Episodes of pulseless, non-perfusing rhythm: A subtle killer

Fiori, P.; Allegorico, Lia; Guglielmo, Capaldo; Curnis, Antonio; Massarelli, Marco; Gizzi, Raffaele; Pozzi, Chiara; Patrizia, Savino; Botticella, Filomena; Dragonetti, Carmela; Gualtiero, Pasquale; Manganelli, Gianvito; Morella, Alessandro; Vincenzo, Pellecchia; Benigni, Giovanni; Damiano, Terenzio; Pace, E. A.; Martino, A R; Bellizzi, Annamaria; Bellizzi, Gennaro; Ferrara, Maurizio; Mazza, Elena; Musto, Lanfranco; Tammaro, C.; D'Agostino, Silvio; Monaco, Antonio; Frieri, Angelo

doi:10.1016/j.jns.2021.118741

Cited by 1 publication

(2 citation statements)

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“…Further studies are needed to validate the reduction in mortality in the absence of traumatic events. However, the paradox of no differences in the rate of haemorragic infarction related to the entity of anticlotting effect of VKA treated patients, in the absence of traumatic events, highlights that the increased risk of bleeding is more related to the underlying cardiological dysfunction and late recanalization rather than to intrinsic VKA risk of bleeding [35,36]. Oral anticoagulant (OAC) therapy in AF is recommended if CHA2DS2VASc score is ≥2 in men or ≥3 in women.…”

Section: Discussionmentioning

confidence: 99%

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Atrial Fibrillation is Not A Dead Horse

Fiori¹,

Lia²,

Guglielmo³

et al. 2022

J Med - Clin Res & Rev

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Prevalence and incidence of Atrial Fibrillation (AF) is high in western countries. It is apparently lower in developing countries, because of unrecognition, undertreatment and related complications and mortality. Studies in subjects wearing cardiac implantable electronic devices showed a wide burden of AF, ranging from subclinical episodes to permanent AF. The aim of our study was to identify haematological and haemodynamic differences between Paroxysmal Atrial Tachyarrhythmias (PAT) compared to Non-Paroxysmal AF (NPAF), detected by 24 hours Holter ECG, and predictive negative factors associated with increased risk of evolution from paroxysmal to persistent or permanent AF. Our data highlight the dynamic nature of PAT and NPAF. PAT in young subjects is a red flag, requiring at least changes in lifestyle and further diagnostic examinations to avoid progression to irreversible pathological myocardial electrical and structural remodeling. Comorbidities, scarce compliance, or inappropriate treatments account for high incidence of acute cerebrovascular events with disabling outcomes in elderly patients. Further studies are needed on genetic susceptibility and vulnerability. Educational campaign is the most effective, long- term strategy. Personalized approach and therapeutical scheme are recommended based on patient compliance and actual risk. A holistic approach to patient is the pillar for any clinical decision and practice.

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Section: Discussionmentioning

confidence: 99%

“…Patients suffering from tachycardia and PAT patients with NCR seems to have a higher risk of conversion to NPAF. Moreover, patients with NCR have a higher probability of AS and/or CCVD (AS OR 4, CCVD OR 6)[35,36]. One limit of our study is related to the lack of healthy controls, which may increase statistical significance.…”

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confidence: 88%