Temporal trends of catheter ablation procedures in patients with atrial fibrillation and atrial flutter: A nationwide cohort study.

Background: Catheter ablation is a well-established treatment to prevent atrial fibrillation (AF) and atrial flutter (AFL) recurrences and to relieve symptoms, whereas pacemaker implantation and atrioventricular node (AVN) ablation is used for rate control when medical therapy fails.

Aims: We investigated temporal trends and patient characteristics in catheter ablation procedures for AF, AFL and AVN in Finland between 2012-2018.

Methods: Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) is a registry-based study including all patients with AF or AFL in Finland between 2012-2018.

Trends and burden of diabetes in patients with atrial fibrillation during 2007-2018: A Finnish nationwide cohort study.

Aims: We assessed the temporal trends in the prevalence of diabetes and in its associations with outcomes among patients with atrial fibrillation (AF).

Methods: The registry-based FinACAF study covered all patients with incident AF in Finland between 2007 and 2018. Ischemic stroke (IS) and mortality rates were computed using Poisson regression model.

Mental health conditions and use of rhythm control therapies in patients with atrial fibrillation: a nationwide cohort study.

Objectives: Mental health conditions (MHCs) have been associated with undertreatment of unrelated medical conditions, but whether patients with MHCs face disparities in receiving rhythm control therapies for atrial fibrillation (AF) is currently unknown. We assessed the hypothesis that MHCs are associated with a lower use of antiarrhythmic therapies (AATs).

Design: A nationwide retrospective registry-based cohort study.

Socioeconomic disparities in use of rhythm control therapies in patients with incident atrial fibrillation: A Finnish nationwide cohort study.

Background: In patients with atrial fibrillation (AF), socioeconomic disparities have been reported in the use of oral anticoagulant therapy and outcomes, but whether income also affects the utilization of antiarrhythmic therapies (AATs) for rhythm control is unknown. We assessed the hypothesis that AF patients with higher income are more likely to receive AATs.

Methods: The nationwide retrospective registry based FinACAF cohort study covers all patients with AF from all levels of care in Finland.

Thromboembolisms related to post-operative electrical cardioversions for atrial fibrillation in patients with surgical aortic valve replacement.

Aims: Post-operative atrial fibrillation (POAF) is a frequent complication after open-heart surgery, and cardioversions (CV) are commonly performed to restore sinus rhythm. However, little data exists on thrombo-embolic risk related to early post-operative CV and on the recurrence of POAF after CV. CAREAVR study sought to assess the rate of strokes, transient ischaemic attacks (TIA), and mortality shortly after POAF-triggered CV in patients who underwent isolated surgical aortic valve replacement (SAVR) with a bioprosthesis.

Value of DAPT score to predict adverse outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: A post-hoc analysis from the AFCAS registry.

Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI.

Methods And Results: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events.

Reliability of pulse palpation in the detection of atrial fibrillation in an elderly population.

Purpose: Atrial fibrillation (AF) may first present as an ischemic stroke. Pulse palpation is a potential screening method for asymptomatic AF. We aimed to assess the reliability of pulse palpation by the elderly in detecting AF.

Cardioversion Of Atrial Fibrillation And Oral Anticoagulation.

The risk of thromboembolic events is a major concern in cardioversion of atrial fibrillation. The vast majority of these events occur in the first week following cardioversion. Processes promoting thrombus formation occur early and thrombus may appear in the left atrium within 48 hours of atrial fibrillation.

The optimal management of patients on oral anticoagulation undergoing coronary artery stenting. The 10th Anniversary Overview.

Even 10 years after the first appearance in the literature of articles reporting on the management of patients on oral anticoagulation (OAC) undergoing percutaneous coronary intervention with stent (PCI-S), this issue is still controversial. Nonetheless, some guidance for the everyday management of this patient subset, accounting for about 5-8 % of all patients referred for PCI-S, has been developed. In general, a period of triple therapy (TT) of OAC, with either vitamin K-antagonists (VKA) or non-vitamin K-antagonist oral anticoagulants (NOAC), aspirin, and clopidogrel is warranted, followed by the combination of OAC, and a single antiplatelet agent for up to 12 months, and then OAC alone.

Bare-metal vs. drug-eluting stents in patients with atrial fibrillation undergoing percutaneous coronary intervention.

Background: We explored 12-month clinical outcomes of 929 patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) with bare-metal stents (BMS) vs. drug-eluting stents (DES) from the prospective multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. METHODS AND RESULTS: Endpoints included the first occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), target vessel revascularization, definite/probable stent thrombosis (ST), transient ischemic attack or stroke.

Cardioversion in Acute Atrial Fibrillation Without Anticoagulation.

A major concern in cardioversion of newly detected atrial fibrillation is the risk of thromboembolic events. The vast majority of these events occur in the first week following cardioversion. Transesophageal echocardiography has demonstrated that thrombus and dense spontaneous echo contrast may occur in the left atrium and left atrial appendage in patients with acute atrial fibrillation (<48 hours) scheduled for cardioversion.

Trimetazidine, a metabolic modulator, has cardiac and extracardiac benefits in idiopathic dilated cardiomyopathy.

Background: The anti-ischemic agent trimetazidine improves ejection fraction in heart failure that is hypothetically linked to inhibitory effects on cardiac free fatty acid (FFA) oxidation. However, FFA oxidation remains unmeasured in humans. We investigated the effects of trimetazidine on cardiac perfusion, efficiency of work, and FFA oxidation in idiopathic dilated cardiomyopathy.

Transesophageal echocardiography in the diagnosis of thrombosis associated with permanent transvenous pacemaker electrodes.

Objectives: We sought to assess the value of transesophageal echocardiography (TEE) in the diagnosis of PM-lead-associated central venous thrombi.

Background: Venous thrombosis is not infrequent after pacemaker (PM) or implantable cardioverter-defibrillator (ICD) implantation. Previous incidence studies of thrombosis have been based on venography or Doppler ultrasound, but the role of TEE has not been systematically evaluated in this setting.

Real world experience with the TITAN(R) stent: a 9-month follow-up report from The Titan PORI Registry.

Aims: The aim of the Titan PORI Registry was to evaluate the safety and efficacy of a stainless steel stent coated with titanium nitride oxide (Titan(R), Hexacath, France) in routine clinical practice.

Methods And Results: We report a prospective single-centre experience in treating patients with the Titan(R) stent. All consecutive patients receiving Titan(R) stent(s) were enrolled.

From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I.

Atherosclerotic cardiovascular disease results in >19 million deaths annually, and coronary heart disease accounts for the majority of this toll. Despite major advances in treatment of coronary heart disease patients, a large number of victims of the disease who are apparently healthy die suddenly without prior symptoms. Available screening and diagnostic methods are insufficient to identify the victims before the event occurs.

Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era.

Objectives: This study assessed the predictive power of arrhythmia risk markers after an acute myocardial infarction (AMI).

Background: Several risk variables have been suggested to predict the occurrence of sudden cardiac death (SCD), but the utility of these variables has not been well established among patients using medical therapy according to contemporary guidelines.

Methods: A consecutive series of 700 patients with AMI was studied.

Relationship between the frequency of paroxysmal episodes of atrial fibrillation and pulmonary venous flow pattern.

Aims: Chronic atrial fibrillation causes mechanical remodelling of the atria, but it is uncertain whether self-terminating episodes of paroxysmal atrial fibrillation (PAF) alter atrial mechanical function during normal sinus rhythm. This study was designed to assess the relationship between the frequency of symptomatic arrhythmic episodes and pulmonary venous flow (PVF) pattern among patients with PAF.

Methods And Results: The effect of symptomatic arrhythmic episodes on PVF was studied in 85 patients with lone PAF (age 48+/-8 years, 66 men).

Low-dose transdermal scopolamine decreases blood pressure in mild essential hypertension.

Background: Increasing cardiovascular parasympathetic nervous activity could have antihypertensive effects. Low-dose transdermal scopolamine increases vagal-cardiac modulation of sinus node and baroreflex sensitivity in healthy subjects and in cardiac patients.

Objective: To study the short-term effects of transdermal scopolamine on blood pressure and cardiovascular autonomic control in patients with mild essential hypertension.