Temporal Trends in the Management Practices of Clinically Important Perioperative Atrial Fibrillation After Noncardiac Surgery.

Background: Clinically important perioperative atrial fibrillation (POAF) is a common cardiac complication after noncardiac surgery. Little is known about how patients with POAF are managed acutely and whether practices have changed over time.

Methods: We conducted an observational substudy of patients who had POAF, were at elevated cardiovascular risk, and were enrolled in the PeriOperative Ischemic Evaluation (POISE)-1, 2 and 3 trials between 2002 and 2021.

Women have less progression of paroxysmal atrial fibrillation: data from the RACE V study.

Background: Sex differences in atrial fibrillation (AF) are observed in terms of comorbidities, symptoms, therapies received, AF progression and cardiovascular complications.

Methods: We assessed the differences in prevalence and the determinants of AF progression, as well as the clinical characteristics and quality of life (QoL), between women and men with paroxysmal AF included in the RACE V (Reappraisal of Atrial Fibrillation: Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilisation in the Progression of AF) study. At baseline, extensive phenotyping was done.

Design and rationale of DUTCH-AF: a prospective nationwide registry programme and observational study on long-term oral antithrombotic treatment in patients with atrial fibrillation.

Introduction: Anticoagulation therapy is pivotal in the management of stroke prevention in atrial fibrillation (AF). Prospective registries, containing longitudinal data are lacking with detailed information on anticoagulant therapy, treatment adherence and AF-related adverse events in practice-based patient cohorts, in particular for non-vitamin K oral anticoagulants (NOAC). With the creation of DUTCH-AF, a nationwide longitudinal AF registry, we aim to provide clinical data and answer questions on the (anticoagulant) management over time and of the clinical course of patients with newly diagnosed AF in routine clinical care.

Opportunistic screening for atrial fibrillation with a single lead device in geriatric patients.

Objective: To determine the diagnostic yield of repeated screening for atrial fibrillation (AF) among geriatric patients.

Methods: A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device (SLD) in a geriatric cohort. Consecutive patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.

When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics.

Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach.

Second-generation cryoballoon ablation for recurrent atrial fibrillation after an index cryoballoon procedure: a staged strategy with variable balloon size.

Purpose: Currently, information on the optimal approach of redo procedures for paroxysmal atrial fibrillation (PAF) is limited. Radiofrequency ablation is the preferred technique, with reported success rates of 50-70% at 1-2 years, whereas only few reports exist on redo cryoballoon (CB) ablations. We describe outcomes on a systematic approach of repeat procedures with a second-generation cryoballoon (CB-2) after a successful index CB ablation.

[Resumption of antithrombotic treatment after an intracerebral haemorrhage].

There is no evidence from randomised clinical trials with regard to the question if and when to resume antithrombotic medication in patients who have suffered an intracerebral haemorrhage and in whom medication continues to be indicated. It is unknown whether new oral anticoagulants are more suitable than vitamin K antagonists in this group of patients. Oral anticoagulants should probably not be resumed in patients with a lobar intracerebral haemorrhage caused by cerebral amyloid angiopathy.

Right atrial preventive and antitachycardia pacing for prevention of paroxysmal atrial fibrillation in patients without bradycardia: a randomized study.

Aims: To investigate the efficacy of preventive and antitachycardia pacing (ATP) in patients with symptomatic paroxysmal atrial fibrillation (AF) without bradyarrhythmias.

Methods And Results: In this randomized cross-over pilot study, we randomized 38 symptomatic paroxysmal AF patients 'without' bradyarrhythmias to atrial pacing lower rate 70 ppm and prevention and ATP therapies ON or to atrial pacing lower rate 34 ppm and prevention and ATP therapies OFF during 12 weeks with a 4 week washout period in between. The atrial lead was preferably placed in the inter-atrial septum.

Outcome of pharmacological rhythm control for new-onset persistent atrial fibrillation in patients with systolic heart failure: a comparison with patients with normal left ventricular function.

Aims: To compare outcome of a serial cardioversion strategy in atrial fibrillation (AF) patients with and without systolic heart failure (HF).

Methods And Results: In patients with new-onset persistent AF and systolic HF [left ventricular ejection fraction (LVEF) <0.40] outcome of a serial electrical cardioversion (ECV) and serial antiarrhythmic drug strategy was compared with a control group of patients without HF.

The progressive nature of atrial fibrillation: a rationale for early restoration and maintenance of sinus rhythm.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting young as well as elderly patients and presenting a major therapeutic challenge for clinical cardiologists. Recent research has elucidated the progressive nature of AF, including the structural and electrical remodelling that may become manifest if normal sinus rhythm is not restored, and the serious morbidities associated with long-term disease. The controversy over the merits of ventricular rate control vs.

Verapamil versus digoxin and acute versus routine serial cardioversion for the improvement of rhythm control for persistent atrial fibrillation.

Objectives: The VERDICT (Verapamil Versus Digoxin and Acute Versus Routine Serial Cardioversion Trial) is a prospective, randomized study to investigate whether: 1) acutely repeated serial electrical cardioversions (ECVs) after a relapse of atrial fibrillation (AF); and 2) prevention of intracellular calcium overload by verapamil, decrease intractability of AF.

Background: Rhythm control is desirable in patients suffering from symptomatic AF.

Methods: A total of 144 patients with persistent AF were included.

Favorable long-term outcome of Maze surgery in patients with lone atrial fibrillation.

Background: Rhythm control is indicated for patients suffering from symptomatic atrial fibrillation (AF), but remains difficult to establish. We investigated the long-term outcome of Cox maze III surgery in patients with symptomatic lone AF refractory to antiarrhythmic drug therapy.

Methods: Patients with a history of symptomatic paroxysmal or persistent AF refractory for at least two class I or III antiarrhythmic drugs and without structural heart disease or bradyarrhythmias were included.

Right atrial overdrive pacing for prevention of symptomatic refractory atrial fibrillation.

Aims: Our aim was to investigate whether right atrial overdrive pacing is effective for the prevention of atrial fibrillation (AF) in patients without bradyarrhythmias.

Methods And Results: Patients with symptomatic paroxysmal or persistent AF refractory to at least two Class I or III antiarrhythmic drugs and without bradyarrhythmias were included. Successful therapy was defined as the combination of (a) a reduction of AF burden with or without AAD use >75%, (b) total AF burden < or =5% per year, and (c) less than one electrical cardioversion per year.

Predictors of non-pharmacological intervention in patients with paroxysmal atrial fibrillation: Value of neuroticism.

Background: Non-pharmacological intervention is gaining increasing popularity in the treatment of patients with paroxysmal atrial fibrillation. We sought to investigate which factors play a role in the choice for non-pharmacological intervention with a particular focus on neuroticism.

Methods: The study group comprised 73 patients with paroxysmal atrial fibrillation (mean age 55+/-13 years, 50 males).

Variability of flow rate when collecting stimulated human parotid saliva.

The aim of this study was to estimate the accuracy and reproducibility of citric-acid-stimulated parotid saliva sampling. In healthy volunteers a strong correlation (r2 = 0.79) between flow rates from the left and right parotid gland was observed.

Genetic aspects of atrial fibrillation.

Atrial fibrillation (AF) occurs predominantly in the elderly and is commonly associated with underlying cardiac diseases. A significant number of patients, however, have early onset AF that is not associated with any underlying disease. At present, it is unknown how often this form of AF is familial and how frequently familial AF is due to genetic causes.