Tag Archives: atrial fibrillation

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

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

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

Dr Fang Qin Goh Introduction With semi-professional sporting events becoming more accessible,1 the effect of endurance training on the body is increasingly relevant, not just in elite athletes, but also fitness enthusiasts. Exercise prevents and aids treatment of coronary heart disease (CHD), hypertension, heart failure, diabetes mellitus, obesity and depression,2,3 reduces cardiac events,1 and improves survival.4,5 However, there is concern excessive exercise could have adverse cardiac effects.2 This article aims to address whether an upper limit to mortality benefits of exercise exists, consider physiological and potentially pathological ch

Introduction Atrial fibrillation (AF) presents as an abnormal cardiac rhythm characterised by an irregular or abnormally fast (>100 bpm) resting heart rate (HR). AF risk factors include increasing age, diabetes, hypertension and coronary artery disease.1 AF increases stroke risk by roughly fivefold, greater than the risk elicited by hypertension, coronary artery disease or previous heart failure.2 AF-related stroke patients experience greater mortality rates, disability, hospitalisation time and healthcare costs relative to non-AF stroke patients.3 The East Midlands primary healthcare services comprise 19 Clinical Commissioning Groups (CCG

Background Atrial fibrillation (AF) occurs at an increased frequency in patients with cancer, however, the link between cancer and AF is not fully understood.1,2 Stroke prophylaxis with anticoagulation is important; however, this can prove challenging in the setting of active malignancy, which predisposes to an increased risk of haemorrhage, as well as thrombosis.3 Traditionally, low molecular weight heparin (LMWH) and warfarin have been used in this setting. There remains limited evidence for direct oral anticoagulants (DOACs) in cancer patients for stroke prophylaxis in AF (SPAF). However, small observational studies have demonstrated compa

Introduction Atrial fibrillation (AF) is the most common cardiac rhythm disturbance in adults, estimated to affect 3.29% of the population in the UK in 2016.1 The condition is strongly associated with increased cardiovascular morbidity and mortality, in addition to reduced quality of life.2 The healthcare costs of managing patients with AF are high: estimates of the direct cost in Western Europe range from €450 to €3,000 per patient-year.3 Exercise-based cardiac rehabilitation is an established intervention in the management of several cardiovascular conditions, including coronary artery disease4 and heart failure.5 There is increasing re

Effective anticoagulation improves outcomes in patients with AF or VTE.4-7 Non-vitamin K antagonist oral anticoagulants (NOACs) have provided an alternative to warfarin for prevention of stroke or recurrent VTE in these patients in recent years. Compared with warfarin, NOACs have more predictable pharmacokinetics and pharmacodynamics, do not require monitoring of the international normalised ratio (INR), and have a wider therapeutic window that enables prescription at fixed daily doses over an extended period.8 Edoxaban, an inhibitor of Factor Xa is a member of the NOAC class. The accompanying articles summarise latest findings on the effect

Introduction Atrial fibrillation (AF) is encountered with increasing frequency in clinical practice,1 and is associated strongly with adverse clinical outcomes, including stroke, cardiovascular events and death.2,3 Concomitant atherosclerotic disease may increase the risk of adverse outcomes in people with AF. For example, peripheral arterial disease was present in 11% of a large cohort of European patients with AF, and increased the risk of all-cause and cardiovascular death, compared with patients with AF but no peripheral arterial disease.4 In addition, AF is associated with adverse outcomes in a range of other subgroups of patients, inclu

Introduction Atrial fibrillation (AF) more than doubles the five-year risk of stroke in middle-aged men and women.1 Prior cerebrovascular disease markedly amplifies the risk of recurrent stroke in patients with or without AF.1,2 Figure 1 shows the influence of AF and prior cerebrovascular disease (stroke or transient ischaemic attack [TIA]) on the estimated five-year risk of a composite of stroke, systemic thromboembolism, or TIA (most events were ischaemic strokes) for a 60-year-old individual, from a large cohort study conducted in the UK.1 These observations demonstrate the need for long-term treatment to reduce the risk of stroke in thes