Background: Short and rare episodes of atrial fibrillation (AF) are commonly detected using implanted devices (device-detected AF) in patients with prior stroke or transient ischemic attack (TIA). The effectiveness and safety of oral anticoagulation in patients with prior stroke or TIA and device-detected AF but with no ECG-documented AF is unclear.
Methods And Results: This prespecified analysis of the NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes) trial with post hoc elements assessed the effect of oral anticoagulation in patients with device-detected AF with and without a prior stroke or TIA in the randomized, double-blind, double-dummy NOAH-AFNET 6 trial. Outcomes were stroke, systemic embolism, and cardiovascular death (primary outcome) and major bleeding and death (safety outcome). A prior stroke or TIA was found in 253 patients with device-detected AF randomized in the NOAH-AFNET 6 (mean age, 78 years; 36.4% women). There was no treatment interaction with prior stroke or TIA for any of the primary and secondary time-to-event outcomes. In patients with a prior stroke or TIA, 14 out of 122 patients experienced a primary outcome event with anticoagulation (5.7% per patient-year). Without anticoagulation, there were 16 out of 131 patients with an event (6.3% per patient-year). The rate of stroke was lower than expected (anticoagulation: 4 out of 122 [1.6% per patient-year]; no anticoagulation: 6 out of 131 [2.3% per patient-year]). Numerically, there were more major bleeding events with anticoagulation in patients with prior stroke or TIA (8 out of 122 patients) than without anticoagulation (2 out of 131 patients).
Conclusions: Anticoagulation appears to have ambiguous effects in patients with device-detected AF and a prior stroke or TIA in this hypothesis-generating analysis of the NOAH-AFNET 6 in the absence of ECG-documented AF, partially due to a low rate of stroke without anticoagulation.
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http://dx.doi.org/10.1161/JAHA.124.036429 | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646511 | PMC |
Med Image Anal
December 2024
Division of Pediatric Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA. Electronic address:
Patients with congenitally corrected transposition of the great arteries (ccTGA) can be treated with a double switch operation (DSO) to restore the normal anatomical connection of the left ventricle (LV) to the systemic circulation and the right ventricle (RV) to the pulmonary circulation. The subpulmonary LV progressively deconditions over time due to its connection to the low pressure pulmonary circulation and needs to be retrained using a surgical pulmonary artery band (PAB) for 6-12 months prior to the DSO. The subsequent clinical follow-up, consisting of invasive cardiac pressure and non-invasive imaging data, evaluates LV preparedness for the DSO.
View Article and Find Full Text PDFMagn Reson Imaging
December 2024
Department of Neurology, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China. Electronic address:
Introduction: More and more evidence suggesting that internal carotid artery stenosis is not only a risk factor for ischemic stroke but also for cognitive impairments. Hypoperfusion and silent micro emboli have been reported as the pathophysiological mechanisms causing cognitive impairment. The effect of carotid artery stenting (CAS) on cognitive function varied from study to study.
View Article and Find Full Text PDFBiomed Eng Online
December 2024
Department of Clinical Physiology, Motion Analysis Center, University Hospital of Toulouse, Hôpital de Purpan, Toulouse, France.
Background: Stroke is the leading cause of acquired motor deficiencies in adults. Restoring prehension abilities is challenging for individuals who have not recovered active hand opening capacities after their rehabilitation. Self-triggered functional electrical stimulation applied to finger extensor muscles to restore grasping abilities in daily life is called grasp neuroprosthesis (GNP) and remains poorly accessible to the post-stroke population.
View Article and Find Full Text PDFBMC Geriatr
December 2024
Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.
Background: Exergames are interactive technology-based exercise programs. By combining physical and cognitive training components, they aim to preserve independence in older adults and reduce their risk of falling. This study explored whether primary end users (PEU, healthy older adults and patients with neurological and geriatric diagnoses) and secondary end users (SEU, health professionals) evaluated the ExerG functional model to be usable, providing a positive experience and therefore acceptable.
View Article and Find Full Text PDFMagn Reson Imaging
December 2024
Department of Radiology, Iwate Medical University, Yahaba, Japan.
Objective: The total examination time can be reduced if high-quality two-dimensional (2D) cine images can be collected post-contrast to minimize non-scanning time prior to late gadolinium-enhanced imaging. This study aimed to assess the equivalency of the pre-and post-contrast performance of 2D deep learning-based highly accelerated cardiac cine (DL cine) imaging by evaluating the image quality and the quantification of biventricular volumes and function in the clinical setting.
Material And Methods: Thirty patients (20 men, mean age 53.
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