Treatment of Atrial Fibrillation

Prystowsky, Eric N.; Padanilam, Benzy J.; Fogel, Richard I.

doi:10.1001/jama.2015.7505

Cited by 103 publications

(67 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In my experience, after these trial results were reported many physicians opted for a rate control strategy in their patients, which is certainly easier to accomplish than dealing with the complexities of rhythm control. What may not be known by many nonelectrophysiologists is that persistence of AF over time typically leads to fibrosis of the atria and atrial enlargement, and in many patients a point of no return is reached . In such situations, it may be impossible to restore and maintain sinus rhythm, even though the patient may need it several years after the initial diagnosis for either new symptoms or a change in their underlying cardiovascular status.…”

Section: Discussionmentioning

confidence: 99%

A bridge to the future: Maintenance of sinus rhythm in patients with atrial fibrillation

Prystowsky

2018

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

A bridge to the future: Maintenance of sinus rhythm in patients with atrial fibrillation

Prystowsky

2018

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

“…Patients with AF have an age-adjusted risk of stroke that is five-fold higher compared to the normal population regardless of the type of AF21. If the ventricular rate is uncontrolled for a prolonged period, tachycardia-mediated cardiomyopathy can occur22. Other comorbidities, such as hypertension, heart failure, diabetes and COPD, occur as age increases23.…”

Section: Discussionmentioning

confidence: 99%

Ethnicity and anticoagulation management of hospitalized patients with atrial fibrillation in northwest China

Cheng

Zhou

Song

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The therapeutic management and health challenges caused by atrial fibrillation (AF) differ between different groups. The purpose of this study was to investigate the clinical features of patients hospitalized with AF and to explore the use of anticoagulation treatments in Han and Uygur patients in Xinjiang, northwest China. Data were collected from a retrospective descriptive study involving patients hospitalized at 13 hospitals in Xinjiang, China from Jul 1, 2014 to Jun 31, 2015. Anticoagulation management was measured according to guideline-recommended risk scores. A total of 4,181 patients with AF were included (mean age 69.5 ± 11.7 years, 41.4% females; 71.5% Han, 28.5% Uygur). The prevalence of AF in Uygur individuals may occur earlier than in Han individuals (mean age 64.9 vs 71.3, P < 0.001). Most of the hospitalized patients with AF had a high risk of stroke (CHA2DS2-VASc score ≥2; 80.6% Han vs 73.7% Uygur, P < 0.05); this risk was especially high in elderly patients. In AF patients, the application of anticoagulants according to the guidelines is far from expected, and the underutilization of anticoagulants exists in both ethnic groups.

show abstract

“…(17) However, while a growing number of prestigious clinical laboratories are finding evidence that rotors may underlie human atrial and ventricular fibrillation, as demonstrated by targeted ablation of rotor sites, (13,14,18,19) the idea remains under intense debate, particularly in the field of AF. Of note, recent data from two different laboratories have failed to identify rotors in human AF.…”

Section: Mechanisms Underlying Cardiac Fibrillationmentioning

confidence: 99%

Structural and Functional Bases of Cardiac Fibrillation

Filgueiras‐Rama

Jalife

2016

JACC: Clinical Electrophysiology

View full text Add to dashboard Cite

Evidence accumulated over the last 25 years suggests that, whether in the atria or ventricles, fibrillation may be explained by the self-organization of the cardiac electrical activity into rapidly spinning rotors giving way to spiral waves that break intermittently and result in fibrillatory conduction. The dynamics and frequency of such rotors depend on the ion channel composition, excitability and refractory properties of the tissues involved, as well as on the thickness and respective three-dimensional fiber structure of the atrial and ventricular chambers. Therefore, improving the understanding of fibrillation has required the use of multidisciplinary research approaches, including optical mapping, patch clamping and molecular biology, and the application of concepts derived from the theory of wave propagation in excitable media. Moreover, translation of such concepts to the clinic has recently opened new opportunities to apply novel mechanistic approaches to therapy, particularly during atrial fibrillation ablation. Here we review the current understanding of the manner in which the underlying myocardial structure and function influence rotor initiation and maintenance during cardiac fibrillation. We also examine relevant underlying differences and similarities between atrial fibrillation and ventricular fibrillation and evaluate the latest clinical mapping technologies used to identify rotors in either arrhythmia. Altogether, the data being discussed have significantly improved our understanding of the cellular and structural bases of cardiac fibrillation and pointed toward potentially exciting new avenues for more efficient and effective identification and therapy of the most complex cardiac arrhythmias.

show abstract

Treatment of Atrial Fibrillation

Cited by 103 publications

References 71 publications

A bridge to the future: Maintenance of sinus rhythm in patients with atrial fibrillation

A bridge to the future: Maintenance of sinus rhythm in patients with atrial fibrillation

Ethnicity and anticoagulation management of hospitalized patients with atrial fibrillation in northwest China

Structural and Functional Bases of Cardiac Fibrillation

Contact Info

Product

Resources

About