Anticoagulation patients with paroxysmal catheter ablation. Medical search. Frequent questions

Thirty-nine percent of patients underwent a repeat procedure because of arrhythmia recurrence after a mean follow-up of 11 months. (afibbers.org)
It is the most common form of arrhythmia, as 50% of the arrhythmia patients are diagnosed with atrial fibrillation. (skylabs.io)
If, by this time, medications, cardioversion , catheter ablation , and other techniques are unable to restore a normal rhythm, and it seems unlikely that this will happen, the doctor may recommend ending efforts to control the arrhythmia . (medicalnewstoday.com)
2015). Diagnosing paroxysmal atrial fibrillation: Are biomarkers the solution to this elusive arrhythmia? (medicalnewstoday.com)
The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia. (nih.gov)
Of note, these recommendations apply to atrial fibrillation (AF) and atrial flutter, regardless of the pattern of arrhythmia (i.e. paroxysmal, persistent, or permanent). (pcmedproject.com)
While anticoagulation treatment is necessary in all cases, the definition of the optimal therapy prescribed to control arrhythmia itself is much more difficult. (ecrjournal.com)
6 The most common arrhythmia in patients with CHD is IART that occurs secondary to reentrant circuits in the right atrium. (aerjournal.com)
AF is a less common cause of atrial arrhythmia in CHD, but its prevalence is increasing in these patients because of improved survival to older age. (aerjournal.com)
Given the significant morbidity associated with this common arrhythmia, surgical and catheter ablation techniques have been developed to treat AF. (readme.io)
Paradoxically, recent studies using implantable cardiac monitors and arrhythmia-detecting pacemakers have revealed that patients in sinus rhythm also report symptoms of AF. (jafib.com)

Surgical treatments for atrial fibrillation are reserved for patients who are undergoing cardiac surgery for other reasons. (aafp.org)
In addition, reversal agents may be helpful when there are signs of severe bleeding caused by a NOAC or when a patient on a NOAC needs an emergency surgical procedure. (acc.org)
Convergent ablation is a novel hybrid technique combining an endocardial radiofrequency ablation with a minimally invasive epicardial surgical ablation. (aerjournal.com)
Convergent ablation - also known as the convergent procedure - is a hybrid technique combining an endocardial RF ablation procedure with minimally invasive epicardial surgical ablation of the posterior left atrial (LA) wall. (aerjournal.com)
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. (aerjournal.com)
Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures. (aerjournal.com)
1-3 Furthermore, the prevalence of patients living with CHD has been increasing secondary to the improvements in surgical techniques and medical management over the past few decades. (aerjournal.com)
By reducing the critical mass required to sustain AF through either surgical or catheter-based compartmentalization of the atria (ie, MAZE procedure), fibrillatory wavelets collide with fixed anatomic obstacles, such as suture lines or complete lines of ablation, thus eliminating or reducing the development of permanent AF. (medscape.com)
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. (medscape.org)
Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. (e-arrhythmia.org)
Surgical ablation of AF is available in most major hospitals throughout the world. (e-arrhythmia.org)
Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure. (e-arrhythmia.org)
Cardiac complications constitute a major cause of postoperative morbidity and mortality in surgical patients. (medscape.com)

The 2014 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines for the management of AF describe medical therapies including rate control, rhythm control and anticoagulation, with radiofrequency catheter ablation mainly reserved for patients who are refractory or intolerant to treatment with antiarrhythmic medication. (aerjournal.com)
Anti-arrhythmic medications have limited success in maintaining sinus rhythm, are associated with side effects, and appear ineffective at reducing mortality compared to a strategy of rate control and anticoagulation. (readme.io)

continue beta blockers and start anticoagulation. (acc.org)
This HAS-BLED score calculator offers a bleeding risk classification in patients with atrial fibrillation due to start anticoagulation therapy. (thecalculator.co)

Background: Marshall vein ethanol infusion (MVEI) as an additional therapy to conventional catheter ablation (CA) has been proved to be efficacious in patients with persistent atrial fibrillation (PeAF). (bvsalud.org)
2018). Insights into ablation of persistent atrial fibrillation: Lessons from 6-year clinical outcomes [Abstract]. (medicalnewstoday.com)
REACT-AF is a multicenter prospective, randomized, open-label, blinded endpoint (PROBE design), controlled trial comparing the current Standard Of Care (SOC) of continuous Direct Oral Anticoagulation (DOAC) use versus time-delimited (1 month) DOAC guided by an AF-sensing Smart Watch (AFSW) in participants with a history of paroxysmal or persistent Atrial Fibrillation (AF) and low-to-moderate stroke risk. (nih.gov)
Persistent atrial fibrillation continues unless it is interrupted by electrical or pharmacologic cardioversion, and it is associated with greater atrial fibrosis than paroxysmal atrial fibrillation. (nejm.org)

Reports for 30 of the studies identified patients by rhythm-control procedure, and the remaining five didn't specify TEE indications. (the-hospitalist.org)
Here, we aim to compare the efficacy, safety, and long-term outcomes between provisional and empirical MVEI in PeAF patients undergoing the index MI ablation procedure. (bvsalud.org)
Electrophysiologists agree that ablation for AF is beneficial in some cases but disagree about when this invasive procedure should be performed in the trajectory of the patient's condition. (medscape.com)
All patients underwent a pulmonary vein isolation (PVI) procedure with additional lesions as required. (afibbers.org)
At the last follow-up (a median of 4.3 years after the initial procedure), 66% of paroxysmal afibbers and 50% of persistent afibbers were in normal sinus rhythm without the use of antiarrhythmics. (afibbers.org)
The questionnaires were repeated 3 months and an average of 4.3 years after the initial ablation procedure. (afibbers.org)
However, patients with a successful ablation had significantly greater improvement in QoL than did those with an unsuccessful procedure, especially in regard to depression, AF symptoms, and AF severity. (afibbers.org)
Further, considering that about 70% of ablatees, whose procedure failed, still reduced their afib burden by at least 50%, brings one to the conclusion that RF ablation, whether successful or not, is likely to improve quality of life in close to 90% of those undergoing the procedure. (afibbers.org)
Hypercoagulopathy or an inability to tolerate anticoagulation therapy during an electrophysiology procedure. (fda.gov)
A contraindication to an invasive electrophysiology procedure where insertion or manipulation of a catheter in the cardiac chambers is deemed unsafe. (fda.gov)
To participate in this study, you must not have had a catheter ablation procedure to treat atrial fibrillation, had surgery to replace your heart valves, or been treated for sleep apnea. (nih.gov)
Radiofrequency catheter ablation (RFA) of the pulmonary veins was the first and most widely performed ablation procedure and cryoablation is a newer and rapidly progressing technique which has resulted in shorter procedure times and reduced treatment costs. (aerjournal.com)
This procedure targets the posterior wall of the LA, an area difficult to ablate effectively using a catheter-based approach. (aerjournal.com)
Studies have shown that in patients with longer AF durations, atrial stretch leads to structural and electrical atrial remodelling and development of vulnerable atrial substrate, particularly in the posterior LA. 12 The rationale behind the convergent procedure is to target this substrate in combination with conventional endocardial pulmonary vein isolation. (aerjournal.com)
Ablation is a procedure that uses a small tube called a catheter to deliver energy to the inside of the heart. (hhma.org)
The clinical decision to use a rhythm-control or rate-control strategy requires an integrated consideration of several factors, including degree of symptoms, likelihood of successful cardioversion, presence of comorbidities, and candidacy for AF ablation (eg, pulmonary vein electric isolation or MAZE procedure). (medscape.com)
We included studies comparing patients underwent HPSD and LPLD strategies for AF ablation and reporting either of the following outcomes: freedom from atrial tachyarrhythmia (AT) including AF and atrial flutter, procedure time, or periprocedural complications. (authorea.com)
There was a significant reduction in the HPSD group for total procedure (WMD=49.60, 95%CI:29.76-69.44) and ablation (WMD=17.92, 95%CI:13.63-22.22) times, but not for fluoroscopy time (WMD=1.15, 95%CI:-0.67-2.97). (authorea.com)
However, a HPSD strategy can significantly reduce total procedure and ablation times. (authorea.com)
Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. (e-arrhythmia.org)
Further studies on the effects of different periprocedural anticoagulation regimen, different steps of the ablation procedure and new technologies are needed. (jafib.com)
Complications may involve thromboembolic stroke during the ablation procedure. (jafib.com)
In the present study, we sought to determine the pattern of LA performance change immediately and short-term after AF ablation and whether such alternation of LA function is related the procedure outcome at long-term follow-up. (biomedcentral.com)
18 years old, had previous AF ablation or cardiac surgery procedure, valvular AF, congenital heart disease, previous atrioventricular node ablation, permanent pacing or no follow-up data. (biomedcentral.com)

Anticoagulation reduces the risk of stroke while increasing the risk of bleeding. (aafp.org)
The CHADS 2 and the CHA 2 DS 2 -VASc scoring systems assess the risk of stroke, with a score of 2 or greater indicating a need for anticoagulation. (aafp.org)
1 The mortality and morbidity of AF is well established, with a higher risk of stroke and heart failure in older patients with comorbidities. (aerjournal.com)
2-6 The AFFIRM and RACE studies underscored the importance of continued anticoagulation as a major therapeutic intervention for reducing the risk of stroke, which is achieved independently of whether a rate or rhythm control strategy is chosen. (ecrjournal.com)
However, several randomized controlled trials have demonstrated that a strategy aimed at restoring and maintaining sinus rhythm neither improves survival nor reduces the risk of stroke in patients with AF. (medscape.com)
One of the major management decisions in AF (and atrial flutter) is determining the risk of stroke and appropriate anticoagulation regimen for low-, intermediate-, and high-risk patients. (medscape.com)
Amin A. Oral anticoagulation to reduce risk of stroke in patients with atrial fibrillation: current and future therapies. (medscape.org)
Anticoagulation has been shown to lower risk of stroke and mortality. (imiowa.com)
The HAS-BLED score is often used alongside the CHA2DS2-VASc score to evaluate and stratify risk of stroke in patients with atrial fibrillation because the risk factors that contribute to stroke in patients with anticoagulation treatment are similar to the factors for major bleeding risk. (thecalculator.co)
The risk of stroke in patients with nonrheumatic AF is 5 percent per year, and this risk approaches 7 percent per year in patients with heart failure. (ahrq.gov)
Patients with atrial fibrillation scheduled for cardioversion or ablation therapy are at a heightened risk of stroke both pre and post-treatment, and require optimal protection from dangerous blood clots," said Professor John Camm, St George's University Hospital, London. (hospitalpharmacyeurope.com)
Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. (jafib.com)
Therefore, improvement of symptoms is an important therapeutic goal in itself and is also related to lower risk of stroke and mortality in patients with AF. (jafib.com)
For patients with AF of greater than 48 hours or unknown duration undergoing elective electrical or pharmacologic cardioversion, we recommend therapeutic anticoagulation (with VKA or NOAC) for at least 4 weeks after succesful cardioversion to sinus rhythm rather than no anticoagulation, regardless of the baseline risk of stroke. (guidelinecentral.com)
However, atrial fibrillation itself probably contributes to adverse outcomes by increasing the risk of stroke, diminishing cardiac performance, and exposing symptomatic patients to therapies that also have risks. (nejm.org)

TEE imaging in select patients at an elevated risk of LA thrombus, despite anticoagulation status, may be a reasonable approach to minimize the risk of thromboembolic complications following cardioversion or catheter ablation," propose the study's authors, led by Antony Lurie, BMSC, Population Health Research Institute, Hamilton, Ont. (the-hospitalist.org)
A study presented at the European Heart Rhythm Association (EHRA)-Europace conference (26-29 June, Madrid) shows that gender does not affect periprocedural complications or outcomes of catheter ablation for paroxysmal atrial fibrillation. (cardiacrhythmnews.com)
In the early years, complications of catheter ablation for atrial fibrillation were more frequent. (cardiacrhythmnews.com)
This review will shed light on the procedural techniques, success rates and complications of AF catheter ablation in patients with different types of CHD, including atrial septal defects, tetralogy of Fallot, persistent left superior vena cava, heterotaxy syndrome and atrial isomerism, and Ebstein anomaly. (aerjournal.com)
7 Here in this review we describe the efficacy, technical limitations and common complications of radiofrequency catheter ablation for AF in patients with different types of CHD. (aerjournal.com)
When undetected and untreated, AF in some patients can lead to potential complications including stroke or heart failure. (hospitalprofessionalnews.ie)

This novel technology comes at an exciting time for cardiac electrophysiology (EP), with the further development of new technology such as pulse field ablation (PFA) which is also due to start in Blackrock Clinic this year. (hospitalprofessionalnews.ie)
In the treatment of patients with paroxysmal atrial fibrillation (AF), pulse field ablation (PFA) system appears to yield safety and efficacy outcomes that are noninferior to those of conventional thermal ablation, according to data from the ADVENT trial. (mims.com)

The meta-analysis covered 10 prospective and 25 retrospective studies with a total of 14,653 patients that reported whether LA thrombus was present in patients with AF or atrial flutter (AFL) who underwent TEE after at least 3 weeks of VKA or DOAC therapy. (the-hospitalist.org)
Of the 317 patients treated with the POLARx cryoablation catheter, 127 people (59.9%) did not experience an atrial fibrillation, atrial flutter, or atrial tachycardia recurrence one year after treatment. (fda.gov)
Atrial flutter in an unstable patient should be treated immediately with synchronized cardioversion. (medscape.com)
For patient education information, see the Heart Health Center , as well as Atrial Flutter , Arrhythmias (Heart Rhythm Disorders) , Stroke , Supraventricular Tachycardia (SVT, PSVT) , and Palpitations . (medscape.com)

Both radiofrequency catheter ablation and cryoablation are widely performed, rapidly developing techniques. (aerjournal.com)

Go to Medscape Reference articles Acute Management of Stroke , Ischemic Stroke in Emergency Medicine , Hemorrhagic Stroke in Emergency Medicine , and Stroke Anticoagulation and Prophylaxis [ Ischemic Stroke ] for more information on these topics. (medscape.com)
11 Importantly, when ischemic stroke occurs in patients with AF, it is either fatal or of moderate to high severity in most patients. (ahrq.gov)

The current study suggests that 3 weeks of OAC isn't enough for a substantial number of patients, who might be put at thromboembolic risk if TEE were to be skipped before rhythm-control procedures. (the-hospitalist.org)
Based on this new analysis of existing data, a risk-based use of TEE imaging in anticoagulated patients could enable further improvement in the safe delivery of rhythm control interventions in patients with AF," the editorialists agree. (the-hospitalist.org)
For most patients, rate control is preferred to rhythm control. (aafp.org)
Ablation therapy may be superior to antiarrhythmics in selected patients, including those with paroxysmal atrial fibrillation who are symptomatic but without structural heart disease, patients who are intolerant of antiarrhythmics, and patients with inadequate pharmacologic rhythm control. (aafp.org)
For HF patients, rhythm control medication hasn't proven superior to rate control medication in randomized trials. (medpagetoday.com)
Conventional treatment for AF has focused on rate and rhythm control using anti-arrhythmic drugs (AADs), as well as anticoagulation therapy based on individual risk profile. (aerjournal.com)
For these reasons, most clinicians focus initially on restoration and maintenance of sinus rhythm in patients with new-onset AF and opt for a rate-control strategy only when rhythm control fails. (medscape.com)
In the AFFIRM study (Atrial Fibrillation Follow-up Investigation of Rhythm Management), an insignificant trend toward increased mortality was noted in the rate control group, and importantly, no evidence suggested that the rhythm-control strategy protected patients from stroke. (medscape.com)
This underscores the importance of anticoagulation in both rhythm-control and rate-control patients. (medscape.com)
A comparison of rate control and rhythm control in patients with atrial fibrillation. (medscape.org)
Early rhythm control is useful in patients with atrial fibrillation regardless of the AF pattern. (kompetenznetz-vorhofflimmern.de)
Patients with first diagnosed atrial fibrillation benefit from early rhythm control therapy comparably to patients with paroxysmal or persistent AF. (kompetenznetz-vorhofflimmern.de)
The current guidelines for the management of AF recommend anticoagulation and therapy of concomitant cardiovascular conditions in all patients with AF, while rhythm control is not considered as a first line therapy so far. (kompetenznetz-vorhofflimmern.de)
The EAST - AFNET 4 trial investigated whether rhythm control therapy - with antiarrhythmic drugs or ablation - delivered within one year after AF diagnosis improves outcomes. (kompetenznetz-vorhofflimmern.de)
The main study result, published last year [2], demonstrated a clinical benefit of early rhythm control therapy for all patients: Early rhythm control therapy with antiarrhythmic drugs and/or AF ablation reduced a composite of cardiovascular death, stroke, and hospitalization for worsening heart failure or acute coronary syndrome in 2789 patients with early AF and cardiovascular risk factors compared to usual care over a 5-year follow-up time. (kompetenznetz-vorhofflimmern.de)
In the present EAST - AFNET 4 sub-study, Professor Goette and colleagues analyzed the effect of early rhythm control therapy in three groups of patients with different AF patterns: 1048 patients with first diagnosed AF namely enrolled within seven days after their first AF episode, 2042 patients with paroxysmal AF, and 743 patients with persistent AF. (kompetenznetz-vorhofflimmern.de)
Nights spent in hospital and hospitalization due to acute coronary syndrome were increased in FDAF patients randomized to early rhythm control compared to FDAF patients randomized to usual care, while there was no difference between randomized groups in patients with paroxysmal AF or persistent AF. (kompetenznetz-vorhofflimmern.de)
Patients with first diagnosed AF spent more nights in hospital and experienced more often hospitalization for acute coronary syndrome when they were randomized to early rhythm control compared to usual care. (kompetenznetz-vorhofflimmern.de)
He concluded: "In our opinion, the clinical AF pattern should not influence the decision for rhythm control therapy in patients with recently diagnosed atrial fibrillation and concomitant cardiovascular conditions. (kompetenznetz-vorhofflimmern.de)
Whether or not a rhythm-control strategy is adopted, adequate rate control should be achieved in all patients with AF to prevent myocardial infarction (if significant coronary artery disease is present), exacerbation of heart failure, and tachycardia-induced cardiomyopathy and to alleviate symptoms. (ahrq.gov)
There was no advantage to catheter ablation for rhythm control in atrial fibrillation (AF) compared with an aggressive rate-control strategy in patients who also had heart failure (HF) in a randomized trial. (medscape.com)
But some trends suggested to researchers that, had there been continued enrollment and follow-up, the rhythm control strategy would have emerged as clearly superior, especially in at least one subgroup of patients. (medscape.com)
In RAFT-AF , with a final enrollment of 411 out of a planned 600 patients with HF and a high burden of paroxysmal or persistent AF, those assigned to the ablation-based rhythm-control strategy showed a 23.4% rate of the primary endpoint of death or HF events over a median of about 3 years. (medscape.com)
Of note, patients who entered the study with a left-ventricular ejection fraction (LVEF) no higher than 45% displayed what was considered a signal of possible benefit from the rhythm-control strategy vs rate control, a 37% reduction in risk of death or HF events ( P = .059), Tang said. (medscape.com)
One could say at least, probably, there's clinical significance for the ablation-based rhythm control vs rate control, especially in patients with the lower ejection fraction," Tang said. (medscape.com)
Of the trial's patients with AF and in HF who were enrolled at 21 centers in Brazil, Canada, Sweden, and Taiwan, 197 were randomly assigned to rate control and 214 to rhythm control, and were included in the intention-to-treat analysis. (medscape.com)
However, 9 of those patients in the rhythm-control group did not receive their assigned treatment, Tang reported. (medscape.com)

In this article, the authors examine the safety and efficacy of catheter ablation and convergent ablation for long-standing, persistent AF. (aerjournal.com)

Advances in molecular genetics and imaging, coupled with techniques for endocardial and epicardial mapping in the electrophysiology laboratory present an opportunity to significantly improve our understanding of (1) The relation of paroxysmal versus persistent AF with (a) structural left atrial changes (left/right atrial scar, wall thinning, pulmonary vein anomalies, and coronary sinus dilation) and with (b) candidate genetic variants. (readme.io)

The finding was not significantly changed in separate sensitivity analyses, the report says, including one limited to studies with low risk of bias and others excluding patients with valvular AF, interrupted OAC, heparin bridging, or subtherapeutic anticoagulation, respectively. (the-hospitalist.org)
Known risk factors for stroke in patients with AF include male sex, valvular heart disease (rheumatic valvular disease), heart failure, hypertension, and diabetes. (medscape.com)
VENTURE-AF will evaluate the safety profile of Xarelto in patients with non-valvular AF undergoing first catheter ablation, in 200 patients across five countries, including the UK. (hospitalpharmacyeurope.com)
X-VeRT and VENTURE-AF complement the Phase III ROCKET AF study, where once-daily rivaroxaban was proven to be effective in preventing stroke and non-CNS (central nervous system) systemic embolism in patients with non-valvular AF. (hospitalpharmacyeurope.com)
X-VeRT (EXplore the efficacy and safety of once-daily oral riVaroxaban for the prEvention of caRdiovascular events in subjects with non-valvular aTrial fibrillation scheduled for cardioversion) is a Phase IIIb prospective, randomised, open-label, parallel-group, active-controlled, multi-centre study of 1,500 patients with non-valvular AF cardioversion. (hospitalpharmacyeurope.com)
VENTURE-AF (A Randomised, Open-label, Active-controlled Multi-centre Study to Evaluate the Safety of Rivaroxaban and Vitamin K Antagonists in Subjects Undergoing Catheter Ablation for Atrial Fibrillation) is a Phase IIIb randomised, open-label, active-controlled study in 200 patients with paroxysmal (occasional) or persistent non-valvular AF undergoing first catheter ablation. (hospitalpharmacyeurope.com)
The study is designed to evaluate the safety profile of uninterrupted once-daily oral rivaroxaban 20 mg in comparison to uninterrupted VKA or the dual drug approach of VKA plus low molecular weight heparin for patients with non-valvular AF undergoing first catheter ablation. (hospitalpharmacyeurope.com)

The Boston Scientific Cardiac Cryoablation System using the POLARx Cryoablation Balloon Catheters is indicated for the treatment of people with drug refractory, recurrent symptomatic paroxysmal atrial fibrillation (PAF). (fda.gov)

Simple electric isolation of the origins of the pulmonary veins has proven roughly 80% successful in substantially reducing frequency and duration of AF in patients who do not tolerate AF well. (medscape.com)
We aimed to explore target LI measurements at each radiofrequency application (RFA) for creating sufficient ablation lesions during pulmonary vein (PV) isolation. (authorea.com)
Current techniques for catheter ablation of AF include pulmonary vein isolation and complex fractionated atrial electrogram (CFAE) ablation. (readme.io)
A key component of catheter ablation of AF is electrical isolation of the pulmonary veins from the left atrium. (hospitalprofessionalnews.ie)

METHODS: A total of 316 patients with symptomatic drug-refractory AF who underwent combined CA and LAAC between January 2016 and December 2020 were retrospectively included. (bvsalud.org)
Their study involved 133 patients who underwent catheter ablation at the Center between July 2004 and August 2006. (afibbers.org)
Results: Nine studies from 2006-2020 involving 2,282 patients were included (1,369 patients underwent HPSD strategy and 853 patients underwent LPLD strategy). (authorea.com)
A total of 659 patients (57±9 years, 76% male) with AF who underwent catheter ablation and 659 age, and sex-matched controls were genotyped for the common AF susceptibility alleles rs2200733 and rs6843082 at 4q25, rs2106261 at ZFHX3 , and rs13376333 at KCNN3 . (e-arrhythmia.org)
We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. (biomedcentral.com)
Patients with symptomatic and drug-refractory AF who underwent first time AF ablation at Mayo Clinic (Rochester, MN) between April 2009 and May 2011 were included. (biomedcentral.com)

Methods: This prospective study included 15 consecutive patients scheduled to undergo an initial ablation of paroxysmal atrial fibrillation (AF). (authorea.com)

Concern regarding use of hydroxychloroquine without adequate rhythm monitoring in clinical trials has been recently expressed.1 A review of clinicaltrials.gov at the time of submission of this correspondence reveals actively recruiting trials of combined hydroxychloroquine/azithromycin with or without additional COVID-19 therapies, for both ambulatory and hospitalized patients within and outside the US. (authorea.com)
This is a health tool designed to work as a major bleeding risk score, stratifying patients with atrial fibrillation in terms of anticoagulation therapies. (thecalculator.co)
Cardioversion and catheter ablation are therapies commonly used to restore normal heart rhythm in patients with AF, but can cause pre-existing blood clots to dislodge and travel to the brain, causing a stroke. (hospitalpharmacyeurope.com)
11 , 15 - 19 Paradoxically, even without evidence for improvement of symptoms when rhythm is restored in patients with AF, a significant number of patients undergo pharmacological and interventional therapies to restore sinus rhythm in an effort to improve symptoms. (jafib.com)
A randomized trial involving 150 patients with atrial fibrillation showed that the addition of an intensive weight loss program to other therapies (including treatment and counseling for hypertension, sleep apnea, alcohol consumption, hyperlipidemia, and diabetes mellitus) resulted in weight loss as well as less atrial fibrillation and fewer symptoms of atrial fibrillation than the standard intervention. (nejm.org)

The phenotypes of AF patients, including electroanatomical characteristics of the left atrium and recurrence after ablation, were compared. (e-arrhythmia.org)
The primary endpoint was atrial tachyarrhythmia recurrence after ablation. (biomedcentral.com)

HYPOTHESIS: We aimed to investigate the clinical outcomes of combined CA and LAAC in elderly patients. (bvsalud.org)
This study showed the common AF susceptibility alleles at 4q25 and ZFHX3 are associated with electroanatomical characteristics of the left atrium and the clinical outcomes of catheter ablation in Korean patients with AF. (e-arrhythmia.org)

Catheter ablation boosts outcomes in patients with advanced heart failure (HF) who are being considered for heart transplantation or left ventricular assist device (LVAD) implantation in the CASTLE-HTx trial presented at ESC 2023. (mims.com)
The treatment of atrial fibrillation (AF) improves long-term outcomes in patients with heart failure (HF), but the most beneficial treatment option is debated [1]. (pace-cme.org)

He remains free from tachycardia three months post ablation. (acc.org)
(4) In three large series of patients undergoing ablation for focal pulmonary vein tachycardia, the reported development of atrial fibrillation post ablation is low. (acc.org)

After a 3-month blanking period, 65% of patients with paroxysmal AF and 46% of those with persistent AF were in normal sinus rhythm without the use of antiarrhythmic drugs. (afibbers.org)
The main inclusion criteria were: New York Heart Association (NYHA) class II-IV, left ventricular ejection fraction (LVEF) ≤ 35%, paroxysmal or persistent AF not responding to antiarrhythmic drugs, or with serious adverse events due to antiarrhythmic drug therapy, implantation of a Biotronik-manufactured cardioverter-defibrillator (ICD) device or a cardiac resynchronization therapy defibrillator (CRT-D) with automatic daily remote-monitoring capabilities. (pace-cme.org)
Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. (pace-cme.org)

Some clinicians consider AADs for initial treatment, whereas others follow a more invasive approach, such as cryoballoon ablation (also referred to as cryoablation) or radiofrequency ablation shortly after the initial diagnosis. (medscape.com)

Results at 1 year showed a significantly lower recurrence of AF in the ablation group compared with the AAD group: 42.9% vs 67.8%, respectively. (medscape.com)
Several studies have reported that the quality of life (QoL) of atrial fibrillation (AF) patients is significantly reduced compared to that of age-matched healthy control subjects. (afibbers.org)
The authors conclude that, "Ablation for AF significantly improves QoL irrespective of ablation success during short- and long-term follow-up. (afibbers.org)
The degree of QoL improvement is significantly correlated with ablation success during long-term follow-up in the questionnaires especially designed for AF and in the depression questionnaire. (afibbers.org)
She explained that in her study, the duration of atrial fibrillation before ablation was about six years in both men and women and, unlike other studies, women were not referred later for catheter ablation despite being significantly older than men (61±9 years vs. 55±10 years). (cardiacrhythmnews.com)
Although gender does not appear to have a significant effect, according to this study at least, on the outcome of catheter ablation, it does significantly influence the pathophysiology, epidemiology, and clinical presentation of many cardiac arrhythmias. (cardiacrhythmnews.com)
A lirocumab administered every 2 or 4 weeks (Q2W or Q4W dosing regimen) significantly reduced low-density lipoprotein-cholesterol (LDL-C) levels in paediatric patients with heterozygous familial hypercholesterolaemia (HeFH), according to a study presented at ESC 2023. (mims.com)
Importantly, in ROCKET AF, patients treated with rivaroxaban were associated with significantly fewer major bleeding events, namely intracranial haemorrhages and fatal bleeds, when compared with warfarin, although GI bleeding did occur more commonly with rivaroxaban than with warfarin. (hospitalpharmacyeurope.com)
In patients with prior unprovoked bleeding, warfarin-associated bleeding, or at high risk of bleeding, we suggest using apixaban, edoxaban, or dabigatran 110 mg (where available) as all demonstrate significantly less major bleeding compared with warfarin. (guidelinecentral.com)

Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. (medscape.org)
Comparative favoring evidence regarding the efficacy, logistics, and safety of a higher power, shorter duration (HPSD) ablation strategy compared to a lower power, longer duration (LPLD) ablation strategy is insubstantial. (authorea.com)
The study is designed to explore the efficacy and safety of once-daily oral rivaroxaban, 20 mg, (15 mg for patients with moderate renal impairment) in comparison to dose-adjusted VKA for the prevention of cardiovascular events including stroke, transient ischemic attack (TIA), non-CNS systemic embolism, myocardial infarction (MI), and cardiovascular death. (hospitalpharmacyeurope.com)

For example, in people with paroxysmal atrial fibrillation , we found that the risk of left atrial appendage clot was approximately 1% or less. (the-hospitalist.org)
BACKGROUND: Catheter ablation (CA) combined with left atrial appendage closure (LAAC) has emerged as a promising method to relieve symptoms while reducing the incidence of stroke in selected high-risk patients with atrial fibrillation (AF). (bvsalud.org)
AF also predisposes a patient to blood clot formation in the atria, particularly the left atrial appendage. (kkh.com.sg)

However, data and guidelines regarding catheter ablation in patients with congenital heart disease are not well established. (aerjournal.com)

One of the most important causes of morbidity in patients with CHD is the development of cardiac arrhythmias, in particular tachyarrhythmias. (aerjournal.com)

Methods: We enrolled 133 patients with PeAF either in the provisional group (n = 38, MVEI was performed when conventional endocardial and/or epicardial ablation procedures were inadequate to achieve bidirectional MI block) or in the empirical group (n = 95, MVEI was performed empirically before MI CA). Results: All of the baseline characteristics were comparable. (bvsalud.org)
Some suggest that hybrid ablation may be more effective than lone endocardial ablation in achieving the elusive goal of maintaining sinus rhythm in patients with non-paroxysmal AF. (aerjournal.com)

More epicardial ablations were applied (26.3% vs. 9.5%, P = 0.016) and a higher incidence of CA-facilitated restoration of sinus rhythm was recorded (86.8% vs. 11.7%, P (bvsalud.org)
In the last few years, we had an incidence of tamponades of less than 1% in paroxysmal atrial fibrillation ablation. (cardiacrhythmnews.com)
Incidence and Determinants of QT Interval Prolongation in COVID-19 Patients Treated w. (authorea.com)
The incidence of AF is on the rise, and it is projected that by the year 2050 more than 10 million patients will be affected by AF in the United States alone. (readme.io)
For now, SCL incidence may determine the thrombogenic potential of an ablation technology and further studies to reduce or avoid SCL generation are desirable. (jafib.com)

It worsens heart failure and increases mortality in patients with myocardial infarction, and is an independent risk factor for death. (aafp.org)
Not only is the risk of death in patients with AF twice that of patients without AF, but AF can result in myocardial ischemia or even infarction, heart failure exacerbation, and tachycardia-induced cardiomyopathy if the ventricular rate is not well-controlled. (ahrq.gov)

Notably, only 23% of patients enrolled in the largest rate versus rhythm AF trial to date, Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM), had HF. (ecrjournal.com)
The 2011 Focused Update on the Management of Patients with Atrial Fibrillation-by the American College of Cardiology Foundation (ACCF), the AHA, and the Heart Rhythm Society (HRS)-addressed the issue of strict versus lenient rate control in patients with AF. (ahrq.gov)
In the Catheter Ablation versus Standard Conventional Therapy in Patients with Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF) trial, a multicenter, open-label, randomized, controlled trial, the effect of catheter ablation on morbidity and mortality was evaluated compared with medical therapy in HF patients with symptomatic AF. (pace-cme.org)

Major guidelines, including those of the American College of Cardiology/American Heart Association/Heart Rhythm Society , European Society of Cardiology/European Association for Cardio-Thoracic Surgery , and Canadian Cardiovascular Society/Canadian Heart Rhythm Society recommend systemic anticoagulation for those with increased risk for stroke and anti-arrhythmic drugs (AADs) as the initial treatment for AF before considering ablation. (medscape.com)
Results from the randomized trials EARLY-AF and STOP AF showed that cryoablation was a promising first-line treatment for paroxysmal AF. (medscape.com)
In EARLY-AF, 303 symptomatic treatment-naive participants who had at least one episode of AF within the last 24 months or paroxysmal AF were randomly assigned to receive either an AAD or undergo cryoablation. (medscape.com)
2. Though research on ablation as a first-line treatment for AF is promising, study limitations exist. (medscape.com)
Another electrophysiologist, Dhiraj Gupta, MD , noted the potential for bias against the AAD arm in the STOP AF trial since more than 15% of participants in that group crossed over to the ablation group and crossover was included in the treatment success endpoint. (medscape.com)
3. Ablation is a mainstay of AF treatment, but disagreement persists regarding its use as a first-line option. (medscape.com)
The catheter is removed after treatment. (fda.gov)
These catheters may be used as an alternative to medicine or other ablation catheters for treatment of recurrent symptomatic PAF. (fda.gov)
B. Catheter ablation as the first line of treatment. (acc.org)
Catheter ablation is a well-established treatment for patients with AF in whom sinus rhythm is desired. (aerjournal.com)
Catheter ablation of AF is a well-established treatment for patients in which sinus rhythm is desired, such as those with refractory symptoms despite maximal medical therapy, heart failure secondary to AF and intolerance to AADs. (aerjournal.com)
Investigators plan to study Emergency Department (ED) patients with recent-onset episodes of AF or AFL (RAFF) where rapid heart rate requires urgent treatment to restore normal heart rhythm. (vchri.ca)
With some types of ablation treatment, you will also need a pacemaker. (hhma.org)
However, the treatment of patients with both AF and HF remains a specific challenge. (ecrjournal.com)
For decades, conventional wisdom suggested that sinus rhythm was preferred over rate control in the treatment of patients with atrial fibrillation (AF). (ecrjournal.com)
Recent randomised trials have been unable to substantiate this viewpoint, and the occurrence of serious outcomes for patients has been similar for both treatment strategies. (ecrjournal.com)
Catheter ablation for AF has been shown to be a very effective treatment modality in patients with refractory AF. (aerjournal.com)
Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care Heart . (medscape.org)
Both hydroxychloroquine and azithromycin continue to be administered in US clinical trials examining their potential role in prevention of infection, treatment of mild infection in ambulatory patients, and in combination with other medical regimens in treatment of patients with severe disease. (authorea.com)
There were no major differences in anticoagulation and treatment of concomitant cardiovascular conditions. (kompetenznetz-vorhofflimmern.de)
Paroxysmal atrial fibrillation - episodes varying, stopping in less than 48h without treatment. (thecalculator.co)
Specifically, the Institute called upon researchers to compare the effectiveness of treatment strategies for AF, including surgery, catheter ablation, and pharmacological treatment. (ahrq.gov)
Catheter ablation has been documented to be an effective and safe treatment option in patients with symptomatic AF. (jafib.com)
Prehospital treatment is usually only indicated in hemodynamically unstable patients. (medscape.com)
For patients with AF of documented duration of 48 hours or less undergoing elective cardioversion (electrical or pharmacologic), we suggest starting anticoagulation at presentation (low-molecular weight heparin or unfractionated heparin at full venous thromboembolism treatment doses) and proceeding to cardioversion rather than delaying cardioversion for 3 weeks of therapeutic anticoagulation or a TEE-guided approach. (guidelinecentral.com)

1. Two recent studies find that early intervention with cryoablation may be more effective than are medications in preventing AF recurrence for patients with paroxysmal AF. (medscape.com)
For example, though EARLY-AF reported serious adverse events in 3.2% of patients in the cryoablation group and 4% in the AAD group, adverse events in the cryoablation group included phrenic-nerve palsy compared with wide-complex tachycardia, syncope, and heart failure (HF) exacerbation in the AAD group. (medscape.com)
Boston Scientific Cardiac Cryoablation System and Accessories are balloon-tipped catheters that use cold energy (gas) to treat people with symptomatic recurrent paroxysmal atrial fibrillation (PAF) who do not respond to medicine (drug refractory). (fda.gov)
In addition, the clinical study was expanded to assess the safety and effectiveness of the POLARx FIT cryoablation catheter, which is intended to be used for people with cardiac anatomy that is not suited to the POLARx catheter. (fda.gov)

Extended clopidogrel monotherapy after a 9- to 12-month course of dual antiplatelet therapy (DAPT) reduces bleeding and ischaemic events in patients with acute coronary syndrome (ACS) who are at high risk for both events, according to the OPT-BIRISK* trial presented at ESC 2023. (mims.com)
For patients with AF, we recommend against antiplatelet therapy alone (monotherapy or aspirin in combination with clopidogrel) for stroke prevention alone, regardless of stroke risk. (guidelinecentral.com)

There appear to be specific advantages of sinus rhythm in patients who have AF and HF. (ecrjournal.com)

In cancer patients with isolated distal deep vein thrombosis (IDDVT), a 12-month anticoagulation regimen with the oral factor Xa inhibitor edoxaban fared better than a 3-month regimen, findings from the ONCO DVT study have shown. (mims.com)

Guidelines don't encourage TEE before cardioversion in patients who have been on OAC for at least 3 weeks, the group notes, and policies on TEE use before AF ablation vary widely regardless of anticoagulation status. (the-hospitalist.org)
In this video interview, Dr. Hugh Calkins, President of the Heart Rhythm Society and a member of the guidelines writing committee, discusses what afib patients should know about these new afib guidelines. (stopafib.org)
The guidelines contain some very significant changes that affect afib patients. (stopafib.org)
Question: What should patients know about the 2014 AHA/ACC/HRS Atrial Fibrillation Guidelines? (stopafib.org)
Notably, aggressive rate control may be deleterious in HFpEF patients with AF due to significant LA [left atrial] dysfunction resulting in low stroke volume and inability to increase stroke volume during exertion," the HFpEF guidelines state. (medpagetoday.com)
Guidelines state that scores higher than 3 should be clinically monitored regularly after the oral anticoagulation therapy has begun. (thecalculator.co)
If pharmacological therapy is insufficient or associated with side effects, the 2006 ACC/AHA/ESC Guidelines recommend ablation of the atrioventricular node (AVN) in conjunction with permanent pacemaker implantation to control heart rate. (ahrq.gov)

Three or more weeks of oral anticoagulation (OAC) sometimes isn't up to the job of clearing any potentially embolic left atrial (LA) thrombi before procedures like cardioversion or catheter ablation in patients with atrial fibrillation (AF). (the-hospitalist.org)
Their prevalence was about 2.7% among the study's more than 14,000 patients who received at least 3 weeks of OAC with either vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC) before undergoing TEE. (the-hospitalist.org)
Fortunately, continued oral anticoagulation already yields low peri-procedural stroke rates," observes an accompanying editorial from Paulus Kirchhof, MD, and Christoph Sinning, MD, from the University Heart & Vascular Center and German Centre of Cardiovascular Research, Hamburg. (the-hospitalist.org)
Newer oral anticoagulants have a slightly lower risk of intracranial hemorrhage compared with warfarin (Coumadin), but dose adjustment is required in patients with renal disease. (aafp.org)
Oral anticoagulation was discontinued after 6 months in all patients without AF recurrence provided their CHADS2 score was below 2. (afibbers.org)
Eighty seven per cent of strokes occurred in patients with atrial fibrillation recurrence and/or no adequate oral anticoagulation. (cardiacrhythmnews.com)
Peri-procedural management of patients taking oral anticoagulants. (medscape.org)
Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study. (medscape.org)

(3) In this series, focal ablation of either the earliest activation site at the os of the vein, or circumferential ablation of the culprit vein resulted in favorable long term freedom from recurrent atrial tachycardia, and atrial fibrillation. (acc.org)
Circumferential ablation around both ipsilateral PVs was performed using a 4-mm irrigated ablation catheter with an LI sensor. (authorea.com)

That compared with 32.5% for patients managed with rate control, which featured atrioventricular (AV) node-blocking meds supplemented - as needed - by AV junction ablation followed by insertion of a biventricular pacemaker, the so called "ablate and pace" approach. (medscape.com)

The focused update includes revisions to the sections on anticoagulation, catheter ablation of AFib, management of AFib complicating acute coronary syndrome, and new sections on device detection of AFib and weight loss. (acc.org)
However, for these patients, "uncontrolled blood pressure may precipitate acute HF decompensation, and individuals with HFpEF can have an exaggerated hypertensive response to exercise. (medpagetoday.com)
Recently, MRI of the brain in asymptomatic patients after AF ablation revealed lesions consistent with acute ischemia. (jafib.com)

Considering quality of life improvement rather than strictly success or failure of RF ablation procedures, it becomes clear that even a failed ablation may improve life quality. (afibbers.org)
Predictors and characteristics of multiple (more than 2) catheter ablation procedures for atrial fibrillation. (medscape.org)
Silent cerebral lesions (SCL) have been identified on brain magnetic resonance imaging (MRI) in apparently asymptomatic patients after cardiovascular procedures. (jafib.com)
An important point to consider is that over 60% of patients with AF appear to have asymptomatic cerebral lesions independent of cardiovascular procedures. (jafib.com)
Currently, the majority of patients undergoing these procedures receive VKAs such as warfarin to prevent blood clots. (hospitalpharmacyeurope.com)

(5,6) While our patient has had improvement of his LVEF, and is free from arrhythmias, his future risk of the development of atrial fibrillation is unknown. (acc.org)
The median absolute increase in LVEF was 8.0% (IQ: 2.2-19.1) in the ablation group and 0.2% (IQ: −3.0 to 16.1) in the medical-therapy group (P=0.005). (pace-cme.org)
Moreover, catheter ablation improved the LVEF and reduced the burden of AF. (pace-cme.org)

This clinical trial will have 2 components: a brief dose-ranging study and a randomized comparison of 2 doses of AdKCNH2-G628S with control cardiac surgery patients. (nih.gov)

Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. (medscape.org)
Subsequent to this initial step, for patients with AF, including those with paroxysmal AF, stroke prevention should be offered to those AF patients with one or more non-sex CHA 2 DS 2 VASc stroke risk factors (score of ≥1 in a male or ≥2 in a female). (guidelinecentral.com)

Prophylactic Catheter Ablation of Ventricular Tachycardia in Ischemic Cardiomyopathy: a systematic review and meta-analysis of randomized controlled trials. (jafib.com)

But OAC-resistant LA thrombi were two- to four-times as common in patients with than without certain features, including AF other than paroxysmal and higher CHADS2 and CHA2DS2-VASc stroke risk-stratification scores. (the-hospitalist.org)
Of note, the authors explain that NOACs - including dabigatran, rivaroxaban, apixaban and edoxaban - are now the preferred recommended drug class over warfarin to reduce stroke risk in appropriate AFib patients, unless patients have moderate-to-severe mitral stenosis or a mechanical heart valve. (acc.org)
I'd say number one is that the CHA 2 DS 2 -VASc score has now been recommended for risk stratification of stroke risk in afib patients. (stopafib.org)
Although the main concern of the medical profession when it comes to lone atrial fibrillation is stroke risk, the overwhelming concern of the patient is quality of life. (afibbers.org)
For patients with AF, including those with paroxysmal AF, stroke risk should be assessed using a risk factor based approach, rather than an categorisation into low, moderate/high risk strata. (guidelinecentral.com)
We recommend use of the CHA 2 DS 2 VASc as a simple clinical based stroke risk score to initially identify 'low stroke risk' patients that should not be offered antithrombotic therapy to prevent stroke and reduce mortality. (guidelinecentral.com)

Conventional catheter ablation of AF is achieved by thermal (radiofrequency) or cryothermal energy. (hospitalprofessionalnews.ie)

Creation of sufficient ablation lesions was assessed by the absence of a conduction gap. (authorea.com)
Results: After first-pass encircling PV antrum ablation, left atrium to PV conduction remained in 12 of 30 (40%) ipsilateral PVs. (authorea.com)

Anatomy26

Organisms2

Diseases58

Chemicals and Drugs23

Analytical, Diagnostic and Therapeutic Techniques and Equipment72

Phenomena and Processes13

Disciplines and Occupations4

Technology, Industry, Agriculture1

Information Science4

Health Care18

Arrhythmia11

Surgical13

Control and anticoagulation2

Start anticoagulation2

Persistent atrial4

Procedure24

Risk of stroke15

Complications6

Pulse field ablation2

Atrial flutter4

Radiofrequency catheter1

Ischemic stroke2

Rhythm-control27

Safety and Efficacy1

Electrophysiology1

Valvular7

Symptomatic paroxysmal1

Isolation4

Underwent6

Initial ablation1

Therapies5

Recurrence after ablation2

Clinical outcomes2

Outcomes in Patients2

Post ablation2

Antiarrhythmic drugs3

Cryoballoon ablation1

Significantly9

Efficacy3

Left atrial ap3

Congenital heart d1

Morbidity in patients1

Endocardial2

Incidence5

Myocardial2

Versus3

Treatment25

Cryoablation4

Antiplatelet therapy2

Sinus rhythm in patients1

Regimen1

Guidelines7

Oral8

Circumferential2

Atrioventricular1

Acute3

Procedures5

LVEF3

Cardiac surgery1

Prevention2

Systematic review and meta-analysis1

Stroke risk6

Conventional1

Conduction2