Atrial fibrillation and flutter – the state of the art. Part 2

Janion−Sadowska, Agnieszka; Turek, Łukasz; Dudek, Aneta; Andrychowski, Jarosław; Sadowski, Marcin

doi:10.5114/ms.2021.109530

Cited by 6 publications

(9 citation statements)

References 88 publications

(115 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stroke risk stratification in patients with AFL remains a complicated issue [1,[9][10][11][12]. Left atrial appendage thrombus (LAAT) is regarded as a risk factor for stroke in these patients; however, the actual LAATrelated health risk in patients with AFL on chronic anticoagulation remains unknown [13]. Moreover, the risk factors and prevalence of LAAT in patients with AFL on oral anticoagulation (OAC) (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the risk factors and prevalence of LAAT in patients with AFL on oral anticoagulation (OAC) (i.e. non-VKA oral anticoagulants (NOACs) and vitamin K antagonists (VKAs)) have not been fully established [13]. It seems that the actual LAAT-related health risk varies according to thrombus age, medical management, and procedures (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…It seems that the actual LAAT-related health risk varies according to thrombus age, medical management, and procedures (i.e. cardioversion, conservative management) or left atrial appendage morphology [13]. Although the restoration of sinus rhythm in patients with AFL increases the stroke risk [11,[14][15][16][17], the stroke mechanism can be difficult to establish [13].…”

Section: Introductionmentioning

confidence: 99%

“…cardioversion, conservative management) or left atrial appendage morphology [13]. Although the restoration of sinus rhythm in patients with AFL increases the stroke risk [11,[14][15][16][17], the stroke mechanism can be difficult to establish [13]. The proper anticoagulation reduces stroke risk following the sinus rhythm restoration [1,13].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Left atrial appendage thrombus in patients referred to electrical cardioversion for typical atrial flutter

Turek¹,

Sadowski²,

Janion−Sadowska³

et al. 2022

Self Cite

View full text Add to dashboard Cite

Introduction:Patients with atrial flutter (AFL) are at risk of stroke; however, the stratification of stroke risk is difficult. It remains unknown whether left atrial appendage thrombus (LAAT) in AFL patients on chronic oral anticoagulation (OAC) contributes significantly to that risk. Aim of the research:To assess the prevalence and predictors of LAAT, and its role in the prediction of mortality, stroke, and systemic thromboembolic events among consecutive AFL patients on OAC admitted for electrical cardioversion. Material and methods: This was a prospective, single-centre cohort study. The participants underwent transoesophageal echocardiography before electrical cardioversion. A total of 69 patients were enrolled. The primary outcome was the presence of LAAT. All participants were followed up for 12 months to evaluate the incidence of systemic thromboembolic events, stroke, and death. Results: Despite uninterrupted OAC, irrespective of the anticoagulant agent type, LAAT was present in 10.1% of patients referred for cardioversion due to typical AFL of > 48-hour duration. The significant predictor of LAAT was prior stroke/ transient ischaemic attack/thromboembolic event (OR = 14.75; 95% CI: 2.17-108.33). No deaths, strokes, or systemic thromboembolic events occurred during the follow-up period. Conclusions:The predictive role of LAAT in relation to mortality, stroke, and systemic thromboembolic events among patients with AFL and chronic oral anticoagulation remains unclear. StreszczenieWprowadzenie: Pacjenci z trzepotaniem przedsionków (AFL) są zagrożeni udarem mózgu; jednak stratyfikacja ryzyka udaru mózgu jest trudnym zadaniem. Nie wiadomo, czy skrzeplina uszka lewego przedsionka (LAAT) u pacjentów z AFL w trakcie przewlekłej doustnej antykoagulacji (OAC) istotnie przyczynia się do tego ryzyka. Cel pracy: Ocena częstości występowania i czynników predykcyjnych LAAT oraz predykcyjnej roli LAAT w odniesieniu do śmiertelności, udaru mózgu i ogólnoustrojowych incydentów zakrzepowo-zatorowych wśród kolejnych pacjentów z AFL w trakcie OAC przyjętych do kardiowersji elektrycznej. Materiał i metody: Przeprowadzono prospektywne, jednoośrodkowe badanie kohortowe. Uczestnicy zostali poddani echokardiografii przezprzełykowej przed kardiowersją elektryczną. Do badania włączono 69 pacjentów. Pierwszorzędowym punktem końcowym była obecność LAAT. Wszyscy uczestnicy byli obserwowani przez 12 miesięcy w celu oceny występowania ogólnoustrojowych incydentów zakrzepowo-zatorowych, udaru mózgu i zgonu. Wyniki: Pomimo nieprzerwanej doustnej antykoagulacji, niezależnie od rodzaju antykoagulantu, u pacjentów kierowanych do kardiowersji z powodu typowego AFL > 48 godzin stwierdzono wysoką częstość występowania LAAT (10,1%). Istotnym czynnikiem prognostycznym LAAT był przebyty udar mózgu lub napad przemijającego niedokrwienia mózgu, lub incydent zakrzepowo-zatorowy (OR = 14,75; 95% CI: 2,17-108,33). W okresie obserwacji nie wystąpiły zgony, udary mózgu ani ogólnoustrojowe incydenty zakrzepowo-zatorowe. Wnioski: Predykcyjna rola LAAT w od...

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Left atrial appendage thrombus in patients referred to electrical cardioversion for typical atrial flutter

Turek¹,

Sadowski²,

Janion−Sadowska³

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Prevention of stroke and thromboembolic events remains an essential part of AF treatment according to the recommendations of the European Society of Cardiology and the American Heart Association; however, improved symptom management and optimal cardiovascular and comorbidity management are equally important [2,3]. There are 2 therapeutic strategies for AF: rhythm and heart rate control strategies [2,3], but the evidence on the comparable health effects of these strategies is unclear [4]. Previous trials, such as AFFIRM, RACE, STAF, PIAF, and HOT CAFE, have not shown the superiority of rhythm control over rate control in improving cardiovascular outcomes and reducing mortality in patients with AF; however, many post-hoc analyses have disclosed the advantages of sinus rhythm (SR) maintenance, including improved physical capacity [5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy

Turek¹,

Sadowski²,

Janion−Sadowska³

et al. 2022

View full text Add to dashboard Cite

Introduction:Patients with atrial fibrillation (AF) are at increased risk of cardiovascular diseases and death. Evidence on the comparable effects of rhythm and heart rate control strategies in patients with AF is ambiguous. Aim of the research:To assess the recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with AF receiving oral anticoagulation therapy. Material and methods: This was a prospective, single-centre cohort study. The participants underwent transoesophageal echocardiography before direct current cardioversion (DCC). A total of 226 patients were enrolled. The primary outcome was sinus rhythm (SR) restoration after DCC for AF. All participants were followed up for 12 months to evaluate the incidence of death, systemic thromboembolic events, stroke, acute coronary syndrome, hospitalization due to worsening heart failure (HF), and recurrence of arrhythmia after SR restoration. Results: SR restoration was achieved after DCC in 197 (87.2 %) patients, of whom 112 (56.9%) experienced arrhythmia relapse. Significant risk factors associated with arrhythmia recurrence were β-adrenergic antagonist therapy, chronic obstructive pulmonary disease, and previous stroke/transient ischaemic attack/thromboembolic events. All enrolled patients were free of acute coronary syndrome, systemic thromboembolic events, and stroke, and none of the patients died during the 12-month follow-up period. Hospitalization with worsening HF occurred in 13 patients with SR and in 10 patients with persistent AF (p = 0.42). Conclusions:The arrhythmia recurrence rate was high; however, cardiovascular complications and deaths did not occur. The incidence of hospitalization for HF was comparable between the AF and SR groups. StreszczenieWprowadzenie: U pacjentów z migotaniem przedsionków (AF) stwierdza się zwiększone ryzyko wystapienia chorób sercowo-naczyniowych i zgonu. Dowody na porównywalne efekty strategii kontroli rytmu i częstości rytmu serca u pacjentów z AF są niejednoznaczne. Cel pracy: Ocena nawrotu arytmii i niepożądanych zdarzeń sercowo-naczyniowych w czasie 12 miesięcy po kardiowersji elektrycznej u pacjentów z AF stosujących doustne leki przeciwzakrzepowe. Materiał i metody: Było to prospektywne, jednoośrodkowe badanie kohortowe. Uczestnicy zostali poddani echokardiografii przezprzełykowej przed kardiowersją elektryczną prądem stałym (DCC). Do badania włączono 226 pacjentów. Pierwszorzędowym punktem końcowym było przywrócenie rytmu zatokowego (SR) po DCC z powodu AF. Wszyscy uczestnicy byli obserwowani przez 12 miesięcy w celu oceny częstości występowania zgonów, systemowych incydentów zakrzepowo--zatorowych, udaru mózgu, ostrego zespołu wieńcowego, hospitalizacji z powodu pogorszenia niewydolności serca (HF) oraz nawrotu arytmii po przywróceniu SR.

show abstract

Echocardiographic Evaluation of Atrial Remodelling for the Prognosis of Maintaining Sinus Rhythm after Electrical Cardioversion in Patients with Atrial Fibrillation

Wałek,

Roskal-Wałek,

Dłubis

et al. 2023

JCM

View full text Add to dashboard Cite

Atrial fibrillation (AF) is the most common atrial tachyarrhythmia. One of the methods of AF treatment is direct current cardioversion (DCCV), but in the long-term follow-up we observe quite a high percentage of AF recurrences after this procedure. In order to assess the prognosis of DCCV effectiveness, we use clinical, biochemical and echocardiographic parameters. The objective of this review is to systematise the current knowledge on echocardiographic measurements in patients with persistent AF used to assess the progress of remodelling of the atrial wall, which affects the likelihood of maintaining sinus rhythm after DCCV. In this article, echocardiographic parameters for the evaluation of remodelling of the atrial wall are divided into groups referring to structural, mechanical, and electrical remodelling, as well as parameters for the evaluation of left ventricular filling pressure. The article aims to draw attention to the clinical value of echocardiographic measurements, which is the selection of patients who will maintain sinus rhythm after DCCV in the long-term follow-up, which will allow to avoid unnecessary risks associated with the procedure and enable the selection of the appropriate treatment strategy.

show abstract

Atrial fibrillation and flutter – the state of the art. Part 2

Cited by 6 publications

References 88 publications

Left atrial appendage thrombus in patients referred to electrical cardioversion for typical atrial flutter

Left atrial appendage thrombus in patients referred to electrical cardioversion for typical atrial flutter

Recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy

Echocardiographic Evaluation of Atrial Remodelling for the Prognosis of Maintaining Sinus Rhythm after Electrical Cardioversion in Patients with Atrial Fibrillation

Contact Info

Product

Resources

About