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Source: Cochrane Database of Systematic Reviews
Condition: Atrial Fibrillation

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Total 30 results found since Jan 2013.

WITHDRAWN: Electrical cardioversion for atrial fibrillation and flutter.
CONCLUSIONS: Electrical cardioversion (rhythm control) led to a non-significant increase in stroke risk but improved three domains of quality of life. PMID: 29140555 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Mead GE, Elder A, Flapan AD, Cordina J Tags: Cochrane Database Syst Rev Source Type: research

Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.
CONCLUSIONS: Our findings indicate that DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding. The major limitation is that the results of this study chiefly reflect CKD stage G3. Application of the results to CKD stage G4 patients requires additional investigation. Furthermore, we could not assess CKD stage G5 patients. Future reviews should assess participants at more advanced CKD stages. Additio...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S Tags: Cochrane Database Syst Rev Source Type: research

Educational and behavioural interventions for anticoagulant therapy in patients with atrial fibrillation.
CONCLUSIONS: This review demonstrates that there is insufficient evidence to draw definitive conclusions regarding the impact of educational or behavioural interventions on TTR in AF patients receiving OAT. Thus, more trials are needed to examine the impact of interventions on anticoagulation control in AF patients and the mechanisms by which they are successful. It is also important to explore the psychological implications for patients suffering from this long-term chronic condition. PMID: 28378924 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 5, 2017 Category: Journals (General) Authors: Clarkesmith DE, Pattison HM, Khaing PH, Lane DA Tags: Cochrane Database Syst Rev Source Type: research

Renal denervation for resistant hypertension.
CONCLUSIONS: In patients with resistant hypertension, there is low quality evidence that renal denervation does not change major cardiovascular events, and renal function. There was moderate quality evidence that it does not change blood pressure and and low quality evidence that it caused an increaseof bradycardia episodes. Future trials measuring patient-centred instead of surrogate outcomes, with longer follow-up periods, larger sample size and more standardized procedural methods are necessary to clarify the utility of this procedure in this population. PMID: 28220472 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - February 20, 2017 Category: Journals (General) Authors: Coppolino G, Pisano A, Rivoli L, Bolignano D Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm.
CONCLUSIONS: There is evidence from RCTs to suggest that neither oral anticoagulation with warfarin or platelet inhibition with aspirin is better for mortality in systolic heart failure with sinus rhythm (high quality of the evidence for all-cause mortality and moderate quality of the evidence for non-fatal cardiovascular events and major bleeding events). Treatment with warfarin was associated with a 20% reduction in non-fatal cardiovascular events but a twofold higher risk of major bleeding complications (high quality of the evidence). We saw a similar pattern of results for the warfarin versus clopidogrel comparison (lo...
Source: Cochrane Database of Systematic Reviews - September 14, 2016 Category: Journals (General) Authors: Shantsila E, Lip GY Tags: Cochrane Database Syst Rev Source Type: research

Systematic screening for the detection of atrial fibrillation.
CONCLUSIONS: Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice. Although these approaches have comparable effects on the overall AF diagnosis rate, the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider. Few studies have investigated effects of screening in other health systems and in younger age groups; therefore, caution needs to be exercised in relation to transferability of these results beyond the setting and population i...
Source: Cochrane Database of Systematic Reviews - June 2, 2016 Category: Journals (General) Authors: Moran PS, Teljeur C, Ryan M, Smith SM Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Preoperative statin therapy for patients undergoing cardiac surgery.
CONCLUSIONS: Preoperative statin therapy reduces the odds of postoperative atrial fibrillation (AF) and shortens the patient's stay on the ICU and in the hospital. Statin pretreatment had no influence on perioperative mortality, stroke, myocardial infarction or renal failure, but only two of all included studies assessed mortality. As analysed studies included mainly individuals undergoing myocardial revascularisation, results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery. PMID: 27219528 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 23, 2016 Category: Journals (General) Authors: Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack.
CONCLUSIONS: The combined data from recent RCTs have shown no statistically significant differences between TDC and medical therapy in the prevention of recurrent ischemic stroke. TDC closure was associated with an increased risk of atrial fibrillation but not with serious adverse events. PMID: 26346232 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2015 Category: Journals (General) Authors: Li J, Liu J, Liu M, Zhang S, Hao Z, Zhang J, Zhang C Tags: Cochrane Database Syst Rev Source Type: research

Preoperative statin therapy for patients undergoing cardiac surgery.
CONCLUSIONS: Preoperative statin therapy reduces the odds of postoperative atrial fibrillation (AF) and shortens the patient's stay on the ICU and in the hospital. Statin pretreatment had no influence on perioperative mortality, stroke, myocardial infarction or renal failure, but only two of all included studies assessed mortality. As analysed studies included mainly individuals undergoing myocardial revascularisation, results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery. PMID: 26270008 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 13, 2015 Category: Journals (General) Authors: Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ Tags: Cochrane Database Syst Rev Source Type: research

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.
CONCLUSIONS: Several class IA, IC and III drugs, as well as class II drugs (beta-blockers), are moderately effective in maintaining sinus rhythm after conversion of atrial fibrillation. However, they increase adverse events, including pro-arrhythmia, and some of them (disopyramide, quinidine and sotalol) may increase mortality. Possible benefits on clinically relevant outcomes (stroke, embolism, heart failure) remain to be established. PMID: 25820938 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - April 2, 2015 Category: Journals (General) Authors: Lafuente-Lafuente C, Valembois L, Bergmann JF, Belmin J Tags: Cochrane Database Syst Rev Source Type: research

Anticoagulation versus placebo for heart failure in sinus rhythm.
CONCLUSIONS: Based on the two major randomised trials (HELAS 2006; WASH 2004), there is no convincing evidence that oral anticoagulant therapy modifies mortality or vascular events in patients with heart failure and sinus rhythm. Although oral anticoagulation is indicated in certain groups of patients with heart failure (for example those with atrial fibrillation), the available data does not support the routine use of anticoagulation in heart failure patients who remain in sinus rhythm. PMID: 24683002 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 28, 2014 Category: Journals (General) Authors: Lip GY, Shantsila E Tags: Cochrane Database Syst Rev Source Type: research

Direct thrombin inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in people with non-valvular atrial fibrillation.
CONCLUSIONS: DTIs were as efficacious as VKAs for the composite outcome of vascular death and ischaemic events and only the dose of dabigatran 150 mg twice daily was found to be superior to warfarin. DTIs were associated with fewer major haemorrhagic events, including haemorrhagic strokes. Adverse events that led to discontinuation of treatment occurred more frequently with the DTIs. We detected no difference in death from all causes. PMID: 24677203 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 27, 2014 Category: Journals (General) Authors: Salazar CA, Del Aguila D, Cordova EG Tags: Cochrane Database Syst Rev Source Type: research

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.
CONCLUSIONS: Factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in patients with AF. Factor Xa inhibitors also seem to reduce the number of major bleedings and ICHs compared with warfarin, though the evidence for a reduction of major bleedings is somewhat less robust. There is currently no conclusive evidence to determine which factor Xa inhibitor is more effective and safer for long-term anticoagulant treatment of patients with AF as head-to-head studies of the different factor Xa inhibitors have not yet been performed. PMID: 23925867 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 8, 2013 Category: Journals (General) Authors: Bruins Slot KM, Berge E Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery.
CONCLUSIONS: Prophylaxis to prevent atrial fibrillation after cardiac surgery with any of the studied pharmacological or non-pharmacological interventions may be favored because of its reduction in the rate of atrial fibrillation, decrease in the length of stay and cost of hospital treatment and a possible decrease in the rate of stroke. However, this review is limited by the quality of the available data and heterogeneity between the included studies. Selection of appropriate interventions may depend on the individual patient situation and should take into consideration adverse effects and the cost associated with each ap...
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Arsenault KA, Yusuf AM, Crystal E, Healey JS, Morillo CA, Nair GM, Whitlock RP Tags: Cochrane Database Syst Rev Source Type: research