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Rate or Rhythm Control of Atrial Fibrillation - Pearls for the Internist.
Abstract Atrial fibrillation is an epidemic in Asia that is increasingly prevalent. Apart from stroke risk stratification and management of anticoagulation, physicians managing this group of patients also need to determine an optimal strategy in terms of rate or rhythm control. With new techniques of catheter ablation to maintain patients in sinus rhythm, patients with atrial fibrillation now have more options for treatment, on top of pharmacological methods. This paper aims to review the current evidence for rate and rhythm control in both general patients and subgroups of interest commonly encountered in clinica...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2017 Category: General Medicine Authors: Huang W, Keng FY, Ching CK Tags: Ann Acad Med Singapore Source Type: research

Atrial Fibrillation in Heart Failure: a Therapeutic Challenge of Our Times.
Authors: Batul SA, Gopinathannair R Abstract Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of "atrial kick" translates into poorer quality of life and increased mortality. In the absence of underlying structural heart...
Source: Korean Circulation Journal - September 29, 2017 Category: Cardiology Tags: Korean Circ J Source Type: research

Why should we screen for atrial fibrillation?
Atrial fibrillation (AF) constitutes an increasing challenge to the medical community and healthcare providers. With a prevalence of almost 3% in the adult Swedish population1 and a forecasted twofold or threefold increase by 2050 in the USA, we are facing a diagnosis with epidemic proportions. Apart from increased mortality, AF also increases the risk of heart failure, hospitalisations and ischaemic stroke.2 Of these complications, ischaemic stroke gives a particularly heavy burden on patients, their family and society. Ischaemic stroke is the most common reason for permanent neurological disability in the adult Western p...
Source: Heart - December 8, 2016 Category: Cardiology Authors: Svennberg, E., Engdahl, J. Tags: Press releases, Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Management of Atrial Fibrillation in Elderly Adults
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms. The evidence to support novel AF treatment strategies ...
Source: Journal of the American Geriatrics Society - December 1, 2016 Category: Geriatrics Authors: Yaanik Desai, Mikhael F. El ‐Chami, Angel R. Leon, Faisal M. Merchant Tags: Clinical Management of Older Adult Source Type: research

Left atrial appendage occlusion: rationale, evidence, devices, and patient selection
<span class="paragraphSection">Atrial fibrillation (AF) is a worldwide epidemic associated with significant morbidity and mortality, often due to disabling or fatal thromboembolic stroke. Oral anticoagulation is highly effective at preventing ischaemic stroke and improving all-cause survival in patients with non-valvular AF. Despite the efficacy of oral anticoagulation, many patients are not treated due to either absolute or perceived contraindications to therapy, including bleeding. Left atrial appendage (LAA) closure has emerged as a mechanical alternative to pharmacologic stroke prevention. Initial and mid-term cl...
Source: European Heart Journal - September 14, 2016 Category: Cardiology Source Type: research

Suboptimal Use of Oral Anticoagulants in Atrial Fibrillation: Has the Introduction of Direct Oral Anticoagulants Improved Prescribing Practices?
Conclusion Available data from clinical practice suggest that suboptimal oral anticoagulant use in patients with AF and poor compliance with guidelines still remain commonplace despite transition to a new era of anticoagulation featuring DOACs.
Source: American Journal of Cardiovascular Drugs - February 10, 2016 Category: Cardiology Source Type: research

The Need to Evaluate Net Clinical Effect of Stroke Prevention Therapy in Patients with End Stage Renal Disease and Atrial Fibrillation.
Abstract Chronic kidney disease (CKD) and atrial fibrillation (AF) are both emerging health epidemics worldwide. Atrial fibrillation is the most common heart rhythm disorder and the burden of this dysrhythmia is expected to increase as the population ages(1). Similarly, chronic kidney disease is a disease of the elderly that is estimated to affect 40-50% of US adults over 65 in the near future(2,3). This is likely due to manifestations of common risk factors and pathology that eventually lead to high cardiovascular and stroke risk in patients with CKD, especially patients with AF and CKD(4,5). Unfortunately, the f...
Source: Circulation - December 17, 2015 Category: Cardiology Authors: Patel MR, Piccini JP Tags: Circulation Source Type: research

New journal JAMA Cardiology to debut in 2016
As cardiovascular disease remains the No. 1 cause of death and disability worldwide, a new medical journal will premiere early next year to serve the global cardiology community. JAMA Cardiology—to be led by an internationally renowned cardiologist—will premiere as the 12th journal in the JAMA Network, which includes JAMA and 10 other specialty journals. “The burden of hypertension, ischemic heart disease, heart failure, stroke, valvular heart disease and atrial fibrillation is reaching epidemic proportions worldwide,” writes Howard Bauchner, MD, editor in chief of The JAMA Network, and colleagues in a JAMA edito...
Source: AMA Wire - October 12, 2015 Category: Journals (General) Authors: Amy Farouk Source Type: news

JAMA Cardiology—A New JAMA Network Journal
Cardiovascular disease remains the leading cause of death and disability worldwide, in developed and developing countries. Despite the success in the last decade in reducing heart disease–related mortality in many countries, with aging of the population and persistent cardiovascular risk factors, the burden of hypertension, ischemic heart disease, heart failure, stroke, valvular heart disease, and atrial fibrillation is reaching epidemic proportions worldwide.
Source: JAMA - Journal of the American Medical Association - October 12, 2015 Category: Journals (General) Source Type: research

Relationship between body mass index and left atrial appendage thrombus in nonvalvular atrial fibrillation
Abstract Atrial fibrillation and obesity are two major growing epidemics in the United States and globally. Obese people are at the increased risk of developing atrial fibrillation. The contribution of obesity as an independent risk factor for stroke in the setting of atrial fibrillation remains unclear. We tested the hypothesis that non-valvular atrial fibrillation (NVAF) patients with increased body mass index (BMI) would be at increased risk for the development of left atrial appendage thrombus (LAAT). Consecutive, anticoagulation naïve patients with NVAF referred for a transesophageal echocardiogram (TEE) bet...
Source: Journal of Thrombosis and Thrombolysis - August 18, 2015 Category: Hematology Source Type: research

Smoking, atrial fibrillation, and ischemic stroke: a confluence of epidemics
Purpose of review: Smoking and atrial fibrillation are major contemporary health concerns. They commonly coexist and are frequent causes of ischemic stroke. The purpose of this article is to describe recent scientific investigations about smoking, atrial fibrillation, and ischemic stroke, with a primary focus on prevention. Recent findings: Smoking predisposes to atrial fibrillation and is useful for the prediction of future atrial fibrillation. Several recent risk prediction models for adverse events associated with atrial fibrillation include smoking as a component. Smoking status identifies patients at high risk of inci...
Source: Current Opinion in Cardiology - August 11, 2015 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

The metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic
The prevalence of atrial fibrillation (AF) and AF-related stroke is set to increase dramatically in coming decades, with developing regions such as Latin America experiencing the greatest impact. These trends are primarily driven by aging populations and by the increasing prevalence of the metabolic syndrome. The metabolic syndrome describes an association between diabetes, hypertension, obesity, and dyslipidemia and an increased risk of cardiovascular disease. It is in large part the result of unbalanced diet and sedentary lifestyle.
Source: Heart Rhythm - June 30, 2015 Category: Cardiology Authors: Reza Hajhosseiny, Gareth K. Matthews, Gregory Y.H. Lip Tags: Contemporary Review Source Type: research

The Metabolic Syndrome, Atrial Fibrillation and Stroke: Tackling An Emerging Epidemic
The prevalence of atrial fibrillation (AF) and AF-related stroke is set to increase dramatically in coming decades, with developing regions such as Latin America experiencing the greatest impact. These trends are primarily driven by aging populations and by the increasing prevalence of metabolic syndrome. Metabolic syndrome describes an association between diabetes, hypertension, obesity, dyslipidaemia and an increased risk of cardiovascular disease. It is in large part the result of unbalanced diet and sedentary lifestyle.
Source: Heart Rhythm - June 30, 2015 Category: Cardiology Authors: Reza Hajhosseiny, Gareth K. Matthews, Gregory YH Lip Tags: CRV Source Type: research

Metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic
The prevalence of atrial fibrillation (AF) and AF-related stroke is set to increase dramatically in coming decades, with developing regions such as Latin America experiencing the greatest impact. These trends are primarily driven by aging populations and by the increasing prevalence of the metabolic syndrome. The metabolic syndrome describes an association between diabetes, hypertension, obesity, and dyslipidemia and an increased risk of cardiovascular disease. It is in large part the result of unbalanced diet and sedentary lifestyle.
Source: Heart Rhythm - June 30, 2015 Category: Cardiology Authors: Reza Hajhosseiny, Gareth K. Matthews, Gregory Y.H. Lip Tags: Contemporary Review Source Type: research

Stroke Prevention - Medical and Lifestyle Measures
Background: According to the World Health Organization, stroke is the ‘incoming epidemic of the 21st century'. In light of recent data suggesting that 85% of all strokes may be preventable, strategies for prevention are moving to the forefront in stroke management. Summary: This review discusses the risk factors and provides evidence on the effective medical interventions and lifestyle modifications for optimal stroke prevention. Key Messages: Stroke risk can be substantially reduced using the medical measures that have been proven in many randomized trials, in combination with effective lifestyle modifications. The glob...
Source: European Neurology - January 6, 2015 Category: Neurology Source Type: research

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