Tag Archives: atrial fibrillation

Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia found in clinical practice with increased prevalence in the ageing population.1 It affects 5% of those aged over 65 years and 10% of those aged over 80 years.2 Its prevalence is increasing primarily for two reasons; an increase in the ageing population and advances in medical care leading to survival from underlying conditions closely associated with AF, such as hypertension, coronary heart disease, and cardiac failure.3 It has been described as epidemic in proportion since some researchers have predicted its prevalence will triple by 2050.4 AF can cause significant m

Estimates suggest there will be more than 46,000 cases of acute DVT in England and Wales during 2012, which will rise to nearly 50,000 cases by 2016, due in part to the ageing population. Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: “For many people, using warfarin is difficult because of the need for regular monitoring with blood tests, dosing adjustments, and the need to be careful about their diet because of warfarin’s interaction with certain foods. Because rivaroxaban does not require frequent blood tests to monitor treatment it represents a potential benefit for many people who have had a DVT, p

EVINCI study completed The prevalence of “significant” coronary artery disease in patients with chest pain symptoms is lower than expected in Europe, according to preliminary findings from the The EValuation of INtegrated Cardiac Imaging (EVINCI) study. Once the final analysis is completed, the EVINCI study is expected to demonstrate that performing adequate non-invasive imaging screening of patients with suspected coronary artery disease could safely avoid invasive procedures in 75 out of 100 patients.  The study will have sufficient power to answer the question of which is the most cost-effective non-invasive imaging strategy for the j

Introduction Patients with atrial fibrillation (AF) can benefit from rhythm management to improve unpleasant symptoms or increase exercise capacity,1 making anti-arrhythmic drugs (AADs) an important option in the management of AF. The benefits of any AAD must be weighed against the risks of adverse effects, which in some cases are serious. Defined indications for the use of AADs have been developed by regulatory bodies such as the European Medicines Agency (EMA) and US Food and Drug Administration (FDA), which, in addition to guidelines from groups such as the UK National Institute for Health and Clinical Excellence (NICE) and the European So

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Of the three new drugs, the paper appears to particularly highlight apixaban saying it “is currently the best-documented alternative to both warfarin and aspirin for stroke prevention in a broad population with AF”. It adds that “apixaban has been shown to be superior compared with warfarin concerning the reduction of stroke and mortality in combination with a reduction in major bleeding, with a bleeding risk similar to that of low-dose aspirin, and with better tolerability than both these alternatives, albeit with no reduction in ischaemic stroke compared with warfarin”. The paper says dabigatran 150 mg is also a well-documented alte

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides

Navigating the changing landscape of cardiovascular commissioning A clear majority (58%) of GPs with a special interest in cardiology (GPSIs) feel unprepared to fulfill a commissioning role in the new NHS landscape, despite almost half of GPs being currently involved in commissioning, according to results from the REACCT (REAssessing Cardiology Commissioning and Treatment) report announced at the meeting. The report also reveals that a majority of cardiologists (57%) feel unprepared to take on new commissioning roles around the management of cardiovascular disease (CVD). The report (available from: www.pccs.org.uk/report) was written by the P

When the dentist said: “Be still your beating heart!” Dear Sirs, We all often encounter a patient history and apparent presenting complaint that we can not precisely and cleverly explain. Our patient, Mr BW, a fit and active 53-year-old man, attended a routine appointment as an outpatient. He had done this many times previously as he was experiencing difficuties with heart rate control and troubling symptoms secondary to atrial fibrillation (AF). Coincidentally, he had also had amalgam dental fillings drilled some 18 months previously. Since then, his cardiac problems had escalated. There appeared no clear causality between the fillings a

Controversial salt paper published A new European study has caused controversy by suggesting that lowering salt intake may not be beneficial. The study, published recently in JAMA (May 4th 2011 issue), was conducted by a team from the University of Leuven, Belgium. They followed 3,681 participants who were free of cardiovascular disease at baseline for a median of 7.9 years, and found an inverse relationship between cardiovascular deaths and 24-hour sodium excretion (which correlates to salt intake), although systolic blood pressure was higher with higher salt intake. But an editorial in the Lancet (May 12th 2011 issue) criticises the study,