Heart rhythm最新文献

筛选
英文 中文
Non-invasive Assessment of HydroQUInidine EffecT in Brugada Syndrome (QUIET BrS).
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-13 DOI: 10.1016/j.hrthm.2024.12.014
Julia C Isbister, Marina Strocchi, Matthew Riedy, Laura Yeates, Belinda Gray, Emma S Singer, Richard D Bagnall, Jodie Ingles, Hariharan Raju, Christopher Semsarian, Steven A Niederer, Raymond W Sy
{"title":"Non-invasive Assessment of HydroQUInidine EffecT in Brugada Syndrome (QUIET BrS).","authors":"Julia C Isbister, Marina Strocchi, Matthew Riedy, Laura Yeates, Belinda Gray, Emma S Singer, Richard D Bagnall, Jodie Ingles, Hariharan Raju, Christopher Semsarian, Steven A Niederer, Raymond W Sy","doi":"10.1016/j.hrthm.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.014","url":null,"abstract":"<p><strong>Background: </strong>Hydroquinidine reduces arrhythmic events in patients with Brugada syndrome (BrS). The mechanism by which it exerts antiarrhythmic benefit and its electrophysiological effects on BrS substrate remain incompletely understood.</p><p><strong>Objective: </strong>This study aimed to determine the effect of Hydroquinidine on ventricular depolarisation and repolarisation in patients with BrS in vivo.</p><p><strong>Methods: </strong>Twelve patients with BrS underwent electrocardiogram (standard, high-lead and signal averaged) and electrocardiographic imaging (ECGi) at baseline and \"on-treatment\" with Hydroquinidine 300mg twice daily. ST-segment elevation, activation time (AT), repolarisation time (RT) and activation-recovery intervals (ARI) were computed for the ventricles and the right ventricular outflow tract (RVOT). Serum Hydroquinidine levels were determined, and adverse drug events captured through medication survey.</p><p><strong>Results: </strong>Hydroquinidine increased RT (301.1 ± 24.1ms vs 348.8 ± 28.3ms, p <0.001), repolarisation gradients (1.1 ± 0.4 ms/mm vs 1.6 ± 0.4 ms/mm, p<0.001) and ARI (241.3 ± 18.1 ms vs 284.8 ± 21.5 ms, p<0.001) in the RVOT, with a greater change in the RVOT compared to the rest of the ventricles. In contrast, activation parameters did not change significantly on-treatment with Hydroquinidine, although there was a subtle increase in ST-segment elevation over the RVOT (1.5 ± 0.7mV vs 1.8 ± 0.8mV; P<0.001). Hydroquinidine levels did not correlate with electrophysiological changes or occurrence of adverse drug reactions. One patient developed frequent non-sustained ventricular tachycardia on-treatment with Hydroquinidine.</p><p><strong>Conclusions: </strong>Hydroquinidine primarily effects ventricular repolarisation and action potential duration (indicated by ARI) in patients with BrS and demonstrates regional variation with more significant changes in the RVOT.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Asthma is Associated with Higher Recurrence Rates of Atrial Fibrillation Following Catheter Ablation.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-12 DOI: 10.1016/j.hrthm.2024.12.011
Devin Skoll, Ree Lu, Ahmed Y Gasmelseed, Geoffrey A Rubin, Elaine Y Wan, Amardeep S Saluja, Jose M Dizon, Angelo Biviano, Hasan Garan, Hirad Yarmohammadi
{"title":"Asthma is Associated with Higher Recurrence Rates of Atrial Fibrillation Following Catheter Ablation.","authors":"Devin Skoll, Ree Lu, Ahmed Y Gasmelseed, Geoffrey A Rubin, Elaine Y Wan, Amardeep S Saluja, Jose M Dizon, Angelo Biviano, Hasan Garan, Hirad Yarmohammadi","doi":"10.1016/j.hrthm.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.011","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a known risk factor for atrial fibrillation (AF), the most common sustained arrhythmia. While radiofrequency catheter ablation is effective in treating AF, the impact of asthma and its severity on ablation outcomes has not been previously explored.</p><p><strong>Objective: </strong>To evaluate the impact of asthma and its severity on AF recurrence following ablation.</p><p><strong>Methods: </strong>In this single-center retrospective case control study, 63 cases with AF and asthma who underwent ablation were matched with 126 controls with AF but without asthma who underwent ablation. Cases were also compared to a non-ablated cohort of patients with asthma. AF recurrence was compared between groups. Univariate and multivariate analyses were conducted to determine associations with recurrence.</p><p><strong>Results: </strong>Compared to controls who underwent ablation, patients with asthma, particularly those with severe asthma, had a higher likelihood of AF recurrence following catheter ablation (OR 3.76, p=0.047 and OR 5.06, p=0.041, respectively). However, cases were not more likely to experience adverse outcomes. Multivariate analysis revealed that persistent AF and use of a beta-blocker were associated with recurrence. Patients with moderate or severe persistent asthma were more likely to have left atrial enlargement compared to patients with intermittent or mild persistent asthma (OR 2.53, p=0.009).</p><p><strong>Conclusion: </strong>Patients with AF and asthma, particularly those with severe asthma, were more likely than patients with AF but without asthma to have AF recurrence following ablation. Patients with AF and severe asthma were also more likely to have severe LAE, a known predictor of recurrence following ablation.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early versus later non-vitamin K antagonist oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation: A meta-analysis and systematic review of randomized trials. 急性缺血性脑卒中合并心房颤动患者早期口服抗凝药与晚期口服非维生素 K 拮抗剂的对比:随机试验的荟萃分析和系统回顾。
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-11 DOI: 10.1016/j.hrthm.2024.12.008
Linghua Fu, Jinzhu Hu, Pingping Yang, Qi Chen
{"title":"Early versus later non-vitamin K antagonist oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation: A meta-analysis and systematic review of randomized trials.","authors":"Linghua Fu, Jinzhu Hu, Pingping Yang, Qi Chen","doi":"10.1016/j.hrthm.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>There are conflicting published data on the optimal timing of of non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with acute ischemic stroke.</p><p><strong>Objective: </strong>To compare the efficacy and safety of early NOACs initiation with later NOACs initiation in those patients, we conducted a meta-analysis of phase III or IV randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We systematically searched the Cochrane Library, PubMed, and Embase databases. A random-effect model was selected to pool the effect measurement estimates (Risk Ratios [RRs] and 95% confidence intervals [CIs]).</p><p><strong>Results: </strong>Three RCTs with 6,442 enrolled patients with AF and acute ischemic stroke were included. Compared with later NOAC therapy, early NOACs therapy was associated with non-significant reductions in the risk of primary outcomes (RR 0.82, 95% CI 0.65-0.1.02). Subgroup analysis showed that female patients may benefited more from early anticoagulation in reducing risk of primary outcomes than male patients (0.54, 0.35-0.83 vs 0.97, 0.63-1.50; P for interaction 0.06). Numerically lower rates of recurrent ischemic stroke (RR 0.80, 95% CI 0.56-1.15), death (RR 0.96, 95% CI 0.81-1.15), and systemic embolism (RR 0.43, 95% CI 0.16-1.11) were observed in early NOACs initiation in comparison with later NOACs initiation. There was no difference in major bleeding (RR 0.98, 95% CI 0.55-1.74), symptomatic intracranial haemorrhage (RR 0.93, 95% CI 0.43-1.96), or major extracranial bleeding (RR 0.73, 95% CI 0.28-1.95) between both groups.</p><p><strong>Conclusion: </strong>In AF patients with acute ischemic stroke, early initiation of NOACs is not inferior to later initiation of NOACs in reducing composite events, without increased hazard of bleeding, especially in female, which significantly reduce composite events.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is Aging a Modifiable Risk Factor for Atrial Fibrillation?
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-11 DOI: 10.1016/j.hrthm.2024.12.009
Jason D Roberts, Guilherme L da Rocha
{"title":"Is Aging a Modifiable Risk Factor for Atrial Fibrillation?","authors":"Jason D Roberts, Guilherme L da Rocha","doi":"10.1016/j.hrthm.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.009","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-10 DOI: 10.1016/j.hrthm.2024.12.006
Jingying Liu, Lianjun Xu, Xueyi Wu, Mo Zhang, Wen Jiang, Lianming Kang, Lei Song
{"title":"Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.","authors":"Jingying Liu, Lianjun Xu, Xueyi Wu, Mo Zhang, Wen Jiang, Lianming Kang, Lei Song","doi":"10.1016/j.hrthm.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.006","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) with tachyarrhythmias has been extensively studied in recent years. The characteristics of primary bradycardia in HCM remain largely unknown.</p><p><strong>Objective: </strong>This study aimed to comprehensively investigate the prevalence, clinical features, and prognosis of primary bradycardia in patients with HCM in a large cohort.</p><p><strong>Methods: </strong>A total of 1055 HCM patients with electrocardiogram results were recruited by Fuwai Hospital between 1999 and 2019. The study end point were all-cause death, cardiovascular death, and heart failure (HF)-related death.</p><p><strong>Results: </strong>1003 HCM patients were included in the final analysis, of whom 86 were identified as having primary bradycardia. Of those, 54 patients had sinus node dysfunction (SND) and 43 patients had atrioventricular block (AVB), of whom 11 patients had both SND and AVB. Fibrosis was more severe in patients with primary bradycardia in HCM, and the patterns of fibrosis were different. Median follow-up was 6.8 years. SND-only and AVB-only were significantly associated with an increased risk of all-cause death (SND-only: adjusted hazard ratio [aHR], 2.219, P=0.012; AVB-only: aHR, 2.425, P=0.007), cardiovascular death (SND-only: aHR, 2.737, P=0.019; AVB-only: aHR, 3.853, P<0.001), and HF-related death (SND-only: aHR, 4.217, P=0.027; AVB-only: aHR, 9.367, P<0.001). The coexistence of SND and AVB was associated with an even worse prognosis than SND or AVB alone.</p><p><strong>Conclusions: </strong>Primary bradycardia, including SND and AVB, independently increases the risk of all-cause death, cardiovascular death and HF-related death in patients with HCM. Our study provides an important reference for understanding the full picture of HCM patients with primary bradycardia.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Stakes and High Voltage: The Real Costs of Pulsed Field Ablation: A response to "Cost, efficiency, and outcomes of pulsed-field ablation vs thermal ablation for atrial fibrillation: A real-world study."
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-06 DOI: 10.1016/j.hrthm.2024.11.054
Aashish Katapadi, Jalaj Garg, Rajesh Kabra, Dhanunjaya Lakkireddy
{"title":"High Stakes and High Voltage: The Real Costs of Pulsed Field Ablation: A response to \"Cost, efficiency, and outcomes of pulsed-field ablation vs thermal ablation for atrial fibrillation: A real-world study.\"","authors":"Aashish Katapadi, Jalaj Garg, Rajesh Kabra, Dhanunjaya Lakkireddy","doi":"10.1016/j.hrthm.2024.11.054","DOIUrl":"10.1016/j.hrthm.2024.11.054","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcomes of catheter ablation compared with medical therapy in atrial fibrillation.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-06 DOI: 10.1016/j.hrthm.2024.12.002
Yong-Giun Kim, Sunjidatul Islam, Douglas C Dover, Marc W Deyell, Nathaniel M Hawkins, Roopinder K Sandhu, John L Sapp, Jason G Andrade, Padma Kaul, Ratika Parkash
{"title":"Long-term outcomes of catheter ablation compared with medical therapy in atrial fibrillation.","authors":"Yong-Giun Kim, Sunjidatul Islam, Douglas C Dover, Marc W Deyell, Nathaniel M Hawkins, Roopinder K Sandhu, John L Sapp, Jason G Andrade, Padma Kaul, Ratika Parkash","doi":"10.1016/j.hrthm.2024.12.002","DOIUrl":"10.1016/j.hrthm.2024.12.002","url":null,"abstract":"<p><strong>Background: </strong>The long-term effects of catheter ablation (CA) compared with medical therapy on cardiovascular outcomes for atrial fibrillation (AF) remain undetermined.</p><p><strong>Objective: </strong>Using a population-based cohort, we sought to determine what the association between CA and medical therapy was on these outcomes.</p><p><strong>Methods: </strong>By use of Alberta administrative data, patients with AF as the primary diagnosis during hospitalization, emergency department visit, or physician visit were included between October 1, 2008, and March 31, 2018. Based on therapy received, patients were assigned to categories of CA, rate control, or rhythm control with medication. The association of treatment with the primary composite outcome of all-cause death, hospitalization for heart failure, or stroke was examined after adjustment for age, sex, comorbidities, and baseline medications.</p><p><strong>Results: </strong>Of 39,966 treated AF patients, 2077 (5.2%), 29,467 (73.7%), and 8422 (21.1%) were treated with CA, rate control, and rhythm control with medication, respectively. Patients in the CA group had a lower incidence of the primary outcome (4.0/100 person-years) compared with the rate control group (8.7/100 person-years) or the rhythm control with medication group (6.8/100 person-years) during a median follow-up of 6.3 years. In multivariable analysis, compared with CA, both rate control (hazard ratio, 1.28; 95% confidence interval, 1.09-1.50) and rhythm control with medication (hazard ratio, 1.21; 95% confidence interval, 1.03-1.43) were associated with a higher risk of the primary outcome.</p><p><strong>Conclusion: </strong>In this cohort study, patients who received CA demonstrated a reduction in the risk of long-term adverse cardiovascular outcomes compared with medical therapy in patients with AF, providing some data to indicate the effects of CA in the long-term.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transesophageal 3-Dimensional Echocardiographic Guidance for Pacemaker Lead Placement Improves Lead Position Accuracy and Reduces Fluoroscopy.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-06 DOI: 10.1016/j.hrthm.2024.12.003
Dale A Burkett, Martin Runciman, Pei-Ni Jone, Kathryn K Collins, Dustin B Nash, Johannes C von Alvensleben
{"title":"Transesophageal 3-Dimensional Echocardiographic Guidance for Pacemaker Lead Placement Improves Lead Position Accuracy and Reduces Fluoroscopy.","authors":"Dale A Burkett, Martin Runciman, Pei-Ni Jone, Kathryn K Collins, Dustin B Nash, Johannes C von Alvensleben","doi":"10.1016/j.hrthm.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.003","url":null,"abstract":"<p><strong>Background: </strong>Pacemaker and implantable cardioverter-defibrillator (ICD) lead placement traditionally uses fluoroscopy, often with inaccurate lead placement on the free-wall rather than the ventricular septum, with associated longer QRS duration and pacemaker-induced cardiomyopathy, while exposing staff and patients to radiation.</p><p><strong>Objective: </strong>We sought to determine if transesophageal 3D echocardiography (3DE) guidance: 1) improves lead placement accuracy in the ventricular septum, 2) results in shorter paced QRS durations, and 3) reduces fluoroscopy exposure.</p><p><strong>Methods: </strong>In a single center case-control study, 3DE guided right ventricular (RV) and/or atrial pacemaker & ICD leads to the desired location, with fluoroscopy used per operator preference. Ventricular lead location, paced QRS duration, and fluoroscopy times were recorded and compared to historical controls that used only fluoroscopy during procedures.</p><p><strong>Results: </strong>In 59 patients, 3DE guidance substantially improved ventricular lead placement in the septum (78.4% vs 29.8%, P<0.001), rather than the free-wall (3.9% vs 57.4%, P<0.001) compared to 72 historical controls; this difference was more pronounced when only pacemaker leads were considered (90.2% vs 39.4%, P<0.001 for septal and 2.4% vs 45.5%, P<0.001 for free-wall locations). 3DE guidance reduced fluoroscopy times (6.6 vs 11.2 min for all leads, P=0.005, and 4.7 vs 9.5 for RV leads, P=0.014), compared to controls (respectively), and trended towards shorter paced QRS durations (133 msec vs 141.5 msec, P=0.084).</p><p><strong>Conclusions: </strong>3DE guidance for pacemaker and ICD lead placement substantially improves the accuracy of lead placement in the septum, with a shorter QRS duration, while reducing fluoroscopy exposure.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Author's Reply to High Stakes and High Voltage: The Real Costs of Pulsed Field Ablation.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-06 DOI: 10.1016/j.hrthm.2024.12.005
Peter Calvert, Mark T Mills, Vishal Luther, Dhiraj Gupta
{"title":"Author's Reply to High Stakes and High Voltage: The Real Costs of Pulsed Field Ablation.","authors":"Peter Calvert, Mark T Mills, Vishal Luther, Dhiraj Gupta","doi":"10.1016/j.hrthm.2024.12.005","DOIUrl":"10.1016/j.hrthm.2024.12.005","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bleeding, stroke, and mortality risk of patients with septic shock receiving anticoagulation for atrial fibrillation.
IF 5.6 2区 医学
Heart rhythm Pub Date : 2024-12-06 DOI: 10.1016/j.hrthm.2024.12.001
Sahitya Allam, Jonathan Na, Joanne Moon, Yash Desai, Christopher Messner, Robert Potenza, Mark Sonbol, Faisal Abushullaih, Abdullah Aljudaibi, Maria Abraham, Kevin Chen, Ethan Kotloff, Simin Hossain, Elnaz Esmati, Thomas Kutner, Gregory Norcross, James Childress, Paul Han, Ian Welch, Michael Sokolow, Vincent See, Libin Wang
{"title":"Bleeding, stroke, and mortality risk of patients with septic shock receiving anticoagulation for atrial fibrillation.","authors":"Sahitya Allam, Jonathan Na, Joanne Moon, Yash Desai, Christopher Messner, Robert Potenza, Mark Sonbol, Faisal Abushullaih, Abdullah Aljudaibi, Maria Abraham, Kevin Chen, Ethan Kotloff, Simin Hossain, Elnaz Esmati, Thomas Kutner, Gregory Norcross, James Childress, Paul Han, Ian Welch, Michael Sokolow, Vincent See, Libin Wang","doi":"10.1016/j.hrthm.2024.12.001","DOIUrl":"10.1016/j.hrthm.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the effects of therapeutic anticoagulation (AC) on stroke and bleeding risk in patients with sepsis-induced atrial fibrillation (AF).</p><p><strong>Objective: </strong>This study aimed to determine the effect of therapeutic AC on the development of inpatient strokes and significant bleeding in hospitalized patients with septic shock and AF.</p><p><strong>Methods: </strong>This single-center, retrospective study examined 604 patients with septic shock and AF. The total AF population was further subdivided into new-onset AF. Propensity score matching was used to match patients with similar comorbidities who received and did not receive AC. The risks of bleeding, in-hospital stroke, increased length of stay, and mortality were compared between propensity score-matched cohorts.</p><p><strong>Results: </strong>Bleeding Academic Research Consortium 2 and 3a bleeding events were the most common. After propensity score matching, the relative risk of bleeding on AC was not significantly higher in either group (AF, 1.33 [95% confidence interval, 0.81-2.17]; new-onset AF, 1.60 [95% confidence interval, 0.72-3.54]). AC also did not decrease the number of ischemic strokes (AF, 1.34% with AC vs 1.34% without AC [P = 1]; new-onset AF, 0.89% with AC vs 1.79% without AC [P = .56]). There was significantly reduced mortality of patients who received AC (AF, 52.35% with AC vs 66.44% without AC [P = .01]; new-onset AF, 46.43% with AC vs 66.07% without AC [P = .04]).</p><p><strong>Conclusion: </strong>In patients with septic shock and AF, AC was not associated with a higher incidence of bleeding or lowering of in-hospital strokes but was associated with decreased mortality, potentially protecting against disseminated intravascular coagulopathy or other embolic phenomena.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信