostial Atresia/Abnormality and a Small Persistent Left Superior Vena Cava - Opportunity for Left Ventricular Lead Implantation and Unrecognized Source of Thromboembolic Stroke
Coronary sinus (CS) ostial atresia/anomalies prevents access to the CS from the right atrium (RA) for left ventricular (LV) lead implantation. Some patients with CS ostial anomalies also have a small persistent left superior vena cava (sPLSVC).
Source: Heart Rhythm - May 7, 2021 Category: Cardiology Authors: Fengwei Zou, Seth J. Worley, Torkel Steen, Matthew McKillop, Santosh Padala, Susan O ’Donoghue, Basar Candemir, Khalil Kanjwal, Michael Kaufman, Sahar Mouram, Matthew Sellers, David Strouse, Athanasios Thomaides, Devi Nair, Cyrus A. Hadadi, Alexander Ku Source Type: research
EP News: Clinical
Kar et al (Circulation April 6, 2021;Epub ahead of print, PMID XXXX) evaluated the WATCHMAN FLX left atrial appendage (LAA) closure device in patients in whom oral anticoagulation is indicated but are candidates for a nonpharmaceutical alternative in a prospective multicenter study. The primary safety en d point was the occurrence of one of the following events: death, ischemic stroke, systemic embolism, or device- or procedure-related events requiring cardiac surgery. The primary effectiveness end point was the incidence of effective LAA closure at 12-month follow-up.
Source: Heart Rhythm - May 3, 2021 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research
