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Tag Archives: atrial fibrillation

May 2024 Br J Cardiol 2024;31:49–54 doi:10.5837/bjc.2024.018

Factor XI and XIa inhibition: a new approach to anticoagulant therapy

Mark Anthony Sammut, Nadir Elamin, Robert F Storey

Abstract

Introduction Anticoagulant therapy is an essential component in the treatment and prevention of venous and arterial thromboembolic events. In recent years, direct-acting oral anticoagulants (DOACs) have replaced vitamin K antagonists (VKAs) for many of these indications, due to their more favourable risk-benefit profile.1 Despite this, bleeding remains a significant concern with DOACs, especially in patients at high risk, such as those with an indication for concurrent antiplatelet therapy, and may lead to poor adherence or undertreatment.2–4 Safer anticoagulation that spares haemostasis without compromising efficacy is, therefore, desirab

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April 2024 Br J Cardiol 2024;31:76 doi:10.5837/bjc.2024.014

Cardioversion versus ablation versus ‘pace and ablate’ for persistent atrial fibrillation in older patients

William Eysenck, Neil Sulke, Nick Freemantle, Neil Bodagh, Nikhil Patel, Stephen Furniss, Rick Veasey

Abstract

Introduction The optimal treatment for persistent atrial fibrillation (AF) in patients ≥65 years is unknown. There are several options including medical therapy for rate and rhythm control, direct current cardioversion (DCCV), permanent pacemaker (PPM) and atrioventricular node ablation (AVNA) and catheter ablation of AF.1 These treatment options have not been directly compared and each has its own advantages and disadvantages.2 In many patients, it is desirable to attempt to restore and maintain sinus rhythm to reduce symptoms and improve quality of life (QoL).3 DCCV has been reported to terminate AF in ≥90% of cases.4 However, recurrenc

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BCS 2023: future-proofing cardiology for the next 10 years

August 2023 Br J Cardiol 2023;30:86–9

BCS 2023: future-proofing cardiology for the next 10 years

J. Aaron Henry

Abstract

What is the future of cardiovascular health? NHS Medical Director Professor Sir Stephen Powis opened the conference by outlining the growing need to provide high quality cardiovascular care. With a quarter of deaths in England attributable to cardiovascular disease and a wider cost to the economy of £15.8 billion per year,1 there is an urgent need for innovative care pathways and new technologies. He showcased virtual wards as one example of innovation, with over 100,000 patients having been managed remotely in 2022.2 In Liverpool, a Telehealth team has successfully utilised a medical monitoring app to manage patients at home, leading to a 1

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July 2023 Br J Cardiol 2023;30:108–12 doi:10.5837/bjc.2023.022

The effect of icosapent ethyl on left atrial and left ventricular morphology

Spencer S Kitchin, Suvasini Lakshmanan, April Kinninger, Song S Mao, Mark G Rabbat, Deepak L Bhatt, Matthew J Budoff

Abstract

Introduction Atrial fibrillation (AF) is a common arrhythmia with significant associated morbidity, mortality, and healthcare costs.1 N-3 fatty acids may influence the risk of AF, but previous studies show conflicting evidence on whether N-3 fatty acids are pro- or anti-arrhythmogenic. Given the significant cardiovascular disease risk reduction associated with N-3 fatty acids, there has been interest in delineating their risk profile. In 2004, Mozaffarian et al. noted that increased dietary fish intake was associated with lower incidence of AF.2 Two separate studies suggested that higher levels of circulating long-chain N-3 fatty acid and doc

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November 2022 Br J Cardiol 2022;29:145–9 doi:10.5837/bjc.2022.038

Should we be screening people with diabetes for atrial fibrillation? Exploring patients’ views

Angela Hall, Andrew Robert John Mitchell, Lisa Ashmore, Carol Holland

Abstract

Introduction There is an increasing prevalence of atrial fibrillation (AF) worldwide, with a one-in-three lifetime risk of developing AF over the age of 40 years.1 AF is a leading cause of stroke, and stroke risk is increased further in the presence of diabetes.2 Diabetes has been recognised as a risk factor for AF and, therefore, targeted screening for AF in such groups has been explored in combination with comorbid risk factors.2 There are yet to be universally accepted recommendations for AF screening. The European Society of Cardiology (ESC) recommend opportunistic screening in people >65 years and consideration of systematic screening

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July 2022 Br J Cardiol 2022;29(suppl 2):S7–S12 doi:10.5837/bjc.2022.s07

Drug therapy in heart failure – an update from the 2021 ESC heart failure guideline

Helen Hardy, Paul R Kalra

Abstract

Introduction Heart failure (HF) is a common condition and the majority of patients have multiple co-morbidities. It is therefore essential that all healthcare professionals (HCPs) are familiar with the contemporary management of these patients. Whilst HF specialists are integral to the delivery of optimal patient care, it is important to ensure that therapies are optimised at every opportunity and enable the best care for patients in the context of acute or chronic non-cardiovascular illness. Current practice is often suboptimal; for example, in the latest national HF audit (England and Wales), the number of patients leaving hospital on thre

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May 2022 Br J Cardiol 2022;29:46–51 doi:10.5837/bjc.2022.015

Clinical and health economic evaluation of a post-stroke arrhythmia monitoring service

David Muggeridge, Kara Callum, Lynsey Macpherson, Nick Howard, Claudia Graune, Ian Megson, Adam Giangreco, Susan Gallacher, Linda Campbell, Gethin Williams, Ashish Macaden, Stephen J Leslie

Abstract

Introduction Cerebrovascular disease is a major cause of disability and mortality in adults worldwide.1 Patients can present with a stroke or transient ischaemic attack (TIA). Due to the risk of recurrent events, early investigation and treatment of risk factors is advised.2,3 One of the major risk factors for stroke is atrial fibrillation (AF). AF is a common cardiac arrhythmia, which is estimated to affect 2.5% of the adult population in Scotland, with a large proportion undiagnosed and consequently untreated. Cardioembolism accounts for around a quarter of all ischaemic strokes, which is most commonly caused by AF.4 Current evidence shows

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March 2022 Br J Cardiol 2022;29:21–5 doi:10.5837/bjc.2022.008

Atrial fibrillation prevalence and predictors in patients with diabetes: a cross-sectional screening study

Angela Hall, Andrew Robert John Mitchell, Lisa Ashmore, Carol Holland

Abstract

Introduction Prevalence of atrial fibrillation (AF) and diabetes is increasing worldwide.1,2 AF is a common heart rhythm irregularity and prevalence increases with age. People with AF are up to seven times more likely to have a stroke than the general population,1 with risk increased further in the presence of diabetes.3 AF may exhibit no symptoms and go undiagnosed until patients present with sequelae, such as stroke or heart failure. Stroke secondary to AF is often avoidable with thromboprophylaxis and early identification could lead to stroke prevention. Diabetes mellitus is a major risk factor for cardiovascular disease,4 and frequency of

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March 2022 Br J Cardiol 2022;29:40 doi:10.5837/bjc.2022.010

Correspondence – Obstructive sleep apnoea and atrial fibrillation: a key omission in guidelines

Natalia Shafiqa, Ari Manuel, Gregory Y H Lip, Sriram Iyer

Abstract

AF is the most common cardiac arrhythmia in clinical practice,2 while OSA had an estimated UK prevalence of 1.5 million adults in 2014.3 With the obesity epidemic and demographic changes with an ageing population, the prevalence of both conditions is likely to increase with OSA and AF sharing common independent risk factors, such as age, obesity, smoking status and alcohol intake.4-7 Although the pathophysiological processes for the associated interplay between AF and OSA are complex, and continue to be debated by the scientific community, studies have demonstrated increased prevalence of AF in OSA patients and vice versa.8,9 The Sleep Heart

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October 2021 Br J Cardiol 2021;28:139–43 doi:10.5837/bjc.2021.042

Quality of life among people with atrial fibrillation with and without diabetes: a comparison study

Angela Hall, Andrew Robert John Mitchell, Lisa Ashmore, Carol Holland

Abstract

Introduction It is important to consider quality of life (QoL) when managing the health and wellbeing of patients as it assists in the interpretation of symptoms, functional status, perceptions, experiences and patient expectations.1 Atrial fibrillation (AF) and diabetes are both long-term conditions that are increasing in prevalence. Both AF and diabetes can influence physical and psychological health and reduce QoL.1 Evidence has shown that in up to 40% of patients with diabetes, AF can co-exist,2 and little is known about how diabetes can further worsen QoL in AF. This comparison study, therefore, explores the QoL in these often co-existin

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