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Mohanty S, Torlapati PG, La Fazia VM, Kurt M, Gianni C, MacDonald B, Mayedo A, Allison J, Bassiouny M, Gallinghouse GJ, Burkhardt JD, Horton R, Di Biase L, Al-Ahmad A, Natale A. Best anticoagulation strategy with and without appendage occlusion for stroke-prophylaxis in postablation atrial fibrillation patients with cardiac amyloidosis. J Cardiovasc Electrophysiol 2024; 35:1422-1428. [PMID: 38751010 DOI: 10.1111/jce.16308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis. METHODS Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke-prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC). Group 1 patients were further divided into Gr. 1A: LAAO + half-does NOAC (HD-NOAC) for 6 months followed by aspirin 81 mg/day and Gr. 1B: LAAO + HD-NOAC. In group 1 patients, with complete occlusion at the 45-day transesophageal echocardiogram, patients were switched to aspirin, 81 mg/day at 6 months. In case of leak, or dense "smoke" in the left atrium (LA) or enlarged LA, they were placed on long-term half-dose (HD) NOAC. Group 2 patients remained on full-dose NOAC during the whole study period. RESULTS A total of 92 patients were included in the analysis; group 1: 56 and group 2: 36. After the 45-day TEE, 31 patients from group 1 remained on baby-aspirin and 25 on HD NOAC. At 1-year follow-up, four stroke, one TIA and six device-thrombus were reported in group 1A, compared to none in patients in group 1B (5/31 vs. 0/25, p = .03). No bleeding events were reported in group 1, whereas group 2 had five bleeding events (one subdural hematoma, one retinal hemorrhage, and four GI bleedings). Additionally, one stroke was reported in group 2 that happened during brief discontinuation of OAC. CONCLUSION In patients with coexistent AF and amyloidosis, half-dose NOAC following LAAO was observed to be the safest stroke-prophylaxis strategy.
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Affiliation(s)
- Sanghamitra Mohanty
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Prem Geeta Torlapati
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Vincenzo Mirco La Fazia
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Merve Kurt
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
- Department of Internal Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
| | - Carola Gianni
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Bryan MacDonald
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Angel Mayedo
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - John Allison
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Mohamed Bassiouny
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - G Joseph Gallinghouse
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - John D Burkhardt
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Rodney Horton
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Luigi Di Biase
- Department of Electrophysiology, Albert Einstein College of Medicine at Montefiore Hospital, New York, New York, USA
| | - Amin Al-Ahmad
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Andrea Natale
- Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
- Department of Interventional Electrophysiology, Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA
- Department of Internal Medicine, Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Biomedicine and Prevention, Division of Cardiology, University of Tor Vergata, Rome, Italy
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Erdogan T, Erdogan O, Ozturk S, Oren MM, Karan MA, Bahat G. Non-vitamin K antagonist oral anticoagulant use at doses inappropriately lower than recommended in outpatient older adults: a real-life data. Eur Geriatr Med 2021; 12:809-816. [PMID: 33517553 DOI: 10.1007/s41999-021-00452-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND/PURPOSE There has been a rapid increase in the use of non-vitamin K-antagonist oral anticoagulants (NOAC). Current guidelines recommend dose adjustments be made in accordance with certain criteria for each NOAC. This study is aimed at determining whether or not NOAC were prescribed for non-valvular atrial fibrillation (AF) in guideline-recommended doses in community-dwelling older adults. METHODS Older adults taking NOAC for non-valvular AF presenting to a cardiology outpatient clinic for the first time were included in the study. The NOAC dose for each patient was assessed based on the recommendations of the European Society of Cardiology and were categorized as appropriate or inappropriate (low or high dose). The patients were also evaluated for demographic data, diseases, CHA2DS2-VASc score, HASBLED score, frailty and falls in the previous year. RESULTS A total of 302 older adults were included in the study, with a mean age of 75.5 ± 7.5 years. One hundred eighty-four patients (60.9%) were found to be on appropriate doses of NOAC, while 109 (36.1%) were on inappropriately low doses and nine (2.98%) were on inappropriately high doses. Accordingly, 39.1% of the AF patients were found to be on inappropriate doses of NOAC, 92.4% of which were inappropriately low. A multivariate logistic regression analysis revealed that the only factor associated with inappropriate low-dose NOAC use was patient age (OR = 1.061, 95% CI = 1.009-1.116, p = 0.022). CONCLUSION Our study suggests that the inappropriate use of lower dose NOAC may emerge as a significant problem in outpatient older adults. This inappropriate practice seems to be associated with older age rather than the diseases, CHA2DS2-VASc/HASBLED scores, frailty and presence of falls.
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Affiliation(s)
- Tugba Erdogan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Onur Erdogan
- Department of Cardiology, Istinye State Hospital, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Meryem Merve Oren
- Department of Public Health, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey.
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Measurement reliability of automated oscillometric blood pressure monitor in the elderly with atrial fibrillation: a systematic review and meta-analysis. Blood Press Monit 2020; 25:2-12. [DOI: 10.1097/mbp.0000000000000414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Iwata T, Todo K, Yamagami H, Morimoto M, Hashimoto T, Doijiri R, Furuya H. High Detection Rate of Atrial Fibrillation With Insertable Cardiac Monitor Implantation in Patients With Cryptogenic Stroke Diagnosed by Magnetic Resonance Imaging. J Stroke Cerebrovasc Dis 2019; 28:2569-2573. [PMID: 31230824 DOI: 10.1016/j.jstrokecerebrovasdis.2019.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/12/2019] [Accepted: 05/21/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Detection and treatment of atrial fibrillation (AF) is a major goal in preventing secondary stroke. Insertable cardiac monitors (ICMs) are available for diagnosis of arrhythmia monitoring in patients with cryptogenic stroke. Magnetic resonance imaging (MRI)-based diagnostic evaluation for acute ischemic stroke subtype classification is common in Japan and can be useful for specific diagnosis of cryptogenic stroke. PURPOSE We aimed to investigate the detection rate of AF with an ICM in patients with cryptogenic stroke who were diagnosed by MRI. METHODS We performed a retrospective, multicenter, observational study. AF monitoring data of an ICM (Reveal LINQ) in patients with cryptogenic stroke were registered from 5 stroke centers in Japan between October 2016 and March 2018. ICM candidates in cryptogenic stroke were diagnosed by MRI-based evaluation and selected according to the criteria proposed by the Japan Stroke Society. Detection of AF was defined as AF for longer than 120 seconds. RESULTS Eighty-four consecutive patients (64 men; aged 38-90 years) underwent ICM implantation after diagnosis of cryptogenic stroke. AF was detected in 22 of 84 (26.2%) patients with an ICM during a median follow-up of 221.5 days (range: 93-365 days). The detection rate of AF within 3 months after ICM implantation was 21.4%. CONCLUSIONS The AF detection rate with an ICM is approximately one fifth within 3 months in patients with cryptogenic stroke as diagnosed by MRI. Our data suggest that the Japanese criteria based on MRI may be useful for selecting adequate candidates for ICM implantation.
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Affiliation(s)
- Tomonori Iwata
- Department of Neurology, Tokai University, Isehara, Japan.
| | - Kenichi Todo
- Department of Neurology, Osaka University, Suita, Japan
| | - Hiroshi Yamagami
- Department of Neurology, National Cardiovascular and Cerebral Center, Suita, Japan
| | - Masafumi Morimoto
- Department of Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
| | - Tetsuya Hashimoto
- Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Ryosuke Doijiri
- Department of Neurology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Hiroyuki Furuya
- Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara, Japan
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Goldstein DR, Jalife J. Synergistic Research Between the Center of Arrhythmia Research and the Michigan Biology of Cardiovascular Aging at the University of Michigan. Circ Res 2019; 121:1221-1223. [PMID: 29122944 DOI: 10.1161/circresaha.117.311374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Daniel R Goldstein
- From the Department of Internal Medicine/Cardiovascular Medicine, University of Michigan, Ann Arbor
| | - José Jalife
- From the Department of Internal Medicine/Cardiovascular Medicine, University of Michigan, Ann Arbor.
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Beyer-Westendorf J, Camm AJ, Fox KAA, Le Heuzey JY, Haas S, Turpie AGG, Virdone S, Kakkar AK. International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER). Thromb J 2019; 17:7. [PMID: 31169831 PMCID: PMC6482585 DOI: 10.1186/s12959-019-0195-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/18/2019] [Indexed: 12/12/2022] Open
Abstract
Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world. Trial registration Unique identifier: NCT02444221. Registerd 14 May 2015; Retrospectively Registered.
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Affiliation(s)
- Jan Beyer-Westendorf
- 1Thrombosis Research Unit, Department of Medicine I, Division Haematology, University Hospital "Carl Gustav Carus" Dresden, Dresden, Germany.,2Kings Thrombosis Service, Department of Haematology, Kings College London, London, UK
| | - A John Camm
- 3Cardiology Clinical Academic Group, Molecular and Clinical Sciences Institute, St. George's University of London, London, UK
| | - Keith A A Fox
- 4Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | - Sylvia Haas
- 6Formerly Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | | | - Ajay K Kakkar
- 8Thrombosis Research Institute, London, UK.,9University College of London, London, UK
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Arcinas LA, McIntyre WF, Hayes CJ, Ibrahim OA, Baranchuk AM, Seifer CM. Atrial fibrillation in elderly patients with implantable loop recorders for unexplained syncope. Ann Noninvasive Electrocardiol 2019; 24:e12630. [PMID: 30615233 DOI: 10.1111/anec.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/17/2018] [Accepted: 12/16/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An implantable loop recorder (ILR) assists in the diagnosis of unexplained syncope and atrial fibrillation (AF). Both become prevalent with age. Limited data exist describing the incidence of AF as the diagnostic rhythm underlying syncope in the elderly. This study aims to report the incidence of AF in older adults with ILRs for unexplained syncope and identify clinical characteristics associated with AF in this population. METHODS Retrospective observational study on patients with unexplained syncope seen in syncope clinics from two Canadian centers. Participants were ≥65 years old, without a history of AF, and received an ILR for unexplained syncope. Data were collected from patient's clinic charts. Arrhythmia diagnosis was based on ILR electrocardiogram reading during syncope (symptom-rhythm correlation). Fisher's exact test and the Student's t test were used to compare participants with and without AF. RESULTS In our cohort of 222 patients, 124 were females and 98 were males. Mean age at implant was 80 ± 8 years. Arrhythmia was diagnosed in 98 patients (44.1%). Median time to diagnosis was 18 months. AF was diagnosed in 17 (7.7%) participants. There were fewer males in the AF group than the no AF group (11.8%, 46.8%, p = 0.01). Age, baseline EKG, and prevalence of hypertension, diabetes, stroke, or ischemic heart disease were not statistically different between patients with AF and without AF. CONCLUSIONS Atrial fibrillation was a common diagnostic rhythm in this cohort of adults, aged 65 and older, with ILRs for unexplained syncope. It was observed more frequently in females.
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Affiliation(s)
- Liane A Arcinas
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - William F McIntyre
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Christopher J Hayes
- Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Omar A Ibrahim
- Department of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Adrian M Baranchuk
- Department of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Colette M Seifer
- Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Yoshida K, Obokata M, Kurosawa K, Sorimachi H, Kurabayashi M, Negishi K. Effect of Sex Differences on the Association Between Stroke Risk and Left Atrial Anatomy or Mechanics in Patients With Atrial Fibrillation. Circ Cardiovasc Imaging 2016; 9:CIRCIMAGING.116.004999. [DOI: 10.1161/circimaging.116.004999] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/31/2016] [Indexed: 12/31/2022]
Abstract
Background—
Embolic stroke in atrial fibrillation is more prevalent in women than in men, yet the basis for this difference remains unclear. This study seeks to elucidate whether there are any sex differences in the relationships between stroke risk (CHADS
2
score, CHA
2
DS
2
-VASc score without a sex category, and estimated stroke rate) and left atrial (LA) anatomy or mechanics in patients with atrial fibrillation.
Methods and Results—
LA emptying fraction and global peak atrial longitudinal strain were assessed in 414 subjects with paroxysmal or persistent atrial fibrillation (156 women and 258 men). Linear regression models with an interaction term were performed to test the effect of sex difference on associations between the embolic risk and LA function or anatomy. Sensitivity analyses were performed in 228 age, heart rate, and rhythm-matched subjects (114 women and men). Women were older and had larger LA volumes and lower LA mechanics than men. Significant negative association between the CHADS
2
score and LA emptying fraction was only demonstrated in women with a significant interaction between sexes. Similar significant interactions were found in global peak atrial longitudinal strain but not in LA volume. These findings were corroborated in the comparisons against CHA
2
DS
2
-VASc score without a sex category and the estimated stroke rate. Sensitivity analyses in the matched subgroup also confirmed the robustness of these sex differences in LA emptying fraction, but less so in global peak atrial longitudinal strain.
Conclusions—
Significant sex interactions on the association between global LA function and risk stratification schemes exist, which may be a reason for the higher prevalence of embolic stroke in women.
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Affiliation(s)
- Kuniko Yoshida
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
| | - Masaru Obokata
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
| | - Koji Kurosawa
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
| | - Hidemi Sorimachi
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
| | - Masahiko Kurabayashi
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
| | - Kazuaki Negishi
- From the Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan (K.Y., M.O., K.K., H.S., M.K., K.N.); and Department of Cardiovascular Imaging, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (K.N.)
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Lin T, Du X, Bai R, Chen YW, Yu RH, Long DY, Tang RB, Sang CH, Li SN, Ma CS, Dong JZ. Long-term results of single-procedure catheter ablation for atrial fibrillationin pre- and post-menopausal women. J Geriatr Cardiol 2014; 11:120-125. [PMID: 25009561 PMCID: PMC4076451 DOI: 10.3969/j.issn.1671-5411.2014.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/28/2014] [Accepted: 04/10/2014] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To address whether menopause affects outcome of catheter ablation (CA) for atrial fibrillation (AF) by comparing the safety and long-term outcome of a single-procedure in pre- and post-menopausal women. METHODS A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women (PreM group, 94 patients, 12.7%) and the post-menopausal women (PostM group, 649 patients, 87.3%) were assessed. RESULTS The patients in the PreM group were younger (P < 0.001) and less likely to have hypertension (P < 0.001) and diabetes (P = 0.005) than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complications related to AF ablation was similar in both groups (P = 0.385). After 43 (16-108) months of follow-up, the success rate of ablation was 54.3% in the PreM group and 54.2% in the PostM group (P = 0.842). The overall freedom from atrial tachyarrhythmia recurrence was similar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. CONCLUSIONS The long-term outcomes of single-procedure CA for AF are similar in pre- and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.
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Affiliation(s)
- Tao Lin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Xing Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Rong Bai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Ying-Wei Chen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Rong-Hui Yu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - De-Yong Long
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Ri-Bo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Cai-Hua Sang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Song-Nan Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Chang-Sheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
| | - Jian-Zeng Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road, Chao Yang District, Beijing 100029, China
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Brazilian contribution to a better understanding of geriatric cardiology. J Geriatr Cardiol 2012; 9:77. [PMID: 22916050 PMCID: PMC3418893 DOI: 10.3724/sp.j.1263.2012.05291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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