Tag Archives: atrial fibrillation

Introduction Atrial fibrillation (AF) is a common cardiac arrhythmia affecting approximately six million patients in Europe and 2.3 million in the USA.1 Estimates in the general population suggest a prevalence rate of 0.4–1.0%, with marked increase in prevalence with age, increasing to approximately 10% by the age of 80 years.2 AF can precipitate heart failure, ventricular arrhythmias, and it is associated with a four- to five-fold increase in chance of stroke.3,4 In addition, although AF is frequently asymptomatic, it can reduce quality of life causing fatigue, palpitations, anxiety and dizziness.3 AF is classified in three ways:5 Paroxy

to ensure that primary healthcare professionals (predominantly GPs and practice nurses) are screening, diagnosing and treating AF to optimum levels to raise awareness of AF as a risk factor for stroke amongst the public to lobby national policy makers for improvement in and better implementation of guidance around AF detection/treatment. To raise public awareness, The Stroke Association will be organising advertising campaigns on the dangers of AF. A parliamentary reception is planned to spread awareness amongst and gain support from policymakers. It has also carried out a survey of 1,000 GPs to gauge clinical awareness levels of the link b

Highlights of the American Heart Association 2010 meeting held in November 2010, in Chicago, USA, included a breakthrough for the treatment of resistant hypertension, and another oral anticoagulant that could be used instead of warfarin in atrial fibrillation patients, without the need for monitoring. RAFT: CRT reduces deaths and hospitalisations in mild heart failure Adding cardiac-resynchronisation therapy (CRT) to implantable cardioverter defibrillator (ICD) and medication, led to a reduction in deaths and heart failure hospitalistions among patients with mild-to-moderate symptoms of heart failure in the RAFT (Resynchronisation-Defibrilla

The outcomes of patients with AF are well documented (table 1) but frequently remain underestimated by both patients and health professionals alike. AF is associated with increased rates of death, stroke, other thromboembolic events and heart failure, significant hospitalisation, and reduced quality of life and exercise capacity. Despite these sobering facts, many trials have failed to demonstrate benefit in maintaining sinus rhythm (SR) over anticoagulation and rate control. Yet, quality of life is significantly impaired in patients with AF compared with healthy controls, and post hoc analyses suggest maintaining SR may improve quality of li

Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. SHIFT: ivabradine shows benefit in heart failure

New NT-proBNP test Roche Diagnostics has announced the launch of a new NT-proBNP+ test, which it says can give a result in under 15 minutes when tested on its cobas h232 near-patient testing meter. In addition, the test has an extended measuring range (60 – 9000pg/ml). The test can serve as an aid in the diagnosis of suspected heart failure, in the monitoring of compensated left ventricular dysfunction and in the risk stratification of patients with acute coronary symptoms. Recent recommendations of a consensus group (Br J Cardiol 2010;17:76-80) highlight the importance of B-type natriuretic peptide (NP) testing for heart failure. NP testi

The risks of catheter ablation The aim of CA, essentially, is to manipulate catheters around the left atrium and cauterise the sources of AF without causing unnecessary damage, a skill that is technically challenging. This requires aggressive anticoagulation, and can be a time-consuming procedure. Long-term arrhythmia control or cure rates are quoted in excess of 80%, with data from single large-volume centres reporting low complication rates. Whether experience and high volume are associated with a reduction in complication rates is not proven. Cappato et al.4 recently reported an analysis of a retrospective case series looking at the incide

An initial proof of principle study was reported in The Lancet (Krum H et al. Lancet 2009;373:1275–81) by Dr Henry Krum (Monash University, Melbourne, Australia) and co-investigators who, using the newly developed Symplicity® catheter system, performed RDN in 45 patients with resistant hypertension (systolic blood pressure [SBP] ≥160 mmHg on three antihypertensive agents); the procedure lasting a median of 38 minutes. The primary end points were office blood pressure (BP) and safety data at one, three, six, nine and 12 months, and patient’s renal angiography and magnetic resonance angiography during follow-up. BP was significantly redu

The trial was stopped after a predefined interim analysis by the independent data monitoring committee “revealed clear evidence of a clinically important reduction in stroke and systemic embolism”, a company statement announced. The AVERROES (Apixaban Versus Acetylsalicylic Acid to Prevent Strokes) study included 5,600 patients with all types of atrial fibrillation who were intolerant of or unsuitable for warfarin. They were randomised to 5 mg of apixaban or 81–324 mg of aspirin for up to 36 months. The primary efficacy outcome is the time from the first dose of the study drug to the first occurrence of ischaemic stroke, haemorrhagic

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther