Search results for " Fibrillation"

Antivitamin K Drugs in Stroke Prevention

2014

Among the different subtypes of ischaemic strokes, almost 20 % are of cardiac origin. Different are the causes of cardioembolic stroke, but the most common is the atrial fibrillation, a supraventricular arrhythmia. Appropriate use of antiplatelet drugs and anticoagulants after transient ischaemic attack (TIA) or ischaemic stroke depends on whether the underlying cause is cardioembolic or of presumed arterial origin. Adequate antiplatelet therapy is recommended for secondary prevention after cerebral ischaemia of presumed arterial origin, whether for patients with TIA and ischaemic stroke of cardiac origin, mainly due to atrial fibrillation. Vitamin K antagonists (VKAs) are highly effective …

Atrial fibrillation and chronic kidney disease: focus on rivaroxaban

2015

Renal insufficiency increases the risk of stroke and bleeding in atrial fibrillation patients. Although vitamin K antagonists reduce the risk of stroke in patients with moderate renal dysfunction, this observation is less clear in patients with renal impairment. Moreover, the risk of bleeding with vitamin K antagonists increases as renal function worsens. Maintaining international normalized ratio values within therapeutic targets is more difficult in patients with renal dysfunction, and those agents may cause warfarin-related nephropathy and vascular calcification. Rivaroxaban is the only nonvitamin K oral anticoagulant with a dose specifically tested in patients with moderate renal insuff…

Direct Oral Anticoagulants in the Setting of Catheter Ablation of Atrial Fibrillation: State of art

2021

Atrial fibrillation (AF) represents the arrhythmia of greatest clinical impact and catheter ablation of AF (CAAF) has become the most effective strategy for rhythm control in selected patients. Therefore, appropriate anticoagulation strategies are of paramount importance for patients undergoing CAAF, especially those at high risk, such those with high CHA2DS2VASc scores. Optimal management of anticoagulation before, during, and after CAAF is crucial. Several studies have evaluated the use of different anticoagulation strategies in the periprocedural period. Randomized controlled trial seem to suggest that in patients undergoing CAAF, uninterrupted (or minimally interrupted) direct oral anti…

Recurrence quantification analysis as a tool for complex fractionated atrial electrogram discrimination

2012

International audience; Atrial fibrillation is the most encountered pathology of the heart rate. The reasons of its occurrence and its particular characteristics remain unknown, resulting from complex phenomena interaction. From these interactions emerges Complex Fractionated Atrial Electrograms (CFAE) which are useful for the ablation procedure. This study presents a method based on nonlinear data analysis, the Recurrence Quantification Analysis (RQA) applied on intracardiac atrial electrograms to detect CFAE particularities. The results obtained on areas previously tagged by a cardilogist show a good sensitivity to CFAE. Combination of RQA features offers a larger discrimination potential…

Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction

2020

Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to the autonomic nervous system and altered (reduced or enhanced) HRV may have a major role in the onset of AF in AMI patients. Objective: We investigated the relationship between autonomic dysregulation and new-onset AF during AMI. Methods: As part of the RICO survey, all consecutive patients hospitalized for AMI at Dijon (France) university hospital between June 2001 and November 2014 were analyzed …

Atrial fibrillation in athletes and non-athletes: evidence of different causative mechanisms

2021

Time-frequency analysis for early classification of persistent and long-standing persistent atrial fibrillation

2016

This study aimed to assess an early classification of persistent and long-standing persistent atrial fibrillation patients by means of the time-frequency analysis of the surface ECG, which would allow electrophysiologists to choose the most suitable therapeutic approach to treat this arrhythmia. 140 consecutive unselected patients suffering from atrial fibrillation conformed the study population (84 persistent and 56 long-standing persistent). After ventricular activity cancellation, time-frequency analysis of the atrial activity was performed. Then, the study of phase variations along time for those frequency bands where the average power of atrial activity is concentrated, together with t…

274 Comparative analysis of patients with acute coronary and cerebrovascular syndromes from the national French hospitalisation heath care system dat…

2011

Objective To compare vascular risk factor profiles and early outcomes in all French patients hospitalized for either acute coronary (ACS), or cerebrovascular syndromes (CVS), or both, between 2005 and 2008. Setting All French hospitals. Design Retrospective analysis. Data sources National database called “Hospital Discharge Diagnosis Records”. Main outcomes measured Number and annual rates, vascular risk factors, and early outcome of hospitalized patients for a unique stay for ACS or CVS or for both ACV and CVS in a 2-month time window. Results Over the 4-year study-period, 1,189,043 patients were hospitalized for CVS and/or ACS. Among these, 638,061 (53.7%) had CVS alone, 525,419 (44.3%) h…

P1193Prognostic value of high sensitive troponin I in patients with atrial fibrillation in the emergency department

2018

Quality of Anticoagulation With Vitamin K Antagonists

2015

Background Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF). Hypothesis Control of anticoagulation with VKA is inadequate in a high percentage of patients with AF. Methods Patients with AF under VKA treatment were prospectively recruited in this observational registry. The sample comprised 948 patients. The estimated time spent in the therapeutic range (TTR) was calculated, and variables related with a TTR >65% were analyzed. Results Mean age was 73.8 ± 9.…