9,770 results match your criteria Atrial Fibrillation Diagnosis and Management


Atrioesophageal fistula post atrial fibrillation ablation: A multicenter study from China.

Pacing Clin Electrophysiol 2020 Jun 3. Epub 2020 Jun 3.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Background And Objective: Atrioesophageal fistula (AEF) is a rare but devastating complication with high mortality post atrial fibrillation (AF) ablation. The purpose of current study was to determine the epidemiology, clinical features, pathogenesis, and management of AEF after AF ablation.

Methods And Results: Patients with diagnosed AEF were included and retrospectively analyzed according to the registry of 11 centers in China from January of 2010 to December of 2019. Read More

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http://dx.doi.org/10.1111/pace.13973DOI Listing

Atrial Fibrillation and Ventricular Tachycardia in a Patient with Cardiac Sarcoidosis.

J Innov Card Rhythm Manag 2018 Feb 15;9(2):3016-3021. Epub 2018 Feb 15.

Division of Cardiology, Virginia Commonwealth University Pauley Heart Center, Richmond, VA, USA.

Cardiac sarcoidosis (CS) can cause atrial and ventricular arrhythmias, conduction system disease, and congestive heart failure. The use of advanced imaging modalities including cardiac magnetic resonance and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose can be helpful in evaluating the extent of disease and response to treatment. The management of CS patients can be challenging, requiring immunosuppression medications, antiarrhythmic drugs, implantable cardiac devices, and cardiac ablation procedures. Read More

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http://dx.doi.org/10.19102/icrm.2018.090203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252664PMC
February 2018

Implantable Cardiac Monitors: Evolution Through Disruption.

J Innov Card Rhythm Manag 2017 Sep 15;8(9):2824-2834. Epub 2017 Sep 15.

Department of Cardiology, Mercy Hospital, Mason City, IA.

Syncope and stroke are commonly seen in clinical practice, and the diagnostic workup is often time-consuming and costly and may increase resource utilization in the health-care system. The use of implantable cardiac monitors (ICMs) in syncope evaluation has been well studied, but their use in cryptogenic stroke evaluation and anticoagulation management in patients with atrial fibrillation (AF) is still emerging. The standard workup of the syncope patient or those at risk for a possible cardioembolic stroke includes the utilization of external cardiac monitors; however, these devices cannot provide long-term arrhythmia assessment, whereas ICMs can now last up to three years, increasing the possibility of arriving at a diagnosis. Read More

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http://dx.doi.org/10.19102/icrm.2017.080903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252697PMC
September 2017

Atraumatic splenic rupture in a patient treated with apixaban: A case report.

Int J Surg Case Rep 2020 May 11;71:270-273. Epub 2020 May 11.

Sir Charles Gairdner Hospital, General Surgery - Western Australia Liver and Kidney (WALK), WA, Australia.

Introduction: Splenic rupture is often seen in the context of significant trauma. Atraumatic ruptures are described in the context of malignancy, inflammation or infection directly affecting the spleen. Splenic ruptures occurring in patients taking apixaban, a factor Xa inhibitor, are challenging due to the scarcity of a direct reversal agent. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.04.050DOI Listing

Antiphospholipid syndrome and challenges with direct oral anticoagulants.

Br J Hosp Med (Lond) 2020 May 4;81(5):1-11. Epub 2020 May 4.

Haemophilia and Thrombosis Centre, St Thomas' Hospital, London, UK.

Direct oral anticoagulants have become the mainstay of the management of venous thromboembolism and atrial fibrillation, and long-term anticoagulation is indicated for those at high risk of further thrombotic events. This includes patients diagnosed with antiphospholipid syndrome, for whom the 'triple positive' laboratory combination of lupus anticoagulant, β2-glycoprotein-1 and anti-cardiolipin antibodies signify those at greatest risk. Data from meta-analysis and randomised control trials have raised the concern that direct oral anticoagulants may be less effective than vitamin K antagonists for the prevention of thrombosis in patients with thrombotic antiphospholipid syndrome, particularly those with the triple positive profile. Read More

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http://dx.doi.org/10.12968/hmed.2020.0080DOI Listing

Outcome Analysis Of Total Laryngopharyngeal Oesophagectomy In Carcinoma Hypo-Pharynx And Cervical Esophagus, With Stomach Reconstruction.

J Ayub Med Coll Abbottabad 2020 Jan- Mar;32(1):13-17

Department of Thoracic Surgery, Combined Military Hospital and Medical college, Multan, Pakistan.

Background: Upper cervical oesophageal and hypo-pharyngeal malignancies pose significant challenges in surgical management. In advanced tumours total laryngopharyngeal esophagectomy (TLPO) and gastric pull up provides excellent result.

Methods: It is a descriptive case series and was conducted from Jan 2010 to Jan 2017. Read More

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The management of atrial fibrillation in heart failure: an expert panel consensus.

Heart Fail Rev 2020 May 28. Epub 2020 May 28.

Heart Failure Unit, Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.

Heart failure (HF) and atrial fibrillation (AF) often coexist, being closely interrelated as the one increases the prevalence and incidence and worsens the prognosis of the other. Their frequent coexistence raises several challenges, including under-diagnosis of HF with preserved ejection fraction in AF and of AF in HF, characterization and diagnosis of atrial cardiomyopathy, target and impact of rate control therapy on outcomes, optimal rhythm control strategy in the era of catheter ablation, HF-related thromboembolic risk and management of anticoagulation in patients with comorbidities, such as chronic kidney disease or transient renal function worsening, coronary artery disease or acute coronary syndromes, valvular or structural heart disease interventions and cancer. In the present document, derived by an expert panel meeting, we sought to focus on the above challenging issues, outlining the existing evidence and identifying gaps in knowledge that need to be addressed. Read More

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http://dx.doi.org/10.1007/s10741-020-09978-0DOI Listing

Acute ischemic stroke management in Lebanon: obstacles and solutions.

Funct Neurol 2019 Jul/Sep;34(3):167-176

Management of acute stroke varies greatly within and between different countries. This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Read More

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Polypharmacy, Adverse Outcomes, and Treatment Effectiveness in Patients ≥75 With Atrial Fibrillation.

J Am Heart Assoc 2020 Jun 23;9(11):e015089. Epub 2020 May 23.

Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA.

Background Polypharmacy is highly prevalent in elderly people with chronic conditions, including atrial fibrillation (AF). The impact of polypharmacy on adverse outcomes and on treatment effectiveness in elderly patients with AF remains unaddressed. Methods and Results We studied 338 810 AF patients ≥75 years of age enrolled in the MarketScan Medicare Supplemental database in 2007-2015. Read More

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http://dx.doi.org/10.1161/JAHA.119.015089DOI Listing

Classification of atrial fibrillation and normal sinus rhythm based on convolutional neural network.

Biomed Eng Lett 2020 May 16;10(2):183-193. Epub 2020 Jan 16.

Department of Industrial Engineering and Management, National Chin-Yi University of Technology, Taichung, Taiwan.

Electrocardiogram (ECG) technology plays a vital role in detecting arrhythmia. Numerous achievements have been marked in ECG-related research. Most methods first pre-process ECG signals, then extract features, and finally classify them. Read More

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http://dx.doi.org/10.1007/s13534-020-00146-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235126PMC

Burden and correlates of atrial fibrillation among hypertensive patients attending a tertiary hospital in Tanzania.

BMC Cardiovasc Disord 2020 May 19;20(1):235. Epub 2020 May 19.

Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania.

Background: Atrial fibrillation (AF) is the most common supra ventricular cardiac arrhythmia, which presents with variety of clinical symptoms. Hypertension increases risk of developing Atrial fibrillation by 1.5 fold. Read More

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http://dx.doi.org/10.1186/s12872-020-01517-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236463PMC
May 2020
1.500 Impact Factor

Automated detection of cardiovascular disease by electrocardiogram signal analysis: a deep learning system.

Cardiovasc Diagn Ther 2020 Apr;10(2):227-235

Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China.

Automated electrocardiogram (ECG) diagnosis could be a useful aid for clinical use. We applied a deep learning method to build a system for automated detection and classification of ECG signals. We first trained a convolutional neural network (CNN) to detect cardiovascular disease in ECG signals using a training data set of 259,789 ECG signals collected from the cardiac function rooms of a tertiary care hospital. Read More

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http://dx.doi.org/10.21037/cdt.2019.12.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225435PMC

Clinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction.

Can J Cardiol 2020 Feb 4. Epub 2020 Feb 4.

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Background: It is uncertain whether beta-blockers (BBs) are beneficial in contemporary stable patients with prior myocardial infarction (MI). Therefore, we sought to examine the effectiveness of BB use in this population.

Methods: We conducted a cohort study with the use of administrative databases of patients ≥ 65 years of age, alive on April 1, 2012 (index date) with a hospital discharge diagnosis of MI within the previous 3 years. Read More

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http://dx.doi.org/10.1016/j.cjca.2020.01.024DOI Listing
February 2020

Prevention, diagnosis, and management of atrioesophageal fistula.

Pacing Clin Electrophysiol 2020 May 13. Epub 2020 May 13.

Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, United States.

Atrioesophageal fistula (AEF) is a rare but deadly complication of radiofrequency ablation for atrial fibrillation. Given its rarity, the diagnosis of AEF is usually delayed with a wide variation in management strategies, which contribute to the high mortality associated with AEF. As such, the most important step of AEF management is prevention, whereas early diagnosis and treatment are crucial to reduce its associated high mortality. Read More

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http://dx.doi.org/10.1111/pace.13938DOI Listing

[Combined Approach for Management of the Chronic Heart Failure with Preserved Left Ventricular Ejection Fraction and Permanent Atrial Fibrillation: a Case Report].

Kardiologiia 2020 Mar 30;60(4):157-160. Epub 2020 Mar 30.

M.V. Lomonosov Moscow State University.

The article described a clinical case of a patient with chronic heart failure (CHF) with preserved ejection fraction (CHF-PEF) and permanent normosystolic atrial fibrillation (AF). A 73 year-old man (body mass index, 26.4 kg /m2) with permanent normosystolic AF (duration, 10 years) was hospitalized for augmenting of CHF symptoms. Read More

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http://dx.doi.org/10.18087/cardio.2020.4.n1096DOI Listing

Management of heart failure: an Italian national survey on fellows/specialists in geriatrics.

Aging Clin Exp Res 2020 May 7. Epub 2020 May 7.

Area di Geriatria, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128, Rome, Italy.

Background: Heart failure (HF) is often managed by geriatricians. Few data are available on their knowledge and attitudes about this condition.

Aims: To compare perceptions and knowledge on HF of specialists/fellows in geriatrics working in Italy. Read More

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http://dx.doi.org/10.1007/s40520-020-01577-1DOI Listing

Screening for atrial fibrillation and other arrhythmias in primary care.

BMC Fam Pract 2020 May 6;21(1):79. Epub 2020 May 6.

Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia.

Background: Atrial fibrillation (AF) and other arrhythmias are prevalent and often encountered by general practitioners (GPs). In response to the growing prevalence and to assist practitioners in the diagnosis and management of AF, the Cardiac Society of Australia & New Zealand and Heart Foundation of Australia published the first Australian AF Guidelines in 2018. We aimed to examine (a) the proportion of GPs who performed any form of AF screening and identify the methods they applied, (b) GPs' awareness of the AF Guidelines and approaches to arrhythmia screening, (c) the roles of conventional 12-lead ECG and mobile health devices, and (d) GPs' confidence in ECG interpretation and need for training. Read More

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http://dx.doi.org/10.1186/s12875-020-01151-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201749PMC
May 2020
1.735 Impact Factor

Incidence, Characteristics, and Outcomes of Acute Myocardial Infarction among Patients Admitted with Acute Exacerbation of Chronic Obstructive Lung Disease.

COPD 2020 May 5:1-8. Epub 2020 May 5.

Department of Cardiology, Mayo Clinic School of Medicine, Rochester, MN, USA.

The frequency, characteristics and outcomes of acute myocardial infarction (AMI) during exacerbation of chronic obstructive pulmonary disease (COPD) are unknown. Adult patients hospitalized with a principle diagnosis of acute COPD exacerbation were identified using retrospective analysis of the Nationwide Inpatient Sample (NIS) from 2003 to 2016. Patients were stratified into 2-groups with and without a secondary diagnosis of AMI. Read More

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http://dx.doi.org/10.1080/15412555.2020.1757054DOI Listing

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation.

Medicine (Baltimore) 2020 May;99(18):e19542

Department of Cardiovascular Medicine, Xiangdong Hospital Hunan Normal University, Liling, Hunan.

Background: Data of non-vitamin K antagonist oral anticoagulants (NOACs) in current management of atrial fibrillation (AF) are predominantly derived from North American and European regions. However, the effects of NOACs for stroke prevention in Latin America remain unclear. Therefore, we aimed to compare the efficacy and safety of NOACs with warfarin in Latin American patients with AF. Read More

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http://dx.doi.org/10.1097/MD.0000000000019542DOI Listing

Association of Multimorbidity with Cardiovascular Endpoints and Treatment Effectiveness in Patients 75 Years and Older with Atrial Fibrillation.

Am J Med 2020 Apr 19. Epub 2020 Apr 19.

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga.

Background: The burden imposed by multimorbidity on outcomes and on the effectiveness of atrial fibrillation therapies in elderly adults with atrial fibrillation is unknown.

Methods: Patients with nonvalvular atrial fibrillation ages ≥75 years in the MarketScan Medicare Supplemental database from 2007-2015. Prevalence of 14 chronic conditions at the time of atrial fibrillation diagnosis were obtained and classified as cardiometabolic or noncardiometabolic. Read More

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http://dx.doi.org/10.1016/j.amjmed.2020.03.038DOI Listing

Comparative effectiveness and safety of oral anticoagulants for atrial fibrillation: A retrospective cohort study.

J Popul Ther Clin Pharmacol 2020 Apr 13;27(2):e32-e55. Epub 2020 Apr 13.

Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada.

Oral anticoagulants (OACs) are high-priority medications, frequently used with clinically important benefit and serious harm. Our objective was to compare the safety and effectiveness of direct-acting oral anticoagulants (DOACs) versus warfarin in a population where anticoagulation management and DOACs were readily available. A retrospective cohort study of all adults living in British Columbia with a diagnosis of atrial fibrillation and a first prescription for an OAC was conducted. Read More

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http://dx.doi.org/10.15586/jptcp.v27i2.662DOI Listing

The role of echocardiography for diagnosis and prognostic stratification in hypertrophic cardiomyopathy.

J Echocardiogr 2020 Apr 16. Epub 2020 Apr 16.

University of Medicine and Pharmacy "Carol Davila", Euroecolab, Bucharest, Romania.

Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about 0.2-0.5% of the population. Read More

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http://dx.doi.org/10.1007/s12574-020-00467-9DOI Listing

Associations between cardiac arrhythmia, incident disability in activities of daily living and physical performance: the ILSA study.

J Geriatr Cardiol 2020 Mar;17(3):127-132

National Research Council (CNR), Neuroscience Institute, Aging Branch, Via Giustiniani 2, 35128 Padua, Italy.

Background: Cardiac arrhythmias are common conditions in older people. Unfortunately, there is limited literature on associations between cardiac arrhythmias and physical performance or disability. We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up, using data from the Italian Longitudinal Study on Aging (ILSA). Read More

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http://dx.doi.org/10.11909/j.issn.1671-5411.2020.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118013PMC

Etiologic Workup in Cases of Cryptogenic Stroke: A Systematic Review of International Clinical Practice Guidelines.

Stroke 2020 May 13;51(5):1419-1427. Epub 2020 Apr 13.

From the Faculty of Health and Wellbeing, University of Central Lancashire, Preston, United Kingdom (N.E.M., M.B., V.B., E.P.B., R.F.G., J.M.E.G., A.J.C., C.E.L., C.L.W.).

Background and Purpose- Identifying the etiology of acute ischemic stroke is essential for effective secondary prevention. However, in at least one third of ischemic strokes, existing investigative protocols fail to determine the underlying cause. Establishing etiology is complicated by variation in clinical practice, often reflecting preferences of treating clinicians and variable availability of investigative techniques. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.027123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185056PMC

Myocarditis in the Athlete: Arrhythmogenic Substrates, Clinical Manifestations, Management, and Eligibility Decisions.

J Cardiovasc Transl Res 2020 Apr 8. Epub 2020 Apr 8.

Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.

Myocarditis is as an important cause of sudden cardiac death (SCD) among athletes. The incidence of SCD ascribed to myocarditis did not change after the introduction of pre-participation screening in Italy, due to the transient nature of the disease and problems in the differential diagnosis with the athlete's heart. The arrhythmic burden and the underlying mechanisms differ between the acute and chronic setting, depending on the relative impact of acute inflammation versus post-inflammatory myocardial fibrosis. Read More

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http://dx.doi.org/10.1007/s12265-020-09996-1DOI Listing

Video-based AI for beat-to-beat assessment of cardiac function.

Nature 2020 04 25;580(7802):252-256. Epub 2020 Mar 25.

Department of Computer Science, Stanford University, Stanford, CA, USA.

Accurate assessment of cardiac function is crucial for the diagnosis of cardiovascular disease, screening for cardiotoxicity and decisions regarding the clinical management of patients with a critical illness. However, human assessment of cardiac function focuses on a limited sampling of cardiac cycles and has considerable inter-observer variability despite years of training. Here, to overcome this challenge, we present a video-based deep learning algorithm-EchoNet-Dynamic-that surpasses the performance of human experts in the critical tasks of segmenting the left ventricle, estimating ejection fraction and assessing cardiomyopathy. Read More

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http://dx.doi.org/10.1038/s41586-020-2145-8DOI Listing

Conversion of atrial fibrillation to sinus rhythm during cryoballoon ablation: A favorable and not unusual phenomenon during second-generation cryoballoon pulmonary vein isolation.

J Arrhythm 2020 Apr 16;36(2):319-327. Epub 2020 Jan 16.

Heart Rhythm Management Center UZ Brussel-VUB Brussels Belgium.

Background: The prevalence and the clinical impact of conversion of atrial fibrillation (AF) to sinus rhythm (SR) during cryoballoon ablation (CB-A) are unknown.

Objective: The purpose of this study was to evaluate the prevalence of restoration of SR during CB-A and the clinical impact of this phenomenon.

Methods: Between January 2012 and September 2018, all patients who experienced conversion of AF to SR during CB-A were included. Read More

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http://dx.doi.org/10.1002/joa3.12301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132212PMC

Longer diagnosis-to-ablation time is associated with recurrence of atrial fibrillation after catheter ablation-Systematic review and meta-analysis.

J Arrhythm 2020 Apr 27;36(2):289-294. Epub 2019 Dec 27.

Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Indonesia National Cardiovascular Center Harapan Kita Jakarta Indonesia.

Background: Diagnosis-to-ablation time (DTAT) has been postulated to be one of the predictors of atrial fibrillation (AF) recurrence, and it is a "modifiable" risk factor unlike that of many electrocardiographic or echocardiographic parameters. This development may change our consideration for ablation. In this systematic review and meta-analysis, we aim to analyze the latest evidence on the importance of DTAT and whether they predict the AF recurrence after catheter ablation. Read More

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http://dx.doi.org/10.1002/joa3.12294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132183PMC

Clinical features and prognosis of patients with spontaneous coronary artery dissection.

Int J Cardiol 2020 Mar 20. Epub 2020 Mar 20.

Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, USA. Electronic address:

There have been inconsistent reports regarding the clinical features and characteristics of patients diagnosed with spontaneous coronary artery dissection (SCAD). In addition, predictors of mortality in SCAD patients are unknown. We evaluated the prevalence, clinical characteristics, medical management, and predictors of in-hospital mortality of SCAD-related hospitalizations using data from a single health care system from January 1, 2008, to December 31, 2018. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.03.044DOI Listing
March 2020
4.036 Impact Factor

Efficacy and safety of landiolol, an ultra-short-acting β1-selective antagonist, for treatment of sepsis-related tachyarrhythmia (J-Land 3S): a multicentre, open-label, randomised controlled trial.

Lancet Respir Med 2020 Mar 31. Epub 2020 Mar 31.

Department of Emergency & Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address:

Background: Tachycardia and atrial fibrillation frequently occur in patients being treated for sepsis or septic shock and have a poor prognosis. Treatments for tachyarrhythmias are often ineffective or contraindicated in this setting. We aimed to investigate the efficacy and safety of landiolol, an ultra-short-acting β-blocker, for treating sepsis-related tachyarrhythmias. Read More

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http://dx.doi.org/10.1016/S2213-2600(20)30037-0DOI Listing

Infections causing stroke or stroke-like syndromes.

Infection 2020 Jun 1;48(3):323-332. Epub 2020 Apr 1.

Department of Infectious Diseases, University of Salerno, Salerno, Italy.

Background: Stroke has relevant morbidity and mortality despite appropriate treatments and early diagnosis. Beside common risk factors such as diabetes and atrial fibrillation, infections can be involved in stroke pathogenesis, probably causing a systemic release of cytokines and other inflammatory mediators, triggering a latent pro-thrombotic state or damaging the vascular endothelium. In other cases, infections can occur as stroke-like syndromes, requiring a high grade of suspicion to avoid a delay in establishing a correct diagnosis. Read More

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http://dx.doi.org/10.1007/s15010-020-01415-6DOI Listing

Prognostic Prediction of Cardiopulmonary Exercise Test Parameters in Heart Failure Patients with Atrial Fibrillation.

Arq Bras Cardiol 2020 02;114(2):209-218

Centro Hospitalar Universitário Lisboa Central, Hospital de Santa Marta, Lisbon - Portugal.

Background: Atrial fibrillation (AF) is associated with increased mortality in heart failure (HF) patients.

Objective: To evaluate whether the risk of AF patients can be precisely stratified by relation with cardiopulmonary exercise test (CPET) cut-offs for heart transplantation (HT) selection.

Methods: Prospective evaluation of 274 consecutive HF patients with left ventricular ejection fraction ≤ 40%. Read More

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http://dx.doi.org/10.36660/abc.20180193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077586PMC
February 2020

Prognostic significance of troponin level in 3121 patients presenting with atrial fibrillation (The NIHR Health Informatics Collaborative TROP-AF study).

J Am Heart Assoc 2020 Apr 26;9(7):e013684. Epub 2020 Mar 26.

NIHR Imperial Biomedical Research Centre Imperial College London and Imperial College Healthcare NHS Trust London United Kingdom.

Background Patients presenting with atrial fibrillation (AF) often undergo a blood test to measure troponin, but interpretation of the result is impeded by uncertainty about its clinical importance. We investigated the relationship between troponin level, coronary angiography, and all-cause mortality in real-world patients presenting with AF. Methods and Results We used National Institute of Health Research Health Informatics Collaborative data to identify patients admitted between 2010 and 2017 at 5 tertiary centers in the United Kingdom with a primary diagnosis of AF. Read More

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http://dx.doi.org/10.1161/JAHA.119.013684DOI Listing

Use of oral anticoagulation therapy in the first 3 months after the diagnosis of atrial fibrillation in Israel: A population-based study.

J Cardiovasc Electrophysiol 2020 Jun 1;31(6):1356-1363. Epub 2020 Apr 1.

Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Introduction: Oral anticoagulation (OAC) therapy reduces the risk of ischemic stroke in patients with atrial fibrillation (AF) while increasing the risk of bleeding. Recently, non-vitamin K antagonist oral anticoagulants (NOACs) have become available with lower rates of intracranial bleeding, and some of them have presented a reduced risk of major bleeding. The purpose of this study is to evaluate the change in purchasing patterns of OACs (both warfarin and NOACs) over time in patients with AF according to stroke and bleeding risk, in the first 3 months after diagnosis. Read More

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http://dx.doi.org/10.1111/jce.14452DOI Listing

A Helpful Tool in Diagnosing Stroke Mimics: Arterial Spin Labeled Perfusion Magnetic Resonance Imaging.

J Emerg Med 2020 Mar 18;58(3):439-443. Epub 2020 Mar 18.

Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina.

Background: Prompt and effective management of acute ischemic stroke in the emergency setting requires a high level of suspicion and accurate diagnosis. Conversely, identifying stroke mimics can be challenging, given the similarity of their clinical symptomatology, the necessary rapid assessment and triage, and the overall frenetic pace inherent in the goal of rapid thrombolysis ("time is brain").

Case Report: We describe a case that involves an elderly patient with acute hemiplegia and dysarthria. Read More

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http://dx.doi.org/10.1016/j.jemermed.2019.12.019DOI Listing

Atrial arrhythmias in heart failure with a reduced ejection fraction.

Curr Opin Cardiol 2020 May;35(3):271-275

Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA.

Purpose Of Review: Atrial arrhythmias are common among individuals with heart failure with a reduced ejection fraction (HFrEF). This review describes management options for these arrhythmias and discusses emerging clinical data supporting catheter ablation.

Recent Findings: Several recent clinical trials indicate that catheter ablation is superior to pharmacologic therapy for management of symptomatic atrial fibrillation in the setting of HFrEF. Read More

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http://dx.doi.org/10.1097/HCO.0000000000000734DOI Listing

Anticoagulation in thrombocytopenic patients with hematological malignancy: A multinational clinical vignette-based experiment.

Eur J Intern Med 2020 Mar 12. Epub 2020 Mar 12.

Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Thrombosis Expert Center, Maastricht University Medical Center, Maastricht, the Netherlands.

Background: Thrombocytopenia in cancer patients with an indication for anticoagulation poses a unique clinical challenge. There are guidelines for the setting of venous thromboembolism but not atrial fibrillation (AF). Evidence is lacking and current practice is unclear. Read More

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http://dx.doi.org/10.1016/j.ejim.2020.03.005DOI Listing

Utility of Transthoracic Echocardiography in Diagnostic Evaluation of Ischemic Stroke.

Front Neurol 2020 18;11:103. Epub 2020 Feb 18.

Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States.

Transthoracic echocardiography (TTE) is routinely performed as part of standard acute ischemic stroke (AIS) workup. However, the overall yield of TTE is unclear and many patients may undergo unnecessary investigations. This study aims to investigate the utility of TTE as part of AIS workup. Read More

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http://dx.doi.org/10.3389/fneur.2020.00103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040372PMC
February 2020

Validation of Intraoperative Catheter Phase Mapping Using a Simultaneous Optical Measurement System in Rabbit Ventricular Myocardium.

Circ J 2020 Mar 5;84(4):609-615. Epub 2020 Mar 5.

Faculty of Engineering, The University of Tokyo.

Background: Recently, an interoperative catheter electrode mapping system, termed ExTRa Mapping (EXT), was developed for precise diagnosis and effective treatment of non-paroxysmal atrial fibrillations (non-PAF). However, the mapping accuracy of EXT is still unclear.Methods and Results:In this study, the reliability of the EXT in comparison with that of high-resolution optical membrane potential mapping was compared. Read More

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http://dx.doi.org/10.1253/circj.CJ-19-1020DOI Listing

A Review on the State of the Art in Atrial Fibrillation Detection Enabled by Machine Learning.

IEEE Rev Biomed Eng 2020 Feb 27. Epub 2020 Feb 27.

Atrial Fibrillation (AF) the most commonly occurring type of cardiac arrhythmia is one of the main causes of morbidity and mortality worldwide. The timely diagnosis of AF is an equally important and challenging task because of its asymptomatic and episodic nature. n this paper, state-of-the-art ECG data-based machine learning models and signal processing techniques applied for auto diagnosis of AF are reviewed. Read More

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http://dx.doi.org/10.1109/RBME.2020.2976507DOI Listing
February 2020

Association of postoperative complications and outcomes following coronary artery bypass grafting.

Am Heart J 2020 04 8;222:220-228. Epub 2020 Feb 8.

Department of Surgery, Duke University Medical Center, Durham, NC.

Background: The long-term effects of postoperative complications following coronary artery bypass grafting (CABG) are unknown.

Methods: Medicare-linked records from the Society of Thoracic Surgeons Adult Cardiac Surgery Database were queried for isolated CABG records from 2007 through 2012. Unadjusted and adjusted associations between individual postoperative complications and both mortality and all-cause rehospitalization were evaluated to 7 years using Cox proportional-hazards models and cumulative incidence functions. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.02.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085463PMC

Budget impacts associated with improving diagnosis and treatment of atrial fibrillation in high-risk stroke patients.

J Comp Eff Res 2020 Mar 26;9(4):253-262. Epub 2020 Feb 26.

JB Medical Ltd, Sudbury, CO10 0PB, UK.

Estimate the 3-year budget impact in England from 2016/17 of improving nonvalvular atrial fibrillation management in high-risk stroke patients. The Academic Health Science Network's AF Business Case Model was used to identify detection, protection (risk assessment and treatment initiation) and perfection (optimized treatment) gaps and to project the budget impact of closing these. Closing all gaps over 3 years could prevent 27,550 strokes. Read More

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http://dx.doi.org/10.2217/cer-2019-0125DOI Listing

Racial/Ethnic Disparities in Atrial Fibrillation Treatment and Outcomes among Dialysis Patients in the United States.

J Am Soc Nephrol 2020 Mar 20;31(3):637-649. Epub 2020 Feb 20.

Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland

Background: Because stroke prevention is a major goal in the management of ESKD hemodialysis patients with atrial fibrillation, investigating racial/ethnic disparities in stroke among such patients is important to those who could benefit from strategies to maximize preventive measures.

Methods: We used the United States Renal Data System to identify ESKD patients who initiated hemodialysis from 2006 to 2013 and then identified those with a subsequent atrial fibrillation diagnosis and Medicare Part A/B/D. Patients were followed for 1 year for all-cause stroke, mortality, prescription medications, and cardiovascular disease procedures. Read More

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http://dx.doi.org/10.1681/ASN.2019050543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062215PMC

Pharmacological management of atrial fibrillation in patients with heart failure with reduced ejection fraction: review of current knowledge and future directions.

Expert Rev Cardiovasc Ther 2020 Feb 25;18(2):85-101. Epub 2020 Feb 25.

Division of Cardiology, Department of Medicine, Duke University Hospital, Durham NC, USA.

: Both heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) independently cause significant morbidity and mortality. The two conditions commonly coexist and AF in the setting of HFrEF is associated with worse mortality, hospitalizations, and quality of life compared to HFrEF without AF. Despite the large burden of these conditions, there is no clear optimal management strategy for when they occur together. Read More

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http://dx.doi.org/10.1080/14779072.2020.1732210DOI Listing
February 2020

The role of atrial sensing for new-onset atrial arrhythmias diagnosis and management in single-chamber implantable cardioverter-defibrillator recipients: Results from the THINGS registry.

J Cardiovasc Electrophysiol 2020 Apr 25;31(4):846-853. Epub 2020 Feb 25.

Policlinico S. Orsola-Malpighi, Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy.

Introduction: Atrial tachycardia/fibrillation (AT/AF) episodes are common in implantable cardioverter-defibrillator (ICD) recipients and can be undetected by standard single-chamber devices. This study aims to explore whether a single-lead ICD with an atrial dipole (ICD DX; BIOTRONIK SE & Co, Berlin, Germany) could improve the AT/AF diagnosis and management as compared to standard ICD (ICD VR).

Methods And Results: We selected patients without AT/AF history from the THINGS registry which included consecutive patients implanted with ICD for standard indications. Read More

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http://dx.doi.org/10.1111/jce.14396DOI Listing

Postsurgical Refractory Gastroparesis: Response to Botulinum Toxin Therapy.

Cureus 2020 Jan 8;12(1):e6596. Epub 2020 Jan 8.

Gastroenterology, AdventHealth, Orlando, USA.

Gastroparesis is a complex dysmotility disorder characterized by chronic dyspepsia and delayed gastric emptying in the absence of mechanical obstruction. Postsurgical gastroparesis is the third most common cause and accounts for 13% of total cases. Studies have shown that catheter ablation procedures for atrial fibrillation can rarely result in gastroparesis, secondary to damage to the vagus nerve. Read More

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http://dx.doi.org/10.7759/cureus.6596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003725PMC
January 2020

New-onset lone maternal atrial fibrillation: A case report.

Medicine (Baltimore) 2020 Feb;99(7):e19156

Letterkenny University Hospital. Co. Donegal, Ireland.

Rationale: Atrial fibrillation (AF) is encountered rarely in pregnancy. Management of maternal AF is challenging as it poses a threat to both maternal and fetal well-being.

Patient Concerns: We report a case of a 35 weeks pregnant woman who presented in emergency with sudden-onset palpitations and mild shortness of breath with no personal/family history of cardiac diseases. Read More

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http://dx.doi.org/10.1097/MD.0000000000019156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035010PMC
February 2020

Atrial fibrillation ablation in patients with transthyretin cardiac amyloidosis.

Europace 2020 Feb;22(2):259-264

Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Aims: Atrial fibrillation (AF) occurs in as many as 70% of patients with transthyretin cardiac amyloidosis (ATTR CA). The aim of our study was to investigate the impact of AF ablation on freedom from recurrent arrhythmia, hospitalization for AF or heart failure (HF), and mortality.

Methods And Results: This was a retrospective observational cohort study of 72 patients with ATTR CA and AF, of whom 24 underwent AF ablation and were matched in a 2:1 manner based on age, gender, ATTR CA stage, New York Heart Association functional class, ejection fraction, and date of AF diagnosis with 48 patients with ATTR CA and AF undergoing medical management. Read More

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http://dx.doi.org/10.1093/europace/euz314DOI Listing
February 2020

Treatment strategies and subsequent changes in the patient-reported quality-of-life among elderly patients with atrial fibrillation.

Am Heart J 2020 04 21;222:83-92. Epub 2020 Jan 21.

Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address:

Background: Rhythm-control strategy, including catheter ablation (CA) application, constitutes an integral part of atrial fibrillation (AF) management. However, elderly patients are underrepresented in clinical trials, and reports on patient-reported outcome of various rhythm-control treatments remain limited. Therefore, we aimed to investigate the application of a rhythm-control strategy for elderly patients with AF. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.01.011DOI Listing

Association of smoking cessation after atrial fibrillation diagnosis on the risk of cardiovascular disease: a cohort study of South Korean men.

BMC Public Health 2020 Feb 3;20(1):168. Epub 2020 Feb 3.

Department of Family Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam, South Korea.

Background: While smoking elevates the risk for cardiovascular disease (CVD) among atrial fibrillation (AF) patients, whether smoking cessation after AF diagnosis actually leads to reduced CVD risk is unclear. We aimed to determine the association of smoking cessation after AF diagnosis with subsequent CVD Risk among South Korean men.

Methods: This retrospective cohort study included 2372 newly diagnosed AF male patients during 2003-2012 from the Korean National Health Insurance Service database. Read More

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http://dx.doi.org/10.1186/s12889-020-8275-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998101PMC
February 2020