Latest & greatest articles for atrial fibrillation

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Top results for atrial fibrillation

1. Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care

Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care L Lead-I ECG de ead-I ECG devices for detecting vices for detecting symptomatic atrial fibrillation using symptomatic atrial fibrillation using single time point testing in primary care single time point testing in primary care Diagnostics guidance Published: 8 May 2019 www.nice.org.uk/guidance/dg35 © NICE 2019. All rights reserved. Subject to Notice of rights (https (...) health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care (DG35) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 40Contents Contents 1 Recommendations 4 2 Clinical need and practice 5 The problem addressed 5 The condition 5

2019 National Institute for Health and Clinical Excellence - Diagnostics Guidance

2. Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI?

Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? - CanadiEM Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? In , by Vinai Bhagirath March 5, 2019 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert Main Messages P2Y12 inhibition is important (...) for the first 1-6 months after PCI insertion, and may have ongoing benefits up to 12 months or longer. Addition of anticoagulant to antiplatelet therapy increases the risk of bleeding, but reduces the risk of stroke. Use of an anticoagulant plus P2Y12 inhibitor is preferable to anticoagulant plus dual antiplatelet therapy, because of reduced bleeding risk. Case Description You are seeing a 72-year-old woman with a history of atrial fibrillation (AF), and additional stroke risk factors of hypertension

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2019 CandiEM

3. Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. (PubMed)

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.Using US Truven MarketScan Commercial and Medicare

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2019 ESC heart failure

4. CHA2DS2-VASc Score and Stroke Prediction in Atrial Fibrillation in Whites, Blacks, and Hispanics

CHA2DS2-VASc Score and Stroke Prediction in Atrial Fibrillation in Whites, Blacks, and Hispanics Background and Purpose- Despite modest predictive ability for ischemic stroke (IS), the CHA2DS2-VASc score is widely used for stroke prediction in atrial fibrillation. Among patients with atrial fibrillation, we aimed to (1) compare the IS or transient ischemic attack (TIA) incidence by CHA2DS2-VASc in blacks and Hispanics versus whites; (2) compare predictive ability of CHA2DS2-VASc score (...) for IS or TIA in blacks and Hispanics versus whites; and (3) determine improvement in predictive ability of CHA2DS2-VASc score from addition of race/ethnicity. Methods- Using data from Optum Clinformatics, a large administrative claims database, we analyzed patients with atrial fibrillation enrolled in commercial and Medicare Advantage health plans from 2009 to 2015. We computed IS or TIA incidence rates, improvement in C statistic, continuous and categorical net reclassification improvement, and relative

2019 EvidenceUpdates

5. Decreased risk of renal impairment in atrial fibrillation patients receiving non-vitamin K antagonist oral anticoagulants: A pooled analysis of randomized controlled trials and real-world studies

Decreased risk of renal impairment in atrial fibrillation patients receiving non-vitamin K antagonist oral anticoagulants: A pooled analysis of randomized controlled trials and real-world studies Patients with warfarin have a potential risk of warfarin-related nephropathy, which could result in the discontinuation of anticoagulation therapy. The question of whether non-vitamin K antagonist oral anticoagulants (NOACs) use is associated with increased risk of renal impairment in atrial (...) fibrillation (AF) patients remains unanswered.Studies were systematically searched through Medline, Embase, Cochrane Library databases, and ClinicalTrials.gov Website. Randomized controlled trials (RCTs) reporting renal impairment events and observational nationwide database studies presenting adjusted hazard ratio (HR) in AF patients with NOACs were identified. The Primacy outcome was renal impairment, defined as a composite of any renal disorder. The secondary outcomes were narrow definition of renal

2019 EvidenceUpdates

6. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 (...) This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society , MD, PhD, FACC, Chair , MD, MACC, FAHA, Vice Chair , MD, FACC, FAHA, FHRS , MD, MS

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2019 American Heart Association

7. Refining Prediction of Atrial Fibrillation-Related Stroke Using the P2-CHA2DS2-VASc Score

Refining Prediction of Atrial Fibrillation-Related Stroke Using the P2-CHA2DS2-VASc Score In people with atrial fibrillation (AF), periods of sinus rhythm present an opportunity to detect prothrombotic atrial remodeling through measurement of P-wave indices (PWIs)-prolonged P-wave duration, abnormal P-wave axis, advanced interatrial block, and abnormal P-wave terminal force in lead V1. We hypothesized that the addition of PWIs to the CHA2DS2-VASc score would improve its ability to predict AF (...) -1.44) and 0.82 (0.36-1.39), respectively.Abnormal P-wave axis-an ECG correlate of left atrial abnormality- improves ischemic stroke prediction in AF. Compared with CHA2DS2-VASc, the P2-CHA2DS2-VASc is a better prediction tool for AF-related ischemic stroke.

2019 EvidenceUpdates

8. Open-Label Randomized Trial Comparing Oral Anticoagulation With and Without Single Antiplatelet Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease Beyond 1 Year After Coronary Stent Implantation

Open-Label Randomized Trial Comparing Oral Anticoagulation With and Without Single Antiplatelet Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease Beyond 1 Year After Coronary Stent Implantation Despite recommendations in the guidelines and consensus documents, there has been no randomized controlled trial evaluating oral anticoagulation (OAC) alone without antiplatelet therapy (APT) in patients with atrial fibrillation and stable coronary artery disease beyond 1 (...) year after coronary stenting.This study was a prospective, multicenter, open-label, noninferiority trial comparing OAC alone to combined OAC and single APT among patients with atrial fibrillation beyond 1 year after stenting in a 1:1 randomization fashion. The primary end point was a composite of all-cause death, myocardial infarction, stroke, or systemic embolism. The major secondary end point was a composite of the primary end point or major bleeding according to the International Society

2019 EvidenceUpdates

9. Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation

Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Discover Portal Discover Portal Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Published on 6 February 2018 doi: In people with atrial fibrillation needing anticoagulant treatment, deaths were fewer (...) in those who had direct acting oral anticoagulants compared with warfarin. The picture is less clear for the risk of stroke and complications such as bleeding in the brain or gut. Apixaban had the best efficacy and safety profile and was cost-effective compared with warfarin. This study pooled the data in all trials reporting efficacy, safety and cost of anticoagulant prevention of stroke events in people with atrial fibrillation. Researchers used a technique called network meta-analysis to compare

2019 NIHR Dissemination Centre

10. Alternative drug may prevent atrial fibrillation following heart surgery

Alternative drug may prevent atrial fibrillation following heart surgery Alternative drug may prevent atrial fibrillation following heart surgery Discover Portal Discover Portal Alternative drug may prevent atrial fibrillation following heart surgery Published on 12 December 2017 doi: After heart surgery around a third of people have atrial fibrillation, an abnormal heart rhythm, which impedes their recovery and lengthens hospital stay. Colchicine treatment could reduce this complication (...) by about a third. About 11 people would need this treatment to prevent one of them developing atrial fibrillation. Using amiodarone, an alternative drug commonly used in this situation, other research shows that about seven people would be treated to prevent one person suffering fibrillation. Colchicine is a drug licensed for the treatment of gout that combines both anti-inflammatory and heart rate control properties. As an older drug, it might be a cheaper alternative and could be safer. Further study

2019 NIHR Dissemination Centre

11. Screen reminders for GPs did not improve anticoagulant prescribing in atrial fibrillation

Screen reminders for GPs did not improve anticoagulant prescribing in atrial fibrillation Screen reminders for GPs did not improve anticoagulant prescribing in atrial fibrillation Discover Portal Discover Portal Screen reminders for GPs did not improve anticoagulant prescribing in atrial fibrillation Published on 18 July 2017 doi: General practice software that generated screen reminders for patients with atrial fibrillation did not increase the proportion taking oral anticoagulants (...) appropriately by six months. This NIHR-funded trial included GPs in 47 surgeries in England and found that at the start only 63% of eligible patients with atrial fibrillation were being prescribed anticoagulants. Six months later the rate had increased to 66% in intervention practices and 64% in those following usual practice, a non-significant difference between the groups. Use of the software was associated with increased diagnosis of transient ischemic attack, which could be due to improved detection

2019 NIHR Dissemination Centre

12. Rhythm control drugs after catheter ablation for atrial fibrillation give short-term but not long term benefits

Rhythm control drugs after catheter ablation for atrial fibrillation give short-term but not long term benefits Rhythm control drugs after catheter ablation for atrial fibrillation give short-term but not long term benefits Discover Portal Discover Portal Rhythm control drugs after catheter ablation for atrial fibrillation give short-term but not long term benefits Published on 27 September 2016 doi: When treating atrial fibrillation, short-term use of rhythm control drugs after catheter (...) ablation reduced the risk of abnormal heart rhythms in the three months after the procedure. They were of no benefit in preventing recurrence of atrial fibrillation in the longer term. Atrial fibrillation is a common abnormal heart rhythm that carries a high risk of stroke. Catheter ablation can be used to destroy the electrical pathways in the heart muscle that cause the abnormal rhythm, but recurrence is common. Several factors could influence the likelihood of abnormal rhythms returning after

2019 NIHR Dissemination Centre

13. Antithrombotic therapy use and clinical outcomes following thrombo-embolic events in patients with atrial fibrillation: insights from ARISTOTLE. (PubMed)

Antithrombotic therapy use and clinical outcomes following thrombo-embolic events in patients with atrial fibrillation: insights from ARISTOTLE. We investigated baseline characteristics, antithrombotic use, and clinical outcomes of patients with atrial fibrillation (AF) and a thrombo-embolic event in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) study to better inform the care of these high-risk patients.Thrombo-embolic events were

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2019 European heart journal. Cardiovascular pharmacotherapy

14. Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry  Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. This article

2019 EvidenceUpdates

15. Meta-Analysis of Effects of Digoxin on Survival in Patients with Atrial Fibrillation or Heart Failure: An Update

Meta-Analysis of Effects of Digoxin on Survival in Patients with Atrial Fibrillation or Heart Failure: An Update In 2015, 3 independent meta-analyses raised concerns about digoxin therapy being associated with an increased mortality risk in patients with atrial fibrillation (AF) and with heart failure (HF). Although several other studies have been published since then fostering these safety issues, the most recent 2016 European guidelines for AF still recommend this therapy as a class I

2019 EvidenceUpdates

16. Relation of the CHA2DS2-VASc Score to Risk of Thrombotic and Embolic Stroke in Community-Dwelling Individuals Without Atrial Fibrillation (From The Atherosclerosis Risk in Communities [ARIC] Study)

Relation of the CHA2DS2-VASc Score to Risk of Thrombotic and Embolic Stroke in Community-Dwelling Individuals Without Atrial Fibrillation (From The Atherosclerosis Risk in Communities [ARIC] Study) Recent hospital-based cohort studies found the CHA2DS2-VASc score to be associated with ischemic stroke in individuals without atrial fibrillation (AF). Our aim was to determine the distribution of embolic and thrombotic strokes and association with the CHA2DS2-VASc score, among community-dwelling

2019 EvidenceUpdates

17. Dialysis Modality and Incident Atrial Fibrillation in Older Patients With ESRD

Dialysis Modality and Incident Atrial Fibrillation in Older Patients With ESRD Atrial fibrillation (AF) is common in patients with kidney failure treated by maintenance dialysis. Whether the incidence of AF differs between patients receiving hemodialysis and peritoneal dialysis is uncertain.Retrospective cohort study.Using the US Renal Data System, we identified older patients (≥67 years) with Medicare Parts A and B who initiated dialysis therapy (1996-2011) without a diagnosis of AF during

2019 EvidenceUpdates

18. A randomized, double-blind, placebo-controlled trial assessing the efficacy of S66913 in patients with paroxysmal atrial fibrillation. (PubMed)

A randomized, double-blind, placebo-controlled trial assessing the efficacy of S66913 in patients with paroxysmal atrial fibrillation. Antiarrhythmic drugs (AADs) for the treatment of atrial fibrillation (AF) are associated with limited efficacy and adverse effects. Inhibition of the atrial current IKur, absent from the ventricle, is expected to be antiarrhythmic, without adverse cardiac effects, particularly ventricular pro-arrhythmic effects.A randomized clinical trial in symptomatic (...) related preclinical safety concerns, after 58 patients had been enrolled. The median AFB ranged from 4.3% to 10.3% at baseline in the four treatment groups. S66913 had no significant effect on AFB or on AFB plus atrial tachycardia (AT) burden, at any dosage; nor on any secondary endpoints including the number and duration of AT or AF episodes, and symptoms. The drug was well tolerated with no safety concern during the treatment or the extended clinical follow-up.DIAGRAF-IKUR was the first study

2019 European heart journal. Cardiovascular pharmacotherapy

19. Development and validation of a score to detect paroxysmal atrial fibrillation after stroke

Development and validation of a score to detect paroxysmal atrial fibrillation after stroke Prolonged monitoring times (72 hours) are recommended to detect paroxysmal atrial fibrillation (pAF) after ischemic stroke but this is not yet clinical practice; therefore, an individual patient selection for prolonged ECG monitoring might increase the diagnostic yield of pAF in a resource-saving manner.We used individual patient data from 3 prospective studies (ntotal = 1,556) performing prolonged

2019 EvidenceUpdates

20. Efficacy and safety of reduced-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a meta-analysis of randomized controlled trials

Efficacy and safety of reduced-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a meta-analysis of randomized controlled trials Non-vitamin K antagonist oral anticoagulants (NOACs) require dose reductions according to patient or clinical factors for patients with atrial fibrillation (AF). In this meta-analysis, we aimed to assess outcomes with reduced-dose NOACs when given as pre-specified in pivotal trials.Aggregated data abstracted from Phase III trials

2019 EvidenceUpdates