Background: There is only scant published evidence demonstrating the importance of diagnosing atrial fibrillation (AF) in patients with a ventricularly paced rhythm. This potential pitfall to recognise AF has the implication of devastating outcomes.
Method: A short survey was undertaken in order to gauge the ability of doctors of all grades to recognise AF, and adequate anticoagulation, in the patient with chronic right ventricular pacing (RVp), based on ECG interpretation. Participants were trainee doctors from different grades including foundation doctors, core medical trainee, specialist registrars and consultants.
Results: Only 11.3% of doctors correctly identified the need for oral anticoagulation. There was no association between four groups (F1, F2, core medical training (CMT) and SpR) and incorrect answers (Fisher's exact test, value=4.082, p=0.252). However, there was a trend of better AF recognition towards registrar but this has not reached statistical significance.
Conclusions: Our study demonstrates severe systemic under-recognition of this fairly common condition among hospital doctors. This may lead to a lower rate of anticoagulation and a higher incidence of thromboembolic events.
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http://dx.doi.org/10.1136/heartasia-2013-010442 | DOI Listing |
Physiother Theory Pract
January 2025
Department of Surgical Sciences, Dunedin School of Medicine, Dunedin, New Zealand.
Background: Low cardiorespiratory fitness predicts worse postoperative outcomes, exacerbated by age and frailty. Preoperative High-Intensity Interval Training (HIIT) improves cardiorespiratory fitness and postoperative outcomes but is challenging to implement in frailty due to perceived risks.
Purpose: The aim of this case report was to demonstrate feasibility of HIIT in a patient with frailty and multimorbidity.
Open Heart
January 2025
Department of Public Health, Aarhus University, Aarhus, Denmark.
Background: Atrial fibrillation (AF) and acute myocardial infarction (AMI) share risk factors and are bidirectionally associated. Several studies found higher risks of outcomes in individuals with both conditions. Whether the risks of outcomes differ according to temporal order of AF and AMI is unclear.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Departments of Anesthesiology and Neurological Surgery, Harborview Medical Center, University of Washington, 325 9th Ave, Seattle, WA, 98104, USA.
Background: Early left ventricular systolic dysfunction is common after moderate-severe traumatic brain injury (TBI). Echocardiography (Echo) can evaluate cardiac function across various clinical scenarios; however, its utilization in isolated TBI remains poorly understood. To address this gap, we aim to examine Echo utilization in hospitalized adults with isolated TBI.
View Article and Find Full Text PDFInt Immunopharmacol
January 2025
Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China; Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China. Electronic address:
Background: The antiarrhythmic effect of melatonin(MLT) has been demonstrated in several studies; however, this hypothesis has recently been contested. Our research seeks to determine if exogenous MLT supplementation can reduce atrial fibrillation (AF) susceptibility due to sleep deprivation (SD) by addressing Ca mishandling and atrial mitochondrial oxidative stress.
Methods: Adult rats received daily MLT or vehicle injections and were exposed to a modified water tank.
N Engl J Med
January 2025
From the TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (C.T.R., S.M.P., R.P.G., D.A.M., J.F.K., E.L.G., S.A.M., S.D.W., M.S.S.); Anthos Therapeutics, Cambridge, MA (B.H., S.P., D.B.); the Heart Rhythm Center, Taipei Veterans General Hospital and Cardiovascular Center, Taipei, Taiwan (S.-A.C.); Taichung Veterans Hospital, Taichung, Taiwan (S.-A.C.); National Yang Ming Chiao Tung University, Hsinchu, Taiwan (S.-A.C.); National Chung Hsing University, Taichung, Taiwan (S.-A.C.); St. Michael's Hospital, Unity Health Toronto, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto (S.G.G.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.); the Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (B.J.); the Department of Cardiology, Central Hospital of Northern Pest-Military Hospital, Budapest, Hungary (R.G.K.); the Heart and Vascular Center, Semmelweis University, Budapest, Hungary (R.G.K.); the Internal Cardiology Department, St. Ann University Hospital and Masaryk University, Brno, Czech Republic (J.S.); the Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W.W.); the Departments of Medicine and of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada (J.W.); and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada (J.W.).
Background: Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in patients with atrial fibrillation is unknown.
Methods: Patients with atrial fibrillation and a moderate-to-high risk of stroke were randomly assigned, in a 1:1:1 ratio, to receive subcutaneous injection of abelacimab (150 mg or 90 mg once monthly) administered in a blinded fashion or oral rivaroxaban (20 mg once daily) administered in an open-label fashion.
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