Latest & greatest articles for atrial fibrillation

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Top results for atrial fibrillation

661. Comparative efficacy of dronedarone and amiodarone for the maintenance of sinus rhythm in patients with atrial fibrillation Full Text available with Trip Pro

Comparative efficacy of dronedarone and amiodarone for the maintenance of sinus rhythm in patients with atrial fibrillation Comparative efficacy of dronedarone and amiodarone for the maintenance of sinus rhythm in patients with atrial fibrillation Comparative efficacy of dronedarone and amiodarone for the maintenance of sinus rhythm in patients with atrial fibrillation Piccini JP, Hasselblad V, Peterson ED, Washam JB, Califf RM, Kong DF CRD summary This review compared the efficacy and safety (...) of dronedarone versus amiodarone for the prevention of recurrent atrial fibrillation. It concluded that dronedarone was less effective than amiodarone, but had fewer adverse events. Limitations in the conduct and reporting of this review mean that the estimates on which these conclusions were based may not be reliable. Authors' objectives To compare the efficacy and safety of dronedarone versus amiodarone for the prevention of recurrent atrial fibrillation. Searching MEDLINE was searched from inception

2009 DARE.

662. Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation: a meta-analysis of randomized, controlled trials

Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation: a meta-analysis of randomized, controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 DARE.

663. Chronic atrial fibrillation: a systematic review of medical heart rate control management

Chronic atrial fibrillation: a systematic review of medical heart rate control management Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 DARE.

664. Radiofrequency catheter ablation of the pulmonary veins for treatment of atrial fibrillation

Radiofrequency catheter ablation of the pulmonary veins for treatment of atrial fibrillation Radiofrequency catheter ablation of the pulmonary veins for treatment of atrial fibrillation Radiofrequency catheter ablation of the pulmonary veins for treatment of atrial fibrillation Lefevre F, Aronson N, Ziegler KM, Bonnell CJ, Gere MA CRD summary This review concluded that radiofrequency catheter ablation was superior to medications for maintaining sinus rhythm in patients with atrial fibrillation (...) and superior to atrioventricular nodal ablation in patients with congestive heart failure, symptomatic atrial fibrillation and uncontrolled heart rate. Though broadly reliable, these conclusions are based on a small number of studies that reported 12 months follow-up or less. Authors' objectives To determine whether radiofrequency catheter ablation improves health outcomes when used to treat patients with atrial fibrillation. Searching An earlier search of MEDLINE from 1990 to March 2006 for relevant

2009 DARE.

665. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. (Abstract)

Effect of clopidogrel added to aspirin in patients with atrial fibrillation. Vitamin K antagonists reduce the risk of stroke in patients with atrial fibrillation but are considered unsuitable in many patients, who usually receive aspirin instead. We investigated the hypothesis that the addition of clopidogrel to aspirin would reduce the risk of vascular events in patients with atrial fibrillation.A total of 7554 patients with atrial fibrillation who had an increased risk of stroke and for whom (...) =0.08). Major bleeding occurred in 251 patients receiving clopidogrel (2.0% per year) and in 162 patients receiving placebo (1.3% per year) (relative risk, 1.57; 95% CI, 1.29 to 1.92; P<0.001).In patients with atrial fibrillation for whom vitamin K-antagonist therapy was unsuitable, the addition of clopidogrel to aspirin reduced the risk of major vascular events, especially stroke, and increased the risk of major hemorrhage. (ClinicalTrials.gov number, NCT00249873.)2009 Massachusetts Medical Society

2009 NEJM Controlled trial quality: predicted high

666. Effect of dronedarone on cardiovascular events in atrial fibrillation. Full Text available with Trip Pro

Effect of dronedarone on cardiovascular events in atrial fibrillation. Dronedarone is a new antiarrhythmic drug that is being developed for the treatment of patients with atrial fibrillation.We conducted a multicenter trial to evaluate the use of dronedarone in 4628 patients with atrial fibrillation who had additional risk factors for death. Patients were randomly assigned to receive dronedarone, 400 mg twice a day, or placebo. The primary outcome was the first hospitalization due (...) . The dronedarone group had higher rates of bradycardia, QT-interval prolongation, nausea, diarrhea, rash, and an increased serum creatinine level than the placebo group. Rates of thyroid- and pulmonary-related adverse events were not significantly different between the two groups.Dronedarone reduced the incidence of hospitalization due to cardiovascular events or death in patients with atrial fibrillation. (ClinicalTrials.gov number, NCT00174785.)2009 Massachusetts Medical Society

2009 NEJM Controlled trial quality: predicted high

667. Valsartan for prevention of recurrent atrial fibrillation. (Abstract)

Valsartan for prevention of recurrent atrial fibrillation. Atrial fibrillation is the most common cardiac arrhythmia, and no current therapy is ideal for control of this condition. Experimental studies suggest that angiotensin II-receptor blockers (ARBs) can influence atrial remodeling, and some clinical studies suggest that they may prevent atrial fibrillation.We conducted a large, randomized, prospective, placebo-controlled, multicenter trial to test whether the ARB valsartan could reduce (...) the recurrence of atrial fibrillation. We enrolled patients who were in sinus rhythm but had had either two or more documented episodes of atrial fibrillation in the previous 6 months or successful cardioversion for atrial fibrillation in the previous 2 weeks. To be eligible, patients also had to have underlying cardiovascular disease, diabetes, or left atrial enlargement. Patients were randomly assigned to receive valsartan or placebo. The two primary end points were the time to a first recurrence of atrial

2009 NEJM Controlled trial quality: predicted high

668. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study Full Text available with Trip Pro

Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study The mainstay of treatment for atrial fibrillation (AF) remains pharmacological; however, catheter ablation has increasingly been used over the last decade. The relative merits of each strategy have not been extensively studied.We conducted a randomized multicenter comparison of these 2 treatment strategies in patients with paroxysmal AF resistant to at least 1 antiarrhythmic drug. The primary end point

2009 EvidenceUpdates Controlled trial quality: uncertain

669. Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department?

Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? BestBets: Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Report By: Martin Hossack - Medical Student Search checked by Rick Body - Specialist Registrar Institution: Manchester (...) Royal Infirmary Date Submitted: 7th July 2008 Date Completed: 9th January 2009 Last Modified: 14th November 2008 Status: Green (complete) Three Part Question In [patients presenting to the Emergency Department with atrial fibrillation requiring rate limitation] are [beta blockers superior in efficacy and safety to digoxin] in [achieving rate control]? Clinical Scenario A 60 year old man comes to the Emergency Department with symptoms of palpitations. ECG recording confirms atrial fibrillation

2009 BestBETS

670. Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation

Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Sorensen SV, Dewilde S, Singer DE, Goldhaber SZ, Monz BU, Plumb JM Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of warfarin treatment in patients with atrial fibrillation, who were at moderate-to-high risk of ischaemic stroke, and considered various scenarios for treatment adherence and discontinuation. The cost-effectiveness of warfarin and its beneficial effect deteriorated with poorer

2009 NHS Economic Evaluation Database.

671. Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Full Text available with Trip Pro

Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Patrick AR, Avorn J, Choudhry NK Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to determine the circumstances in which genotyping before warfarin initiation could be cost-effective for patients with atrial fibrillation. Genotyping was cost-effective only if it reduced the out-of-range international normalised ratios by more than five to nine percentage points. There was uncertainty surrounding the effectiveness of genotyping and its

2009 NHS Economic Evaluation Database.

672. Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation

Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Eckman MH, Rosand J, Greenberg SM, Gage BF Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study evaluated the cost-effectiveness of a genotype-guided dose titration strategy compared with the standard induction dosage of warfarin for patients with non-valvular atrial fibrillation. The authors concluded that genotype-guided warfarin dosage was unlikely

2009 NHS Economic Evaluation Database.

673. Alcohol consumption and risk of incident atrial fibrillation in women. Full Text available with Trip Pro

Alcohol consumption and risk of incident atrial fibrillation in women. Previous studies suggest that consuming moderate to high amounts of alcohol on a regular basis might increase the risk of developing atrial fibrillation in men but not in women. However, these studies were not powered to investigate the association of alcohol consumption and atrial fibrillation among women.To prospectively assess the association between regular alcohol consumption and incident atrial fibrillation among (...) women.Participants were 34 715 initially healthy women participating in the Women's Health Study, a completed randomized controlled trial conducted in the United States. Participants were older than 45 years and free of atrial fibrillation at baseline and underwent prospective follow-up from 1993 to October 31, 2006. Alcohol consumption was assessed via questionnaires at baseline and at 48 months of follow-up and was grouped into 4 categories (0, > 0 and < 1, > or = 1 and < 2, and > or = 2 drinks per day

2008 JAMA

674. High-normal thyroid function and risk of atrial fibrillation: the Rotterdam study Full Text available with Trip Pro

High-normal thyroid function and risk of atrial fibrillation: the Rotterdam study Overt and subclinical hyperthyroidism are both well-known independent risk factors for atrial fibrillation. We aimed to investigate the association of high-normal thyroid function with the development of atrial fibrillation in a prospective population-based study in the elderly.The association between thyroid-stimulating hormone (TSH) levels and atrial fibrillation was examined in 1426 subjects with TSH levels (...) in the normal range (0.4-4.0 mU/L) and without atrial fibrillation at baseline. In 1177 of the 1426 persons in this group, we also examined the association between free thyroxine levels within the normal range (0.86-1.94 ng/dL [to convert to picomoles per liter, multiply by 12.871]) and atrial fibrillation. During a median follow-up of 8 years, 105 new cases of atrial fibrillation were identified. Hazard ratios (HRs) were calculated with 95% confidence intervals (CIs) using Cox proportional hazards models

2008 EvidenceUpdates

675. Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery Full Text available with Trip Pro

Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery Postoperative atrial fibrillation (AF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. Inotropic drugs are commonly used perioperatively to support ventricular function. This study tested the hypothesis that the use of inotropic drugs is associated with postoperative AF.We evaluated perioperative risk factors in 232 patients who underwent elective cardiac

2008 EvidenceUpdates Controlled trial quality: uncertain

676. A prospective, randomized trial of an emergency department observation unit for acute onset atrial fibrillation (Abstract)

A prospective, randomized trial of an emergency department observation unit for acute onset atrial fibrillation An emergency department (ED) observation unit protocol for the management of acute onset atrial fibrillation is compared with routine hospital admission and management.Adult patients presenting to the ED with atrial fibrillation of less than 48 hours' duration without hemodynamic instability or other comorbid conditions requiring hospitalization were enrolled. Participants were (...) randomized to either ED observation unit care or routine inpatient care. The ED observation unit protocol included pulse rate control, cardiac monitoring, reassessment, and electrical cardioversion if atrial fibrillation persisted. Patients who reverted to sinus rhythm were discharged with a cardiology follow-up within 3 days, whereas those still in atrial fibrillation were admitted. All cases were followed up for 6 months and adverse events recorded.Of the 153 patients, 75 were randomized to the ED

2008 EvidenceUpdates Controlled trial quality: predicted high

677. Obesity as a risk factor for the progression of paroxysmal to permanent atrial fibrillation: a longitudinal cohort study of 21 years Full Text available with Trip Pro

Obesity as a risk factor for the progression of paroxysmal to permanent atrial fibrillation: a longitudinal cohort study of 21 years Obesity has been shown to be a risk factor for first atrial fibrillation (AF), but whether it is associated with progression from paroxysmal to permanent AF is unknown.In this longitudinal cohort study, Olmsted County, MN residents confirmed to have developed paroxysmal AF during 1980-2000 were identified and followed passively to 2006. The interrelationships (...) of body mass index (BMI), left atrial (LA) size, and progression to permanent AF were analysed. Of a total of 3248 patients (mean age 71 +/- 15 years; 54% men) diagnosed with paroxysmal AF, 557 (17%) progressed to permanent AF (unadjusted incidence, 36/1000 person-years) over a median follow-up period of 5.1 years (interquartile range 1.2-9.4). Adjusting for age and sex, BMI independently predicted the progression to permanent AF (hazard ratio, HR 1.04, CI 1.03-1.06; P < 0.0001). Compared with normal

2008 EvidenceUpdates

678. Does sodium nitroprusside decrease the incidence of atrial fibrillation after myocardial revascularization? Full Text available with Trip Pro

Does sodium nitroprusside decrease the incidence of atrial fibrillation after myocardial revascularization? Atrial fibrillation (AF) often occurs after coronary artery bypass grafting and can result in increased morbidity and mortality. In the present pilot study, our aim was to investigate whether sodium nitroprusside (SNP), as a nitric oxide donor, can reduce the frequency of post-coronary artery bypass grafting AF.To investigate the effectiveness of SNP in the prophylaxis of AF, we conducted

2008 EvidenceUpdates Controlled trial quality: uncertain

679. Atrial natriuretic peptide frameshift mutation in familial atrial fibrillation. Full Text available with Trip Pro

Atrial natriuretic peptide frameshift mutation in familial atrial fibrillation. Atrial fibrillation is a common arrhythmia that is hereditary in a small subgroup of patients. In a family with 11 clinically affected members, we mapped an atrial fibrillation locus to chromosome 1p36-p35 and identified a heterozygous frameshift mutation in the gene encoding atrial natriuretic peptide. Circulating chimeric atrial natriuretic peptide (ANP) was detected in high concentration in subjects (...) with the mutation, and shortened atrial action potentials were seen in an isolated heart model, creating a possible substrate for atrial fibrillation. This report implicates perturbation of the atrial natriuretic peptide-cyclic guanosine monophosphate (cGMP) pathway in cardiac electrical instability.2008 Massachusetts Medical Society

2008 NEJM

680. Biphasic energy selection for transthoracic cardioversion of atrial fibrillation. The BEST AF Trial (Abstract)

Biphasic energy selection for transthoracic cardioversion of atrial fibrillation. The BEST AF Trial To compare the efficacy and safety of an escalating energy protocol with a non-escalating energy protocol using an impedance compensated biphasic defibrillator for direct current cardioversion of atrial fibrillation (AF).This prospective multicentre randomised trial enrolled 380 patients (248 male, mean (SD) age 67 (10) years) with AF. Patients were randomised to either an escalating energy

2008 EvidenceUpdates Controlled trial quality: uncertain