The Epidemiology of Atrial Fibrillation and Stroke

Pistoia, Francesca; Sacco, Simona; Tiseo, Cindy; Degan, Diana; Ornello, Raffaele; Carolei, Antonio

doi:10.1016/j.ccl.2015.12.002

Cited by 220 publications

(167 citation statements)

References 87 publications

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“…Atrial fibrillation and atrial flutter are the most common arrhythmias of the heart and are associated with an increased risk of death and morbidities [1–3, 6–12]. The treatment of atrial fibrillation and atrial flutter is based on two overall treatment strategies—a rhythm control strategy and a rate control strategy [16].…”

Section: Why Is It Important To Do This Review?mentioning

confidence: 99%

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

et al. 2017

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BackgroundAtrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation and atrial flutter have an increased risk of death and morbidities. The management of atrial fibrillation and atrial flutter is often based on interventions aiming at either a rhythm control strategy or a rate control strategy. The evidence on the comparable effects of these strategies is unclear. This protocol for a systematic review aims at identifying the best overall treatment strategy for atrial fibrillation and atrial flutter.MethodsThis protocol for a systematic review was performed following the recommendations of the Cochrane Collaboration and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the effects of any rhythm control strategy versus any rate control strategy. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed and classified as either high risk of bias or low risk of bias, and our conclusions will be based on trials with low risk of bias. The analyses of the extracted data will be performed using Review Manager 5 and Trial Sequential Analysis. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table and use GRADE assessment to assess the quality of the evidence.DiscussionThe results of this systematic review have the potential to benefit thousands of patients worldwide as well as healthcare systems and healthcare economy.Systematic review registrationPROSPERO CRD42016051433 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0449-z) contains supplementary material, which is available to authorized users.

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Section: Why Is It Important To Do This Review?mentioning

confidence: 99%

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

et al. 2017

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“…Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world [1, 2]. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA [3].…”

Section: Introductionmentioning

confidence: 99%

“…Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA [3]. The prevalence of both atrial fibrillation and atrial flutter are increasing possibly because of a greater life expectancy in the general population, an increased prevalence of risk factors for atrial fibrillation and atrial flutter, and an improved ability to suspect and diagnose the arrhythmias [1, 4, 5]. Atrial fibrillation and atrial flutter are associated with an increased risk of death and morbidities [6–12].…”

Section: Introductionmentioning

confidence: 99%

Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

et al. 2017

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BackgroundAtrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation and atrial flutter have an increased risk of death and morbidities. In the management of atrial fibrillation and atrial flutter, it is often necessary to use medical interventions to lower the heart rate. Lowering the heart rate may theoretically prevent the development of heart failure and tachycardia-mediated cardiomyopathy. The evidence on the benefits and harms of digoxin compared with placebo or with other medical interventions is unclear. This protocol for a systematic review aims at identifying the beneficial and harmful effects of digoxin compared with placebo, no intervention, or with other medical interventions for atrial fibrillation and atrial flutter.MethodsThis protocol for a systematic review was conducted following the recommendations of Cochrane and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials comparing digoxin with placebo, no intervention, or with other medical interventions. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed and classified as either at high risk of bias or low risk of bias, and our primary conclusions will be based on trials with low risk of bias. We will perform our meta-analyses of the extracted data using Review Manager 5.3 and Trial Sequential Analysis ver. 0.9.5.5 beta. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table based on GRADE assessments of the quality of the evidence.DiscussionThe results of this systematic review have the potential to benefit millions of patients worldwide as well as healthcare economy.Systematic review registrationPROSPERO CRD42016052935Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0470-2) contains supplementary material, which is available to authorized users.

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“…AF is associated with a high rate of cardiovascular and cerebrovascular morbidity and mortality resulting in significant healthcare resource utilization and public health burden. [1] The estimated US prevalence of AF of 5.1 million is predicted to increase to 9.3 million by 2030. [2] Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke.…”

Section: Introductionmentioning

confidence: 99%

A pilot process to identify and switch high-risk warfarin patients to direct oral anticoagulants

Lee

Groce

Kim

2017

JHA

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Objective: To pilot a process for identifying and switching high-risk warfarin patients to direct oral anticoagulants (DOACs) in nonvalvular atrial fibrillation (AF) or venous thromboembolism (VTE). Methods: A pharmacy resident identified high-risk warfarin patients using three criteria. The resident reviewed medical charts, communicated recommendations to the primary care physician (PCP), and scheduled patients for appointments to switch to DOACs. Patients were followed every 1 to 3 months after initiating DOACs. The primary outcome of the study was the percentage of high-risk warfarin patients before and after process implementation. Secondary outcomes at 6 months included bleeding or thrombotic events, patient-reported side effects, recommendation acceptance rates, adherence rates, clinic time in therapeutic range (TTR), and patient satisfaction. Results: Out of 76 patients evaluated, 22.4% were identified as high-risk using the pre-specified criteria. After program implementation, this percentage was reduced to 9.2%. No significant adverse events occurred by 3-month follow-up, and 100% of recommendations were accepted by physicians. Adherence rates and clinic TTR also improved after implementation (87.5% to 94% and 60.9% to 81.1%, respectively). Overall, patients reported satisfaction with switching from warfarin to DOAC. Conclusions: A pilot process was successful in reducing the percentage of high-risk warfarin patients by switching to DOAC therapy.

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The Epidemiology of Atrial Fibrillation and Stroke

Cited by 220 publications

References 87 publications

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis

A pilot process to identify and switch high-risk warfarin patients to direct oral anticoagulants

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