Transient, Subclinical Atrial Fibrillation and Risk of Systemic Embolism in Patients With Rheumatic Mitral Stenosis in Sinus Rhythm

Karthikeyan, Ganesan; Ramamoorthy, Ananthakrishnan; Devasenapathy, Niveditha; Narang, Rajiv; Yadav, Rakesh Kumar; Seth, Sandeep; Singh, Simar Rajan; Goswami, Kewal C.; Bahl, Vinay K.

doi:10.1016/j.amjcard.2014.06.016

Cited by 27 publications

(19 citation statements)

References 16 publications

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“…On the basis of the abstract evaluation, 19 of these citations were deemed potentially eligible for inclusion ( Figure 1). The full articles were examined carefully and 13 of these were excluded [14][15][16][17][18][19][20][21][22][23][24][25][26]: 10 were excluded because they did not report the data needed for our analysis [14][15][16][19][20][21][22][23][24]26], 1 was a registry [25] and 2 were follow-up of studies [17,18] that were taken into account in included studies. Finally, six studies were included [9,10,[27][28][29][30] in the final analysis and their details are summarized in Table 1.…”

Section: Study Selectionmentioning

confidence: 99%

Asymptomatic atrial fibrillation burden and thromboembolic events: piecing evidence together

Proietti

Labos

AlTurki

et al. 2016

Expert Review of Cardiovascular Therapy

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Section: Study Selectionmentioning

confidence: 99%

Asymptomatic atrial fibrillation burden and thromboembolic events: piecing evidence together

Proietti

Labos

AlTurki

et al. 2016

Expert Review of Cardiovascular Therapy

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“…Atrial events were independently associated with stroke (hazard ratio, 2.8; P50.001). Other studies have demonstrated similar associations between subclinical AF and subsequent overt AF or stroke (61)(62)(63). More recently, the Cryptogenic Stroke and Underlying AF (CRYSTAL AF) (64) study randomly assigned 441 stroke patients without AF who were undergoing 24-hour monitoring to an ILR or conventional follow-up.…”

Section: Relevance Of Subclinical Afmentioning

confidence: 99%

Arrhythmia and Sudden Death in Hemodialysis Patients

Charytan

Foley

McCullough

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background Dialysis patients have high rates of cardiovascular morbidity and mortality, but data on arrhythmia burden, arrhythmia type, arrhythmia triggers, and the identity of terminal arrhythmias have historically been limited by an inability to monitor heart rhythm for prolonged periods.Objectives To investigate arrhythmia and its association with sudden death in dialysis-dependent ESRD, describe the potential for implantable devices to advance study of dialysis physiology, review the ethical implications of using implantable devices in clinical studies, and report on the protocol and baseline results of the Monitoring in Dialysis Study (MiD).Design, setting, participants, & measurements In this multicenter, interventional-observational, prospective cohort study, we placed implantable loop recorders in patients undergoing long-term hemodialysis. The proportion of patients experiencing clinically significant arrhythmias was the primary endpoint. For 6 months, we captured detailed data on the primary endpoint, symptomatic arrhythmias, other electrocardiographic variables, dialysis prescription, electrolytes, dialysis-related variables, and vital signs. We collected additional electrocardiographic data for up to 1 year.Results Overall, 66 patients underwent implantation in sites in the United States and India. Diabetes was present in 63.6% of patients, 12.1% were age $70 years, 69.7% were men, and 53.0% were black. Primary and secondary endpoint data are expected in 2016.Conclusions Cardiac arrhythmia is an important contributor to cardiovascular morbidity and mortality in dialysis patients, but available technology has previously limited the ability to estimate its true burden and triggers and to define terminal rhythms in sudden death. Use of implantable technology in observational studies raises complex issues but may greatly expand understanding of dialysis physiology. The use of implantable loop recorders in MiD is among the first examples of such a trial, and the results are expected to provide novel insights into the nature of arrhythmia in hemodialysis patients.

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“…12 A recent study from India reported a significant correlation between SEC and cardioembolism but failed to reach significance on multivariate analysis. 13 Our study suggested a nonsignificant increased risk of stroke with LA clot (P = .059). This could be result of late presentation in some cases (which could have led to Abbreviations: AF, atrial fibrillation; CI, confidence interval; ECG, electrocardiography; MS, mitral stenosis; PAH, pulmonary arterial hypertension; RHD, rheumatic heart disease; SEC, spontaneous echo contrast.…”

Section: Discussionmentioning

confidence: 79%