MedWorm: Atrial Fibrillation

Pradaxa Worth It in Cases of Prior Stroke (CME/CE)

MedPage Today Geriatrics — Wed, 08 Feb 2012 17:42:17 +0100

NEW ORLEANS (MedPage Today) -- Dabigatran (Pradaxa) is more cost-effective than warfarin at preventing stroke in atrial fibrillation patients who have had a prior stroke or transient ischemic attack, a model analysis showed. (Source: MedPage Today Geriatrics)

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Atrial fibrillation linked to adverse outcomes after PCI

MedWire News - Cardiology — Wed, 08 Feb 2012 14:07:01 +0100

Patients with periprocedural atrial fibrillation are at an increased risk for adverse outcomes after undergoing percutaneous coronary intervention, research suggests. (Source: MedWire News - Cardiology)

For Atrial Fibrillation Patients At Risk For Stroke, Easy-To-Use Blood Thinners Likely To Replace Coumadin

Health News from Medical News Today — Wed, 08 Feb 2012 08:00:00 +0100

Within a few years, a new generation of easy-to-use blood-thinning drugs will likely replace Coumadin for patients with irregular heartbeats who are at risk for stroke, according to a journal article by Loyola University Medical Center physicians. Unlike Coumadin, the new drugs do not require patients to come in to the clinic on a regular basis to check the dose. Nor do the drugs require extensive dietary restrictions. First author Sarkis Morales-Vidal, MD, and colleagues describe the new drugs in a review article in the February issue of the journal Expert Reviews... (Source: Health News from Medical News Today)

An Earnest Search for Atrial Fibrillation Patients Without Thromboembolic Risk

Journal of Cardiovascular Electrophysiology — Tue, 07 Feb 2012 05:00:00 +0100

(Source: Journal of Cardiovascular Electrophysiology)

Incidence of Asymptomatic Cerebral Microthromboembolism After Atrial Fibrillation Ablation Guided by Complex Fractionated Atrial Electrogram

Journal of Cardiovascular Electrophysiology — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: The incidence of cerebral microthromboembolism after CFAE ablation was not greater than previous reports in PVI. Cautious management is required during AF ablation, especially in the patients with low LVEF. (J Cardiovasc Electrophysiol, Vol. pp. 1‐7) (Source: Journal of Cardiovascular Electrophysiology)

ATX‐II‐Induced Pulmonary Vein Arrhythmogenesis Related to Atrial Fibrillation and Long‐QT Syndrome

European Journal of Clinical Investigation — Tue, 07 Feb 2012 02:06:06 +0100

Conclusion: The INa,L enhancer ATX‐II can increase PV arrhythmogenesis, which can be attenuated or blocked by ranolazine. This suggests that AF may be related to type 3 LQTS through increased INa,L. (Source: European Journal of Clinical Investigation)

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Impact of atrial fibrillation and oral anticoagulation on hospital costs and length of stay.

American Journal of Health-System Pharmacy : AJHP — Mon, 06 Feb 2012 12:06:33 +0100

Conclusion Hospitalizations of patients with a secondary diagnosis of AF are significantly longer and more costly than those of patients without a secondary diagnosis of AF, especially when warfarin is used during the hospital stay. Among patients with a primary diagnosis of AF, warfarin therapy during hospitalization is associated with significant increases in mean LOS and hospital costs. PMID: 22302258 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

For Atrial Fibrillation Patients, Rivaroxaban Has Less Risk Of Brain Bleeding In Patients At High Risk For Stroke

Health News from Medical News Today — Mon, 06 Feb 2012 08:00:00 +0100

For patients with a type of irregular heart beat called atrial fibrillation (AF), a new anti-clotting drug might be better at preventing clot-related strokes while minimizing the risk of causing a bleeding stroke. The research was presented at the American Stroke Association's International Stroke Conference 2012. The finding stems from a sub-analysis of data in a large, randomized clinical trial called ROCKET AF, conducted in 45 countries at 1,178 sites... (Source: Health News from Medical News Today)

Review of Contemporary Antiarrhythmic Drug Therapy for Maintenance of Sinus Rhythm in Atrial Fibrillation

Journal of Cardiovascular Pharmacology and Therapeutics — Mon, 06 Feb 2012 05:00:00 +0100

Atrial fibrillation (AF) is the most common rhythm disturbance seen in clinical practice, and its prevalence and incidence are rising rapidly as the population ages with its attendant complications. Management of AF involves anticoagulation, and fortunately new drugs for long-term anticoagulation are now available. Maintenance of sinus rhythm, though intuitively better than rate control strategy, has not been shown to offer mortality benefit. Still, maintenance of sinus rhythm is considered an appropriate therapeutic strategy when symptoms are not adequately controlled with rate control. Though significant advances have been made in ablation techniques for AF, pharmacological therapy is still the first line of treatment for rate control and maintenance of sinus rhythm, given ease of use, n...

Effect of Telmisartan and Ramipril on Atrial Fibrillation Recurrence and Severity in Hypertensive Patients With Metabolic Syndrome and Recurrent Symptomatic Paroxysmal and Persistent Atrial Fibrillation

Journal of Cardiovascular Pharmacology and Therapeutics — Mon, 06 Feb 2012 05:00:00 +0100

This study evaluated the effect of telmisartan, ramipril, and amlodipine on atrial fibrillation (AF) recurrence and severity in hypertensive patients with metabolic syndrome. A total of 391 hypertensive outpatients with metabolic syndrome, in sinus rhythm but with at least 2 episodes of AF in the previous 6 months were randomized to telmisartan, ramipril, or amlodipine for 1 year. At the first AF, ventricular rate (VR) and plasma cardiac troponin I (TnI) were evaluated. P-wave dispersion (PWD) and procollagen type I carboxy-terminal peptide (PIP) were evaluated before and after 12 months of treatment. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similarly and significantly reduced by all treatments (P < .001). In all, 49% of patients treated with amlodipine had ...

From coronary care unit to acute cardiac care unit: the evolving role of specialist cardiac care

Heart — Mon, 06 Feb 2012 05:00:00 +0100

The development of primary angioplasty (PPCI) programmes for acute ST elevation myocardial infarction (STEMI) following Roger Boyle's report ‘Mending hearts and brains’ in 20061 has led to a marked shift in the role of the coronary care unit (CCU) in the UK. Some units no longer admit STEMI patients, while in PPCI centres the concentrated influx of patients previously treated across a network of hospitals has placed CCU beds and staff under considerable pressure. However, there are other factors changing and increasing the workload of acute cardiology, and the development of PPCI cannot be considered in isolation. In particular, the changing demographics of the population has led to an increasing proportion of elderly patients presenting to hospital with non-ST elevation myocar...

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Near Elimination of Ventricular Pacing in SafeR Mode Compared to DDD Modes: A Randomized Study of 422 Patients

Pacing and Clinical Electrophysiology : PACE — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions:In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes.(PACE 2012;1–11) (Source: Pacing and Clinical Electrophysiology : PACE)

Short-term outcome of early electrical cardioversion for atrial fibrillation in hyperthyroid versus euthyroid patients*.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Conclusions: Electrical cardioversion should be performed for patients with persistent AF and hyperthyroidism as soon as possible. (Cardiol J 2012; 19, 1: 53-60). PMID: 22298168 [PubMed - in process] (Source: Cardiology Journal)

Aging reduces left atrial performance during adrenergic stress in middle aged and older patients.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Conclusions: Age is associated with a decrease in LA function during adrenergic stress even after adjusting for co-morbidities associated with cardiovascular disease and LV function. (Cardiol J 2012; 19, 1: 45-52). PMID: 22298167 [PubMed - in process] (Source: Cardiology Journal)

ARISTOTLE RE-LYs on the ROCKET. What's new in stroke prevention in patients with atrial fibrillation?

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Authors: Tendera M, Syzdół M, Parma Z Abstract Warfarin has long been considered the gold standard for stroke prevention in patients with atrial fibrillation (AF). Recently, three major trials comparing the efficacy and safety of new drugs: a thrombin inhibitor dabigatran and two inhibitors of factor Xa - rivaroxaban and apixaban, with that of warfarin, have been published. The aim of this paper is to present the main results of the RE-LY, ROCKET AF and ARISTOTLE trials, compare study populations and outcomes, and discuss clinical implications of their results for the long-term anticoagulation in patients with nonvalvular AF. (Cardiol J 2012; 19, 1: 4-10). PMID: 22298161 [PubMed - in process] (Source: Cardiology Journal)

Minorities with Afib at Greater Risk for Brain Bleeds (CME/CE)

MedPage Today State Required CME — Sun, 05 Feb 2012 00:43:12 +0100

(MedPage Today) -- NEW ORLEANS — Among patients with atrial fibrillation, being Asian or black were among the risk factors associated with intracranial hemorrhage, researchers found. (Source: MedPage Today State Required CME)

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Hidden Afib Common in Stroke of Unknown Cause (CME/CE)

MedPage Today Cardiovascular — Fri, 03 Feb 2012 21:24:07 +0100

NEW ORLEANS (MedPage Today) -- One patient in five with an unexplained stroke or transient ischemic attack has occult paroxysmal atrial fibrillation episodes on subsequent monitoring, researchers found. (Source: MedPage Today Cardiovascular)

Apixaban Works in Afib Even With Prior Stroke (CME/CE)

MedPage Today Cardiovascular — Fri, 03 Feb 2012 19:48:19 +0100

NEW ORLEANS (MedPage Today) -- The investigational anticoagulant, apixaban, appears to prevent stroke and systemic embolism in patients with atrial fibrillation regardless of a prior history of stroke or transient ischemic attack, two studies showed. (Source: MedPage Today Cardiovascular)

Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis

BMC Family Practice — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Warfarin use has increased somewhat over time. The decision to prescribe warfarin for stroke prevention in atrial fibrillation is based upon multiple prescriber and patient characteristics. These findings can be used by family practice prescribers and other healthcare decision-makers to target interventions or methods to improve utilization of warfarin when it is indicated for stroke prevention. (Source: BMC Family Practice)

Cardiac Telemetry Identifies Atrial Fibrillation in Cryptogenic Stroke Cardiac Telemetry Identifies Atrial Fibrillation in Cryptogenic Stroke

Medscape Today Headlines — Fri, 03 Feb 2012 01:18:21 +0100

Outpatient monitoring for 21 days detected atrial fibrillation in 17% of patients, and this could change management. Medscape Medical News (Source: Medscape Today Headlines)

Rivaroxaban Has Less Risk of Brain Bleeding in Patients at High Risk of Stroke

MedlinePlus Health News — Fri, 03 Feb 2012 01:15:10 +0100

Source: American Heart Association Related MedlinePlus Page: Atrial Fibrillation (Source: MedlinePlus Health News)

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Erratic Heart Rhythm May Account for Some Unexplained Strokes

MedlinePlus Health News — Fri, 03 Feb 2012 01:10:16 +0100

Source: American Heart Association Related MedlinePlus Pages: Atrial Fibrillation, Stroke (Source: MedlinePlus Health News)

Growth differentiation factor-15, a novel biomarker related with disease severity in patients with hypertrophic cardiomyopathy.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:26:31 +0100

CONCLUSIONS: The present results show that higher levels of GDF-15 are associated to conditions of severe disease in HCM. Hence, GDF-15 is suggested as a novel marker related to the severity and could represent a further useful tool in monitoring functional capacity of HCM patients. PMID: 22284249 [PubMed - in process] (Source: European Journal of Internal Medicine)

Cardiac telemetry identifies AF in cryptogenic stroke

theHeart.org — Thu, 02 Feb 2012 21:00:00 +0100

Outpatient monitoring for 21 days detected atrial fibrillation in 17% of patients, and this could change management. (Source: theHeart.org)

Study Explores Role of Periprocedural Dabigatran in AF Ablation

Forbes.com Healthcare News — Thu, 02 Feb 2012 20:29:26 +0100

Updated with a comment from John Mandrola-- As dabigatran becomes more widely used in atrial fibrillation (AF) patients, electrophysiologists are now trying to figure out how to handle anticoagulation in patients taking dabigatran (Pradaxa) for whom AF ablation is planned. In a new study published in the Journal of the American College of Cardiology, Dhanunjaya Lakkireddy and colleagues report on a multicenter, observational study of 290 patients who underwent an AF ablation procedure. Half the patients were taking periprocedural dabigatran and half were matched controls taking warfarin. (Source: Forbes.com Healthcare News)

Endobronchial Lipomatous Hamartoma: An Incidental Finding in a Patient with Atrial Fibrillation—A Case Report

Advances in Pharmacological Sciences — Thu, 02 Feb 2012 18:35:24 +0100

Conclusion. Endobronchial tumors such as endobronchial lipoma or hamartoma should be considered as potential causes of exertional dyspnea and thus as differential diagnosis of atrial fibrillation. Although endobronchial hamartomas are benign, resection is recommended to prevent postobstructive lung damage. (Source: Advances in Pharmacological Sciences)

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Anagrelide: First reports of atrial flutter and atrial fibrillation: 4 case reports

Reactions — Thu, 02 Feb 2012 18:34:27 +0100

(Source: Reactions)

Propofol-induced coved-type electrocardiogram during catheter ablation of paroxysmal atrial fibrillation

Herzschrittmachertherapie und Elektrophysiologie — Thu, 02 Feb 2012 18:14:28 +0100

We report a case of a young man with paroxysmal atrial fibrillation, in whom a characteristic coved-type Brugada pattern developed during catheter ablation performed under sedation with propofol. After immediate discontinuation of the propofol infusion, coved-type ST-segment elevation gradually resolved and no ventricular arrhythmias occurred. An ajmaline challenge failed to unmask a coved-type electrocardiogram and genetic testing was negative for ion channel mutations related to Brugada syndrome. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s00399-011-0156-8Authors S. Richter, Department of Electrophysiology, Heart Center, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, GermanyP. Brugada, The Heart Rhythm Management Centre, Cardiovascular Centre...

Biochemical predictors of cardiac rhythm at 1 year follow-up in patients with non-valvular atrial fibrillation

Journal of Thrombosis and Thrombolysis — Thu, 02 Feb 2012 18:12:07 +0100

Abstract C-reactive protein (CRP) is increased in patients with atrial fibrillation (AF) and it might predict the lack of sinus rhythm maintenance in the long term follow-up. Scarce data have been reported relating endothelial dysfunction and/or haemostatic or platelet markers to sinus rhythm maintenance in AF patients. We aimed to determine whether some biochemical markers including soluble thrombomodulin (sTM), soluble P-selectin, thrombin–antithrombin (TAT) complex and CRP levels could predict sinus rhythm maintenance at 1 year follow-up in non-valvular AF patients. 130 patients (70 males, mean age 67 ± 13 years) with newly diagnosed AF naïve of antithrombotic or antiplatelet therapy were studied. Baseline CRP, P-selectin, sTM and TAT levels were ...

“From Bench to Practice”, ESC Congress set for Munich this summer

European Society of Cardiology — Thu, 02 Feb 2012 16:43:01 +0100

In response to feedback from delegates, this year’s congress will kick off on Saturday with a fuller day of scientific sessions. The grand finale on Wednesday will be a two-hour highlight session in which world leading experts summarise all the new and exciting developments in basic, clinical and population sciences presented at the congress. Read more about this year's event.... Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of th...

The Editor's Roundtable: Medical Management of Atrial Fibrillation

The American Journal of Cardiology — Thu, 02 Feb 2012 14:05:53 +0100

This article is supported by an educational grant from sanofi-aventis U.S., Bridgewater, New Jersey. Readers are requested to go to www.ajconline.org to participate in a survey. (Source: The American Journal of Cardiology)

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Electrocardiogram in Left Ventricular Hypertrabeculation/Noncompaction

The American Journal of Cardiology — Thu, 02 Feb 2012 14:05:53 +0100

The report by Stöllberger et al in the October 1, 2011, issue of The American Journal of Cardiology on the frequency of stroke and embolism in 144 patients with left ventricular hypertrabeculation/noncompaction, a cardiac abnormality of unknown origin, was based on a retrograde analysis of baseline clinical, echocardiographic, and electrocardiographic data. In reference to electrocardiographic information, the investigators reported on the prevalence of normal findings, left bundle branch block, pathologic Q waves, and atrial fibrillation. Left ventricular hypertrabeculation/noncompaction is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. One wonders, given these anatomic peculiarities, about possible changes in th...

Atrial Conduction Slows Immediately Before the Onset of Human Atrial Fibrillation: A Bi-Atrial Contact Mapping Study of Transitions to Atrial Fibrillation

Journal of the American College of Cardiology — Thu, 02 Feb 2012 13:55:34 +0100

Conclusions: Acceleration-dependent slowing of atrial conduction (CV restitution) precedes AF initiation, whereas absence of CV restitution identifies inability to induce AF. Conduction restitution, but not fractionated electrograms, may thus track the functional milieu enabling AF initiation and has implications for guiding AF ablation and pharmacological therapy. (Source: Journal of the American College of Cardiology)

Rivaroxaban has less risk of brain bleeding in patients at high risk for stroke

EurekAlert! - Medicine and Health — Thu, 02 Feb 2012 05:00:00 +0100

(American Heart Association) For patients with a type of irregular heart beat called atrial fibrillation, a new anti-clotting drug might be better at preventing clot-related strokes while minimizing the risk of causing a bleeding stroke. The research was presented at the American Stroke Association's International Stroke Conference 2012. (Source: EurekAlert! - Medicine and Health)

Apixaban vs. aspirin in patients with atrial fibrillation and previous stroke or TIA: subgroup analysis from AVERROES trial

NeLM - News — Thu, 02 Feb 2012 05:00:00 +0100

Source: Lancet Neurology Area: News Apixaban, reduced the risk of stroke or systemic embolism in patients with atrial fibrillation who were at high risk of stroke but unsuitable for vitamin K antagonist therapy in the AVERROES study (n= 5599). In a report in the Lancet Neurolgy, researchers evaluated whether the subgroup of patients with previous stroke or transient ischaemic attack (TIA) would show a greater benefit from apixaban compared with aspirin than patients without previous cerebrovascular events. Patients were randomised to apixaban 5mg BD or aspirin (81 to 324mg daily). The mean follow-up was 1.1 years. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding. This pre-specified subgroup analysis estimated compared 1...

Risk of Recurrent Stroke in Patients With Silent Brain Infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) Imaging Substudy.

Stroke — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: The presence of SBI in patients with recent mild noncardioembolic ischemic stroke could not be shown to be an independent risk factor for recurrent stroke, other vascular events, or a higher mortality rate. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00153062. PMID: 22267825 [PubMed - as supplied by publisher] (Source: Stroke)

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When Oral Anticoagulation Therapy is Needed in Patients With Cardiomyopathies: A Review of Literature

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

The question whether to anticoagulate patients with cardiomyopathy or not is over 50years old. Multiple clinical trials have demonstrated the superior therapeutic effect of warfarin compared with placebo in the prevention of thromboembolic events amongst patients with nonvalvular atrial fibrillation. The purpose of our work is to review literature about the role of anticoagulation in the main cardiomyopathies. (Source: Heart, Lung and Circulation)

Dabigatran for patients with a mechanical valve

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

We read with great interest the case report by Stewart et al. , describing a 62 year-old Caucasian patient who suffered thrombosis of a mechanical aortic valve and an embolic stroke whilst being treated for more than eight months with dabigatran (150mg b.i.d.) and 100mg aspirin. Dabigatran etexilate is a new oral direct thrombin inhibitor currently approved for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. In the RELY study , a dose of 150mg b.i.d. was shown to be associated with a significantly lower risk of stroke and systemic embolism with a similar risk of major bleeding when compared with warfarin. (Source: Heart, Lung and Circulation)

Med Sci Monit 2012; 18(2):CR78-87 "Relation of hs-CRP and BNP levels with the atrial spontaneous echo contrast and thrombi in permanent atrial fibrillation patients with different etiologies"

Medical Science Monitor — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Higher hs-CRP levels in AF patients may be a predictor for the presence of SEC and thrombi in the atria. (Source: Medical Science Monitor)

Prevalence and outcome of Middle-eastern Arab and South Asian patients hospitalized with heart failure: insight from a 20-year registry in a Middle-eastern country (1991-2010).

Acute Cardiac Care — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: HF patients in the Middle East present at relatively younger age regardless of ethnicity. In-hospital mortality and stroke rates decreased significantly over the 20-years. PMID: 22295893 [PubMed - as supplied by publisher] (Source: Acute Cardiac Care)

Comparison Between Atrial Fibrillation‐Triggered Implantable Cardioverter‐Defibrillator (ICD) Shocks and Inappropriate Shocks Caused by Lead Failure:

Journal of Cardiovascular Electrophysiology — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Multiple ICD shocks triggered by AF are associated with a worse prognosis in ICD patients, whereas a single shock due to AF or shocks resulting from lead failure are not. These data support that the ICD shock itself has no worse impact on the outcome of ICD patients. (J Cardiovasc Electrophysiol, Vol. pp. 1‐6) (Source: Journal of Cardiovascular Electrophysiology)

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The Funny Current (If): Is it a Novel Antiarrhythmic Target to Treat Atrial Fibrillation?

Journal of Cardiovascular Electrophysiology — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Journal of Cardiovascular Electrophysiology)

Arrhythmogenic Difference between the Left and Right Atria in a Canine Ventricular Pacing‐Induced Heart Failure Model of Atrial Fibrillation

Pacing and Clinical Electrophysiology : PACE — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion:CHF dogs had a higher frequency of focal discharge and reentry, suggesting that CHF provided an arrhythmogenic substrate. LA had a higher frequency of focal discharge and reentry, suggesting that LA is more important to maintain AF. (PACE 2012; 35:188–195) (Source: Pacing and Clinical Electrophysiology : PACE)

Multiple Cardiac Perforations Following Radiofrequency Catheter Ablation: Case Report and Literature Reviews.

Annals of Thoracic and Cardiovascular Surgery — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions: Urgent exploratory surgery with cardiopulmonary bypass is the key to salvage the patient. PMID: 22293306 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovascular Surgery)

Dabigatran in Clinical Practice for Atrial Fibrillation With Special Reference to Activated Partial Thromboplastin Time.

Circulation Journal — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions: We found a wide distribution of APTT in NVAF patients under dabigatran treatment. High APTT might help screen for bleeding risks among patients under dabigatran, but requires future investigation. PMID: 22293451 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Right Atrial Anatomical Remodeling Affects Early Outcomes of Nonvalvular Atrial Fibrillation After Radiofrequency Ablation.

Circulation Journal — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions: RA anatomical remodeling might affect the early recurrence of AF after RFA. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence of AF after RFA. PMID: 22293450 [PubMed - as supplied by publisher] (Source: Circulation Journal)

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Letter by Madias Regarding the Article, "Repolarization Alternans Reveals Vulnerability to Human Atrial fibrillation".

Circulation — Tue, 31 Jan 2012 05:00:00 +0100

Letter by Madias Regarding the Article, "Repolarization Alternans Reveals Vulnerability to Human Atrial fibrillation". Circulation. 2012 Jan 31;125(4):e320 Authors: Madias JE PMID: 22294715 [PubMed - in process] (Source: Circulation)

Letter by montone et Al regarding article, "atrial fibrillation: outpatient presentation and management".

Circulation — Tue, 31 Jan 2012 05:00:00 +0100

Letter by montone et Al regarding article, "atrial fibrillation: outpatient presentation and management". Circulation. 2012 Jan 31;125(4):e318 Authors: Montone RA, Mollo R, Nerla R PMID: 22294714 [PubMed - in process] (Source: Circulation)

Letter by karam and marijon regarding article, "atrial fibrillation: outpatient presentation and management".

Circulation — Tue, 31 Jan 2012 05:00:00 +0100

Letter by karam and marijon regarding article, "atrial fibrillation: outpatient presentation and management". Circulation. 2012 Jan 31;125(4):e317 Authors: Karam N, Marijon E PMID: 22294713 [PubMed - in process] (Source: Circulation)

The Pharmacology and Therapeutic Use of Dabigatran Etexilate.

The Journal of Clinical Pharmacology — Tue, 31 Jan 2012 05:00:00 +0100

Authors: Spinler S Abstract Dabigatran etexilate is an oral prodrug of dabigatran, a direct thrombin inhibitor, that provides the first available oral anticoagulant alternative to warfarin for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). Although warfarin is effective, many patients with AF remain undertreated, primarily because of the management challenges associated with warfarin therapy. Dabigatran etexilate offers several potential advantages over warfarin, including fixed dosing, no requirement for blood coagulation monitoring, and reduced propensity for drug-drug interactions. In a large phase 3 trial in patients with nonvalvular AF, the US Food and Drug Administration (FDA)-approved dose of dabigatran etexilate (150...

An Unusual First Presentation of Ebstein's Anomaly in a 72-Year-Old Patient.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:55 +0100

We report the unusual case of a 72-year-old woman with a primary presentation of right heart failure in the setting of recently diagnosed Ebstein's anomaly with concomitant atrial fibrillation (AF). The patient had New York Heart Association (NYHA) class III dyspnea for 12 months, with refractory right heart failure prior to undergoing surgical management in the form of a tricuspid annuloplasty ring and plication of the atrialized ventricle. The patient had an uneventful postoperative recovery and enjoyed an improvement in her exercise tolerance (NYHA class I) with minimal echocardiographic evidence of tricuspid regurgitation (TR) at the latest follow-up. PMID: 22269761 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

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Amiodarone After Lung Surgery Cuts Afib (CME/CE)

MedPage Today State Required CME — Tue, 31 Jan 2012 00:43:12 +0100

FT. LAUDERDALE (MedPage Today) -- Postoperative administration of amiodarone after lung cancer resection significantly reduced the risk of atrial fibrillation in a randomized trial. (Source: MedPage Today State Required CME)

n-3 PUFAs may protect against AF

MedWire News - Lipidology — Tue, 31 Jan 2012 00:00:00 +0100

Dietary long-chain n-3 polyunsaturated fatty acids could be beneficial for the prevention of atrial fibrillation onset in older adults, suggest study findings. (Source: MedWire News - Lipidology)

POAF linked to increased risk for death following CABG

MedWire News - Lipidology — Mon, 30 Jan 2012 00:00:00 +0100

Patients who undergo coronary artery bypass graft surgery have an increased risk for death if they experience postoperative atrial fibrillation, suggest study findings that also showstatin therapy improved survival in this group of patients. (Source: MedWire News - Lipidology)

Antithrombotic therapy for stroke prevention in atrial fibrillation and mechanical heart valves

American Journal of Hematology — Sun, 29 Jan 2012 22:11:34 +0100

AbstractCardioembolic strokes account for one‐sixth of all strokes and are an important potentially preventable cause of morbidity and mortality. Vitamin K antagonists (e.g., warfarin) are effective for the prevention of cardioembolic stroke in patients with atrial fibrillation (AF) and in those with mechanical heart valves but because of their inherent limitations are underutilized and often suboptimally managed. Antiplatelet therapies have been the only alternatives to warfarin for stroke prevention in AF but although they are safer and more convenient they are much less efficacious. The advent of new oral anticoagulant drugs offers the potential to reduce the burden of cardioembolic stroke by providing access to effective, safe and more convenient therapies. New oral anticoagulants ha...

[Correspondence] New antithrombotic drugs for atrial fibrillation: caution is needed

LANCET — Sat, 28 Jan 2012 05:00:00 +0100

The Correspondence letter by Eloi Marijon and others (Aug 20, p 662) chastises the drug regulation authorities in Europe for the slowness of their assessment processes in the approval of new antithrombotic drugs for use in atrial fibrillation. They claim that the ROCKET-AF and RE-LY studies have shown these new drugs to be superior to vitamin K antagonists. Marijon and colleagues then go on to extrapolate the claimed advantages to the European population with atrial fibrillation and calculate the number of strokes that might have been saved by earlier introduction of these drugs. (Source: LANCET)

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[Correspondence] New antithrombotic drugs for atrial fibrillation: caution is needed – Authors' reply

LANCET — Sat, 28 Jan 2012 05:00:00 +0100

We thank Sarah Bell and colleagues for reinforcing the point that approval processes should be optimised, in terms of delay, without decreasing the rigour of these processes. (Source: LANCET)

Uric Acid and Atrial Fibrillation.

Circulation Journal — Sat, 28 Jan 2012 05:00:00 +0100

Authors: Watanabe E PMID: 22293454 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Left atrial appendage occlusion in valvular atrial fibrillation following MitraClip implantation

Clinical Research in Cardiology — Fri, 27 Jan 2012 17:53:44 +0100

Content Type Journal ArticleCategory Letter to the EditorsPages 1-4DOI 10.1007/s00392-012-0416-6Authors Alexander Jabs, 2nd Department of Medicine, Cardiology/Angiology/Intensive Care, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, GermanyUlrich Hink, 2nd Department of Medicine, Cardiology/Angiology/Intensive Care, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, GermanyAscan Warnholtz, 2nd Department of Medicine, Cardiology/Angiology/Intensive Care, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, GermanyRalph Stephan von Bardeleben, 2nd Department of Medicine, Cardiology/Angiology/Intensive Care, University Medical Center of the...

A giant true aneurysm of the celiac trunk

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:15 +0100

A 80-year-old man was admitted to our department because of an arterial dilatation into the abdomen recorded during a routine ultrasound scan. His medical history was notable for smoking, chronic obstructive pulmonary disease, hypertension, hypercholesterolemia, and atrial fibrillation in anticoagulant therapy. The patient never underwent abdominal surgery and he was asymptomatic for abdominal pain. (Source: Journal of Vascular Surgery)

Coumarins and survival in incident dialysis patients

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. Our data suggest that coumarins might be less harmful than previously anticipated when clearly indicated and closely monitored. (Source: Nephrology Dialysis Transplantation)

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Sluggish CRM sales continue to affect St. Jude’s bottom line

Cardiovascular Business News — Thu, 26 Jan 2012 08:31:29 +0100

St. Jude Medical has reported slight increases in net earnings for the fourth quarter and year ending Dec. 31, 2011, despite a dip in cardiac rhythm management (CRM) sales. However, double-digit sale increases for both the fourth quarter and fiscal year for the atrial fibrillation and cardiovascular units bolstered the company. (Source: Cardiovascular Business News)

Acute Ischemic Stroke: Infarct Core Estimation on CT Angiography Source Images Depends on CT Angiography Protocol [Neuroradiology]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: CT angiography protocol changes designed to speed imaging and optimize arterial opacification are associated with significant overestimation of infarct size on CT angiography source images. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110896/-/DC1 (Source: Radiology)

Association of Plasma Phospholipid Long-Chain Omega-3 Fatty Acids with Incident Atrial Fibrillation in Older Adults: The Cardiovascular Health Study.

Circulation — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSIONS: In older adults, higher circulating total long-chain n-3 PUFA and DHA levels were associated with lower risk of incident AF. These results highlight the need to evaluate whether increased dietary intake of these fatty acids could be effective for primary prevention of AF. PMID: 22282329 [PubMed - as supplied by publisher] (Source: Circulation)

[Evaluation of clinical and demographic characteristics and their association with length of hospital stay in patients admitted to cardiac intensive care unit with the diagnosis of acute heart failure.]

Anadolu Kardiyol Der... — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSION: Underlying cardiovascular risk factors, comorbidities and precipitating pathologies were diverse and highlighted the inhomogeneous characteristics of AHF syndromes. However, in-hospital mortality was high and initial clinical presentation characteristics were significantly associated with in-hospital outcome. PMID: 22281792 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

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Physiological Parameter Monitoring from Optical Recordings With a Mobile Phone

IEEE Transactions on Biomedical Engineering — Wed, 25 Jan 2012 14:46:07 +0100

We show that a mobile phone can serve as an accurate monitor for several physiological variables, based on its ability to record and analyze the varying color signals of a fingertip placed in contact with its optical sensor. We confirm the accuracy of measurements of breathing rate, cardiac R-R intervals, and blood oxygen saturation, by comparisons to standard methods for making such measurements (respiration belts, ECGs, and pulse-oximeters, respectively). Measurement of respiratory rate uses a previously reported algorithm developed for use with a pulse-oximeter, based on amplitude and frequency modulation sequences within the light signal. We note that this technology can also be used with recently developed algorithms for detection of atrial fibrillation or blood loss. (Source: IEEE Tr...

[Summary of the article: Patel MR, Mahaffey KW, Garg J et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med, 2011; 365: 1557-1559.]

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

Authors: Szczerba E PMID: 22267443 [PubMed - as supplied by publisher] (Source: Kardiologia Polska)

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Clinical Cardiology — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions:POAF is an independent predictor of both short‐ and long‐term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Després has served as a speaker for Abbott Laboratories, AstraZeneca, Solvay Pharma, GlaxoSmithKline, and Pfizer Canada Inc.; has received research funding from Eli Lilly Canada; and has served on the advisory boards of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd., and Sanofi‐Aventis. The authors have no other funding, financial relationships, or conflicts of in...

Management of postoperative atrial fibrillation

Journal of Anesthesia — Tue, 24 Jan 2012 18:14:08 +0100

Abstract The impact of postoperative atrial fibrillation (PAF) on patient outcomes has prompted intense investigation into the optimal methods for prevention and treatment of this complication. In the prevention of PAF, β-blockers and amiodarone are particularly effective and are recommended by guidelines. However, their use requires caution due to the possibility of drug-related adverse effects. Aside from these risks, perioperative prophylactic treatment with statins seems to be effective for preventing PAF and is associated with a low incidence of adverse effects. PAF can be treated by rhythm control, heart-rate control, and antithrombotic therapy. For the purpose of heart rate control, β-blockers, calcium-channel antagonists, and amiodarone are used. In patients with...

Estimating the time scale and anatomical location of atrial fibrillation spontaneous termination in a biophysical model

Medical and Biological Engineering and Computing — Tue, 24 Jan 2012 07:19:28 +0100

This study contributes to the interpretation of previous clinical observations, and illustrates how computer modeling provides a complementary approach to study the mechanisms of cardiac arrhythmias. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11517-011-0859-3Authors Laurent Uldry, Applied Signal Processing Group, Swiss Federal Institute of Technology, EPFL-STI-SCI-JMV, Bâtiment ELD, Station 11, 1015 Lausanne, SwitzerlandVincent Jacquemet, Department of Physiology, Université de Montréal, Montréal, CanadaNathalie Virag, Medtronic Europe, Tolochenaz, SwitzerlandLukas Kappenberger, University of Lausanne, Lausanne, SwitzerlandJean-Marc Vesin, Applied Signal Processing Group, Swiss Federal Institute of Technology, EPFL-STI-SCI-JMV, Bâtiment ELD, Sta...

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An Unusual First Presentation of Ebstein's Anomaly in a 72-Year-Old Patient [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Reply to Letters Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial".

Circulation — Tue, 24 Jan 2012 05:00:00 +0100

Reply to Letters Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial". Circulation. 2012 Jan 24;125(3):e293-4 Authors: Eikelboom JW, Connolly SJ, Healey JS, Yang S, Yusuf S, Wallentin L, Oldgren J, Ezekowitz M, Alings M, Kaatz S, Hohnloser SH, Diener HC, Franzosi MG, Huber K, Reilly P, Varrone J PMID: 22271859 [PubMed - in process] (Source: Circulation)

Letter by Reiffel Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial".

Circulation — Tue, 24 Jan 2012 05:00:00 +0100

Letter by Reiffel Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial". Circulation. 2012 Jan 24;125(3):e292 Authors: Reiffel JA PMID: 22271858 [PubMed - in process] (Source: Circulation)

Letter by Reynolds et al Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial".

Circulation — Tue, 24 Jan 2012 05:00:00 +0100

Letter by Reynolds et al Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial". Circulation. 2012 Jan 24;125(3):e291 Authors: Reynolds S, Parra D, Rosenstein RS PMID: 22271857 [PubMed - in process] (Source: Circulation)

Letter by Govindarajan and Salgado Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial".

Circulation — Tue, 24 Jan 2012 05:00:00 +0100

Letter by Govindarajan and Salgado Regarding Article, "Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial". Circulation. 2012 Jan 24;125(3):e290 Authors: Govindarajan R, Salgado E PMID: 22271856 [PubMed - in process] (Source: Circulation)

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Atrial Electrical and Structural Remodeling Associated with Longstanding Pulmonary Hypertension and Right Ventricular Hypertrophy in Humans

Journal of Cardiovascular Electrophysiology — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion: Idiopathic PH is associated with RA remodeling characterized by: generalized conduction slowing with marked regional abnormalities; reduced tissue voltage; and regions of electrical silence. These changes provide important insights into the isolated effects of PH fundamental to a range of clinical conditions associated with AF. (J Cardiovasc Electrophysiol, Vol. pp. 1–7) (Source: Journal of Cardiovascular Electrophysiology)

Epicardial Atrial Mapping Can Predict Elimination of Chronic Atrial Fibrillation After the Box Pulmonary Vein Isolation During Mitral Valve Surgery.

Circulation Journal — Sat, 21 Jan 2012 05:00:00 +0100

Conclusions: Box PV isolation was effective in the treatment of chronic AF associated with MV disease. Epicardial atrial mapping may predict elimination of AF after the box PV isolation. PMID: 22277315 [PubMed - as supplied by publisher] (Source: Circulation Journal)

The king is dead (warfarin): direct thrombin and factor Xa inhibitors: the next Diadochian War?

International Journal of Stroke — Sat, 21 Jan 2012 00:38:01 +0100

Atrial fibrillation is an important risk factor for stroke. New drugs for oral anticoagulation that do not exhibit the limitations of vitamin K antagonists like warfarin are under investigation. These include direct factor Xa inhibitors and direct thrombin‐inhibitors. Recent studies provide promising results for apixaban, dabigatran, and rivaroxaban, including higher efficacy and significantly lower incidences of intracranial bleeds compared with warfarin. The new oral anticoagulants substances show similar results in secondary as in primary stroke prevention in patients with AF and will on the long run replace warfarin. (Source: International Journal of Stroke)

Upper normal blood pressure in men 'raises AF risk'

Nursing Times Breaking News — Fri, 20 Jan 2012 09:59:00 +0100

Atrial fibrillation (AF) is more likely to occur among middle-aged men with a diastolic blood pressure of just 80 mm Hg or higher, a new study suggests. (Source: Nursing Times Breaking News)

Middle-Aged Men with Upper-Normal Blood Pressure at Risk for AF

MedlinePlus Health News — Fri, 20 Jan 2012 06:23:26 +0100

Source: American Heart Association Related MedlinePlus Pages: Atrial Fibrillation, High Blood Pressure (Source: MedlinePlus Health News)

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ACP Foundation provides tools for preventing strokes in patients with atrial fibrillation

Modern Medicine — Fri, 20 Jan 2012 05:00:00 +0100

The ACP Foundation recently published a 31-page primer, Initiative on Atrial Fibrillation and Stroke Prevention, in the hopes of improving the care of patients with atrial fibrillation within health systems (Source: Modern Medicine)

Idiopathic atrial fibrillation: a rose by any other name?

Europace — Fri, 20 Jan 2012 05:00:00 +0100

(Source: Europace)

Cryoballoon ablation as first-line therapy of paroxysmal atrial fibrillation: dusk of global warming and the dawn of a new ice age era?

Europace — Fri, 20 Jan 2012 05:00:00 +0100

(Source: Europace)

Post-operative atrial fibrillation: a maze of mechanisms

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Post-operative atrial fibrillation (POAF) is one of the most frequent complications of cardiac surgery and an important predictor of patient morbidity as well as of prolonged hospitalization. It significantly increases costs for hospitalization. Insights into the pathophysiological factors causing POAF have been provided by both experimental and clinical investigations and show that POAF is ‘multi-factorial’. Facilitating factors in the mechanism of the arrhythmia can be classified as acute factors caused by the surgical intervention and chronic factors related to structural heart disease and ageing of the heart. Furthermore, some proarrhythmic mechanisms specifically occur in the setting of POAF. For example, inflammation and beta-adrenergic activation have been shown to play ...

Idiopathic atrial fibrillation revisited in a large longitudinal clinical cohort

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion Idiopathic AF may present at advanced age and is even then not associated with significant atrial enlargement, AF progression, or an adverse short-term prognosis. In contrast, elevated blood pressure even when found in the absence of significant atrial remodelling, seems of prognostic importance. (Source: Europace)

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Simplified electrocardiogram sampling maintains high diagnostic capability for atrial fibrillation: implications for opportunistic atrial fibrillation screening in primary care

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions Despite inferior electrocardiographic quality a 6-lead frontal plane ECG acquired by a simple prototype hand-held electrode assembly allowed reliable differentiation of AF from SR compared with standard 12-lead ECG. (Source: Europace)

Isolating the pulmonary veins as first-line therapy in patients with lone paroxysmal atrial fibrillation using the Cryoballoon

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion Cryoballoon ablation in patients with lone paroxysmal AF yields a high acute efficacy rate with a great chance of being free of symptomatic AF recurrence without antiarrhythmic drugs on a mid-term follow-up period, when offered as a first-line treatment. (Source: Europace)

Clinical characteristics of massive air embolism complicating left atrial ablation of atrial fibrillation: lessons from five cases

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion Serious air embolism can occur in patients with long apnoea under sedation during AF ablation with the use of long sheaths. Supportive therapy and air aspiration were effective in resolving the complication. A sedative that causes less respiratory depression and the timing of the saline flush were important for preventing air embolism. (Source: Europace)

Prevalence and clinical significance of collateral findings detected by chest computed tomography in patients undergoing atrial fibrillation ablation

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions Chest CT images acquired for integration in AF ablation should be read thoroughly as they may serve as a screening tool for otherwise unrecognized clinically significant conditions of the heart, lungs, or other visualized organs. (Source: Europace)

Detection of atrial high-rate events by continuous Home Monitoring: clinical significance in the heart failure-cardiac resynchronization therapy population

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion In a high-risk cohort of HF patients, device-detected atrial arrhythmias are associated with an increased incidence of TE events. A cut-off point of 3.8 h over 24 h was associated with significant increase in the event rate. Routine assessment of AHRE should be considered with other data when assessing stroke risk and considering anti-coagulation initiation and should also prompt the optimization of cardioprotective HF therapy in CRT patients. (Source: Europace)

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Is cardiac resynchronisation therapy better than right ventricular pacing after atrioventricular junction ablation for medically refractory atrial fibrillation?

Heart — Fri, 20 Jan 2012 05:00:00 +0100

Despite improvements in our understanding of the mechanisms underlying atrial fibrillation (AF) and significant advancements in the treatment options available, optimal management and symptom relief remains a challenge in some patients. In patients with medically refractory AF more aggressive measures may be required, including percutaneous catheter ablation (pulmonary vein isolation, with or without additional substrate modification) or atrioventricular (AV) junction ablation with concomitant insertion of a permanent pacemaker. The latter option, widely known as an ‘ablate and pace’ strategy, may be preferable in patients who want a definitive, albeit palliative, treatment of their symptoms and are not willing to take the risks and potential recurrences associated with AF abla...

Predictors of clinical efficacy of 'Ablate and Pace' therapy in patients with permanent atrial fibrillation

Heart — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions In patients affected by severely symptomatic permanent AF, Ablate and Pace therapy yielded a clinical benefit in 63% of RV-paced patients and 83% of CRT-paced patients. CRT pacing and echo-optimised CRT were the only independent predictor of clinical benefit. (Source: Heart)

Atrial Fibrillation A Risk Factor In Later Life For Middle-Aged Men With Upper-Normal Blood Pressure

Health News from Medical News Today — Thu, 19 Jan 2012 08:00:00 +0100

Middle-aged men at the upper end of normal blood pressure had an elevated risk for atrial fibrillation later in life, according to new research in Hypertension: Journal of the American Heart Association. Atrial fibrillation (AF) is a common heart rhythm disorder in which irregular heartbeats can lead to stroke and other heart-related complications; it affects over 2.7 million Americans. While hypertension is a risk factor for AF, the health consequences of upper-normal blood pressure are not yet fully understood... (Source: Health News from Medical News Today)

Thromboembolic Events During the Perioperative Period in Patients Undergoing Permanent Pacemaker Implantation

Clinical Cardiology — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions:We found TE events during the perioperative period in patients undergoing pacemaker implantation were not uncommon. Because persistent AF during the perioperative period was the only independent risk factor for perioperative TE, appropriate anticoagulation therapy may be necessary in those patients. © 2012 Wiley Periodicals, Inc.J. Liu, MD, is co‐first author. The authors have no funding, financial relationships, or conflicts of interest to disclose. (Source: Clinical Cardiology)

ACP Foundation hopes tools can help prevent strokes in patients with atrial fibrillation

Drug Topics - Top News — Thu, 19 Jan 2012 05:00:00 +0100

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Incidence of thromboembolic complications in patients with atrial fibrillation or mechanical heart valves with a subtherapeutic international normalized ratio: A prospective multicenter cohort study

American Journal of Hematology — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion:The risk of TE in this population was not negligible. Given the frequent observation of subtherapeutic INR levels when monitoring vitamin K antagonists, this finding warrants additional investigation to improve the management of these patients. Am. J. Hematol., 2012. © 2012 Wiley‐Liss, Inc. (Source: American Journal of Hematology)

ACP Foundation hopes tools can help prevent strokes in patients with atrial fibrillation

Modern Medicine — Thu, 19 Jan 2012 05:00:00 +0100

Identification of Recurring Patterns in Fractionated Atrial Electrograms using New Transform Coefficients

BioMedical Engineering OnLine — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: Transform coefficients computed from ensemble averages can be used to succinctly quantify synchronized patterns present in AF data. The technique can is useful to automatically detect recurrent patterns in CFAE that are embedded in interference without user bias. This quantitation can be implemented in real-time to map the AF substrate prior to and during catheter ablation. (Source: BioMedical Engineering OnLine)

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Middle-aged men with upper-normal BP at increased risk for AF

MedWire News - Cardiology — Thu, 19 Jan 2012 00:00:00 +0100

Middle-aged men with upper-normal systolic blood pressure are at significantly increased risk for atrial fibrillation, say Norwegian researchers. (Source: MedWire News - Cardiology)

New AF Ablation Programs Need Time, Money, and DataNew AF Ablation Programs Need Time, Money, and Data

Medscape Today Headlines — Wed, 18 Jan 2012 23:18:16 +0100

Starting up an atrial fibrillation ablation program takes more than just a couple of skilled electrophysiologists, Dr Rodney Horton explained at the Boston Atrial Fibrillation Symposium. Heartwire (Source: Medscape Today Headlines)

Gastroesophageal Reflux Disease – Another Risk Factor for Atrial Fibrillation

Cardiology — Wed, 18 Jan 2012 23:00:00 +0100

Cardiology 2011;120:185–186 (DOI:10.1159/000334799) (Source: Cardiology)

New Frontiers for Stroke Prevention in Atrial Fibrillation

Cerebrovascular Diseases — Wed, 18 Jan 2012 23:00:00 +0100

Cerebrovasc Dis 2012;33:199–208 (DOI:10.1159/000334979) (Source: Cerebrovascular Diseases)

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'High-Normal' Blood Pressure Linked to AF 'High-Normal' Blood Pressure Linked to AF

Medscape Today Headlines — Wed, 18 Jan 2012 22:42:00 +0100

Upper-normal levels of blood pressure in otherwise-healthy middle-aged men appear to predict a higher risk for the development of atrial fibrillation in older age, a new study suggests. Heartwire (Source: Medscape Today Headlines)

"High-normal" blood pressure linked to AF

theHeart.org — Wed, 18 Jan 2012 22:15:44 +0100

New AF ablation programs need time, money, and data

theHeart.org — Wed, 18 Jan 2012 20:00:06 +0100

High-Normal BP Portends Afib (CME/CE)

MedPage Today Cardiovascular — Wed, 18 Jan 2012 16:30:00 +0100

(MedPage Today) -- Blood pressure in the prehypertensive range appears to be a risk factor for the development of atrial fibrillation in otherwise healthy, middle-age men, a Norwegian study showed. (Source: MedPage Today Cardiovascular)

The prevalence of atrial fibrillation in a geographically well‐defined population in Northern Sweden: implications for anticoagulation prophylaxis

Journal of Internal Medicine — Wed, 18 Jan 2012 14:46:50 +0100

Conclusion: Within this large Caucasian population, we identified the highest community‐based prevalence of AF to date. The prevalence was strongly associated with increasing age and male gender. Using CHA2DS2‐VASc instead of CHADS2 widened the indication for OAC prophylactic therapy of AF in this population. (Source: Journal of Internal Medicine)

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Bayer’s Xarelto® Approved in Japan for Stroke Prevention in Patients with Non-Valvular Atrial Fibrillation

Bayer Company News — Wed, 18 Jan 2012 07:00:00 +0100

(Source: Bayer Company News)

Switching from enoxaparin to dabigatran etexilate: pharmacokinetics, pharmacodynamics, and safety profile

European Journal of Clinical Pharmacology — Wed, 18 Jan 2012 06:59:04 +0100

Conclusion Prior administration of enoxaparin did not meaningfully affect the PK or PD properties of dabigatran, and the switch from enoxaparin to dabigatran etexilate was well tolerated among the study subjects. These data support the safety of switching patients from enoxaparin to dabigatran etexilate. Content Type Journal ArticleCategory PharmacodynamicsPages 1-10DOI 10.1007/s00228-011-1205-2Authors Andreas Clemens, Department of Global Clinical Development & Medical Affairs, Boehringer Ingelheim Pharma GmbH, Ingelheim am Rhein, GermanyJoanne van Ryn, Department of CardioMetabolic Disease Research, Boehringer Ingelheim Pharma GmbH, Biberach, GermanyRegina Sennewald, Department of Translational Medicine, Boehringer Ingelheim Pharma GmbH, Biberach, GermanyNorio Yam...

Is it safe to include octogenarians at the start of a video-assisted thoracic surgery lobectomy programme? [THORACIC]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSION Octogenarians undergoing VMPR have a higher incidence of atrial fibrillation and admission to the intensive care unit for cardiopulmonary support but otherwise are no different from younger age groups when it comes to rate of conversion to thoracotomy, hospital stay, morbidity and mortality. Age should not be an excuse to deny the elderly curative VATS resection. In our experience, accepting octogenarians early in the VMPR programme did not compromise the outcome results. (Source: European Journal of Cardio-Thoracic Surgery)

High-Normal Blood Pressure Raises Heart Risks in Men

WebMD Health — Tue, 17 Jan 2012 23:31:46 +0100

Having high blood pressure in middle age is a major risk factor for developing atrial fibrillation later in life, and now new research links high-normal-range blood pressure with an increase in risk. (Source: WebMD Health)

Middle-Aged Men With Upper-Normal Blood Pressure at Risk for AF

Medical News (via PRIMEZONE) — Tue, 17 Jan 2012 21:00:00 +0100

DALLAS, Jan. 17, 2012 (GLOBE NEWSWIRE) -- Middle-aged men at the upper end of normal blood pressure had an elevated risk for atrial fibrillation later in life, according to new research in Hypertension: Journal of the American Heart Association. (Source: Medical News (via PRIMEZONE))

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'Upper Normal' Blood Pressure Linked to Heart Risk in Men

MedlinePlus Health News — Tue, 17 Jan 2012 21:00:00 +0100

Those with levels in the high end of the normal range may later develop irregular heartbeat, study says Source: HealthDay Related MedlinePlus Pages: Atrial Fibrillation, High Blood Pressure, Men's Health (Source: MedlinePlus Health News)

Methylprednisolone: Atrial fibrillation: case report

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

EPs, Surgeons Team Can Defeat Afib (CME/CE)

MedPage Today State Required CME — Tue, 17 Jan 2012 16:43:11 +0100

BOSTON (MedPage Today) -- Minimally invasive surgical ablation paired with percutaneous catheter ablation might be the answer for patients with persistent atrial fibrillation. (Source: MedPage Today State Required CME)

96 hours ECG monitoring for patients with ischemic cryptogenic stroke or transient ischaemic attack

Internal and Emergency Medicine — Tue, 17 Jan 2012 07:07:37 +0100

Abstract Atrial fibrillation (AF) is intermittent in 30% of patients with cardioembolic stroke and, therefore, might not be seen in a single standard ECG recording. The aim of this study was to evaluate if prolonged ECG monitoring (96 h) finds episodes of intermittent AF beyond the 24 h ECG monitoring in patients with cryptogenic stroke or transient ischemic attack (TIA). We prospectively evaluated consecutive patients affected by cryptogenic stroke or TIA who had sinus rhythm on a 12-lead ECG on admission, and during ECG monitoring performed in the acute phase (for at least 24 h). Patients had continuous 96 h Holter ECG monitoring within 30 days from stroke onset. 114 patients were included in the study (mean age 63.1 ± 15.1, 59 males). ...

Review: Antiarrhythmic drug therapy for atrial fibrillation

NeLM - News — Tue, 17 Jan 2012 05:00:00 +0100

Source: Circulation Area: News This review on antiarrhythmic drug use in patients with atrial fibrillation (AF) looks at the following topics: . The decision to maintain sinus rhythm . Currently available antiarrhythmic drugs . Selected antiarrhythmic therapies in development . Proarrhythmic toxicity of antiarrhythmic drugs . Drug selection and comparative efficacy of drugs for maintaining sinus rhythm . Drugs for cardioversion of AF . Outpatient initiation of antiarrhythmic drugs . Upstream therapies (Source: NeLM - News)

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Follow-Up: Interview on the Clinical Significance of Subclinical Atrial Fibrillation

Physician's First Watch current issue — Tue, 17 Jan 2012 05:00:00 +0100

(Source: Physician's First Watch current issue)

Apixaban: A New Player in the Anticoagulant Class.

Current Drug Targets — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Agrawal R, Jain P, Dikshit SN Abstract Apixaban (BMS-562247-01) is a compound being investigated as an anticoagulant. Apixaban molecule is developed in a joint venture by Pfizer and Bristol-Myers Squibb. Apixaban, a coagulation factor Xa inhibitor, approved in the E.U. in 2011 for the prevention of venous thromboembolic events in adult patients, who have undergone elective hip or knee replacement. The Apixaban based drug will be marketed under the brand name Eliquis® and is expected to rack up annual sales of over $2.5 billion. Apixaban is expected to provide stiff competition to warfarin, a popular blood thinner used in Europe. Warfarin is known to cause some serious side effects in patients. Apixaban, as compared with aspirin, reduced the risk of stroke or systemic embo...

Stroke aetiology and predictors of outcome in patients with heart failure and acute stroke: a 10-year follow-up study

European Journal of Heart Failure — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions In patients with HF, stroke aetiology is influenced by the presence of AF and the underlying cause of HF. Early and late stroke outcome is associated with HF severity but not with the presence of AF. (Source: European Journal of Heart Failure)

Apixaban reduced stroke and systemic embolism compared with warfarin in atrial fibrillation.

Annals of Internal Medicine — Tue, 17 Jan 2012 05:00:00 +0100

Authors: PMID: 22250164 [PubMed - in process] (Source: Annals of Internal Medicine)

Antiarrhythmic drug therapy for atrial fibrillation.

Circulation — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Zimetbaum P PMID: 22249528 [PubMed - in process] (Source: Circulation)

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Evaluation of risk stratification schemes for ischaemic stroke and bleeding in patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study

NeLM - News — Mon, 16 Jan 2012 05:00:00 +0100

Source: European Heart Journal Area: News The European Heart Journal has featured a study evaluating the risk of stroke and bleeding in atrial fibrillation, and the application of the CHA2DS2-VASc and HAS-BLED schemes for stroke and bleeding risk assessments, respectively. Data from the Swedish Atrial Fibrillation cohort study, a nationwide cohort study of 182,678 subjects with a diagnosis of AF at any Swedish hospital between 1 July 2005 and 31 December 2008, and who were prospectively followed for 1.5 years were reviewed. All patients who used an oral anticoagulant anytime during follow-up were identified, and most of the analyses were made on a subset of 90,490 patients who never used anticoagulants. Risk factors for stroke, the composite thromboembolism endpoint (stroke, TI...

FDA approves drugs for BPH, AF

Modern Medicine — Sun, 15 Jan 2012 05:00:00 +0100

FDA has approved tadalafil to treat benign prostatic hyperplasia in patients with or without erectile dysfunction and rivaroxaban to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. (Source: Modern Medicine)

CardioPulse Articles * Bleeding risk assessment and management in atrial fibrillation patients * Current Opinion in Cardiology is aimed at the practicing cardiologist * Dr Harvey Weiss discoverer of the anti-platelet benefits of acetylsalicylic acid * Heart disease and cancer: the new discipline of cardioncology * The story of the heartbeat, II * Book review * Transesophageal Echocardiography * Asia's heart for diversity

European Heart Journal — Sat, 14 Jan 2012 05:00:00 +0100

(Source: European Heart Journal)

Levothyroxine sodium/thyroid: Atrial fibrillation: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

Yoga Therapy for AF Yields Insight Into Brain-Heart AxisYoga Therapy for AF Yields Insight Into Brain-Heart Axis

Medscape Today Headlines — Fri, 13 Jan 2012 21:35:35 +0100

Yoga has shown to help some patients manage atrial fibrillation, so researchers are moving forward with investigations of yoga's influence on cardiac autonomics to better understand the biology of meditative practice. Heartwire (Source: Medscape Today Headlines)

[Primary and secondary cardiovascular prevention results in patients with stroke: relapse risk and associated survival (Ebrictus study)].

Revista de Neurologia — Fri, 13 Jan 2012 18:29:05 +0100

CONCLUSION. The cardiovascular secondary prevention seems to be more effective both in CVRF's detection and its control and is extremely important to get better results of survival. PMID: 22234566 [PubMed - in process] (Source: Revista de Neurologia)

Yoga therapy for AF yields insight into brain-heart axis

theHeart.org — Fri, 13 Jan 2012 16:10:43 +0100

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Giant Left Anterior Descending Artery Aneurysm: The Value of Cardiac Magnetic Resonance Imaging

Journal of the American College of Cardiology — Fri, 13 Jan 2012 13:52:06 +0100

An 85-year-old man with chronic kidney disease and cardiomegaly presented with atrial fibrillation. Echocardiography revealed a large spherical structure adjacent to the anterolateral left ventricular wall (A). Thoracic magnetic resonance imaging confirmed that the structure was anterior and superior to the left ventricle (B and C, Online Videos 1 and 2). Cardiac magnetic resonance imaging revealed a large (85 × 100 × 83 mm) coronary artery aneurysm close to the main pulmonary artery (C, Online Video 3). Although the left main coronary artery had a normal origin, its course was displaced posteriorly. The aneurysm arose from the proximal left anterior descending artery. It was separate from the left ventricle and main pulmonary artery, which appeared normal (D, Online Video 3). (Source: J...

BAFS: Ablation complications down, but patients outcomes are similar

Cardiovascular Business News — Fri, 13 Jan 2012 13:25:37 +0100

BOSTON—Since 2003, fluoroscopy times and complication rates of ablation procedures have decreased; however, managing to keep patients atrial fibrillation (AF)-free post-ablation still needs work, according to data presented at a poster session Jan. 13 at this year’s Boston Atrial Fibrillation Symposium (BAFS). (Source: Cardiovascular Business News)

Stroke Risk Increased By Atrial Arrhythmias

Health News from Medical News Today — Fri, 13 Jan 2012 08:00:00 +0100

An irregular heartbeat that you don't even feel but can be picked up by a pacemaker is associated with a significantly increased risk of stroke, says a new McMaster University study. The report, published in the New England Journal of Medicine, says that of nearly 2,600 patients without a history of atrial fibrillation but with a recently implanted pacemaker, more than one-third had episodes when the heartbeat would become rapid and irregular for more than six minutes... (Source: Health News from Medical News Today)

Even When Silent, Irregular Heartbeat Linked to Stroke Risk

The Doctors Lounge - Cardiology — Fri, 13 Jan 2012 05:00:00 +0100

Study found people with pacemakers experienced atrial fibrillation without realizing it (Source: The Doctors Lounge - Cardiology)

Population Pharmacokinetics and Pharmacodynamics of Rivaroxaban in Patients with Acute Coronary Syndromes

British Journal of Clinical Pharmacology — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions: The similarity in pharmacokinetics/pharmacodynamics of rivaroxaban among different patient populations and the low interindividual variability in exposure‐PT relationship indicate the anticoagulant effect of rivaroxaban is highly predictable and consistent across all the patient populations studied.© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society (Source: British Journal of Clinical Pharmacology)

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Silent heart irregularity also raises risk of stroke

Health Facts and Fears — Fri, 13 Jan 2012 05:00:00 +0100

Affecting over 2 million people in the U.S., atrial fibrillation (AF) is the most common cardiac arrhythmia (irregular heart beat) and can be associated with palpitations, chest pains, fainting, and congestive heart failure. (Source: Health Facts and Fears)

Effects of Rosuvastatin on Serum Asymmetric Dimethylarginine Levels and Atrial Structural Remodeling in Atrial Fibrillation Dogs

Pacing and Clinical Electrophysiology : PACE — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion:A short course of rosuvastatin treatment decreased apoptosis and prevented atrial structural remodeling in association with a decrease in ADMA levels in AF dogs. (PACE 2012; 1–9) (Source: Pacing and Clinical Electrophysiology : PACE)

Higher LDL Level Linked to Lower Incidence of Afib (CME/CE)

MedPage Today Cardiovascular — Thu, 12 Jan 2012 20:17:47 +0100

(MedPage Today) -- Although physicians usually aim to lower patients' total and, in particular, LDL cholesterol, lower LDL levels are associated with developing atrial fibrillation, a study has found. (Source: MedPage Today Cardiovascular)

17th Annual Boston Atrial Fibrillation Symposium (BAFS)17th Annual Boston Atrial Fibrillation Symposium (BAFS)

Medscape Today Headlines — Thu, 12 Jan 2012 17:58:59 +0100

Read clinically focused news coverage of key developments from the meeting. Medscape Cardiology (Source: Medscape Today Headlines)

Silent Atrial Fibrillation Increases Stroke RiskSilent Atrial Fibrillation Increases Stroke Risk

Medscape Today Headlines — Thu, 12 Jan 2012 16:43:49 +0100

A new study finds that device-detected atrial tachyarrhythmias occur frequently and are associated with a significant increase in risk for stroke and systemic embolism. Medscape Medical News (Source: Medscape Today Headlines)

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Silent atrial fibrillation increases stroke risk

theHeart.org — Thu, 12 Jan 2012 13:15:50 +0100

A new study finds device-detected atrial tachyarrhythmias occur frequently and are associated with a significant increase in risk for stroke and systemic embolism. (Source: theHeart.org)

Surgery for atrial fibrillation: recent progress and future perspective

General Thoracic and Cardiovascular Surgery — Thu, 12 Jan 2012 06:43:57 +0100

Abstract Development and introduction of radiofrequency ablation devices allowed the maze procedures to be performed safely and easily, further enabling off-pump pulmonary vein isolation through a mini-thoracotomy or thoracoscope. The effects of the maze procedure include prevention of stroke and other complications related to atrial fibrillation, improved cardiac performance, and relief of symptoms. Indications for the maze procedure have been discussed on the basis of the evidence. Pulmonary vein isolation has been shown to be effective in most patients with paroxysmal atrial fibrillation and can be performed with endocardial catheter ablation and minimally invasive epicardial ablation. These two modalities should be compared in terms of the success rate, occurrence of c...

In patients with an enlarged left atrium does left atrial size reduction improve maze surgery success?

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In [adults undergoing a maze procedure for Atrial Fibrillation (AF)], [does Left Atrial size reduction] compared to [maze surgery alone] improve [maze surgery success]? A total of 58 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four out of eight papers compared a volume reduction technique as an adjunct to the maze procedure to a maze procedure alone – all four papers reported that atrial volume reduction significantly increased restorat...

Is it safe to stop anticoagulants after successful surgery for atrial fibrillation?

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: is it safe to stop anticoagulants after successful surgery for atrial fibrillation? Altogether, 177 papers were found using the reported search, of which 14 were selected that represented the best evidence to answer the clinical question. Selection criteria included study relevance, primary outcome, size of study population and length of follow-up. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The weight of evidence, including over 10,000 patient–years of follow-up, supports the discontinuation of warfarin following atrial fibrillation correction procedures a...