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Source: Heart Rhythm

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Total 406 results found since Jan 2013.

Patients with atrial fibrillation and CHADS-VASc score 1: “To anticoagulate or not to anticoagulate? That is the question!”
There is uncertainty regarding the optimal therapy for preventing thrombo-embolic stroke in patients with atrial fibrillation and CHA2DS2-VASc score 1; in fact, no extensive data on this topic are available and the latest guidelines provide different recommendations. In this paper we examine current results on use of various anti-thrombotic agents in those patients, including the newer oral anticoagulant agents. Several factors must be considered and weighted in this setting and may influence the choice of the anti-thrombotic approach: the expected incidence of both thrombo-embolic stroke and bleeding complications as well...
Source: Heart Rhythm - July 15, 2015 Category: Cardiology Authors: Giuseppe Patti, Ilaria Cavallari Tags: CRV Source Type: research

Role of TEE before atrial fibrillation ablation: Is less really more?
Catheter ablation of atrial fibrillation has become standard therapy for patients with refractory symptoms despite antiarrhythmic drugs.1 Aside from long-term stroke risk in this patient population,2 a periprocedural transient ischemic attack (TIA) or stroke is a potential complication with reported event rates of
Source: Heart Rhythm - September 17, 2015 Category: Cardiology Authors: Nilesh Mathuria Tags: Editorial Commentary Source Type: research

Preventing Heart Failure in Atrial Fibrillation: In the Middle of Difficulty Lies Opportunity
Atrial fibrillation increases the risk of several adverse cardiovascular events. While a great deal of attention is focused on the prevention of stroke, relatively little attention is paid to the prevention of heart failure in patients with atrial fibrillation (AF) despite the fact that heart failure (HF) complicates AF more often than stroke does. The risk of developing heart failure is 3-4 times greater in patients with AF1 and as many as half of all patients with long-standing persistent AF have HF.
Source: Heart Rhythm - February 22, 2017 Category: Cardiology Authors: Jonathan P. Piccini, Benjamin A. Steinberg Source Type: research

PREdicting Determinants of Atrial Fibrillation for Therapy Elucidation in Patients at Risk for Thromboembolic Events (PREDATE AF) Study
AF is the most common, clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke and OAC has been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long term outcomes but the optimal patient population and screening intensity are unknown.
Source: Heart Rhythm - May 12, 2017 Category: Cardiology Authors: Javed M. Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater Source Type: research

Predicting Determinants of Atrial Fibrillation or Flutter for Therapy Elucidation in Patients at Risk for Thromboembolic Events (PREDATE AF) Study
Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown.
Source: Heart Rhythm - May 12, 2017 Category: Cardiology Authors: Javed M. Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater 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

Atrial Ca2+/calmodulin-dependent protein kinase II: A druggable master switch of atrial fibrillation-associated atrial remodeling?
Atrial fibrillation (AF) is the most common arrhythmia and is associated with increased morbidity and mortality, with heart failure (HF) and thromboembolism including stroke being the major consequences.1 Thus, stroke prevention with oral anticoagulants is crucial, but highly challenging, for AF management in many patients.2,3 Although our understanding of the underlying molecular mechanisms promoting AF increased substantially over the years, contemporary approaches using drugs are only moderately effective and have substantial side effects, including proarrhythmia.
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Dobromir Dobrev Tags: Editorial Commentary Source Type: research

The Heart Rhythm Society/American College of Physicians Atrial Fibrillation Screening and Education Initiative
The prevalence of both atrial fibrillation (AF) and stroke is increasing. Stroke is common in AF and can have devastating consequences, especially when AF is unrecognized, and anticoagulation is not initiated.
Source: Heart Rhythm - April 3, 2019 Category: Cardiology Authors: Lynda E. Rosenfeld, Alpesh Navin Amin, Jonathan C. Hsu, Asa Oxner, Mellanie True Hills, David S. Frankel Source Type: research

EP News: Case Reports
Detection of atrial fibrillation (AF) in patients with cryptogenic stroke is critical and impacts treatment approaches. Multiple tools now are available that can detect AF with high sensitivity and specificity. However, continuous monitors often are required to detect subclinical, short, or infrequent AF episodes. Implantable cardiac monitors are expensive, require surgical insertion, and monitor for 2 –3 years on average. These limitations and the lack of broad availability of monitors prompt the need to consider novel approaches to AF risk assessment in patients post cryptogenic stroke.
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Allied Professionals
In this paper, the authors (Poole et al J Am Coll Cardiol. 2020;75:3105-3118. PMID 32586583) provide expanded results of an important secondary endpoint of the CABANA (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial, the recurrence of atrial fibrillation (AF). In the CABANA trial, 2204 patients with symptomatic AF and risk factors for stroke were randomized to catheter ablation or drug therapy with a primary endpoint was a composite of death, stroke, major bleeding or cardiac arrest during 5 years of follow-up.
Source: Heart Rhythm - July 7, 2020 Category: Cardiology Authors: Erica S. Zado Source Type: research

EP News Clinical November 2020
Okumura and colleagues (N Eng J Med 2020 Oct 29;383(18):1735-1745. PMID: 32865374) conducted a multicenter, randomized, double-blind, placebo-controlled, trial to compare a once-daily 15-mg dose of edoxaban (E) with placebo in elderly patients ( ≥80 years of age) with nonvalvular atrial fibrillation who were not candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy end point was the composite of stroke or systemic embolism. A total of 984 patients were randomly assigned in a 1:1 ratio to r eceive a daily dose of 15 mg of E (492 patients) or placebo (492 patients).
Source: Heart Rhythm - November 4, 2020 Category: Cardiology Authors: N. A. Mark Estes Source Type: research

Cardiac Implantable Electronic Device-Detected Atrial Fibrillation - “To anticoagulate or not to anticoagulate, that is the question”: The Noble or Ignoble Choice?
Atrial fibrillation (AF) detected during interrogation of a cardiovascular implantable electronic device (CIED) is a common event1 with available studies suggesting that it is associated with an increased risk of stroke.2,3 While current guidelines recommend oral anticoagulant (OAC) therapy for AF patients with an elevated CHA2DS2-VASc score,4 controversy exists about whether the various components of CIED-detected AF (e.g. duration, burden, CHA2DS2-VASc score, etc.) predict stroke and, if effective as predictors, which characteristics best define that risk.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Thomas F. Deering, Faiez Zannad Source Type: research

EP News: Clinical
Okumura et  al (N Engl J Med 2020;383:1735–1745, PMID 32865374) conducted a multicenter, randomized, double-blind, placebo-controlled trial comparing a once-daily, 15-mg dose of edoxaban (E) with placebo in elderly patients (age ≥80 years) with nonvalvular atrial fibrillation (AF) who were not candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy endpoint was the composite of stroke or systemic embolism. A total of 984 patients were randomly assigned in a 1:1 ratio to receive a daily dose of 15 mg of E (n = 492) or placebo (n = 492).
Source: Heart Rhythm - November 4, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: Ep News Source Type: research

Cardiac implantable electronic device-detected atrial fibrillation —“To anticoagulate or not to anticoagulate, that is the question”: The noble or ignoble choice?
Atrial fibrillation (AF) detected during interrogation of a cardiovascular implantable electronic device (CIED) is a common event,1 with available studies suggesting that it is associated with an increased risk of stroke.2,3 While current guidelines recommend oral anticoagulant (OAC) therapy for patients with AF and an elevated CHA2DS2-VASc score,4 controversy exists about whether the various components of CIED-detected AF (eg, duration, burden, and CHA2DS2-VASc score) predict stroke and, if effective as predictors, which characteristics best define that risk.
Source: Heart Rhythm - November 9, 2020 Category: Cardiology Authors: Thomas F. Deering, Faiez Zannad Tags: Editorial Commentary Source Type: research

EP News: Quality Improvement and Outcomes: Defining and Measuring Atrial Fibrillation Quality Indicators in Canada
In 2016, the Working Group published an initial report identifying and defining priority QIs in 3 distinct categories: access to care, treatment, and outcomes (Can J Cardiol 2016;32:1566, PMID 27297003). An iterative process resulted in the selection of 3 priority QIs: (i) proportion of AF patients at high risk of stroke receiving an oral anticoagulant, (ii) annual rate of stroke, (iii) annual rate of major hemorrhage. A feasibility assessment followed, which determined that none of the QIs as defined could be adequately measured with existing data sources.
Source: Heart Rhythm - April 26, 2021 Category: Cardiology Authors: Roopinder K. Sandhu, Stephen B. Wilton, Anne Marie Smith, Paul Dorian Source Type: research