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Source: Heart Rhythm

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Total 406 results found since Jan 2013.

Po-05-218 atrial myopathy forms the substrate for ischemic stroke in patients without atrial fibrillation: secondary analysis of topcat trial.
Around 25% of all ischemic strokes do not have an etiology despite a complete standardized diagnostic workup. Recent studies emphasized the effect of atrial dysfunction on arrhythmogenesis and thrombogenesis. At present, there is a lack of a direct link between atrial myopathy and ischemic stroke independently of atrial fibrillation (AF).
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Kassem Farhat, Khaled Elkholey, Stavros Stavrakis Source Type: research

Po-03-005 best anticoagulation strategy for stroke prophylaxis in atrial fibrillation patients with amyloidosis
A considerable proportion of elderly patients are known to have coexistent atrial fibrillation (AF) and amyloidosis. Both conditions increase stroke risk.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Andrea Natale, Carola Gianni, Bryan MacDonald, Angel Quintero Mayedo, Vincenzo Mirco La Fazia, Prem Geeta Torlapati, Domenico G. Della Rocca, Rami Helmy, Mohanad Elchouemi, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. burkhardt, Rodney P. Horton, Lu Source Type: research

Po-01-220 invasively diagnosed hfpef in af associated with functional remodelling of the left atrial appendage: implications for stroke risk
HFpEF commonly coexists with atrial fibrillation (AF). The influence of coexisting HFpEF on function of the left atrial appendage (LAA) and risk of stroke remains unknown.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Jonathan P. Ariyaratnam, Ricardo S. Mishima, Adrian D. Elliott, Prashanthan Sanders Source Type: research

Po-01-140 atrial fibrillation and septic shock: a five-year retrospective observational study of anticoagulation usage, bleeding and stroke rates
Anticoagulation (AC) for atrial fibrillation (AF) is a cornerstone of management, and the benefit of mitigating stroke risk is accompanied by an increased risk of bleeding. The risk and benefit of AC in septic shock remains unclear as this disruptive hyperinflammatory state leads to multi-organ dysfunction, which can include coagulopathies.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Jonathan Na, Joanne Moon, Sahitya Allam, Maria Abraham, Kevin Chen, Ethan Kotloff, Yash Desai, Simin Hossain, Christopher Messner, Elnaz Esmati, Thomas Kutner, Gregory Norcross, James Childress, Paul Han, Ian Welch, Michael Sokolow, Libin Wang, Vincent Se Source Type: research

En-452414-3 predictors of ischemic stroke in the young: sleep apnea, race and risk factors beyond af and chads2vasc
Risk factors for stroke beyond CHADS2VASc and atrial fibrillation (AF) are not well established.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Brototo Deb, Sunil K. Vasireddi, Neal K. Bhatia, Albert J. Rogers, Paul Clopton, Sanjiv M. Narayan Source Type: research

Dh-452784-2 identifying atrial fibrillation with sinus rhythm electrocardiogram using artificial intelligence in embolic stroke with undetermined source
Previous studies have demonstrated acceptable ranges of accuracy of artificial intelligence (AI) algorithms for identifying patients with paroxysmal atrial fibrillation (AF) based on their sinus rhythm electrocardiograms (ECGs). However, none of them has been validated in patients with embolic stroke with undetermined source (ESUS) in which thorough AF screening is required.
Source: Heart Rhythm - May 1, 2023 Category: Cardiology Authors: Ji Hyun Lee, Youngjin Cho, Joonghee Kim Source Type: research

Left atrial appendage closure: A new technique for clinical practice
Conclusion: This review concludes that it is now appropriate to consider these techniques for patients with AF who are at high risk for stroke for whom effective conventional or novel anticoagulant therapy is not available or who present problems in managing drug treatment.
Source: Heart Rhythm - December 2, 2013 Category: Cardiology Authors: A John Camm, Antonio Colombo, Giorgio Corbucci, Luigi Padeletti Tags: Contemporary Review--Section Editor: Sami Viskin 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

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

Outcomes of Percutaneous Left Atrial Appendage Occlusion Device Implantation in Patients with Rheumatic Atrial Fibrillation
Patients with atrial fibrillation (AF) and rheumatic heart disease (RHD) disease have a 17-fold increased risk of stroke, and in comparison, those with AF without RHD have a 5-fold increased risk of stroke (1). However, the contemporary trials of pharmaceutical and device therapies have systematically excluded patients with AF and RHD. While Vitamin K antagonist remains the favored approach to mitigate stroke risk in patients with RHD and AF, the optimal strategy for preventing stroke in patients with RHD-associated AF who cannot tolerate oral anticoagulation therapy remains unknown (1).
Source: Heart Rhythm - May 12, 2023 Category: Cardiology Authors: Siddharth Agarwal, Muhammad Bilal Munir, Agam Bansal, Christopher V. DeSimone, Abhishek Deshmukh, Mohamad Alkhouli, Zain Ul Abideen Asad Source Type: research

EP News: Clinical
Piccini et al (J Am Coll Cardiol 2013;61:1998, PMID 23500298) investigated the outcomes following cardioversion (CV) or catheter ablation in patients with atrial fibrillation (AF) treated with warfarin or rivaroxaban. Over a median follow-up of 2.1 years, 143 patients underwent electrical CV, 142 underwent pharmacologic CV, and 79 underwent catheter ablation. The overall incidence of CV or AF ablation was 1.45 per 100 patient-years (n = 321; 1.44 [n = 161] in the warfarin arm and 1.46 [n = 160] in the rivaroxaban arm. The long-term incidence of stroke or systemic embolism (hazard ratio [HR] 1.38), cardiovascular death (HR ...
Source: Heart Rhythm - July 1, 2013 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News--Associate Editors: Peng-Sheng Chen and N.A. Mark Estes III Source Type: research

Patients treated with catheter ablation for ventricular tachycardia after an ICD shock have lower long-term rates of death and heart failure hospitalization than do patients treated with medical management only
Background: Ventricular arrhythmias in patients with implantable cardioverter-defibrillators (ICDs) adversely affect outcomes. Antiarrhythmic approaches to ventricular tachycardia (VT) have variable efficacy and may increase risk of ventricular arrhythmias, worsening cardiomyopathy, and death. Comparatively, VT ablation is an alternative approach that may favorably affect outcomes.Objective: To further explore the effect on long-term outcomes after catheter ablation of VT, we compared patients with history of ICD shocks who did not undergo ablation, patients with a history of ICD shocks that underwent ablation, and patient...
Source: Heart Rhythm - December 12, 2013 Category: Cardiology Authors: T. Jared Bunch, J. Peter Weiss, Brian G. Crandall, John D. Day, Heidi T. May, Tami L. Bair, Jeffrey S. Osborn, Charles Mallender, Avi Fischer, Kyle J. Brunner, Srijoy Mahapatra Tags: Ventricular Tachycardia Source Type: research

Virchow triad and beyond in atrial fibrillation
Atrial fibrillation (AF), the most common type of arrhythmia in adults, is associated with a 5-fold increase in the incidence of ischemic stroke. Stroke in patients with AF is believed to be mostly cardioembolic caused by left atrial thrombi and is an important cause for hospitalizations and cardiovascular deaths. Although various kinds of direct oral anticoagulants have been developed and used for the prevention hopefully decreasing this fateful event, more knowledge about the left atrial thrombi would be required to improve and refine the pharmacological stroke prevention in AF.
Source: Heart Rhythm - September 7, 2016 Category: Cardiology Authors: Takeshi Yamashita Tags: Editorial Commentary 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

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