The Association of Malignancy With Stroke and Bleeding in Atrial Fibrillation DOI Creative Commons

Malak El-Rayes,

Mohamed A. Adam, Jiming Fang

et al.

JACC CardioOncology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

It is undetermined if malignancy independently increases stroke risk in atrial fibrillation (AF). This study sought to determine the association of with and bleeding AF. Population-based cohort using administrative datasets people aged ≥66 years newly diagnosed People within 5 before AF diagnosis were matched cancer-free control subjects on age, sex, details, CHA2DS2-VASc score, ATRIA score. Outcomes included hospitalizations for hospitalization/emergency visits bleeding. Cause-specific regression was used HR after adjusting time-varying anticoagulation status. Analyses repeated specific subgroups cancer patients (with subjects). Among 199,710 patients, 24,991 (12.5%) had prior malignancy. Malignancy associated more inpatient diagnoses (vs outpatient) less anticoagulation. We 43,802 (21,901 malignancy, mean age 78.1 years; 59.5% male). After status, a similar hazard (HR: 1.01; 95% CI: 0.88-1.15) but higher 1.45; 1.37-1.53) compared sample. comparison mostly showed consistent results, except for: 1) increased lung cancer; 2) lack breast lymphoma. generally hazards subjects, suggesting that should not lower threshold

Language: Английский

2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy DOI
Steve R. Ommen, Carolyn Y. Ho, Irfan M. Asif

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(23), P. 2324 - 2405

Published: May 8, 2024

Language: Английский

Citations

91
2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction DOI
Thomas M. Maddox, James L. Januzzi, Larry A. Allen

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(15), P. 1444 - 1488

Published: March 8, 2024

Language: Английский

Citations

71
2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease DOI
Heather L. Gornik, Herbert D. Aronow, Philip P. Goodney

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(24), P. 2497 - 2604

Published: May 14, 2024

Language: Английский

Citations

50
Temporal trends in lifetime risks of atrial fibrillation and its complications between 2000 and 2022: Danish, nationwide, population based cohort study DOI
Nicklas Vinter, Pia Cordsen, Søren Paaske Johnsen

et al.

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e077209 - e077209

Published: April 10, 2024

To examine how the lifetime risks of atrial fibrillation and complications after changed over time.

Language: Английский

Citations

31
Left Atrial Appendage Closure after Ablation for Atrial Fibrillation DOI

Oussama M. Wazni,

Walid I. Saliba, Devi G. Nair

et al.

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 16, 2024

Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk stroke. Left appendage closure a mechanical alternative to anticoagulation, but data regarding its use are lacking.

Language: Английский

Citations

30
Pulmonary vein narrowing after pulsed field versus thermal ablation DOI Creative Commons
Moussa Mansour, Edward P. Gerstenfeld, Chinmay Patel

et al.

EP Europace, Journal Year: 2024, Volume and Issue: 26(2)

Published: Feb. 1, 2024

Abstract Aims When it occurs, pulmonary vein (PV) stenosis after atrial fibrillation (AF) ablation is associated with significant morbidity. Even mild-to-moderate PV narrowing may have long-term implications. Unlike thermal energies, such as radiofrequency (RF) or cryothermy, pulsed field (PFA) a non-thermal modality less fibrotic proliferation. Herein, we compared the effects of PFA vs. on AF ablation. Methods and results ADVENT was multi-centre, randomized, single-blind study comparing (pentaspline catheter) ablation—force-sensing RF cryoballoon (CB)—to treat drug-refractory paroxysmal AF. Pulmonary diameter aggregate cross-sectional area were obtained by baseline 3-month imaging. The pre-specified, formally tested, secondary safety endpoint measure between groups, superiority defined posterior probability > 0.975. Among subjects randomized to (n = 305) 302), 259 255 (137 118 CB) had complete No subject (≥70%) stenosis. Change in (−0.9%) than (−12%, 0.999)—primarily driven sub-cohort (−19.5%) CB (−3.3%). Almost half all diameters did not decrease, but majority (80%) PVs decreased, regardless anatomic location. Conclusion In this first comparison ablation, resulted narrowing—thereby underscoring qualitatively differential favourable impact tissue.

Language: Английский

Citations

25
Apixaban vs Aspirin According to CHA2DS2-VASc Score in Subclinical Atrial Fibrillation DOI
Renato D. Lópes, Christopher B. Granger,

Daniel Wojdyla

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(4), P. 354 - 364

Published: May 19, 2024

Language: Английский

Citations

25
Pulsed Field vs Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation DOI Creative Commons
Vivek Y. Reddy, Moussa Mansour, Hugh Calkins

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(1), P. 61 - 74

Published: May 18, 2024

The ADVENT randomized trial revealed no significant difference in 1-year freedom from atrial arrhythmias (AA) between thermal (radiofrequency/cryoballoon) and pulsed field ablation (PFA). However, recent studies indicate that the postablation AA burden is a better predictor of clinical outcomes than dichotomous endpoint 30-second recurrence. goal this study was to determine: 1) impact on outcomes; 2) effect modality burden. In ADVENT, symptomatic drug-refractory patients with paroxysmal fibrillation underwent PFA or ablation. Postablation transtelephonic electrocardiogram monitor recordings were collected weekly for symptoms, 72-hour Holters at 6 12 months. calculated percentage monitors. Quality-of-life assessments baseline From 593 (299 PFA, 294 thermal), using aggregate PFA/thermal data, an exceeding 0.1% associated significantly reduced quality life increase interventions: redo ablation, cardioversion, hospitalization. There more residual <0.1% (OR: 1.5; 95% CI: 1.0-2.3; P = 0.04). Evaluation by demographics prior failed class I/III antiarrhythmic drugs had less after compared 2.5; 1.4-4.3; 0.002); receiving only II/IV pre-ablation groups. Compared often resulted clinically threshold (The FARAPULSE PIVOTAL Trial System vs SOC Ablation Paroxysmal Atrial Fibrillation [ADVENT]; NCT04612244)

Language: Английский

Citations

22
Left atrial appendage closure for stroke prevention in atrial fibrillation: current status and perspectives DOI Creative Commons
Ulf Landmesser, Carsten Skurk, Apostolos Tzikas

et al.

European Heart Journal, Journal Year: 2024, Volume and Issue: unknown

Published: July 19, 2024

Atrial fibrillation (AF) is associated with an increased risk of stroke and systemic embolism, the left atrial appendage (LAA) has been identified as a principal source thromboembolism in these patients. While oral anticoagulation current standard care, LAA closure (LAAC) emerges alternative or complementary treatment approach to reduce embolism patients AF. Moderate-sized randomized clinical studies have provided data for efficacy safety catheter-based LAAC, largely compared vitamin K antagonists. device iterations, advances pre- peri-procedural imaging, implantation techniques continue increase LAAC. More about LAAC collected, several trials are currently underway compare best medical care (including non-vitamin antagonist anticoagulants) different settings. Surgical AF undergoing cardiac surgery reduced on background therapy LAAOS III study. In this review, we describe rapidly evolving field discuss recent data, ongoing studies, open questions, limitations

Language: Английский

Citations

19
Pulsed-field ablation versus thermal ablation for atrial fibrillation: A meta-analysis DOI Creative Commons
Maria Clara Azzi Vaz de Campos, Vitor Ryuiti Yamamoto Moraes, Rafael Ferreira Daher

et al.

Heart Rhythm O2, Journal Year: 2024, Volume and Issue: 5(6), P. 385 - 395

Published: April 30, 2024

BackgroundPulsed-field ablation (PFA) is an alternative to thermal (TA) in patients with atrial fibrillation (AF) receiving catheter-based therapy for pulmonary vein isolation (PVI). However, its efficacy and safety have yet be fully elucidated.ObjectiveThis study compared PFA TA's acute long-term efficacies safety.MethodsWe performed a systematic review meta-analysis of randomized non-randomized controlled trials comparing TA AF undergoing their first PVI ablation. The group was divided into cryoballoon (CB) radiofrequency (RF) subgroups, were paroxysmal (PAF) persistent (PersAF) subgroups further analysis.ResultsEighteen studies involving 4,998 (35,2% PFA) included. Overall, associated shorter procedure time (MD, -21.68; 95% CI: -32.81–[-10.54]) but longer fluoroscopy 4.53; 2.18–6.88) than TA. Regarding safety, lower (peri-)esophageal injury rates (OR 0.17; 0.06–0.46) higher tamponade 2.98; 1.27-7.00) observed following PFA. In assessment, better first-pass rate 6.82; 1.37-34.01) treatment failure 0.83; 0,70-0.98). Subgroup analysis showed no differences PersAF PAF; CB related (peri)esophageal injury, success, time.ConclusionCompared TA, results significant procedural data.

Language: Английский

Citations

18