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Latest & greatest articles for atrial fibrillation
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on atrial fibrillation or other clinical topics then use Trip today.
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Atrialfibrillation Evidence Maps - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4
Risk of Ischemic Stroke After Perioperative AtrialFibrillation in Total Knee and Hip Arthroplasty Patients To determine if new-onset perioperative atrialfibrillation during arthroplasty represents a benign response to intraoperative cardiac stress or is a risk factor for stroke, we evaluated the subsequent risk of ischemic stroke in patients with new-onset atrialfibrillation occurring during primary total knee arthroplasty (TKA) and total hip arthroplasty (THA).Discharge data of all adult (...) patients undergoing primary TKA or THA from 1997 to 2013 were queried via the New York Statewide Planning and Research Cooperative System database to find patients with new-onset perioperative atrialfibrillation. These patients were then followed up over time to determine their risk of ischemic stroke.Of the 312,636 TKA and 215,610 THA unique patient admissions, 3646 (0.7%) had a diagnosis of new-onset perioperative atrialfibrillation. The cohort of patients with this finding was 58.9% female
Dynamic Changes of CHA2DS2-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with AtrialFibrillation: A Nationwide Cohort Study Stroke risk in atrialfibrillation (AF) is often assessed at initial presentation, and risk stratification performed as a 'one off'. In validation studies of risk prediction, baseline values are often used to 'predict' events that occur many years later. Many clinical variables have 'dynamic' changes over time, as the patient is followed up. These dynamic
Regional Dominant Frequency: A New Tool for Wave Break Identification During AtrialFibrillation Cardiac mapping systems are based on the time/frequency feature analyses of intracardiac electrograms recorded from individual bipolar/unipolar electrodes. Signals from each electrode are processed independently. Such approaches fail to investigate the interrelationship between simultaneously recorded channels of any given mapping catheter during atrialfibrillation (AF). We introduce a novel signal (...) locations of AF or atrial tachycardia (ATach) termination and later compared offline with RDF and WBR maps. We inspected our novel metrics for associations with AF termination sites. Areas associated with AF termination demonstrated high RDF and low WBR (↑RDF,↓WBR). These sites were present in 14 of 15 patients (mean 2.6 ± 1.2 sites per patient; range, 1-4 sites), 43% situated within the pulmonary veins. In nine patients where AF terminated to sinus rhythm (6) or ATach (3), post-hoc analysis
Features of atrialfibrillation in wildâ€type transthyretin cardiac amyloidosis: a systematic review and clinical experience Wild-type transthyretin (ATTRwt) cardiac amyloidosis has emerged as an important cause of heart failure in the elderly. Atrialfibrillation (AF) commonly affects older adults with heart failure and is associated with reduced survival, but its role in ATTRwt is unclear. We sought to explore the clinical impact of AF in ATTRwt.Patients with biopsy-proven ATTRwt cardiac (...) % warfarin, 17% novel anticoagulant, and 6% no anticoagulation. Amiodarone was prescribed to 24%. There were no differences in left ventricular ejection fraction (P = 0.09) or left atrial volume (P = 0.87); however, mean diastolic dysfunction grade was higher in AF (mean 2.7 ± 0.5 vs. 2.4 ± 0.5, P = 0.01). While creatinine (P = 0.52) and B-type natriuretic peptide (P = 0.48) were similar, patients with AF had lower serum transthyretin concentrations (221 ± 51 vs. 250 ± 52 μg/mL, P < 0.01). Survival
Indexed Left Atrial Adipose Tissue Area Is Associated With Severity of AtrialFibrillation and AtrialFibrillation Recurrence Among Patients Undergoing Catheter Ablation Background: Epicardial adipose tissue (EAT) has been associated with adverse left atrial (LA) remodeling and atrialfibrillation (AF) outcomes, possibly because of paracrine signaling. Objectives: We examined factors associated with a novel measure of EAT i.e., indexed LAEAT (iLAEAT) and its prognostic significance after (...) catheter ablation (CA) of atrialfibrillation (AF). Methods: We performed a retrospective analysis of 274 participants with AF referred for CA. LAEAT area was measured from a single pre-ablation CT image and indexed to body surface area (BSA) to calculate iLAEAT. Clinical, echocardiographic data and 1-year AF recurrence rates after CA were compared across tertiles of iLAEAT. We performed logistic regression analysis adjusting for factors associated with AF to examine relations between iLAEAT and AF
CJEM Visual Abstract: Implementing an atrialfibrillation pathway CJEM Visual Abstract: Implementing an atrialfibrillation pathway - CanadiEM CJEM Visual Abstract: Implementing an atrialfibrillation pathway In by Alvin Chin June 8, 2018 In this issue, we collaborated with the CJEM team to create a visual abstract on the article: “Implementation of an emergency department atrialfibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty (...) -day revisit rates for congestive heart failure.” 1 Atrialfibrillation and flutter are arrhythmias that come with significant morbidity and mortality 2 . Barbic et al. examined the effects of implementing an atrialfibrillation and flutter pathway on patient at two university-affiliated urban sites. 1 Their primary outcome was the proportion of patients who were correctly started on new anticoagulant medications by the treating emergency physician over an eight month period. The results
Treatment of AtrialFibrillation in Patients with Co-existing Heart Failure and Reduced Ejection Fraction: Time to Revisit the Management Guidelines? AF in patients with heart failure and reduced ejection fraction (HFrEF) is common and is associated with an increased risk of stroke, heart failure hospitalisation and all-cause mortality. Rhythm control of AF in this population has been traditionally limited to the use of antiarrhythmic drugs. Clinical trials assessing superiority
AtrialFibrillation Ablation in Patients with Heart Failure: One Size Does Not Fit All Atrialfibrillation (AF) is common in patients with heart failure and is associated with poorer clinical outcomes compared with patients with heart failure alone. Recent evidence has challenged previous treatment paradigms in which rate control was considered equivalent to rhythm control in this population. Catheter ablation has emerged as a safe and effective treatment strategy in selected patients
Risk Factor Management in AtrialFibrillationAtrialfibrillation (AF) is the most common clinical arrhythmia and is associated with increased morbidity and mortality. There is growing evidence that numerous cardiovascular diseases and risk factors are associated with incident AF and that lone AF is rare. Beyond oral anticoagulant therapy, rate and rhythm control, therapy targeting risk factors and underlying conditions is an emerging AF management strategy that warrants better implementation
Association of Burden of AtrialFibrillation With Risk of Ischemic Stroke in Adults With Paroxysmal AtrialFibrillation: The KP-RHYTHM Study Atrialfibrillation is a potent risk factor for stroke, but whether the burden of atrialfibrillation in patients with paroxysmal atrialfibrillation independently influences the risk of thromboembolism remains controversial.To determine if the burden of atrialfibrillation characterized using noninvasive, continuous ambulatory monitoring is associated (...) with the risk of ischemic stroke or arterial thromboembolism in adults with paroxysmal atrial fibrillation.This retrospective cohort study conducted from October 2011 and October 2016 at 2 large integrated health care delivery systems used an extended continuous cardiac monitoring system to identify adults who were found to have paroxysmal atrialfibrillation on 14-day continuous ambulatory electrocardiographic monitoring.The burden of atrialfibrillation was defined as the percentage of analyzable wear
Model-based meta-analysis to evaluate optimal doses of direct oral factor Xa inhibitors in atrialfibrillation patients The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrialfibrillation were demonstrated compared with warfarin by several large clinical trials; however, subsequent meta-analyses reported a higher risk of major bleeding with rivaroxaban than with the other FXa inhibitors. In the present study, we first estimated
Risk of stroke and transient ischaemic attack in patients with a diagnosis of resolved atrialfibrillation: retrospective cohort studies. To determine rates of stroke or transient ischaemic attack (TIA) and all cause mortality in patients with a diagnosis of "resolved" atrialfibrillation compared to patients with unresolved atrialfibrillation and without atrial fibrillation.Two retrospective cohort studies.General practices contributing to The Health Improvement Network, 1 January 2000 to 15 (...) May 2016.Adults aged 18 years or more with no previous stroke or TIA: 11 159 with resolved atrialfibrillation, 15 059 controls with atrialfibrillation, and 22 266 controls without atrial fibrillation.Primary outcome was incidence of stroke or TIA. Secondary outcome was all cause mortality.Adjusted incidence rate ratios for stroke or TIA in patients with resolved atrialfibrillation were 0.76 (95% confidence interval 0.67 to 0.85, P<0.001) versus controls with atrialfibrillation and 1.63 (1.46
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With AtrialFibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis. Vasopressin is an alternative to catecholamine vasopressors for patients with distributive shock-a condition due to excessive vasodilation, most frequently from severe infection. Blood pressure support with a noncatecholamine vasopressor may reduce stimulation of adrenergic receptors and decrease myocardial oxygen (...) demand. Atrialfibrillation is common with catecholamines and is associated with adverse events, including mortality and increased length of stay (LOS).To determine whether treatment with vasopressin + catecholamine vasopressors compared with catecholamine vasopressors alone was associated with reductions in the risk of adverse events.MEDLINE, EMBASE, and CENTRAL were searched from inception to February 2018. Experts were asked and meta-registries searched to identify ongoing trials.Pairs
Lifestyle Therapy for the Management of AtrialFibrillationAtrialfibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited
Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrialfibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials Of patients with atrialfibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population.A systematic review and meta-analysis was conducted using PubMed
A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrialfibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study) Atrialfibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains significant undertreatment. The main aim of the current study was to investigate
Apixaban compared to heparin/vitamin K antagonist in patients with atrialfibrillation scheduled for cardioversion: the EMANATE trial The primary objective was to compare apixaban to heparin/vitamin K antagonist (VKA) in patients with atrialfibrillation (AF) and ≤48 h anticoagulation prior to randomization undergoing cardioversion.One thousand five hundred patients were randomized. The apixaban dose of 5 mg b.i.d. was reduced to 2.5 mg b.i.d. in patients with two of the following: age ≥ 80