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Source: Heart Rhythm
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Total 406 results found since Jan 2013.
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
Subclinical Atrial Fibrillation: The significance of progression to longer episodes
Subclinical atrial fibrillation (SCAF) is a term to describe short-lasting (minutes to hours), asymptomatic AF detected via long-term continuous monitoring, typically using an implanted pacemaker, defibrillator or cardiac monitor (1). Both the TRENDS and ASSERT studies have shown that SCAF is associated with an increased risk of stroke (1, 2). However, unlike clinical AF where stroke risk is increased 4-5 times, the risk is only 2-2.5 times increased, and the absolute risk of stroke observed in these studies was much lower than expected based on the subjects ’ CHADS-2 score (1-3).
Source: Heart Rhythm - December 1, 2017 Category: Cardiology Authors: Jeff S. Healey, Jorge A. Wong Source Type: research
Device-Guided Anticoagulation in Atrial Fibrillation: Not yet ready for prime time
Atrial fibrillation (AF), the most common sustained arrhythmia encountered in clinical practice, is associated with a three- to five-fold increased risk of stroke (accounting for>20% of all strokes).1 Independent of age and other risk factors, AF-associated strokes are relatively more severe, causing greater resource utilization, long-term disability, and mortality compared to non-AF stroke. Oral anticoagulants (OACs) are paramount in preventing AF-associated stroke and systemic thromboembolism.
Source: Heart Rhythm - July 10, 2018 Category: Cardiology Authors: Christopher C. Cheung, Jason G. Andrade Source Type: research
Atrial Fibrillation after Transcatheter PFO Closure – To Measure Is To Know
A patent foramen ovale (PFO) results from an incomplete fusion of the septum primum and secundum at birth.1 The prevalence of a PFO in the adult population has been estimated at approximately 25%, but this rate was highly dependent on the diagnostic modality used and selection bias by including a disproportionate number of patients with prior cryptogenic stroke in comparative studies.2 The causal relation between cryptogenic stroke and the presence of a PFO has long been debated, yet with rates up to 40% the prevalence for PFOs is significantly higher in patients with cryptogenic stroke.
Source: Heart Rhythm - May 25, 2022 Category: Cardiology Authors: Bert Vandenberk, Carlos A. Morillo Source Type: research
Atrial fibrillation after transcatheter patent foramen ovale closure: To measure is to know
A patent foramen ovale (PFO) results from an incomplete fusion of the septum primum and secundum at birth.1 The prevalence of a PFO in the adult population has been estimated at approximately 25%, but this rate was highly dependent on the diagnostic modality used and selection bias by including a disproportionate number of patients with previous cryptogenic stroke in comparative studies.2 The causal relation between cryptogenic stroke and the presence of a PFO has long been debated, yet with rates up to 40% the prevalence for PFOs is significantly higher in patients with cryptogenic stroke.
Source: Heart Rhythm - May 25, 2022 Category: Cardiology Authors: Bert Vandenberk, Carlos A. Morillo Tags: Editorial Commentary Source Type: research
Increasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long-term outcomes
Conclusion: Delays in treatment with catheter ablation impact procedural success rates independent of temporal changes to the AF subtype at ablation.
Source: Heart Rhythm - May 22, 2013 Category: Cardiology Authors: T. Jared Bunch, Heidi T. May, Tami L. Bair, David L. Johnson, J. Peter Weiss, Brian G. Crandall, Jeffrey S. Osborn, Jeffrey L. Anderson, J. Brent Muhlestein, Donald L. Lappe, John D. Day Tags: Clinical Source Type: research
Right superior vena cava drainage into the left atrium revealed by multiples strokes after pacemaker implantation
An 84-year-old woman had undergone dual-chamber pacemaker implantation in a primary care hospital for sick sinus syndrome. The leads were inserted through the right subclavian vein because the patient was left-handed. One year later, she suffered from an ischemic stroke. During ventricular pacing, ECG showed a right bundle branch block pattern, and chest radiography (A) suggested that pacing lead tips were in the left atrium (LA) and left ventricle. After transthoracic and transesophageal echocardiography, it was initially thought that the leads passed through a patent foramen ovale. A thrombus on the ventricular lead was ...
Source: Heart Rhythm - August 2, 2012 Category: Cardiology Authors: Pierre-Yves Courand, Nicolas Girerd, Samuel Chauveau, Philippe Chevalier Tags: Images Source Type: research
Left atrial appendage closure followed by 6 weeks of antithrombotic therapy: A prospective single-center experience
Conclusions: Implantation of both LAA closure devices can be performed with high success rates in high-risk patients. Postprocedural 6 weeks antithrombotic therapy followed by aspirin therapy needs to be confirmed in a larger study.
Source: Heart Rhythm - August 26, 2013 Category: Cardiology Authors: KR Julian Chun, Stefano Bordignon, Verena Urban, Laura Perrotta, Daniela Dugo, Alexander Fürnkranz, Bernd Nowak, Boris Schmidt Tags: Clinical Source Type: research
Additive effect of the metabolic syndrome score to the conventional CHADS2 score for the thromboembolic risk stratification of patients with atrial fibrillation
Conclusions: We, for the first time, demonstrated that metabolic syndrome components were associated with thromboembolic risk in Taiwanese patients with AF. In addition to the conventional CHADS2 scheme, the calculation of the CHADS2-MS score provides additional information on stroke risk assessment.
Source: Heart Rhythm - November 18, 2013 Category: Cardiology Authors: Chia-Ti Tsai, Shu-Hsuan Chang, Sheng-Nan Chang, Juey-Jen Hwang, Cho-Kai Wu, Yi-Chih Wang, Chuen-Den Tseng, Huei-Ming Yeh, Ling-Ping Lai, Fu-Tien Chiang, Jiunn-Lee Lin Tags: Atrial Fibrillation Source Type: research
Eastern promises: Additive role of metabolic syndrome for thromboembolic risk stratification in Taiwanese atrial fibrillation patients
The key to prevention of stroke and other thromboembolic (TE) events in atrial fibrillation (AF) patients is effective risk stratification. Several schemes have been developed that use a combination of factors found to be associated with higher occurrence of TE events. Among the various risk stratification schemes, the CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes, and prior history of stroke) scoring system is the most popular. Although the simplicity of this scoring system has resulted in its wide adoption, a major criticism has been its inability to consistently identify a truly low-risk grou...
Source: Heart Rhythm - December 6, 2013 Category: Cardiology Authors: Sanjay Dixit, Vinay Kini Tags: Editorial Commentary Source Type: research
Multipoint left ventricular pacing improves acute hemodynamic response assessed with pressure-volume loops in cardiac resynchronization therapy patients
Backgound: Conventional cardiac resynchronization therapy (CRT) improves acute cardiac hemodynamics.Objective: To investigate if CRT with multipoint left ventricular (LV) pacing in a single coronary sinus branch (MultiPoint Pacing [MPP], St Jude Medical, Sylmar, CA) can offer further hemodynamic benefits to patients.Methods: Forty-four consecutive patients (80% men, New York Heart Association III, end-systolic volume 180 ± 77 mL, ejection fraction 27% ± 6%, and QRS duration 152 ± 17 ms) receiving a CRT device implant (Unify Quadra MP or Quadra Assura MP and Quartet LV lead, St Jude Medical) underwent intraoperative asse...
Source: Heart Rhythm - December 2, 2013 Category: Cardiology Authors: Carlo Pappone, Žarko Ćalović, Gabriele Vicedomini, Amarild Cuko, Luke C. McSpadden, Kyungmoo Ryu, Enrico Romano, Massimo Saviano, Mario Baldi, Alessia Pappone, Cristiano Ciaccio, Luigi Giannelli, Bogdan Ionescu, Andrea Petretta, Raffaele Vitale, Angeli Tags: Devices Source Type: research
Clinical significance of atrial fibrillation detected by cardiac implantable electronic devices
The detection of atrial fibrillation (AF) by a cardiac implantable electronic device (CIED) in patients without a prior history of AF is increasing. This trend is the result of the increased number of CIEDs being implanted in a population whose multiple medical comorbidities are known to predispose to AF. Cardiac implantable electronic device–detected atrial fibrillation (CDAF) is independently associated with the development of ischemic stroke, and the annual risk may depend on both total AF burden and individual risk factors. No data evaluating the benefit of oral anticoagulation in this population are available, which...
Source: Heart Rhythm - January 6, 2014 Category: Cardiology Authors: Anthony E. DeCicco, Jonathan B. Finkel, Arnold J. Greenspon, Daniel R. Frisch Tags: Contemporary Review--Section Editor: Sami Viskin Source Type: research
Mortality and cerebrovascular events after radiofrequency catheter ablation of atrial fibrillation
Atrial fibrillation (AF) is associated with a significant increase in the risk of stroke and mortality. It is unclear whether maintaining sinus rhythm (SR) after radiofrequency ablation (RFA) is associated with an improvement in stroke risk and survival.
Source: Heart Rhythm - May 6, 2014 Category: Cardiology Authors: Hamid Ghanbari, Kazım Başer, Krit Jongnarangsin, Aman Chugh, Brahmajee K. Nallamothu, Brenda W. Gillespie, Hatice Duygu Başer, Arisara Swangasool, Thomas Crawford, Rakesh Latchamsetty, Eric Good, Frank Pelosi, Frank Bogun, Fred Morady, Hakan Oral Source Type: research
Left atrial appendage thrombus post LARIAT closure device
Embolic stroke remains one of the most severe complications of atrial fibrillation, and anticoagulation has been a problematic therapeutic option for several years. Recently, the development of alternative methods for stroke prevention, such as left atrial appendage (LAA) percutaneous closure, has been introduced, but its long-term efficacy and safety remain unknown.
Source: Heart Rhythm - November 4, 2013 Category: Cardiology Authors: David F. Briceno, Rajeev R. Fernando, Susan T. Laing Tags: Image Source Type: research
