Atrial fibrillation is the most common arrhythmia and accounts for one-third of hospitalizations for rhythm disorders in the United States. The prevalence of atrial fibrillation averages 1% and increases with age. With the aging of the population, the number of patients with atrial fibrillation is expected to increase 150% by 2050, with more than 50% of atrial fibrillation patients being over the age of 80. This increasing burden of atrial fibrillation will lead to a higher incidence of stroke, as patients with atrial fibrillation have a five- to sevenfold greater risk of stroke than the general population. Strokes secondary to atrial fibrillation have a worse prognosis than in patients without atrial fibrillation. Vitamin K antagonists (e.g., warfarin), direct thrombin inhibitors (dabigatran), and factor Xa inhibitors (rivaroxaban and apixaban) are all oral anticoagulants that have been FDA approved for the prevention of stroke in atrial fibrillation. This review will summarize the
Preface, vii List of contributors, ix. VeniceChart task force composition, xxxiii. List of abbreviations, xxxvii. 1 Anatomy of structures relevant to atrial fibrillation ablation, 1. 2 Pathophysiology of atrial fibrillation, 20. 3 Techniques and technologies for atrial fibrillation catheter ablation, 35. 4 Endpoints of catheter ablation for atrial fibrillation, 61. 5 Patient management pre-, during-, and postablation, 70. 6 Periprocedural and long-term anticoagulation, 77. 7 Periprocedural and late complications, 85. 8 Short- and long-term efficacy of catheter ablation procedures for atrial fibrillation, 118. 9 Indications to atrial fibrillation ablation and cost-effectiveness, 127. 10 Clinical trials on atrial fibrillation/future perspectives, 137. 11 Surgical approach/ablation, 161. 12 Hospital equipment and facilities, personnel, training requirements, and competences, 176. Index, 184. ...
I review the present understanding of thromboembolic complications and their prevention in patients with nonrheumatic atrial fibrillation. Chronic atrial fibrillation carries an annual 3-6% risk of thromboembolic complications, which is 5-7 times greater than that of controls with sinus rhythm. Paroxysmal atrial fibrillation is associated with a lower risk of thromboembolic complications than chronic atrial fibrillation. Heart failure and systemic hypertension seem to be significant clinical risk factors for stroke in patients with atrial fibrillation, but disagreement persists, and, with few exceptions, subgroups at particular risk have not been convincingly identified. The risk of stroke in persons with thyrotoxic atrial fibrillation seems to be lower than believed previously. Clinical studies have shown that left atrial dilatation is a consequence of the duration of atrial fibrillation rather than a cause, but the relation of left atrial enlargement to stroke is uncertain. Cerebral blood flow ...
Atrial fibrillation is a common cause of stroke and other morbidity. Adequate treatment with anticoagulants reduces the risk of stroke by 60 %. Early detection and treatment of atrial fibrillation could prevent strokes. Atrial fibrillation is often asymptomatic and/or paroxysmal. Case-finding with pulse palpation is an effective screening method, but new methods for detecting atrial fibrillation have been developed. To detect paroxysmal atrial fibrillation ambulatory rhythm recording is needed. This study aims to determine the yield of case-finding for atrial fibrillation in primary care patients. In addition, it will determine the diagnostic accuracy of three different case-finding methods. In a multicenter cluster randomised controlled trial, we compare an enhanced protocol for case-finding of atrial fibrillation with usual care. We recruit 96 practices. We include primary care patients aged 65 years or older not diagnosed with atrial fibrillation. Within each practice, a cluster of 200 patients is
Most current treatment guidelines recommend warfarin therapy for patients with atrial fibrillation who are older than 60 years.24 25 In our study only 11% of patients did not have at least one additional vascular risk factor beyond atrial fibrillation and age. This means that most of our patients were at moderate to high risk for stroke.21 This finding is similar to the Cardiovascular Health Study, in which only 8% of patients with atrial fibrillation older than 65 years did not have evidence of cardiovascular disease,39 and the pooled data from the atrial fibrillation trials, in which 15% of patients had no vascular risk factors other than atrial fibrillation.21 Our primary analysis was based on those at moderate to high risk for stroke. Among these patients, there is little controversy among consensus statements and guidelines.14 25 40 Our principal finding is that 60% of patients with atrial fibrillation who are good candidates for anticoagulation (atrial fibrillation plus at least one other ...
Newly diagnosed Atrial Fibrillation patients have many questions about living with A-Fib. These are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer). 1. Cause: "Did I cause my Atrial Fibrillation? Am I responsible for getting A-Fib?". 2. Severity: "My doctor says I had an attack of Atrial Fibrillation. How much trouble am I in?". Related Question: "Is Atrial Fibrillation a prelude to a heart attack?". Related Question: "Can I die from my Atrial Fibrillation? Is it life threatening?". 3. Anomaly? "Could my Atrial Fibrillation go away on its own? I dont want to take any medication. Can I just wait and see?". Related Question: "Is it possible to have a single Atrial Fibrillation attack and not have any others? I had a single episode of A-Fib and was successfully converted in the ER with meds.". Related Question: "How can I tell when Im in A-Fib or just having something like indigestion?". 4. Sex/Exercise: "Should I cool ...
Previous data on spontaneous conversion of atrial fibrillation to sinus rhythm have been derived from smaller series that focused on the utility of specific AV node blocking agents or antiarrhythmic medications for promoting cardioversion. With the possible exception of sotalol, agents such as digoxin, beta-adrenergic receptor antagonists or calcium channel blockers are effective for ventricular rate control but ineffective for converting atrial fibrillation to sinus rhythm [20-25]. Previously, Falk and colleagues [8], examining the efficacy of digoxin for converting atrial fibrillation in a study of 36 patients, reported that 44% of the patients in the placebo arm had spontaneous conversion, compared with 50% of patients randomized to digoxin. Similar results were recently reported by the Digitalis in Acute Atrial Fibrillation (DAAF) investigators [12]. In that multicenter prospective study of digoxin versus placebo for conversion of recent atrial fibrillation, there was no significant ...
Introduction Catheter ablation (CA) for atrial fibrillation (AF) is growing exponentially. Although ablation for paroxysmal AF (PAF) is associated with shorter procedure times and less extensive left atrial ablation vs persistent AF thromboembolic complications can occur in both sub-groups. Inadequate anticoagulation leads to thrombotic complications and excessive anticoagulation can lead to bleeding risks. Many centres adopt a policy of discontinuing warfarin in the immediate run-up to the procedure, covering the procedure with unfractionated heparin and "bridging" postoperative patients with low molecular weight heparins (LMWH) back onto warfarin. We wished to determine the safety of CA for AF with a therapeutic INR using both the single transseptal approach and duty cycled radiofrequency energy (RF) with non irrigated PVAC catheters and the double transseptal puncture technique using irrigated RF catheters and either CARTO or NAVX electroanatomical mapping. ...
Atrial Fibrillation patients often have loads of "Why?" and "How?" questions. Here are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer.). 1. Causes: "Why does so much Atrial Fibrillation come from the Pulmonary Vein openings?". Related Question: "Why do older people get Atrial Fibrillation more than younger people?". Related Question: "What causes Paroxysmal A-Fib to turn into Persistent (Chronic) A-Fib?". Related Question: "A-Fib and Flutter-I have both. Does one cause the other?". 2. Hereditary: "Is my Atrial Fibrillation genetic? Will my children get A-Fib too?". 3. PSVT: "Is Atrial Fibrillation (A-Fib) different from what doctors call Paroxysmal Supraventricular Tachycardia?". 4. Adrenergic/Vagal: "What is the difference between "Adrenergic" and "Vagal" Atrial Fibrillation? How can I tell if I have one or the other? Does it really matter? Does Pulmonary Vein Ablation (Isolation) work for Adrenergic and/or Vagal ...
The current study is, to the best of our knowledge, the first to assess the association between the whole spectrum of thyroid disease and the subsequent risk of atrial fibrillation in a population of primary care patients. Our main finding was an apparent linear relation between levels of thyroid dysfunction and atrial fibrillation risk-that is, a low atrial fibrillation risk in hypothyroid patients, a high risk in hyperthyroidism, and a TSH level dependent (a dose-response relation) increased risk of atrial fibrillation in all levels of hyperthyroid disease, even in high normal euthyroid subjects. Notably, in subjects with reduced serum TSH levels but normal free thyroid hormone levels the risk of developing atrial fibrillation was increased approximately 10% in individuals with high normal thyroid function and increased about 40% in those with subclinical hyperthyroidism with suppressed TSH levels (table 4⇑, fig 3⇑). Overall, the relative risk of atrial fibrillation associated with thyroid ...
article{3aabedf9-a573-45ce-ab4a-dcc4e7a6b467, abstract = {,p,Background Electrical cardioversion of atrial fibrillation is associated with an increased risk of embolic stroke, but is generally considered safe if performed within 48 h after onset. Our objective was to investigate if thromboembolism and bleeding in association with cardioversion of atrial fibrillation differed between patients with and without oral anticoagulation. Methods Retrospective study of patients with atrial fibrillation undergoing electrical cardioversion from national Swedish health registries from January 1st 2006 until December 1st 2010. Main outcome measures were thromboembolism and bleeding. Results In total 22,874 atrial fibrillation patients underwent electrical cardioversion, 10,722 with and 12,152 without oral anticoagulation pre-treatment. Patients with low stroke risk (CHA,sub,2,/sub,DS,sub,2,/sub,-VASc 0-1) did not suffer from any thromboembolic complications within 30 days after cardioversion. After ...
Researchers at Western University hope their systematic review of almost 12,000 patients will raise awareness among physicians about the need for more extensive testing for atrial fibrillation, or heart rhythm disturbances, following a stroke or transient ischemic attack (TIA).. The review, published by Lancet Neurology, analyzed the results of 50 studies from four continents and showed that almost 24 per cent of stroke patients with no history of atrial fibrillation can be newly diagnosed with atrial fibrillation when using multiple cardiac monitoring methods sequentially. Thats more than twice higher than previous estimates which are based on only one or two methods of diagnosis.. "We found that by using a sequential combination of different cardiac monitoring methods, the number of ischemic stroke and TIA patients newly diagnosed with atrial fibrillation can be increased considerably," said Dr. Luciano Sposato, a recently recruited Associate Professor of Neurology at Westerns Schulich ...
Atrial fibrillation is a condition in which the hearts upper chambers, the atria, contract at an abnormally rapid rate. It is a common type of arrhythmia, and occurs in 1-2% of the general population. The prevalence of atrial fibrillation increases with age. Between 50 and 70% of patients with atrial fibrillation lasting ,48 hours spontaneously convert to normal sinus rhythm, and drug therapy increases the likelihood of conversion to sinus rhythm. Another treatment option for conversion of atrial fibrillation and atrial flutter is electrical conversion. This is an effective treatment but requires anesthesia.. Current treatment strategy for medical conversion of atrial fibrillation and atrial flutter is to employ drugs that affect ion channel activity in atrial cardiomyocytes. However, such converting drugs all have potentially serious side effects and are expensive. Potassium, sodium, calcium, and magnesium molecules are the most important ions causing electric current in the heart tissue. Our ...
Definition: Patients with persistent atrial fibrillation will be enrolled in this trial. All patients will be required to be in atrial fibrillation on the day of the procedure. Standard pulmonary vein (PV) isolation will be performed. Patients will be enrolled in the trial if they remain in atrial fibrillation after bi-directional block is obtained in the left and right sided PVs. At this point, patients will be randomized to receive 0.25mg of IV ibutilide or a placebo (normal saline). Patients will then undergo additional ablation with areas of complex fractionate electrograms (CFE) being targeted. The duration of additional CFE ablation and use of additional non-PV ablation (i.e. placement of linear lesions) will be left to the discretion of the operator. Patients will be followed for 1 year. The primary outcome assessed will be freedom from AF at 1 year ...
Headline: Bitcoin & Blockchain Searches Exceed Trump! Blockchain Stocks Are Next!. Atrial Fibrillation Therapeutics market report covers research informatics related to Atrial Fibrillation Therapeutics clinical trials, such as a listing of industry and sponsored clinical trials as well as new drug therapies.. Designed to be a resource both for patients interested in participating in Atrial Fibrillation Therapeutics clinical trials and for research professionals.. The report, "Atrial Fibrillation Therapeutics Global Clinical Trials Review, H2, 2016″ provides an overview of Atrial Fibrillation Therapeutics clinical trials scenario. This report provides top line data relating to the clinical trials on Atrial Fibrillation Therapeutics. Report includes an overview of trial numbers and their average enrolment in top countries conducted across the globe. The report also offers coverage of disease clinical trials by region, country (G7 & E7), phase, trial status, end points status and sponsor ...
We sought to determine how well PACs predict atrial fibrillation compared to an established but substantially more complex prediction model derived from the Framingham Heart Study," said senior author Gregory Marcus, MD, MAS, an associate professor of medicine who specializes in electrophysiology in the UCSF Division of Cardiology. "Because PACs may themselves have a causal relationship with atrial fibrillation, it is theoretically possible that their eradication, such as through drugs or a catheter ablation procedure, could actually modify atrial fibrillation risk." People who have atrial fibrillation may not show any symptoms, but the condition can increase ones risk of heart failure or stroke. Atrial fibrillation occurs when rapid, random electrical signals cause the atria to contract irregularly and quickly. Marcus and his colleagues studied a random sample of individuals 65 years and older who underwent 24-hour Holter monitoring as part of the national Cardiovascular Health Study from 1989 ...
TY - JOUR. T1 - Postoperative atrial fibrillation in noncardiothoracic surgical patients. AU - Christians, Kathleen K.. AU - Wu, Bobby. AU - Quebbeman, Edward J.. AU - Brasel, Karen J.. PY - 2001/12/1. Y1 - 2001/12/1. N2 - Background: Atrial fibrillation is a common arrhythmia whose prevalence increases with age. It is a well-known complication of cardiothoracic surgery, but the incidence and contributing factors to the development of atrial fibrillation in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, association with known risk factors, treatment, and outcome of atrial fibrillation in postoperative noncardiac, nonthoracic surgical patients. Methods: A 2-year retrospective review was performed of all noncardiac, nonthoracic surgical patients that developed atrial fibrillation within 30 days of operation. Incidence, risk factors, treatment and outcome related to the development of this arrhythmia were analyzed. Results: Fifty-one ...
Aims To test the ability of four circulating biomarkers of fibrosis, and of low left atrial voltage, to predict recurrence of atrial fibrillation after catheter ablation. Background Circulating biomarkers potentially may be used to improve patient selection for atrial fibrillation ablation. Low voltage areas in the left atrium predict arrhythmia recurrence when mapped in sinus rhythm. This study tested type III procollagen N terminal peptide (PIIINP), galectin-3 (gal-3), fibroblast growth factor 23 (FGF-23), and type I collagen C terminal telopeptide (ICTP), and whether low voltage areas in the left atrium predicted atrial fibrillation recurrence, irrespective of the rhythm during mapping. Methods 92 atrial fibrillation ablation patients were studied. Biomarker levels in peripheral and intra-cardiac blood were measured with enzyme-linked immunosorbent assay. Low voltage (,0.5mV) was expressed as a proportion of the mapped left atrial surface area. Follow-up was one year. The primary endpoint was ...
Best Syndication New) - Researchers from the University of California, San Francisco (UCSF) and the Kaiser Permanente Northern California Division of Research, found an increased risk for kidney failure in people who have atrial fibrillation and chronic kidney disease. In general, kidney function can fail over time with the chronic condition which can lead to dialysis treatments or a kidney transplant. Kidney problems are more likely to worsen in atrial fibrillation patients who already have kidney function impairment. The study results were published in the journal Circulation.. Irregular heart rhythm is a very common type of atrial fibrillation. Patients who have atrial fibrillation along with chronic kidney disease or end stage-renal disease (ESRD) are at an increased risk for suffering from a stroke or death. The researchers wanted to understand why atrial fibrillation patients with kidney disease are more likely to have end-stage renal disease compared to those with chronic kidney disease ...
Sophia Antipolis, 10 Oct 2017: Novel smartphone and tablet applications (apps) for atrial fibrillation patients and healthcare professionals have been launched by heart experts. The objectives and design of the apps are outlined in a paper published online today in EP Europace(1), with a summary published in the European Heart Journal (2).. Atrial fibrillation is the most common heart rhythm disorder and significantly increases the risk of stroke and death. One in four middle-aged adults in Europe and the US will develop atrial fibrillation, and the incidence and prevalence are rising.. "Around two-thirds of people in Europe and the US have a mobile device and use it as their main way of accessing online information," said lead author Dr Dipak Kotecha, a clinician scientist in cardiovascular medicine at the Institute of Cardiovascular Sciences, University of Birmingham, UK. "This presents a big opportunity to improve self management and shared decision making in atrial fibrillation.". The My AF ...
A new clinical trial is now underway at the Massachusetts General Hospital to investigate whether combining two endovascular catheter-based procedures will improve the long-term outcome in the treatment of atrial fibrillation, the most common heart rhythm disorder. Mass General is the first hospital in New England - and only the second in the nation - to pair renal artery sympathetic denervation with pulmonary vein isolation (PVI) for patients with atrial fibrillation and hypertension.. "Typically these procedures are done separately," said Moussa Mansour, MD, director of the Atrial Fibrillation Program in the Mass General Institute for Heart, Vascular and Stroke Care. "In this trial, renal denervation is not only performed to treat the patients hypertension, which is the usual goal of the procedure, but as an adjunct to PVI to improve the outcome of atrial fibrillation ablation. We see real potential in this treatment for patients who continue to experience atrial fibrillation symptoms in ...
TY - JOUR. T1 - Stroke prevention in atrial fibrillation. AU - Katsnelson, Michael. AU - Koch, Sebastian. AU - Rundek, Tatjana. PY - 2010/10/1. Y1 - 2010/10/1. N2 - Non-valvular atrial fibrillation is a common and from a neurological perspective the most significant cardiac arrhythmia with a growing world-wide incidence. It also carries a significant associated morbidity and mortality, with cardioembolic strokes arguably being the most disabling sequelae. This brief review will highlight the important studies and the latest treatment modalities available for stroke prevention in patients with non-valvular atrial fibrillation.. AB - Non-valvular atrial fibrillation is a common and from a neurological perspective the most significant cardiac arrhythmia with a growing world-wide incidence. It also carries a significant associated morbidity and mortality, with cardioembolic strokes arguably being the most disabling sequelae. This brief review will highlight the important studies and the latest ...
The data show that there is no survival benefit to the strategy of rhythm control in elderly patients with atrial fibrillation. Indeed there were trends toward higher rates of death and stroke among patients treated with rhythm control. Rate control appears to be an acceptable primary strategy in patients with atrial fibrillation. Long term anticoagulation appears warranted in all patients with risk factors for stroke. Risk factors for ischemic stroke in nonvalvular AF include prior thromboembolism, CHF, HTN, age, DM, female gender, BP greater than 160 mmHg and LV dysfunction. As stated in the ACC/AHA guidelines, maximum protection against ischemic stroke in AF is probably achieved with an international normalized ratio (INR) of 2 to 3, whereas an INR range of 1.6 to 2.5 appears to be associated with incomplete efficacy, estimated at approximately 80% of that achieved with higher intensity anticoagulation. ACC/AHA guidelines recommend that physicians individualize the selection of the ...
Atrial fibrillation is a heterogeneous disorder that is usually characterized by paroxysmal onset, particularly in patients without structural heart disease. Defining biological markers of atrial remodelling would help identify patients at high risk who would benefit most from prophylactic treatment and careful monitoring. Biomarkers of atrial fibrillation progression would be helpful for following patients that present with asymptomatic atrial fibrillation. Notably, the roles of such markers in the pathophysiology of atrial fibrillation must be determined. Some markers may indicate the presence, complications or progression of the disease, while others may be involved in key pathological processes and thus represent novel therapeutic targets. Although a number of markers have been reported as potential predictors of paroxysmal atrial fibrillation progression towards persistent arrhythmia, their usefulness and clinical value need further validation. This report reviews several newly identified markers
Doctors at Washington University School of Medicine in St. Louis are performing a new procedure to treat atrial fibrillation, a common irregular heartbeat.. Available at only a handful of U.S. medical centers, this "hybrid" procedure combines minimally invasive surgical techniques with the latest advances in catheter ablation, a technique that applies scars to the hearts inner surface to block signals causing the heart to misfire. The two-pronged approach gives doctors access to both the inside and outside of the heart at the same time, helping to more completely block the erratic electrical signals that cause atrial fibrillation.. Atrial fibrillation affects more than 2 million Americans, a number that continues to increase as the population ages. While not fatal in itself, patients who suffer from atrial fibrillation are at increased risk of stroke and congestive heart failure. And many, especially those who feel the fibrillations, have shortness of breath, chest pain, fatigue and feelings of ...
The concept that "atrial fibrillation begets atrial fibrillation" might have some important clinical implications. First of all it emphasizes that most of our electrophysiological knowledge stems from acute experiments and that we know relatively little about chronic electrophysiological adaptation processes. If it is true that the long-term shortening of atrial refractoriness during fibrillation is based on a fundamental change in composition of the ion channels responsible for repolarization of the atrial cells, the action of antiarrhythmic drugs on fibrillating atria may be different than the effects as measured during sinus rhythm. The clinically observed diminished efficacy of chemical cardioversion after a prolonged period of atrial fibrillation9 10 11 12 might be explained by such a process of electrical remodeling. In fact it might be imperative to reevaluate the effects of existing anti-fibrillatory drugs in chronically fibrillating hearts. On the other hand it opens the possibility to ...
Our study demonstrates that in dyspneic patients without HF, permanent/paroxysmal AF is associated with increased circulating BNP levels. This pattern was not evident in patients with a final diagnosis of HF. Although the overall diagnostic performance of BNP for HF tended to be lower in patients with AF than in those without, BNP performed well in both groups. Our data also demonstrate that the conventional cutoff value of 100 pg/ml was associated with a markedly lower specificity and positive likelihood ratio in patients with AF than in those without, suggesting that a higher diagnostic threshold should be used to diagnose HF in patients with AF.. The most widely accepted indication for BNP measurement in clinical practice is for the emergency diagnosis of HF in patients presenting with acute dyspnea. The first study suggesting that BNP measurement could prove useful in this setting was published 10 years ago (20). However, clinical use of this test was limited until the publication of the ...
In this paper, R wave peak interval independent atrial fibrillation detection algorithm is proposed based on the analysis of the synchronization feature of the electrocardiogram signal by a deep neural network. Firstly, the synchronization feature of each heartbeat of the electrocardiogram signal is constructed by a Recurrence Complex Network. Then, a convolution neural network is used to detect atrial fibrillation by analyzing the eigenvalues of the Recurrence Complex Network. Finally, a voting algorithm is developed to improve the performance of the beat-wise atrial fibrillation detection. The MIT-BIH atrial fibrillation database is used to evaluate the performance of the proposed method. Experimental results show that the sensitivity, specificity, and accuracy of the algorithm can achieve 94.28%, 94.91%, and 94.59%, respectively. Remarkably, the proposed method was more effective than the traditional algorithms to the problem of individual variation in the atrial fibrillation detection ...
Arterial hypertension (HTN) and atrial fibrillation often coexist and the combination of these two conditions carries an increased risk of stroke. HTN is one of the most important risk factors included in the scores for stoke prediction in atrial fibrillation used to assess the need of anticoagulation, and HTN has also been strictly related to bleeding complications of antithrombotic therapy. Antithrombotic drugs options include vitamin K antagonists, or new oral anticoagulants, recently approved for stroke prevention in nonvalvular atrial fibrillation. More favorable new oral anticoagulant efficacy and safety, compared with warfarin, have been reported in hypertensive patients, making these drugs a first-line choice in this population to prevent cerebrovascular events and reduce the risk of major bleedings. The aim of this review is to explore the relationship among HTN, atrial fibrillation and the risk of stroke and to summarize the evidence on the impact of HTN on the choice of the most ...
Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: The Losartan Intervention for End point reduction in hypertension (LIFE) study Academic Article ...
The most common arrhythmia in older adults is atrial fibrillation, with an estimated prevalence of ≈9% in adults aged ≥80 years and a concomitant increased burden of developing stroke. Additionally, over the past decade, both the incidence and prevalence of atrial fibrillation has markedly increased1 and, with it, the total number of patients potentially requiring long-term oral anticoagulation therapy for the prevention of stroke and systemic embolism. In 2009, the estimated number of atrial fibrillation diagnoses in the United States was 2 643 000, with equal distribution between men and women and 82% at ages ≥65 years, with that number increasing 10% between 1999 to 2005.2 The magnitude of the problem is exemplified by the fact that the risk of stroke in patients with atrial fibrillation increases with age and accounts for ≈45% of embolic strokes, approximately 100 000 annually in the United States.3. Article see p 138. The advent of the novel oral anticoagulants has strikingly ...
Atrial fibrillation is an important and independent risk factor for cerebrovascular disease and vascular dementia. There is increasing evidence that atrial fibrillation is associated with an increased risk of asymptomatic or silent cerebral infarction and as a result may confer an increased risk of progressive cognitive impairment on a person. In this study we sought to determine whether this hypothesis could be explored in a prospective case controlled design. Twenty seven patients with non-valvular atrial fibrillation (NVAF) and no history of stroke, transient ischaemic attack, dementia, and thyrotoxicosis were compared with 54 age and sex matched controls in sinus rhythm. All cases underwent clinical examination, ECG, and psychological assessment using a battery of nine neuropsychological tests. Between group analysis and a comparison of mean test scores of paired controls with cases were undertaken. The presence of atrial fibrillation was consistently associated with poorer performances on ...
Aims To assess the impact of the introduction of direct oral anticoagulants upon the outcomes from elective electrical cardioversion for atrial fibrillation. Methods This is a retrospective comparison of delay to elective cardioversion with different anticoagulants. The data was gathered from a large regional hospital from January 2013 to September 2017. There were 3 measured outcomes: 1) the time in weeks from referral to the date of attempted electrical cardioversion; 2) the proportion of patients who were successfully cardioverted; and 3) the proportion of patients who remained in sinus rhythm by the 12 week follow-up. Time-to-cardioversion was non-parametrically distributed so was analysed with Kruskal-Wallis testing and Mann-Whitney-U testing. Maintenance of sinus rhythm was analysed using z-testing. Results 1,374 patients were submitted to cardioversion. The referrals for cardioversion were either from primary care or from cardiologists. At the time of cardioversion, 789 cases were
A comprehensive research report titled "Global Atrial Fibrillation (Afib) Market (Non-Surgical/Catheter, Surgical- Mini Maze, Hybrid): Analysis By Region, By Country (2016-2021F)" created through extensive primary research (inputs from industry experts, companies, stakeholders) and secondary research, presents the analysis of the global atrial fibrillation or Afib market and has been segmented By Procedures (Surgical Ablation- Mini Maze, Hybrid, Non-Surgical - Catheter); By Region (North America, Europe, APAC, ROW) and By Country (U.S., Canada, UK, Germany, China, Japan).. Market for Afib is growing steadily on account of the rising number of Afib cases, which is caused by the lifestyle related diseases, such as hypertension, diabetes, obesity, and is gaining prominence among both adult and aged population. Rising cases of atrial fibrillation (Afib) among the population along with the growing focus on catheter ablation procedures has led to the growth of atrial fibrillation market.. Among the ...
A comprehensive research report titled "Global Atrial Fibrillation (Afib) Market (Non-Surgical/Catheter, Surgical- Mini Maze, Hybrid): Analysis By Region, By Country (2016-2021F)" created through extensive primary research (inputs from industry experts, companies, stakeholders) and secondary research, presents the analysis of the global atrial fibrillation or Afib market and has been segmented By Procedures (Surgical Ablation- Mini Maze, Hybrid, Non-Surgical - Catheter); By Region (North America, Europe, APAC, ROW) and By Country (U.S., Canada, UK, Germany, China, Japan).. Market for Afib is growing steadily on account of the rising number of Afib cases, which is caused by the lifestyle related diseases, such as hypertension, diabetes, obesity, and is gaining prominence among both adult and aged population. Rising cases of atrial fibrillation (Afib) among the population along with the growing focus on catheter ablation procedures has led to the growth of atrial fibrillation market.. Among the ...
TY - JOUR. T1 - Meta-analysis of randomized controlled trials on atrial fibrillation ablation in patients with heart failure with reduced ejection fraction. AU - Smer, Aiman. AU - Salih, Mohsin. AU - Darrat, Yousef H.. AU - Saadi, Abdulghani. AU - Guddeti, Raviteja. AU - Mahfood Haddad, Toufik. AU - Kabach, Amjad. AU - Ayan, Mohamed. AU - Saurav, Alok. AU - Abuissa, Hussam. AU - Elayi, Claude S.. PY - 2018/11/1. Y1 - 2018/11/1. N2 - Background: The role of catheter ablation (CA) is increasingly recognized as a reasonable therapeutic option in patients with atrial fibrillation (AF) and heart failure (HF). Hypothesis: We aimed to compare CA to medical therapy in AF patients with HF with reduced ejection fraction (HFrEF). Methods: We searched the literature for randomized clinical trials comparing CA to medical therapy in this population. Results: Six trials with a total of 775 patients were included. AF was persistent in 95% of patients with a mean duration of 18.5 ± 23 months prior enrollment. ...
Cardioversion. If a cause cannot be found or easily treated, or if treating the cause does not get rid of the atrial fibrillation, then doctors can use a technique called cardioversion to knock the heart back into a normal rhythm. This involves giving the heart a small electric shock or using medication to force the heart back into normal rhythm.. If this is unsuccessful then the next step particularly in a younger person or someone with simple atrial fibrillation is to do some electrical work, Prof Harbison explained.. Electrical work. Doctors can use what is known as electrophysiology; the study of the electrical function of the heart, to detect the part in the heart that is causing the atrial fibrillation.. Catheter Ablation. They can then use a procedure called catheter ablation which finds and remove the main cause of the atrial fibrillation.. With catheter ablation, narrow, flexible wires, are inserted into a blood vessel, often at the top of your leg or your neck and threaded up to your ...
The CARMA Center at the University of Utah Health Care kicked off a clinical trial aiming to improve the treatment of atrial fibrillation (AF). Under the guidance of lead investigator Nassir Marrouche, M.D., the DECAAF II trial will evaluate the efficacy of targeting atrial fibrotic tissue during catheter ablation of AF in improving procedural outcome.. Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States. Each year millions of Americans are diagnosed and treated for this condition, which is an electrical problem in the upper chambers in the heart that causes an irregular heartbeat. Currently one of the most widely used treatments is catheter ablation that involves radiofrequency energy or freezing directed through a catheter to specific heart cells.. In the DECAAF II study two ablation protocols will be compared: the conventional Pulmonary Vein Isolation procedure versus ablation of atrial fibrotic tissue detected using MRI. "This study follows our initial work at ...
Implantable atrial defibrillators are able to deliver shocks immediately after the onset of paroxysmal atrial fibrillation (PAF). It is anticipated that rapid restoration of sinus rhythm may allow electrical remodeling and thus reduce PAF recurrence (sinus rhythm begets sinus rhythm). Methods: 8 patients with atrial defibrillators (Metrix 3020, InControl) were studied for a mean of 11.6+/-3.7 (range 8-18) months. Data were prospectively collected by device telemetry and patient diary. Patient characteristics, PAF episodes and results of device therapy were recorded. Results: All patients had failed | 2 medical therapies. 6/8 patients had structurally normal hearts, 2/8 had dilated left atria and hypertension. Mean number of PAF episodes per month prior to implant was 3.0 (range 0.25-8.0). Post-implant, patients had a mean of 15.4+/-9 (range 0-28) AF episodes during follow-up, with 12.6+/-10.8 attempted therapies with a success rate of 74%. The most common cause of failure of therapy was early
Background: Clinical trials have indicated that an active rhythm control strategy aiming at restoration of sinus rhythm in patients with atrial fibrillation (AF) is no better than a rate-control strategy in terms of mortality and morbidity. To what extent restoration and maintenance of sinus rhythm per se affect long-term prognosis in AF patients is less clear.. Aim: To investigate if there are differences in mortality and morbidity between direct current (DC)-cardioverted AF patients who remain in sinus rhythm after cardioversion and those who relapse early.. Method: 361 cardioverted patients from the Stockholm Cohort Study on Atrial Fibrillation were studied by means of medical records and national registers. Patients were followed for a mean of 4.2 years from DC cardioversion regarding all-cause mortality and for a mean of 3.2 years for a composite endpoint of death, ischaemic stroke, myocardial infarction or hospitalisation for heart failure.. Results: All-cause mortality tended to be lower ...
Atrial Fibrillation: Complications of atrial fibrillation. Atrial fibrillation (also known as AF or AFib) is the most common type of arrhythmia (irregular heartbeat or heart rhythm). The most common symptom of AF is heart palpitations (an irregular and rapid heartbeat, typically experienced as a rapid thumping in the chest). The majority of people with AF live active, healthy lives with treatment.
This study investigated comparison of bleeding risk among elderly patients and overall non-valvular atrial fibrillation patients treated with apixaban,
Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodelling due to atrial fibrillation (AF). To investigate the effect of detomidine administration on AFCL measured invasively from an intra-atrial electrog
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BACKGROUND: While tall stature has been related to lower risk of vascular disease, it has been proposed as a risk factor for atrial fibrillation. Little is known about other anthropometric measures and their joint effects on risk for atrial fibrillation. OBJECTIVES: We aim to investigate associations and potential joint effects of height, weight, body surface area (BSA) and body mass index (BMI) with risk of atrial fibrillation. METHODS: In a cohort covering 1,153,151 18-years old men participating in the Swedish military conscription (1972-1995) Cox regression was used to investigate associations of height, weight, BSA and BMI with risk of atrial fibrillation ...
This page includes the following topics and synonyms: Atrial Fibrillation Causes, Atrial Fibrillation Associated Conditions, Atrial Fibrillation Etiology, Atrial Fibrillation Risk Factors.
TY - JOUR. T1 - Female sex as a risk factor for stroke in atrial fibrillation. T2 - a nationwide cohort study. AU - Mikkelsen, Anders. AU - Lindhardsen, J. AU - Lip, G Y H. AU - Gislason, G H. AU - Torp-Pedersen, C. AU - Olesen, J B. N1 - © 2012 International Society on Thrombosis and Haemostasis.. PY - 2012. Y1 - 2012. N2 - Female sex has been suggested as a risk factor for stroke/thromboembolism in patients with non-valvular atrial fibrillation (AF) and has therefore been included within risk scores, e.g., the CHA2 DS2 -VASc score, and guidelines.. AB - Female sex has been suggested as a risk factor for stroke/thromboembolism in patients with non-valvular atrial fibrillation (AF) and has therefore been included within risk scores, e.g., the CHA2 DS2 -VASc score, and guidelines.. U2 - 10.1111/j.1538-7836.2012.04853.x. DO - 10.1111/j.1538-7836.2012.04853.x. M3 - Journal article. VL - 10. SP - 1745. EP - 1751. JO - Journal of Thrombosis and Haemostasis. JF - Journal of Thrombosis and ...
PSYCHOLOGICAL DISTRESS AND IS ASSOCIATED INFECTION IS AN INDEPENDENT RISK OF ATRIAL FIBRILLATION RECURRENCES RATE IN LONE ATRIAL FIBRILLATION PATIENTS: P049 ...
TY - JOUR. T1 - Virtual ablation for atrial fibrillation in personalized in-silico three-dimensional left atrial modeling. T2 - Comparison with clinical catheter ablation. AU - Hwang, Minki. AU - Kwon, Soon Sung. AU - Wi, Jin. AU - Park, Mijin. AU - Lee, Hyun Seung. AU - Park, Jin Seo. AU - Lee, Young Seon. AU - Shim, Eun Bo. AU - Pak, Hui Nam. PY - 2014/9/1. Y1 - 2014/9/1. N2 - Background: Although catheter ablation is an effective rhythm control strategy for atrial fibrillation (AF), empirically-based ablation has a substantial recurrence rate. The purposes of this study were to develop a computational platform for patient-specific virtual AF ablation and to compare the anti-fibrillatory effects of 5 different virtual ablation protocols with empirically chosen clinical ablations. Methods: We included 20 patients with AF (65% male, 60.1±10.5 years old, 80% persistent AF [PeAF]) who had undergone empirically-based catheter ablation: circumferential pulmonary vein isolation (CPVI) for paroxysmal ...
Atrial fibrillation is a heart arrhythmia in which abnormal electrical signals begin in the atria (top chambers) of the heart. Atrial fibrillation may be treated by catheter ablation, if medications alone are not effective. In ablation, areas of tissue in the heart that cause arrhythmias are destroyed.. Before ablation procedure, electrical mapping of the heart is performed. An electrically-sensitive catheter is used to map the heart muscle and the origins of the electrical activity throughout the heart. The map tells the specialist which areas of the heart are creating problematic electric signals that interfere with the proper rhythm.. Catheter ablation is a non-invasive procedure; no major incision is necessary. A surgeon inserts a catheter into the heart via a blood vessel. The surgeon carefully destroys malfunctioning tissue using the catheter to deliver energy (such as radiofrequency, laser or cyrotherapy) to scar the problematic areas. The scarred areas will no longer send abnormal ...