<scp>JCS</scp>/<scp>JHRS</scp> 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias

Ono, Katsushige; Iwasaki, Yu‐ki; Akao, Masaharu; Ikeda, Takanori; Ishii, Kuniaki; Inden, Yasuya; Kusano, Kengo; Kobayashi, Yoshinori; Koretsune, Yukihiro; Sasano, Tetsuo; Sumitomo, Naokata; Takahashi, Naohiko; Niwano, Shinichi; Hagiwara, Nobuhisa; Hisatome, Ichiro; Furukawa, Tetsushi; Honjo, Haruo; Maruyama, Toru; Murakawa, Yuji; Yasaka, Masahiro; Watanabe, Eiichi; Aiba, Takeshi; Amino, Mari; Itoh, Hideki; Ogawa, Hisashi; Okumura, Yasuo; Aoki‐Kamiya, Chizuko; Kishihara, Jun; Kodani, Eitaro; Kubo, Takashi; Sakamoto, Yusuke; Sato, Kazuhiro; Shiga, Tsuyoshi; Shinohara, Tetsuji; Suzuki, Atsushi; Suzuki, Shinya; Sekiguchi, Yukio; Nagase, Satoshi; Hayami, Noriyuki; Harada, Masahide; Fujino, Tadashi; Makiyama, Takeru; Maruyama, Mitsunori; Miake, Junichiro; Muraji, Shota; Murata, Hiroshige; Morita, Norishige; Yokoshiki, Hisashi; Yoshioka, Koichiro; Yodogawa, Kenji; Inoue, Hiroshi; Okumura, Ken; Kimura, Takeshi; Tsutsui, Hiroyuki; Shimizu, Wataru

doi:10.1002/joa3.12714

Cited by 16 publications

(9 citation statements)

References 1,036 publications

(2,866 reference statements)

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“…Atrial fibrillation (AF) increases the risk of cardiogenic stroke fivefold 1 . Anticoagulation is highly effective in preventing stroke in patients with AF, with risk stratification based on the CHADS 2 score determining the indication 2 . However, given that stroke has been reported even in patients with a CHADS 2 score of 0, 3 other risk factors should also be evaluated when considering the indication for oral anticoagulants (OACs) 2 .…”

Section: Introductionmentioning

confidence: 99%

Impact of left ventricular diastolic function and direct oral anticoagulant use for predicting embolic events in patients with heart failure and atrial fibrillation

Yamamoto,

Hayama,

Enomoto

et al. 2024

Journal of Arrhythmia

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BackgroundPatients with atrial fibrillation (AF) and heart failure (HF) have high stroke risk owing to left atrial dysfunction. However, anticoagulation is a concern in patients with high bleeding risk. We aimed to identify independent predictors of stroke in HF patients with AF.MethodsWe retrospectively examined 320 patients (mean age 79 ± 12 years, 163 women) hospitalized with acute HF complicated by AF between January 2014 and December 2018. Patients were followed from admission until ischemic stroke or systemic embolism (SSE) onset or death or were censored at the last contact date or September 2023.ResultsSSE occurred in 40 patients (median follow‐up of 528 days). Multivariate Cox regression analysis identified age (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.00–1.07, p = .034), direct oral anticoagulant (DOAC) use (HR 0.26, 95% CI 0.11–0.60, p = .002), and early diastolic peak flow velocity to early diastolic peak annular velocity (E/e'; HR 1.05, 95% CI 1.02–1.08, p < .001) to be independent predictors of SSE, whereas left atrial reservoir strain was not. After determining an appropriate E/e' cutoff by receiver‐operating characteristic curve analysis and adjusting the multivariate Cox model, E/e' ≥17.5 (HR 3.30, 95% CI 1.56–6.83, p = .001) independently predicted SSE. The results were consistent with no interaction in the subanalysis except for gender.ConclusionElderly patients not on DOACs with elevated E/e' may be at higher risk of stroke, suggesting that DOACs should be the first choice for patients with elevated E/e' and aggressive additional prophylaxis and careful follow‐up are needed.

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Section: Introductionmentioning

confidence: 99%

Impact of left ventricular diastolic function and direct oral anticoagulant use for predicting embolic events in patients with heart failure and atrial fibrillation

Yamamoto,

Hayama,

Enomoto

et al. 2024

Journal of Arrhythmia

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“…[3][4][5][6] Many guidelines recommend oral anticoagulation therapy for patients with AF at elevated risk of stroke. [7][8][9] The data from the Swedish Riksstroke registry of >94 000 strokes have helped identify the major gaps in prevention of AFrelated strokes, which represent 33% of all ischemic strokes. 10,11 In 9% of all strokes, the presence of AF is not known prior to stroke.…”

Section: Introductionmentioning

confidence: 99%

“…AF is associated with a high relative risk of dementia, stroke, major adverse cardiac events, and all‐cause mortality 3–6 . Many guidelines recommend oral anticoagulation therapy for patients with AF at elevated risk of stroke 7–9 …”

Section: Introductionmentioning

confidence: 99%

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Risk factor profile for newly diagnosed atrial fibrillation: 4‐year follow‐up of annual health examinations in a Japanese Adult Cohort

Nagata

Wang

Yamagami

et al. 2023

Journal of Arrhythmia

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BackgroundDetecting unknown atrial fibrillation (AF) would provide an opportunity to prevent ischemic stroke by instituting appropriate anticoagulation. Although opportunistic screening of older patients is recommended in current guidelines, which patients may benefit from intensive AF screening remains unclear. We sought to clarify the risk factor profile for newly diagnosed AF in annual health examinations of a Japanese adult cohort.MethodsAmong 141 441 Japanese patients who underwent annual health examinations in 2014, 87 872 patients aged ≥20 years without known AF who had undergone electrocardiography were analyzed (mean age: 47 ± 12 years; 64% men). The absence of known AF was confirmed by prior electrocardiography in 2012 and/or 2013. Newly diagnosed AF was observed in 244 patients in 2014–2017 (mean age: 62 ± 12 years; 83% men).ResultsIn the multivariable analysis, waist circumference obesity (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.13–1.99; p = .005) high blood pressure (HR, 1.9; 95% CI, 1.01–3.59; p = .047), on‐treatment hypertension (HR, 1.53; 95% CI, 1.01–2.31; p = .046), and daily alcohol drinking (HR, 2.18; 95% CI, 1.52–3.12; p < .001) were significantly associated with newly diagnosed AF.ConclusionsIn this Japanese cohort, waist circumference obesity, hypertension, and alcohol drinking were independent predictors of newly diagnosed AF in annual medical examinations. This finding encourages further evaluation of systematic AF screening programs in at‐risk populations.

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“…The Japanese Society of Hypertension Guidelines for the Management of Hypertension recommend the use of betablockers in patients with ischemic heart disease and known AF, but not as first-line agents in non-AF hypertensive patients, and they recommend the use of renin-angiotensin system inhibitors for hypertensive heart disease [8]. The Japanese Circulation Society/The Japanese Heart Rhythm Society guidelines indicate the use of beta-blockers for symptomatic atrial premature contractions in Class IIa [11]. Multiple atrial premature contractions are associated not only with the development of AF but also with cardiovascular mortality [12], and beta-blockers for atrial premature contractions have been shown to be effective in reducing AF [13].…”

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confidence: 99%