13 results on '"Turakhia, Mintu P"'
Search Results
2. Termination of persistent atrial fibrillation by ablating sites that control large atrial areas
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Bhatia, Neal K, Rogers, Albert J, Krummen, David E, Hossainy, Samir, Sauer, William, Miller, John M, Alhusseini, Mahmood I, Peszek, Adam, Armenia, Erin, Baykaner, Tina, Brachmann, Johannes, Turakhia, Mintu P, Clopton, Paul, Wang, Paul J, Rappel, Wouter-Jan, and Narayan, Sanjiv M
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Focal ,Drivers ,Clinical Sciences ,Electric Countershock ,Multiwavelet re-entry ,Middle Aged ,Ablation ,Cardiovascular ,Atrial fibrillation ,Rotational ,Heart Disease ,Cardiovascular System & Hematology ,Catheter Ablation ,Mechanisms ,Humans ,Heart Atria ,Aged - Abstract
AimsPersistent atrial fibrillation (AF) has been explained by multiple mechanisms which, while they conflict, all agree that more disorganized AF is more difficult to treat than organized AF. We hypothesized that persistent AF consists of interacting organized areas which may enlarge, shrink or coalesce, and that patients whose AF areas enlarge by ablation are more likely to respond to therapy.Methods and resultsWe mapped vectorial propagation in persistent AF using wavefront fields (WFF), constructed from raw unipolar electrograms at 64-pole basket catheters, during ablation until termination (Group 1, N = 20 patients) or cardioversion (Group 2, N = 20 patients). Wavefront field mapping of patients (age 61.1 ± 13.2 years, left atrium 47.1 ± 6.9 mm) at baseline showed 4.6 ± 1.0 organized areas, each separated by disorganization. Ablation of sites that led to termination controlled larger organized area than competing sites (44.1 ± 11.1% vs. 22.4 ± 7.0%, P
- Published
- 2020
3. Comparison of Patient-Reported Care Satisfaction, Quality of Warfarin Therapy, and Outcomes of Atrial Fibrillation: Findings From the ORBIT - AF Registry
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Perino, Alexander C, Shrader, Peter, Turakhia, Mintu P, Ansell, Jack E, Gersh, Bernard J, Fonarow, Gregg C, Go, Alan S, Kaiser, Daniel W, Hylek, Elaine M, Kowey, Peter R, Singer, Daniel E, Thomas, Laine, Steinberg, Benjamin A, Peterson, Eric D, Piccini, Jonathan P, and Mahaffey, Kenneth W
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Male ,Time Factors ,Hemorrhage ,patient-centered care ,Cardiorespiratory Medicine and Haematology ,patient-reported outcome ,Medication Adherence ,patient‐centered care ,Atrial Fibrillation ,80 and over ,Humans ,International Normalized Ratio ,Patient Reported Outcome Measures ,Mortality ,anticoagulation ,Aged ,Quality of Health Care ,patient‐reported outcome ,Age Factors ,Anticoagulants ,Middle Aged ,Hospitalization ,Stroke ,warfarin ,Patient Satisfaction ,Multivariate Analysis ,Female ,Anti-Arrhythmia Agents - Abstract
Background Patient satisfaction with therapy is an important metric of care quality and has been associated with greater medication persistence. We evaluated the association of patient satisfaction with warfarin therapy to other metrics of anticoagulation care quality and clinical outcomes among patients with atrial fibrillation ( AF ). Methods and Results Using data from the ORBIT - AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry, patients were identified with AF who were taking warfarin and had completed an Anti-Clot Treatment Scale ( ACTS ) questionnaire, a validated metric of patient-reported burden and benefit of oral anticoagulation. Multivariate regressions were used to determine association of ACTS burden and benefit scores with time in therapeutic international normalized ratio range ( TTR ; both ≥75% and ≥60%), warfarin discontinuation, and clinical outcomes (death, stroke, major bleed, and all-cause hospitalization). Among 1514 patients with AF on warfarin therapy (75±10 years; 42% women; CHA 2 DS 2- VAS c 3.9±1.7), those most burdened with warfarin therapy were younger and more likely to be women, have paroxysmal AF , and to be treated with antiarrhythmic drugs. After adjustment for covariates, ACTS burden scores were independent of TTR ( TTR ≥75%: odds ratio, 1.01 [95% CI , 0.99-1.03]; TTR ≥60%: odds ratio, 1.01 [95% CI , 0.98-1.05]), warfarin discontinuation (odds ratio, 0.99; 95% CI , 0.97-1.01), or clinical outcomes. ACTS benefit scores were also not associated with TTR , warfarin discontinuation, or clinical outcomes. Conclusions In a large registry of patients with AF taking warfarin, ACTS scores provided independent information beyond other traditional metrics of oral anticoagulation care quality and identified patient groups at high risk for dissatisfaction with warfarin therapy.
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- 2019
4. Chronic kidney disease and arrhythmias : highlights from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
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Wanner, Christoph, Herzog, Charles A., Turakhia, Mintu P., Blankestijn, Peter J., Carrero, Juan Jesus, Clase, Catherine M., Deo, Rajat, Kasner, Scott E., Passman, Rod S., Pecoits-Filho, Roberto, Reinecke, Holger, Shroff, Gautam R., Zareba, Wojciech, Cheung, Michael, Wheeler, David C., Winkelmayer, Wolfgang C., and Conference Steering Committee
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Nephrology ,atrial fibrillation ,arrhythmia ,stroke ,chronic kidney disease ,sudden cardiac death - Published
- 2018
5. Safety and Clinical Outcomes of Catheter Ablation of Atrial Fibrillation in Patients With Chronic Kidney Disease
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Ullal, Aditya J., Kaiser, Daniel W., Fan, Jun, Schmitt, Susan, Than, Claire T., Winkelmayer, Wolfgang C., Heidenreich, Paul A., Piccini, Jonathon P., Perez, Marco V., Wang, Paul J., and Turakhia, Mintu P.
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Adult ,Male ,Time Factors ,Adolescent ,Databases, Factual ,Comorbidity ,Kaplan-Meier Estimate ,Patient Readmission ,Article ,Disease-Free Survival ,Young Adult ,Recurrence ,Risk Factors ,Atrial Fibrillation ,Humans ,Renal Insufficiency, Chronic ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Heart Failure ,Incidence ,Middle Aged ,United States ,Treatment Outcome ,Chronic Disease ,Multivariate Analysis ,Catheter Ablation ,Female - Abstract
Data regarding catheter ablation of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) is limited. We therefore assessed the association of CKD with common safety and clinical outcomes in a nationwide sample of ablation recipients.Using MarketScanOf 21,091 patients included, 1,593 (7.6%) had CKD. Patients with CKD were older (64 years vs. 59 years, P0.001) with higher CHAAmong patients selected for AF ablation, those with and without CKD had similar rates of postprocedural complications although they were more likely to be re-admitted for heart failure. CKD was not independently associated with AF hospitalization, cardioversion, and repeat ablation. These findings can inform clinical decision-making in patients with AF and CKD.
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- 2016
6. Oral Anticoagulant Therapy Prescription in Patients With Atrial Fibrillation Across the Spectrum of Stroke Risk: Insights From the NCDR PINNACLE Registry
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Marzec, Lucas N., Katz, David F., Marcus, Gregory M., Turakhia, Mintu P., Gehi, Anil K., Lubitz, Steven A., Hsu, Jonathan C., Kennedy, Kevin F., and Maddox, Thomas M.
- Abstract
IMPORTANCE: Patients with atrial fibrillation (AF) are at a proportionally higher risk of stroke based on accumulation of well-defined risk factors. OBJECTIVE: To examine the extent to which prescription of an oral anticoagulant (OAC) in US cardiology practices increases as the number of stroke risk factors increases. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional registry study of outpatients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's PINNACLE (Practice Innovation and Clinical Excellence) Registry between January 1, 2008, and December 30, 2012. As a measure of stroke risk, we calculated the CHADS2 score and the CHA2DS2-VASc score for all patients. Using multinomial logistic regression models adjusted for patient, physician, and practice characteristics, we examined the association between increased stroke risk score and prescription of an OAC. MAIN OUTCOMES AND MEASURES: The primary outcome was prescription of an OAC with warfarin sodium or a non-vitamin K antagonist OAC. RESULTS: The study cohort comprised 429 417 outpatients with AF. Their mean (SD) age was 71.3 (12.9) years, and 55.8% were male. Prescribed treatment consisted of an OAC (192 600 [44.9%]), aspirin only (111 134 [25.9%]), aspirin plus a thienopyridine (23 454 [5.5%]), or no antithrombotic therapy (102 229 [23.8%]). Each 1-point increase in risk score was associated with increased odds of OAC prescription compared with aspirin-only prescription using the CHADS2 score (adjusted odds ratio, 1.158; 95% CI, 1.144-1.172; P
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- 2016
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7. Chronic kidney disease and arrhythmias : Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
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Turakhia, Mintu P, Blankestijn, Peter J, Carrero, Juan-Jesus, Clase, Catherine M, Deo, Rajat, Herzog, Charles A, Kasner, Scott E, Passman, Rod S, Pecoits-Filho, Roberto, Reinecke, Holger, Shroff, Gautam R, Zareba, Wojciech, Cheung, Michael, Wheeler, David C, Wanner, Christoph, Winkelmayer, Wolfgang C, Conference Participants, Amann, Kerstin, Banerjee, Debasish, Bansal, Nisha, Boriani, Giuseppe, Bunch, Jared, Chan, Christopher T, Charytan, David M, Conen, David, Friedman, Allon N, Genovesi, Simonetta, Holden, Rachel M, House, Andrew A, Jadoul, Michel, Jardine, Alan G, Johnson, David W, Jun, Min, Labriola, Laura, Mark, Patrick B, McCullough, Peter A, Nolin, Thomas D, Potpara, Tatjana S, Pun, Patrick H, Ribeiro, Antonio L P, Rossignol, Patrick, Shen, Jenny I, Sood, Manish M, Tsukamoto, Yusuke, Wang, Angela Yee-Moon, Weir, Matthew R, Wetmore, James B, Wranicz, Jerzy K, Yamasaki, Hiro, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Turakhia, M, Blankestijn, P, Carrero, J, Clase, C, Deo, R, Herzog, C, Kasner, S, Passman, R, Pecoits-Filho, R, Reinecke, H, Shroff, G, Zareba, W, Cheung, M, Wheeler, D, Winkelmayer, W, Wanner, C, and Genovesi, S
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Nephrology ,Heart rhythm disorders ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Kidney ,law.invention ,Sudden cardiac death ,0302 clinical medicine ,Randomized controlled trial ,law ,Risk Factors ,atrial fibrillation ,Arrhythmia/Electrophysiology ,Treatment options ,Atrial fibrillation ,stroke ,Defibrillators, Implantable ,Current Opinion ,cardiovascular system ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Hypokalemia ,arrhythmia ,Sudden death ,sudden cardiac death ,End stage renal disease ,03 medical and health sciences ,Renal Dialysis ,Internal medicine ,Chronic kidney disease, end stage renal disease, arrhythmias, atrial fibrillation, sudden death ,medicine ,Humans ,In patient ,cardiovascular diseases ,Renal Insufficiency, Chronic ,Intensive care medicine ,Inflammation ,business.industry ,Arrhythmias, Cardiac ,medicine.disease ,Oxidative Stress ,Death, Sudden, Cardiac ,Potassium ,Hyperkalemia ,Kidney Failure, Chronic ,business ,Atrial flutter ,chronic kidney disease ,030217 neurology & neurosurgery ,Kidney disease - Abstract
Patients with chronic kidney disease (CKD) are predisposed to heart rhythm disorders, including atrial fibrillation (AF)/atrial flutter, supraventricular tachycardias, ventricular arrhythmias, and sudden cardiac death (SCD). While treatment options, including drug, device, and procedural therapies, are available, their use in the setting of CKD is complex and limited. Patients with CKD and end-stage kidney disease (ESKD) have historically been under-represented or excluded from randomized trials of arrhythmia treatment strategies,1 although this situation is changing.2 Cardiovascular society consensus documents have recently identified evidence gaps for treating patients with CKD and heart rhythm disorders.3–7 To identify key issues relevant to the optimal prevention, management, and treatment of arrhythmias and their complications in patients with kidney disease, Kidney Disease: Improving Global Outcomes (KDIGO) convened an international, multidisciplinary Controversies Conference in Berlin, Germany, titled CKD and Arrhythmias in October 2016. The conference agenda and discussion questions are available on the KDIGO website (http://kdigo.org/conferences/ckd-arrhythmias/; 13 February 2018).
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- 2018
8. Left Atrial Function Predicts Heart Failure Hospitalization in Subjects with Preserved Ejection Fraction and Coronary Heart Disease: Longitudinal Data from the Heart and Soul Study
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Welles, Christine C., Ku, Ivy A., Kwan, Damon M., Whooley, Mary A., Schiller, Nelson B., and Turakhia, Mintu P.
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heart failure with preserved ejection fraction ,left atrial functional index ,Aged, 80 and over ,Heart Failure ,Male ,heart failure hospitalization ,Coronary Disease ,Stroke Volume ,Middle Aged ,Article ,Cohort Studies ,Hospitalization ,Predictive Value of Tests ,Humans ,Atrial Function, Left ,Female ,Longitudinal Studies ,Prospective Studies ,coronary heart disease ,left atrial function ,Aged ,Follow-Up Studies ,Psychophysiology - Abstract
ObjectivesThis study sought to determine whether left atrial (LA) dysfunction predicts heart failure (HF) hospitalization in subjects with preserved baseline ejection fraction (EF).BackgroundAmong patients with preserved EF, factors leading to HF are not fully understood. Cross-sectional studies have demonstrated LA dysfunction at the time of HF, but longitudinal data on antecedent atrial function are lacking.MethodsWe performed resting transthoracic echocardiography in 855 subjects with coronary heart disease and EF ≥50%. Left atrial functional index (LAFI) was calculated as ([LA emptying fraction × left ventricular outflow tract-velocity time integral] / [indexed LA end-systolic volume]), where LA emptying fraction was defined as (LA end-systolic volume − LA end-diastolic volume) / LA end-systolic volume. We used Cox models to evaluate the association between LAFI and HF hospitalization.ResultsOver a median follow-up of 7.9 years, 106 participants (12.4%) were hospitalized for HF. Rates of HF hospitalization were inversely proportional to quartile (Q) of LAFI: Q1, 47 per 1,000 person-years; Q2, 18.3; Q3, 9.6; and Q4, 5.3 (p < 0.001). Each standard deviation decrease in LAFI was associated with a 2.6-fold increased hazard of adverse cardiovascular outcomes (unadjusted hazard ratio: 2.6, 95% confidence interval: 2.1 to 3.3, p < 0.001), and the association persisted even after adjustment for clinical risk factors, N-terminal pro–B-type natriuretic peptide, and a wide range of echocardiographic parameters (adjusted hazard ratio: 1.5, 95% confidence interval: 1.0 to 2.1, p = 0.05).ConclusionsLeft atrial dysfunction independently predicts HF hospitalization in subjects with coronary heart disease and preserved baseline EF. The LAFI may be useful for HF risk stratification, and LA dysfunction may be a potential therapeutic target.
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- 2012
9. Wolff-Parkinson-White syndrome: where is the pathway?
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Turakhia, Mintu P, Scheinman, Melvin, and Badhwar, Nitish
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Interesting ECG ,pre-excitation ,Heart Disease ,Cardiovascular System & Hematology ,coronary sinus ablation ,Medical Physiology ,cardiovascular system ,cardiovascular diseases ,accessory pathway ,Cardiovascular ,ablation ,Heart Disease - Coronary Heart Disease ,Wolff-Parkinson-White - Abstract
A 31-year old male presented with atrial fibrillation and ventricular preexcitation that was positive in leads V1-V4, negative in lead II, and positive in lead AVR. The patient was cardioverted and invasive electrophysiologic study was performed. Based on the ECG findings, the coronary sinus and its branches were interrogated during orthodromic atrioventricular reentrant tachycardia. The earliest local activation was seen in the true coronary sinus lumen at the bifurcation of the posterolateral branch. Radiofrequency energy application at this area led to loss of preexcitation. When localizing left septal and posterior accessory pathways, ventricular preexcitation that is both negative in II and positive in AVR has been shown in previous studies to be highly sensitive and specific for a subepicardial location. Therefore, investigation of the coronary sinus and its branches may allow for effective ablation without the need for left ventricular access.
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- 2009
10. Increased Mortality Associated With Digoxin in Contemporary Patients With Atrial Fibrillation Findings From the TREAT-AF Study
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Turakhia, Mintu P., Santangeli, Pasquale, Winkelmayer, Wolfgang C., Xu, Xiangyan, Ullal, Aditya J., Than, Claire T., Schmitt, Susan, Holmes, Tyson H., Frayne, Susan M., Phibbs, Ciaran S., Yang, Felix, Hoang, Donald D., Ho, P. Michael, and Heidenreich, Paul A.
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safety ,atrial fibrillation ,digoxin ,mortality - Abstract
BackgroundDespite endorsement of digoxin in clinical practice guidelines, there exist limited data on its safety in atrial fibrillation/flutter (AF).ObjectivesThe goal of this study was to evaluate the association of digoxin with mortality in AF.MethodsUsing complete data of the TREAT-AF (The Retrospective Evaluation and Assessment of Therapies in AF) study from the U.S. Department of Veterans Affairs (VA) healthcare system, we identified patients with newly diagnosed, nonvalvular AF seen within 90 days in an outpatient setting between VA fiscal years 2004 and 2008. We used multivariate and propensity-matched Cox proportional hazards to evaluate the association of digoxin use with death. Residual confounding was assessed by sensitivity analysis.ResultsOf 122,465 patients with 353,168 person-years of follow-up (age 72.1 ± 10.3 years, 98.4% male), 28,679 (23.4%) patients received digoxin. Cumulative mortality rates were higher for digoxin-treated patients than for untreated patients (95 vs. 67 per 1,000 person-years; p < 0.001). Digoxin use was independently associated with mortality after multivariate adjustment (hazard ratio [HR]: 1.26, 95% confidence interval [CI]: 1.23 to 1.29, p < 0.001) and propensity matching (HR: 1.21, 95% CI: 1.17 to 1.25, p < 0.001), even after adjustment for drug adherence. The risk of death was not modified by age, sex, heart failure, kidney function, or concomitant use of beta-blockers, amiodarone, or warfarin.ConclusionsDigoxin was associated with increased risk of death in patients with newly diagnosed AF, independent of drug adherence, kidney function, cardiovascular comorbidities, and concomitant therapies. These findings challenge current cardiovascular society recommendations on use of digoxin in AF.
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11. Research Priorities in Atrial Fibrillation Screening
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Benjamin, Emelia J., Go, Alan S., Desvigne-Nickens, Patrice, Anderson, Christopher D., Casadei, Barbara, Chen, Lin Y., Crijns, Harry J.G.M., Freedman, Ben, Hills, Mellanie True, Healey, Jeff S., Kamel, Hooman, Kim, Dong-Yun, Link, Mark S., Lopes, Renato D., Lubitz, Steven A., McManus, David D., Noseworthy, Peter A., Perez, Marco V., Piccini, Jonathan P., Schnabel, Renate B., Singer, Daniel E., Tieleman, Robert G., Turakhia, Mintu P., Van Gelder, Isabelle C., Cooper, Lawton S., and Al-Khatib, Sana M.
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12. Screening for Atrial Fibrillation
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Freedman, Ben, Camm, John, Calkins, Hugh, Healey, Jeffrey S., Rosenqvist, Mårten, Wang, Jiguang, Albert, Christine M., Anderson, Craig S., Antoniou, Sotiris, Benjamin, Emelia J., Boriani, Giuseppe, Brachmann, Johannes, Brandes, Axel, Chao, Tze-Fan, Conen, David, Engdahl, Johan, Fauchier, Laurent, Fitzmaurice, David A., Friberg, Leif, Gersh, Bernard J., Gladstone, David J., Glotzer, Taya V., Gwynne, Kylie, Hankey, Graeme J., Harbison, Joseph, Hillis, Graham S., Hills, Mellanie T., Kamel, Hooman, Kirchhof, Paulus, Kowey, Peter R., Krieger, Derk, Lee, Vivian W. Y., Levin, Lars-Åke, Lip, Gregory Y. H., Lobban, Trudie, Lowres, Nicole, Mairesse, Georges H., Martinez, Carlos, Neubeck, Lis, Orchard, Jessica, Piccini, Jonathan P., Poppe, Katrina, Potpara, Tatjana S., Puererfellner, Helmut, Rienstra, Michiel, Sandhu, Roopinder K., Schnabel, Renate B., Siu, Chung-Wah, Steinhubl, Steven, Svendsen, Jesper H., Svennberg, Emma, Themistoclakis, Sakis, Tieleman, Robert G., Turakhia, Mintu P., Tveit, Arnljot, Uittenbogaart, Steven B., Van Gelder, Isabelle C., Verma, Atul, Wachter, Rolf, Yan, Bryan P., Al Awwad, A, Al-Kalili, F, Berge, T, Breithardt, G, Bury, G, Caorsi, WR, Chan, NY, Chen, SA, Christophersen, I, Connolly, S, Crijns, H, Davis, S, Dixen, U, Doughty, R, Du, X, Ezekowitz, M, Fay, M, Frykman, V, Geanta, M, Gray, H, Grubb, N, Guerra, A, Halcox, J, Hatala, R, Heidbuchel, H, Jackson, R, Johnson, L, Kaab, S, Keane, K, Kim, YH, Kollios, G, Løchen, ML, Ma, C, Mant, J, Martinek, M, Marzona, I, Matsumoto, K, McManus, D, Moran, P, Naik, N, Ngarmukos, T, Prabhakaran, D, Reidpath, D, Ribeiro, A, Rudd, A, Savalieva, I, Schilling, R, Sinner, M, Stewart, S, Suwanwela, N, Takahashi, N, Topol, E, Ushiyama, S, Verbiest van Gurp, N, Walker, N, and Wijeratne, T
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13. Reply Increased Mortality by Digoxin in Patients With Atrial Fibrillation?
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Turakhia, Mintu P. and Heidenreich, Paul A.
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