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Articles 1 - 30 of 174
Full-Text Articles in Medicine and Health Sciences
Non-St Elevation Myocardial Infarction Presentation In Severe Aortic Stenotic Patient, Margi Desai, Daniel Maysonet
Non-St Elevation Myocardial Infarction Presentation In Severe Aortic Stenotic Patient, Margi Desai, Daniel Maysonet
The Journal of Integrated Primary Care
This case report demonstrates a patient who presents with typical findings for a diagnosis of NSTEMI. Upon further evaluation, this diagnosis was able to be ruled out. Presentations and labs consistent with NSTEMI masked the true diagnosis of aortic stenosis due to oxygen supply/demand mismatch.
Real-World Comparison Of Standard Versus Reduced Dose Apixaban In Stroke Prevention And Bleeding Risk In Atrial Fibrillation Patients With Chronic Kidney Disease: A Retrospective Analysis Of Trinetx Data., Sameh Gomaa, Joseph Hellman, Olutoyin Lawal, Edward Hovick, Slawomir Kusmirek
Real-World Comparison Of Standard Versus Reduced Dose Apixaban In Stroke Prevention And Bleeding Risk In Atrial Fibrillation Patients With Chronic Kidney Disease: A Retrospective Analysis Of Trinetx Data., Sameh Gomaa, Joseph Hellman, Olutoyin Lawal, Edward Hovick, Slawomir Kusmirek
Tower Health Research Day
No abstract provided.
Predicting Risk Of Atrial Fibrillation In Hematopoietic Stem Cell Transplant, Min Yi Wu, Madhulata Reddy, Shatha Farhan
Predicting Risk Of Atrial Fibrillation In Hematopoietic Stem Cell Transplant, Min Yi Wu, Madhulata Reddy, Shatha Farhan
Medical Student Research Symposium
Background
Atrial fibrillation (AF) in hematopoietic stem cell transplant (HSCT) recipients is associated with significant morbidity. We have previously reported that obstructive sleep apnea (OSA), older age and presence of dilated left atrium (LA) are significant predictors of AF early post HSCT. In the current study, we sought to evaluate if TSH pre HSCT and serum electrolytes and eGFR at engraftment in patients undergoing HSCT are associated with increased risk of AF.
Methods
This is a single center retrospective study, involving 748 consecutive patients undergoing autologous and allogenic HSCT from 2012 to 2022. Patients’ charts were reviewed to acquire clinical …
Effect Of Flecainide And Ibutilide Alone And In Combination To Terminate And Prevent Recurrence Of Atrial Fibrillation, Alexander Burashnikov, José M. Di Diego, Bence Patocskai, Debra S. Echt, Luiz Belardinelli, Charles Antzelevitch
Effect Of Flecainide And Ibutilide Alone And In Combination To Terminate And Prevent Recurrence Of Atrial Fibrillation, Alexander Burashnikov, José M. Di Diego, Bence Patocskai, Debra S. Echt, Luiz Belardinelli, Charles Antzelevitch
Division of Cardiology Faculty Papers
BACKGROUND: There is a need for improved approaches to rhythm control therapy of atrial fibrillation (AF).
METHODS: The effectiveness of flecainide (1.5 µmol/L) and ibutilide (20 nmol/L), alone and in combination, to cardiovert and prevent AF recurrence was studied in canine-isolated coronary-perfused right atrioventricular preparations. We also examined the safety of the combination of flecainide (1.5 µmol/L) and ibutilide (50 nmol/L) using canine left ventricular wedge preparations.
RESULTS: Sustained AF (>1 hour) was inducible in 100%, 60%, 20%, and 0% of atria in the presence of acetylcholine alone, acetylcholine+ibutilide, acetylcholine+flecainide, and acetylcholine+ibutilide+flecainide, respectively. When used alone, flecainide and ibutilide …
Paroxysmal Atrial Fibrillation In A Life-Long Endurance Athlete: A Descriptive Case Study, Timothy Curry, Scott N. Drum
Paroxysmal Atrial Fibrillation In A Life-Long Endurance Athlete: A Descriptive Case Study, Timothy Curry, Scott N. Drum
International Journal of Exercise Science: Conference Proceedings
The diagnosis of atrial fibrillation (AF) in lifelong endurance athletes occurs at a greater incidence over a lifetime vs the undertrained, general population. In fact, the more intense an aerobic-oriented person trains or races and over a greater amount of time, the higher the diagnosis of general cardiac arrhythmias. PURPOSE: Therefore, the primary aim was to observe the cumulative effects of life-long endurance training (since the age of 10-yrs old) and the yearly occurrences of paroxysmal AF (PAF) in an otherwise healthy, 53-yr-old male. METHODS: The complete health history of a 53-yr-old male (ht: 1.83 m, wt: 72.7 kg, …
Utilization And Short-Term Outcomes Of Percutaneous Left Atrial Appendage Occlusion In Patients With Cancer, Yaqi Zhang, Zhuoran Yang, Muhammad Usman Almani, Raquel Soon-Shiong, Bolun Liu
Utilization And Short-Term Outcomes Of Percutaneous Left Atrial Appendage Occlusion In Patients With Cancer, Yaqi Zhang, Zhuoran Yang, Muhammad Usman Almani, Raquel Soon-Shiong, Bolun Liu
Einstein Health Papers
Background
Percutaneous left atrial appendage occlusion (LAAO) has been rapidly evolving since FDA’s approval in 2015 and has become more of a same-day-discharge procedure. Cancer patient with atrial fibrillation/flutter (AF) population can benefit from the procedure but the in-hospital outcomes and readmission data were rarely studied.
Objectives
We investigated the utilization, in-hospital and readmission outcomes in cancer patients with AF who underwent LAAO.
Methods
Data were derived from the National Inpatient Sample and National Readmissions Database from 2016 to 2019. Patients with primary diagnosis of AF admitted for LAAO (ICD-10 code 02L73DK) were grouped by cancer as a secondary diagnosis. …
Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas
Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas
Division of Cardiology Faculty Papers
Background: Atrial fibrillation (AF) is highly prevalent among cancer patients. The role of traditional risk stratification scores in the context of different cancer types in these patients remains unknown. Objectives: The purpose of this study was to determine the discriminative accuracy of the CHA2DS2VASc score for ischemic stroke using receiver operating characteristic and area under the curve. Methods: The National Readmission Database (2015-2019) was used to identify all AF patients stratified by the cancer diagnosis, type, and CHA2DS2VASc category (low; moderate; high risk). Outcomes at 30-day readmission were compared between cancer and …
Spectral Doppler Ultrasonography Of Hepatic Vein In A Patient With Atrial Fibrillation And Rapid Ventricular Rate, Hector Arredondo, Oscar J. Lopez
Spectral Doppler Ultrasonography Of Hepatic Vein In A Patient With Atrial Fibrillation And Rapid Ventricular Rate, Hector Arredondo, Oscar J. Lopez
Research Symposium
Background: Point of Care ultrasound (POCUS) is a tool that enables the clinicians to objectively assess hemodynamics at the bedside. Recently, a novel concept of venous excess Doppler ultrasound (VExUS) grading system has been proposed to assess venous congestion at the organ level in real time. This concept evaluates the presence of severe flow abnormalities in 2 or more veins (of the hepatic, portal, and kidney parenchymal veins) with a dilated IVC (≥2 cm). There are reports in literature that tachyarrhythmias alter the flow pattern in the hepatic veins.
Case presentation: We present a case of a 88-year-old gentleman with …
A Retrospective Review Of 30-Day Hospital Readmission Risk After Open Heart Surgery In Patients With Atrial Fibrillation, Varun Ashutosh Rao, Genaro Deleon, Aish Thamba, Mindy Flanagan, Kathleen Nickel, Douglas Gray Md
A Retrospective Review Of 30-Day Hospital Readmission Risk After Open Heart Surgery In Patients With Atrial Fibrillation, Varun Ashutosh Rao, Genaro Deleon, Aish Thamba, Mindy Flanagan, Kathleen Nickel, Douglas Gray Md
Medical Student Research
Introduction
Readmission rates after open heart surgery (OHS) remain an important clinical issue. The causes are varied, with identifying risk factors potentially providing valuable information to reduce healthcare costs and the rate of post-operative complications. This study aimed to characterize the reasons for 30-day hospital readmission rates of patients after open heart surgery.
Methods
All patients over 18 years of age undergoing OHS at a community hospital from January 2020 through December 2020 were identified. Demographic data, medical history, operative reports, post-operative complications, and telehealth interventions were obtained through chart review. Descriptive statistics and readmission rates were calculated, along with …
The Therapeutic Potential Of Targeting Cardiac Rgs4., Giselle Del Calvo, Teresa Baggio Lopez, Anastasios Lymperopoulos
The Therapeutic Potential Of Targeting Cardiac Rgs4., Giselle Del Calvo, Teresa Baggio Lopez, Anastasios Lymperopoulos
HPD Articles
G protein-coupled receptors (GPCRs) play pivotal roles in regulation of cardiac function and homeostasis. To function properly, every cell needs these receptors to be stimulated only when a specific extracellular stimulus is present, and to be silenced the moment that stimulus is removed. The regulator of G protein signaling (RGS) proteins are crucial for the latter to occur at the cell membrane, where the GPCR normally resides. Perturbations in both activation and termination of G protein signaling underlie numerous heart pathologies. Although more than 30 mammalian RGS proteins have been identified, each RGS protein seems to interact only with a …
Protein-Energy Malnutrition Is Associated With Worse Outcomes In Patients With Atrial Fibrillation: A Nationwide Analysis, Favour Markson, Emmanuel Akuna, Iriagbonse Asemota, Gabriel Areoye, Anoz Shahi, Praise Nwachukwu, Kenneth Ong
Protein-Energy Malnutrition Is Associated With Worse Outcomes In Patients With Atrial Fibrillation: A Nationwide Analysis, Favour Markson, Emmanuel Akuna, Iriagbonse Asemota, Gabriel Areoye, Anoz Shahi, Praise Nwachukwu, Kenneth Ong
Einstein Health Papers
Protein–energy malnutrition (PEM), which leads to a reduced ability of tissues to regenerate and repair themselves, may exacerbate many chronic diseases, including atrial fibrillation (AF), which occurs as a response of the heart to chronic inflammation. However, population-based studies examining the association between PEM and the prevalence and health care burden of AF are lacking. The aim of this retrospective cohort study was to estimate the impact of PEM on the prevalence and clinical outcomes of hospitalization for AF. The National Inpatient Sample (NIS) 2016 and 2017 datasets were searched for data on hospitalized adult patients with AF as a …
Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis
Digital Journal of Clinical Medicine
Abstract
Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.
Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.
Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …
Effect Of Implantable Cardiac Monitors On Preventing Stroke: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials, Jialing He, Yaxin Jiang, Yangchun Xiao, Pengfei Hao, Tiangui Li, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang, Weelic Chong, Yang Hai, Lvlin Chen, Chao You, Lu Jia, Fang Fang, Shui Yu, Yu Zhang
Effect Of Implantable Cardiac Monitors On Preventing Stroke: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials, Jialing He, Yaxin Jiang, Yangchun Xiao, Pengfei Hao, Tiangui Li, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang, Weelic Chong, Yang Hai, Lvlin Chen, Chao You, Lu Jia, Fang Fang, Shui Yu, Yu Zhang
Department of Medical Oncology Faculty Papers
BACKGROUND AND AIM: Implantable cardiac monitors (ICM) can facilitate the detection of asymptomatic atrial fibrillation episodes. We performed a systematic review and meta-analysis to investigate whether ICM can prevent stroke in patients with prior stroke and risk factors for stroke.
METHODS: This study included randomized controlled trials comparing ICM with conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. We searched Medline, Embase, and CENTRAL from inception until January 5, 2022, without language restriction. Quantitative pooling of the data was undertaken using a random-effects model. The primary outcome was ischemic stroke at the longest …
A Unique Case Of Atrial Fibrillation Secondary To Squamous Cell Lung Carcinoma, Mohammad J. Malik, Emily K. Wilson, Vijay Bandhakavi
A Unique Case Of Atrial Fibrillation Secondary To Squamous Cell Lung Carcinoma, Mohammad J. Malik, Emily K. Wilson, Vijay Bandhakavi
Research Day
Atrial fibrillation (AF) is widely considered to be the most prevalent cardiac arrhythmia with an incidence of roughly 1-2% in the United States alone. The incidence of AF has been known to increase with advancing age and thus presents a significant burden on healthcare systems across the globe. AF arises as a result of several mechanisms including structural changes that occur to the heart overtime. Here we present a case in which a 63-year-old male with no past medical history except heavy tobacco use presented to the emergency department complaining of shortness of breath. He also endorsed having palpitations and …
Effects Of Pregnancy And Progesterone On Atrial Fibrillation, Heloisa M. Rutigliano
Effects Of Pregnancy And Progesterone On Atrial Fibrillation, Heloisa M. Rutigliano
Browse all Datasets
Atrial Fibrillation (AF) is the most common cardiac arrythmia in adults with likely sex-specific risk factors. Female sex hormones may be important in modulating risk for atrial fibrillation. We hypothesize that pregnancy and progesterone (P4), a hormone found in high levels during pregnancy with abrupt withdrawal immediately after parturition, modulates AF susceptibility in female goats. Cardiac specific TGF-?1 transgenic female goats and age-matched wild-type (WT) female goats were utilized. Pacemakers were implanted in all animals for continuous arrhythmia monitoring and AF inducibility. AF inducibility was evaluated using 5 separate 10 s bursts of atrial pacing (160 - 200 ms). In …
Cardiac Rgs Proteins In Human Heart Failure And Atrial Fibrillation: Focus On Rgs4., Jordana I. Borges, Malka S. Suster, Anastasios Lymperopoulos
Cardiac Rgs Proteins In Human Heart Failure And Atrial Fibrillation: Focus On Rgs4., Jordana I. Borges, Malka S. Suster, Anastasios Lymperopoulos
HPD Articles
The regulator of G protein signaling (RGS) proteins are crucial for the termination of G protein signals elicited by G protein-coupled receptors (GPCRs). This superfamily of cell membrane receptors, by far the largest and most versatile in mammals, including humans, play pivotal roles in the regulation of cardiac function and homeostasis. Perturbations in both the activation and termination of their G protein-mediated signaling underlie numerous heart pathologies, including heart failure (HF) and atrial fibrillation (AFib). Therefore, RGS proteins play important roles in the pathophysiology of these two devasting cardiac diseases, and several of them could be targeted therapeutically. Although close …
Adverse Outcomes Of Atrial Fibrillation Ablation In Heart Failure Patients With And Without Cardiac Amyloidosis: A Nationwide Readmissions Database Analysis (2015-2019), Waqas Ullah, Max Ruge, Md, Alexander G. Hajduczok, Kirpal Kochar, Daniel R. Frisch, Behzad B. Pavri, René J Alvarez, Indranee N. Rajapreyar, Yevgeniy Brailovsky
Adverse Outcomes Of Atrial Fibrillation Ablation In Heart Failure Patients With And Without Cardiac Amyloidosis: A Nationwide Readmissions Database Analysis (2015-2019), Waqas Ullah, Max Ruge, Md, Alexander G. Hajduczok, Kirpal Kochar, Daniel R. Frisch, Behzad B. Pavri, René J Alvarez, Indranee N. Rajapreyar, Yevgeniy Brailovsky
Jefferson Hospital Staff Papers and Presentations
AIMS: Atrial fibrillation (AF) in patients with cardiac amyloidosis (CA) has been linked with a worse prognosis. The current study aimed to determine the outcomes of AF catheter ablation in patients with CA.
METHODS AND RESULTS: The Nationwide Readmissions Database (2015-2019) was used to identify patients with AF and concomitant heart failure. Among these, patients who underwent catheter ablation were classified into two groups, patients with and without CA. The adjusted odds ratio (aOR) of index admission and 30-day readmission outcomes was calculated using a propensity score matching (PSM) analysis. A total of 148 134 patients with AF undergoing catheter …
Adverse Events In Low Versus Normal Body Weight Patients Prescrdibed Apixaban Or Rivaroxaban For Atrial Fibrillation, Deborah Decamillo, Brian Haymart, Xiaowen Kong, Scott Kaatz, Mona Ali, Geoffrey Barnes, Scott Kaatz
Adverse Events In Low Versus Normal Body Weight Patients Prescrdibed Apixaban Or Rivaroxaban For Atrial Fibrillation, Deborah Decamillo, Brian Haymart, Xiaowen Kong, Scott Kaatz, Mona Ali, Geoffrey Barnes, Scott Kaatz
Conference Presentation Abstracts
Title: Adverse Events in Low versus Normal Body Weight Patients Prescribed Apixaban or Rivaroxaban for Atrial Fibrillation. Background: Clinical trials comparing direct oral anticoagulants (DOACs) to warfarin included only a small number of patients that weighed less than 60 kilograms (kg). The safety and efficacy of DOACs in low weight adult patients with atrial fibrillation (AF) is still unclear. Published data is not only sparse but have mixed outcomes. Therapy with DOACs may increase bleeding and/or clotting risk with uncertain antithrombotic benefit in low weight patients. Objective: To assess bleeding and thrombotic event rates for patients with AF that are …
Incidence And Risk Factors Leading To Stress Test And Coronary Intervention In The Patient Presenting With Atrial Fibrillation In The Ed, Ali Mohsin Choudhry, Srikanth Tadepali, Bernard Dankyi, Sandi Dunn, Rakesh Prashad
Incidence And Risk Factors Leading To Stress Test And Coronary Intervention In The Patient Presenting With Atrial Fibrillation In The Ed, Ali Mohsin Choudhry, Srikanth Tadepali, Bernard Dankyi, Sandi Dunn, Rakesh Prashad
North Florida Division Research Day 2023
No abstract provided.
Anticoagulation Adherence In Atrial Fibrillation Patients With A Scheduled Cardioversion, Caitlin Naimo
Anticoagulation Adherence In Atrial Fibrillation Patients With A Scheduled Cardioversion, Caitlin Naimo
West Chester University Doctoral Projects
Atrial fibrillation is a chronic disease managed through rate control, rhythm control, and anticoagulation. Anticoagulation compliance must be verified when a patient needs a cardioversion to convert to normal sinus rhythm. If a patient has missed a dose within the last four weeks, a Transesophageal Echocardiogram (TEE) is required to confirm that a clot has not formed in the heart. Medication noncompliance plagues the healthcare industry, costing millions of preventable healthcare dollars. The literature review shows that educational and behavioral interventions effectively increased medication compliance. Educational material was created, and a verified medication compliance survey was utilized to evaluate anticoagulation …
Development Of A Prediction Model For Atrial Fibrillation In Patients With Heart Failure And Preserved Ejection Fraction: Secondary Analysis Of Treatment Of Preserved Cardiac Function Heart Failure With An Aldosterone Antagonist (Topcat) Trial, Khaled Elkholey, Stavros Stavrakis
Development Of A Prediction Model For Atrial Fibrillation In Patients With Heart Failure And Preserved Ejection Fraction: Secondary Analysis Of Treatment Of Preserved Cardiac Function Heart Failure With An Aldosterone Antagonist (Topcat) Trial, Khaled Elkholey, Stavros Stavrakis
TriStar Division Research Day 2023
No abstract provided.
Utilizing A Mechanical Aspiration Device To Debulk Intracardiac Mass, Vivek Nadipalli, Ahmed Mahmood, Muhammad Uzair Lodhi, Christel Cuevas, Scott Mckinstry, Thomas Alexander
Utilizing A Mechanical Aspiration Device To Debulk Intracardiac Mass, Vivek Nadipalli, Ahmed Mahmood, Muhammad Uzair Lodhi, Christel Cuevas, Scott Mckinstry, Thomas Alexander
Gulf Coast Division Research Day 2023
No abstract provided.
Massive Small Bowel Resection In A 74-Year-Old Patient With Atrial Fibrillation-Induced Mesenteric Ischemia, Armand Edalati, Bita C. Behaeddin, Raul Aguilar, Shaikh Hai
Massive Small Bowel Resection In A 74-Year-Old Patient With Atrial Fibrillation-Induced Mesenteric Ischemia, Armand Edalati, Bita C. Behaeddin, Raul Aguilar, Shaikh Hai
East Florida Research Day 2023
Acute mesenteric ischemia (AMI) in the setting of atrial fibrillation is a life-threatening abdominal emergency that requires immediate localization and clinical intervention to restore mesenteric perfusion for the prevention of developing bowel necrosis. As bowel ischemia rapidly progresses, serum metabolic derangements become prominent, guiding practitioners on effective therapeutic options. Ultimately, mesenteric ischemia progressively bolsters the possibility of a patient developing multiple organ dysfunction. Due to this minacious pathogenesis, rapid time to diagnosis can become the difference between life and death. Intraoperatively, emergent surgical intervention regarding bowel resection needs to be thoroughly reviewed and planned based on the patient's medical history …
Charting And Navigating The "Scylla And Charybdis" Conundrum Of Our Ageing Hearts - Heart Failure & Atrial Fibrillation, Simon Stewart
Charting And Navigating The "Scylla And Charybdis" Conundrum Of Our Ageing Hearts - Heart Failure & Atrial Fibrillation, Simon Stewart
Theses
Residing on opposite sides of the Strait of Messina between Sicily and Calabria, Scylla and Charybdis were mythical sea monsters (one a fearsome creature, the other a deadly whirlpool) described by Homer. For anyone seeking to navigate that narrow and treacherous passage, avoid one of these lethal threats and you would be devoured by the other. For many populations around the world, the conundrum of successfully preventing and/or treating heart failure (HF) to increase longevity, only to increase the probability that it will increase the number of people living with and dying from atrial fibrillation (AF), represents a conundrum of …
Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman
Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman
Doctors of Nursing Practice (DNP) Final Projects, 2020-current
Postoperative atrial fibrillation remains one of the most common complications after cardiac surgery despite surgical and medical advances in the field. While generally transient, postoperative atrial fibrillation increases long-term morbidity and mortality, hospital length of stay, and financial obligation. The postoperative heart's unique chemical and physical properties make tactics for preventing and treating postoperative atrial fibrillation differ from classic atrial fibrillation management. This quality improvement project utilizes a care bundle for non-pharmacologic measures and early beta-blockade administration to reduce the incidence of postoperative atrial fibrillation. Implementation of this care bundle establishes a standard of care, increases clinician knowledge and accountability, …
Sociodemographic Determinants Of Oral Anticoagulant Prescription In Patients With Atrial Fibrillations: Findings From The Pinnacle Registry Using Machine Learning, Zahra Azizi, Andrew T. Ward, Donghyun J. Lee, Sanchit S. Gad, Kanchan Bhasin, Robert J. Beetel, Tiago Ferreira, Sushant Shankar, John S. Rumsfeld, Salim S. Virani
Sociodemographic Determinants Of Oral Anticoagulant Prescription In Patients With Atrial Fibrillations: Findings From The Pinnacle Registry Using Machine Learning, Zahra Azizi, Andrew T. Ward, Donghyun J. Lee, Sanchit S. Gad, Kanchan Bhasin, Robert J. Beetel, Tiago Ferreira, Sushant Shankar, John S. Rumsfeld, Salim S. Virani
Office of the Provost
Background: Current risk scores that are solely based on clinical factors have shown modest predictive ability for understanding of factors associated with gaps in real-world prescription of oral anticoagulation (OAC) in patients with atrial fibrillation (AF).
Objective: In this study, we sought to identify the role of social and geographic determinants, beyond clinical factors associated with variation in OAC prescriptions using a large national registry of ambulatory patients with AF.
Methods: Between January 2017 and June 2018, we identified patients with AF from the American College of Cardiology PINNACLE (Practice Innovation and Clinical Excellence) Registry. We examined associations between patient …
Dysnatremia Is Associated With Increased Risk Of All-Cause Mortality Within 365 Days Post-Discharge In Patients With Atrial Fibrillation Without Heart Failure: A Prospective Cohort Study, Yan Zhou, Dong Lin, Shiwan Wu, Jiaxin Xiao, Min Yu, Zhongbo Xiao, Muli Wu, Zhisheng Chen, Cuihong Tian, Rongbing Chen, Yequn Chen, Xuerui Tan
Dysnatremia Is Associated With Increased Risk Of All-Cause Mortality Within 365 Days Post-Discharge In Patients With Atrial Fibrillation Without Heart Failure: A Prospective Cohort Study, Yan Zhou, Dong Lin, Shiwan Wu, Jiaxin Xiao, Min Yu, Zhongbo Xiao, Muli Wu, Zhisheng Chen, Cuihong Tian, Rongbing Chen, Yequn Chen, Xuerui Tan
Research outputs 2022 to 2026
Aim: The aim of this study is to evaluate the association between serum sodium concentrations at hospital admission and all-cause mortality within 365 days post-discharge in patients with atrial fibrillation (AF) without heart failure (HF). Methods: The prospective cohort study enrolled 1,446 patients with AF without HF between November 2018 and October 2020. A follow-up was performed 30, 90, 180, and 365 days after enrollment through outpatient visits or telephone interviews. All-cause mortality was estimated in three groups according to serum sodium concentrations: hyponatremia ( < 135 mmol/L), normonatremia (135 – 145 mmol/L), and hypernatremia ( > 145 mmol/L). We estimated the risk of all-cause mortalities using univariable and multivariable Cox proportional …
Retrospective Comparison Of Patients ≥ 80 Years With Atrial Fibrillation Prescribed Either An Fda-Approved Reduced Or Full Dose Direct-Acting Oral Anticoagulant, Roy Taoutel, Michael D. Ezekowitz, Usman A. Chaudhry, Carly Weber, Dana Hassan, Ed J. Gracely, Mohammed H. Kamareddine, Benjamin I. Horn, Glenn R. Harper
Retrospective Comparison Of Patients ≥ 80 Years With Atrial Fibrillation Prescribed Either An Fda-Approved Reduced Or Full Dose Direct-Acting Oral Anticoagulant, Roy Taoutel, Michael D. Ezekowitz, Usman A. Chaudhry, Carly Weber, Dana Hassan, Ed J. Gracely, Mohammed H. Kamareddine, Benjamin I. Horn, Glenn R. Harper
Department of Medicine Faculty Papers
Direct-acting oral anticoagulants (DOACs) represent the standard for preventing stroke and systemic embolization (SSE) in patients with atrial fibrillation (AF). There is limited information for patients ≥ 80 years. We report a retrospective analysis of AF patients ≥ 80 years prescribed either a US Food and Drug Administration (FDA)-approved reduced (n = 514) or full dose (n = 199) DOAC (Dabigatran, Rivaroxaban, or Apixaban) between January 1st, 2011 (first DOAC commercially available) and May 31st, 2017. The following multivariable differences in baseline characteristics were identified: patients prescribed a reduced dose DOAC were older (p < 0.001), had worse renal function (p = 0.001), were more often prescribed aspirin (p = 0.004) or aspirin and clopidogrel (p < 0.001), and more often had new-onset AF (p = 0.001). SSE and central nervous system (CNS) bleed rates were low and not different (1.02 vs 0 %/yr and 1.45 vs 0.44 %/yr) for the reduced and full dose groups, respectively. For non-CNS bleeds, rates were 10.89 vs 4.15 %/yr (p < 0.001, univariable) for the reduced and full doses, respectively. The mortality rate was 6.24 vs 1.75 %/yr (p = 0.001, univariable) for the reduced and full doses. Unlike the non-CNS bleed rate, mortality rate differences remained significant when adjusted for baseline characteristics. Thus, DOACs in patients ≥ 80 with AF effectively reduce SSE with a low risk of CNS bleeding, independent of DOAC dose. The higher non-CNS bleed rate and not the mortality rate is explained by the higher risk baseline characteristics in the reduced DOAC dose group. Further investigation of the etiology of non-CNS bleeds and mortality is warranted.
Bridging Thrombolysis In Atrial Fibrillation Stroke Is Associated With Increased Hemorrhagic Complications Without Improved Outcomes, Feras Akbik, Ali Alawieh, Laurie Dimisko, Brian M. Howard, C Michael Cawley, Frank C. Tong, Fadi Nahab, Owen B. Samuels, Ilko Maier, Wuwei Feng, Nitin Goyal, Robert M. Starke, Ansaar Rai, Kyle M. Fargen, Marios N. Psychogios, Pascal Jabbour, Reade De Leacy, Saleh G. Keyrouz, Travis M. Dumont, Peter Kan, Jan Liman, Adam S. Arthur, Stacey Q. Wolfe, J. Mocco, Roberto Javier Crosa, W Christopher Fox, Benjamin Gory, Alejandro M. Spiotta, Jonathan A. Grossberg
Bridging Thrombolysis In Atrial Fibrillation Stroke Is Associated With Increased Hemorrhagic Complications Without Improved Outcomes, Feras Akbik, Ali Alawieh, Laurie Dimisko, Brian M. Howard, C Michael Cawley, Frank C. Tong, Fadi Nahab, Owen B. Samuels, Ilko Maier, Wuwei Feng, Nitin Goyal, Robert M. Starke, Ansaar Rai, Kyle M. Fargen, Marios N. Psychogios, Pascal Jabbour, Reade De Leacy, Saleh G. Keyrouz, Travis M. Dumont, Peter Kan, Jan Liman, Adam S. Arthur, Stacey Q. Wolfe, J. Mocco, Roberto Javier Crosa, W Christopher Fox, Benjamin Gory, Alejandro M. Spiotta, Jonathan A. Grossberg
Department of Neurosurgery Faculty Papers
BACKGROUND: Atrial fibrillation (AF) associated ischemic stroke is associated with worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Conversely, AF is not associated with hemorrhagic complications or functional outcomes in patients undergoing mechanical thrombectomy (MT). This differential effect of MT and IVT in AF associated stroke raises the question of whether bridging thrombolysis increases hemorrhagic complications in AF patients undergoing MT.
METHODS: This international cohort study of 22 comprehensive stroke centers analyzed patients with large vessel occlusion (LVO) undergoing MT between June 1, 2015 and December 31, 2020. Patients were divided into …
Atrial Fibrillation And Cognitive Decline: A Computational Hemodynamics Investigation, Timothy J. Hunter
Atrial Fibrillation And Cognitive Decline: A Computational Hemodynamics Investigation, Timothy J. Hunter
Electronic Thesis and Dissertation Repository
Background: Atrial fibrillation (AF) is a prevalent cardiac disease which has been associated with increased risk of dementia and cognitive decline. We hypothesize that atrial fibrillation leads to regional transient hypoperfusion events in the brain, and that geometric variations in the arterial structure called the Circle of Willis (CoW) play a role in these events.
Methods: A computational model was developed to simulate cerebral blood flow in six common variations of the CoW. Risk was assessed based on frequency of beat-wise regional hypoperfusion events during AF, and sensitivity analysis was performed with respect to this model output.
Results …