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Source: Heart Rhythm
Condition: Atrial Fibrillation
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Total 356 results found since Jan 2013.
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
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
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
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
