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Manzo-Silberman S, Chouihed T, Fraticelli L, Charpentier S, Claustre C, Bonnefoy-Cudraz E, Elbaz M, Peiretti A, Taboulet P, Waintraub X, Roubille F, El Khoury C. Assessment of atrial fibrillation in European emergency departments: insights from a prospective observational multicenter study. Minerva Cardiol Angiol 2023; 71:444-455. [PMID: 36422468 DOI: 10.23736/s2724-5683.22.06179-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The diagnosis and management of atrial fibrillation (AF) in emergency departments (EDs) have not been well described in France, with limited EU research. This study aimed to describe the diagnosis, management, and prognosis of AF patients in French EDs. METHODS A prospective, observational 2-month study in adults diagnosed with AF was conducted at 32 French EDs. Data regarding patient characteristics, diagnosis, and treatment at EDs were collected, with 12-month follow-up. RESULTS The study included a total of 1369 patients diagnosed with AF at an ED: 279 patients (20.4%) with idiopathic AF (no identified cause of the AF) and 1090 (79.6%) with secondary AF (with a principal diagnosis identified as the cause of AF). Patients were aged 84 years (median) and 51.3% were female. Significantly more idiopathic AF patients than secondary AF patients underwent CHA<inf>2</inf>DS<inf>2</inf>-VASc assessment (67.8% vs. 52.1%,) or echocardiography (21.2% vs. 8.3%), or received an oral anticoagulant and/or antiarrhythmic (62.0% vs. 12.9%). Idiopathic AF patients also had significantly higher rates of discharge to home (36.4% vs. 20.4%) and 3-month cardiologist follow-up (67.0% vs. 41.1%). At 12 months, 96% of patients with follow-up achieved sinus rhythm. The estimated Kaplan-Meier 12-month mortality rate was significantly lower with idiopathic AF than secondary AF (11.9% vs. 34.5%). CONCLUSIONS Patients diagnosed with idiopathic or secondary AF at the ED presented heterogeneous characteristics and prognoses, with those with secondary AF having worse outcomes. Further studies are warranted to optimize patients' initial evaluation in EDs and provide appropriate follow-up.
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Affiliation(s)
- Stéphane Manzo-Silberman
- Institute of Cardiology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, ACTION Study Group, Paris, France -
| | - Tahar Chouihed
- Emergency Department, University Hospital of Nancy, University of Lorraine, Vandoeuvre-les-Nancy, France
- Cliniques-Inserm 1433 Investigation Center, Inserm UMR_S 1116, F-CRIN INI-CRCT, Vandoeuvre-les-Nancy, France
| | - Laurie Fraticelli
- Auvergne Rhône-Alpes Agency for Health, RESCUe Network, Lyon, France
- EA4129, Systemic Health Pathway Laboratory, Lyon, France
| | | | - Clément Claustre
- Auvergne Rhône-Alpes Agency for Health, RESCUe Network, Lyon, France
| | | | - Meyer Elbaz
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | | | - Pierre Taboulet
- Emergency Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - Xavier Waintraub
- Institute of Cardiology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, ACTION Study Group, Paris, France
| | - François Roubille
- Department of Cardiology, Montpellier University Hospital, Montpellier, France
| | - Carlos El Khoury
- Clinical Research Unit, Emergency Department, Médipôle Hôpital Mutualiste, Lyon, France
- HESPER EA7425, University Lyon1, Lyon, France
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From Bench to Bedside—Implementing the New ABC Approach for Atrial Fibrillation in an Emergency Department Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084797. [PMID: 35457664 PMCID: PMC9031451 DOI: 10.3390/ijerph19084797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023]
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Evaluación del tratamiento de la fibrilación auricular valvular y no valvular y su relación con eventos adversos en pacientes hospitalizados en el servicio de urgencias de un hospital de tercer nivel. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Nadimi AE, Ebrahimipour SY, Afshar EG, Falahati-Pour SK, Ahmadi Z, Mohammadinejad R, Mohamadi M. Nano-scale drug delivery systems for antiarrhythmic agents. Eur J Med Chem 2018; 157:1153-1163. [PMID: 30189397 DOI: 10.1016/j.ejmech.2018.08.080] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/08/2018] [Accepted: 08/27/2018] [Indexed: 12/20/2022]
Abstract
Arrhythmia means the heart is beating too fast, too slow, or with an irregular pattern. Due to the side effects and low bioavailability of many antiarrhythmic drugs, nano-encapsulation has been widely used for their targeted delivery. Lipid nanocapsules, nano liposomes, nano niosomes, solid lipid nanoparticles and polymeric nanoparticles are common nano-carriers used for this purpose. The aim of this article is to summarize some of nano systems used for the specific delivery of antiarrhythmic agents to target tissues. At first, nanotechnology and its applications in drug delivery are described in brief. Then, some information on arrhythmias and antiarrhythmic drugs are provided. Finally, the nano drug delivery systems are explained and examples of their applications in encapsulation of antiarrhythmic drugs are presented.
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Affiliation(s)
- Ali Esmaeili Nadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Dept. of Cardiology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - S Yousef Ebrahimipour
- Department of Chemistry, Faculty of Science, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Elham Ghasemipour Afshar
- Department of Microbiology, Faculty of Science, Kerman Branch, Islamic Azad University, Kerman, Iran
| | | | - Zahra Ahmadi
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Reza Mohammadinejad
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Mohamadi
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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