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1. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

Author

Tzeis, Stylianos, Gerstenfeld, Edward P., Kalman, Jonathan, Saad, Eduardo, Shamloo, Alireza Sepehri, Andrade, Jason G., Barbhaiya, Chirag R., Baykaner, Tina, Boveda, Serge, Calkins, Hugh, Chan, Ngai-Yin, Chen, Minglong, Chen, Shih-Ann, Dagres, Nikolaos, Damiano, Ralph J., De Potter, Tom, Deisenhofer, Isabel, Derval, Nicolas, Di Biase, Luigi, Duytschaever, Mattias, Dyrda, Katia, Hindricks, Gerhard, Hocini, Meleze, Kim, Young-Hoon, la Meir, Mark, Merino, Jose Luis, Michaud, Gregory F., Natale, Andrea, Nault, Isabelle, Nava, Santiago, Nitta, Takashi, O’Neill, Mark, Pak, Hui-Nam, Piccini, Jonathan P., Pürerfellner, Helmut, Reichlin, Tobias, Saenz, Luis Carlos, Sanders, Prashanthan, Schilling, Richard, Schmidt, Boris, Supple, Gregory E., Thomas, Kevin L., Tondo, Claudio, Verma, Atul, and Wan, Elaine Y.

Published
2024
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2. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Author

Joglar, José, Chung, Mina, Armbruster, Anastasia, Benjamin, Emelia, Chyou, Janice, Cronin, Edmond, Deswal, Anita, Eckhardt, Lee, Goldberger, Zachary, Gopinathannair, Rakesh, Gorenek, Bulent, Hess, Paul, Hlatky, Mark, Hogan, Gail, Ibeh, Chinwe, Indik, Julia, Kido, Kazuhiko, Kusumoto, Fred, Link, Mark, Linta, Kathleen, McCarthy, Patrick, Patel, Nimesh, Patton, Kristen, Perez, Marco, Piccini, Jonathan, Russo, Andrea, Sanders, Prashanthan, Streur, Megan, Thomas, Kevin, Times, Sabrina, Tisdale, James, Valente, Anne, Van Wagoner, David, and Marcus, Gregory

Subjects
ACC/AHA Clinical Practice Guidelines, acute coronary syndrome, alcohol, anticoagulants, anticoagulation agents, antiplatelet agents, apixaban, atrial fibrillation, atrial flutter, cardioversion, catheter ablation, coronary artery disease, coronary heart disease, dabigatran, edoxaban, exercise, heart failure, hypertension, idarucizumab, left atrial appendage occlusion, myocardial infarction, obesity, percutaneous coronary intervention, pulmonary vein isolation, risk factors, rivaroxaban, sleep apnea, stents, stroke, surgical ablation, thromboembolism, warfarin, Humans, United States, Atrial Fibrillation, American Heart Association, Cardiology, Thromboembolism, Risk Factors
Abstract

AIM: The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Patients With Atrial Fibrillation provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS: A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE: Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation and the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

Published
2024

6. Diagnosis to Ablation in Persistent AF: Any Time Can Be a Good Time to Ablate

Author

Crowley, Rose, Lim, Michael W., Chieng, David, Segan, Louise, William, Jeremy, Morton, Joseph B., Lee, Geoffrey, Sparks, Paul, McLellan, Alex J., Sugumar, Hariharan, Prabhu, Sandeep, Ling, Liang-Han, Voskoboinik, Aleksandr, Pathak, Rajeev K., Sterns, Laurence, Ginks, Matthew, Sanders, Prashanthan, Kistler, Peter M., and Kalman, Jonathan M.

Published
2024
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8. Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy

Author

Claessen, Guido, De Bosscher, Ruben, Janssens, Kristel, Young, Paul, Dausin, Christophe, Claeys, Mathias, Claus, Piet, Goetschalckx, Kaatje, Bogaert, Jan, Mitchell, Amy M., Flannery, Michael D., Elliott, Adrian D., Yu, Chenglong, Ghekiere, Olivier, Robyns, Tomas, Van De Heyning, Caroline M., Sanders, Prashanthan, Kalman, Jonathan M., Ohanian, Monique, Soka, Magdalena, Rath, Emma, Giannoulatou, Eleni, Johnson, Renee, Lacaze, Paul, Herbots, Lieven, Willems, Rik, Fatkin, Diane, Heidbuchel, Hein, La Gerche, André, Van Soest, Sofie, Bekhuis, Youri, Pauwels, Rik, De Paepe, Jarne, Hespel, Peter, Dymarkowski, Steven, Dresselaers, Tom, Miljoen, Hielko, Favere, Kasper, Paelinck, Bernard, Vermeulen, Dorien, Witvrouwen, Isabel, Hansen, Dominique, Op’t Eijnde, Bert, Thijs, Daisy, Vanvoorden, Peter, Lefebvre, Kristof, D’Ambrosio, Paolo, Rowe, Stephanie, Paratz, Elizabeth, Brosnan, Maria J., and Prior, David L.

Published
2024
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10. Safety of outpatient commencement of sotalol

Author

Kamsani, Suraya H., Middeldorp, Melissa E., Chiang, Glenda, Stefil, Maria, Evans, Shaun, Nguyen, Mau T., Shahmohamadi, Elnaz, Zhang, Jessica Qingying, Roberts-Thomson, Kurt C., Emami, Mehrdad, Young, Glenn D., and Sanders, Prashanthan

Published
2024
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13. Sex-specific outcomes after catheter ablation for persistent AF

Author

Segan, Louise, Chieng, David, Crowley, Rose, William, Jeremy, Sugumar, Hariharan, Ling, Liang-Han, Hawson, Joshua, Prabhu, Sandeep, Voskoboinik, Aleksandr, Morton, Joseph B., Lee, Geoffrey, Sterns, Laurence D., Ginks, Matthew, Sanders, Prashanthan, Kalman, Jonathan M., and Kistler, Peter M.

Published
2024
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15. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Krahn, Andrew D., Andrade, Jason G., Beavers, Craig J., Bischoff, James M., Bunch, T. Jared, Campbell, Kristen Bova, Chen, Lin Yee, Dharia, Robin, Dorsch, Michael P., Gerstenfeld, Edward P., Jones, Aubrey E., Kaluzna, Stephanie Dwyer, Masha, Luke, Nault, Isabelle, Noseworthy, Peter A., Pellegrini, Cara N., Tzeis, Stylianos E., Volgman, Annabelle Santos, Zeitler, Emily P., Joglar, José A., Chung, Mina K., Armbruster, Anastasia L., Benjamin, Emelia J., Chyou, Janice Y., Cronin, Edmond M., Deswal, Anita, Eckhardt, Lee L., Goldberger, Zachary D., Gopinathannair, Rakesh, Gorenek, Bulent, Hess, Paul L., Hlatky, Mark, Hogan, Gail, Ibeh, Chinwe, Indik, Julia H., Kido, Kazuhiko, Kusumoto, Fred, Link, Mark S., Linta, Kathleen T., Marcus, Gregory M., McCarthy, Patrick M., Patel, Nimesh, Patton, Kristen K., Perez, Marco V., Piccini, Jonathan P., Russo, Andrea M., Sanders, Prashanthan, Streur, Megan M., Thomas, Kevin L., Times, Sabrina, Tisdale, James E., Valente, Anne Marie, and Van Wagoner, David R.

Published
2024
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16. Research Priorities for Atrial Fibrillation in Australia: A Statement From the Australian Cardiovascular Alliance Clinical Arrhythmia Theme

Author

Abhayaratna, Walter, Al-Falahi, Zaidon, Bell, James, Burrell, Louise, Delbridge, Lea, Elliott, Adrian, Fatkin, Diane, Ganesan, Anand, Hall, Tanya, Hendriks, Jeroen, Hill, Adam, Hsu, Meng, Jenkins, Alicia, Kalman, Jonathan, Kilkenny, Monique, Kizana, Eddy, La Gerche, Andre, McMullen, Julie, Middeldorp, Melissa, Olaiya, Muideen, Ritchie, Rebecca, Sanders, Prash, Shang, Catherine, Thijs, Vincent, Thomas, Liza, Vandenberg, Jamie, Elliott, Adrian D., Middeldorp, Melissa E., McMullen, Julie R., Gwynne, Kylie, Hill, Adam P., Hsu, Meng-Ping, Vandenberg, Jamie I., Kalman, Jonathan M., and Sanders, Prashanthan

Published
2024
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18. Prevalence, timing, and impact of early recurrence of atrial tachyarrhythmias after pulsed field ablation: A secondary analysis of the PULSED AF trial

Author

Boersma, Lucas V.A., Natale, Andrea, Haines, David, DeLurgio, David, Sood, Nitesh, Marchlinski, Francis, Calkins, Hugh, Hoyt, Robert H., Sanders, Prashanthan, Irwin, James, Packer, Douglas, Mittal, Suneet, Durrani, Sarfraz, Di Biase, Luigi, Sangrigoli, Robert, Tada, Hiroshi, Sasano, Tetsuo, Tomita, Hirofumi, Yamane, Teiichi, Kuck, Karl-Heinz, Wazni, Oussama, Tarakji, Khaldoun, Cerkvenik, Jeffrey, van Bragt, Kelly A., Abeln, Bob G.S., and Verma, Atul

Published
2024
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19. Safety, efficacy, and reliability evaluation ofa novel small-diameter defibrillation lead: Global LEADR pivotal trial results

Author

Sanders, Prashanthan, Pathak, Rajeev, Denman, Russell Allen, Mihalcz, Attila, Philippon, Francois, Tsang, Bernice, Sumner, Glenn, Chen, Minglong, Han, Xiuebin, Liu, Xingbin, Philbert, Berit Thornvig, Defaye, Pascal, Anselme, Frederic, Stellbrink, Christoph, Chan, Ngai-Yin, Tse, Hung-Fat, De Filippo, Paolo, Ando, Kenji, Kusano, Kengo, Shoda, Morio, Khelae, Surinder Kaur, Lopes do Carmo, Pedro Miguel, Milasinovic, Goran, Boey, Elaine, Anguera Camos, Ignasi, Cano Pérez, Oscar, Whinnett, Zachary, Baranowski, Bryan, Friedman, Meir, Dinerman, Jay, Schaller, Robert, Bozorgnia, Babak, Zakaib, John, Chinitz, Jason, West, Michael, Ramza, Brian, Canby, Robert, Takata, Theodore, Shah, Maully, Winner, Marshall, Wilson, David, Mason, Pamela, Richardson, Travis, Kalahasty, Gautham, Sholevar, Darius, Smith, Timothy, Crossley, George H., III, Hansky, Bert, Shah, Maully J., Richardson, Travis D., Philippon, François, Zakaib, John S., Sholevar, Darius P., Pathak, Rajeev K., Milašinović, Goran, Chinitz, Jason S., West, Michael B., Ramza, Brian M., Han, Xuebin, Carta, Roberto, Geelen, Tessa, Himes, Adam K., Platner, Megan L., Thompson, Amy E., and Mason, Pamela K.

Published
2024
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21. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Joglar, José A., Chung, Mina K., Armbruster, Anastasia L., Benjamin, Emelia J., Chyou, Janice Y., Cronin, Edmond M., Deswal, Anita, Eckhardt, Lee L., Goldberger, Zachary D., Gopinathannair, Rakesh, Gorenek, Bulent, Hess, Paul L., Hlatky, Mark, Hogan, Gail, Ibeh, Chinwe, Indik, Julia H., Kido, Kazuhiko, Kusumoto, Fred, Link, Mark S., Linta, Kathleen T., Marcus, Gregory M., McCarthy, Patrick M., Patel, Nimesh, Patton, Kristen K., Perez, Marco V., Piccini, Jonathan P., Russo, Andrea M., Sanders, Prashanthan, Streur, Megan M., Thomas, Kevin L., Times, Sabrina, Tisdale, James E., Valente, Anne Marie, and Van Wagoner, David R.

Published
2024
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23. Correlation of Extent of Left Ventricular Endocardial Unipolar Low Voltage Zones with Ventricular Tachycardia in Non-ischemic Cardiomyopathy

Author

Raja, Deep Chandh, primary, Shroff, Jenish, additional, Nair, Anugrah, additional, Abhilash, Sreevilasam P., additional, Tuan, Lukah Q., additional, Mehta, Abhinav, additional, Abhayaratna, Walter P., additional, Sanders, Prashanthan, additional, Frankel, David S., additional, Marchlinski, Francis E., additional, and Pathak, Rajeev Kumar, additional

Published
2024
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24. Catheter ablation for persistent atrial fibrillation: patterns of recurrence and impact on quality of life and health care utilization.

Author

Crowley, Rose, Chieng, David, Sugumar, Hariharan, Ling, Liang-Han, Segan, Louise, William, Jeremy, Prabhu, Sandeep, Voskoboinik, Aleksandr, Wong, Geoffrey, Morton, Joseph B, Lee, Geoffrey, McLellan, Alex J, Wong, Michael, Pathak, Rajeev K, Sterns, Laurence, Ginks, Matthew, Sanders, Prashanthan, Kalman, Jonathan M, and Kistler, Peter M

Abstract

Background and Aims Patterns of atrial fibrillation (AF) recurrence post-catheter ablation for persistent AF (PsAF) are not well described. This study aimed to describe the pattern of AF recurrence seen following catheter ablation for PsAF and the implications for healthcare utilization and quality of life (QoL). Methods This was a post-hoc analysis of the CAPLA study, an international, multicentre study that randomized patients with symptomatic PsAF to pulmonary vein isolation plus posterior wall isolation or pulmonary vein isolation alone. Patients underwent twice daily single lead ECG, implantable device monitoring or three monthly Holter monitoring. Results 154 of 333 (46.2%) patients (median age 67.3 years, 28% female) experienced AF recurrence at 12-month follow-up. Recurrence was paroxysmal in 97 (63%) patients and persistent in 57 (37%). Recurrence type did not differ between randomization groups (P =.508). Median AF burden was 27.4% in PsAF recurrence and.9% in paroxysmal AF (PAF) recurrence (P <.001). Patients with PsAF recurrence had lower baseline left ventricular ejection fraction (PsAF 50% vs. PAF 60%, P <.001) and larger left atrial volume (PsAF 54.2 ± 19.3 mL/m² vs. PAF 44.8 ± 11.6 mL/m², P =.008). Healthcare utilization was significantly higher in PsAF (45 patients [78.9%]) vs. PAF recurrence (45 patients [46.4%], P <.001) and lowest in those without recurrence (17 patients [9.5%], P <.001). Patients without AF recurrence had greater improvements in QoL as assessed by the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire (Δ33.3 ± 25.2 points) compared to those with PAF (Δ24.0 ± 25.0 points, P =.012) or PsAF (Δ13.4 ± 22.9 points, P <.001) recurrence. Conclusions AF recurrence is more often paroxysmal after catheter ablation for PsAF irrespective of ablation strategy. Recurrent PsAF was associated with higher AF burden, increased healthcare utilization and antiarrhythmic drug use. The type of AF recurrence and AF burden may be considered important endpoints in clinical trials investigating ablation of PsAF. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Sex Differences in Outcomes of an Intensive Risk Factor Modification Program in Patients With Atrial Fibrillation.

Author

Noubiap, Jean Jacques, Pathak, Rajeev K., Thomas, Gijo, Elliott, Adrian D., Sanders, Prashanthan, and Middeldorp, Melissa E.

Abstract

BACKGROUND: The outcomes of atrial fibrillation (AF) seem to be variable between males and females. We therefore aimed to determine sex differences in weight loss, cardiorespiratory fitness gain, and recurrence and progression of AF following risk factor management. METHODS: Of 1415 consecutive patients referred for electrophysiology management of AF, 825 had a body mass index of ≥27 kg/m²; after exclusions, 355 (males, 234; females, 121) were offered risk factor management and participation in a tailored exercise program. RESULTS: Females were older than males (65.5±10.4 versus 62.5±10.6 years; P=0.013) with a higher body mass index (34.1±5.4 versus 32.6±4.1 kg/m²; P=0.003) and more commonly paroxysmal AF (67.8% versus 48.3%; P<0.001). There was no sex difference in clinic attendance (58.7% versus 60%; P=0.82), weight loss (P=0.86), fitness gain (P=0.44), or improvement in AF symptoms (P=0.35). Weight loss (≥10% compared with <10%) was associated with lower total AF recurrence in males (hazard ratio, 0.41 [95% CI, 0.23–0.73]) and females (hazard ratio, 0.41 [95% CI, 0.20–0.83]). Fitness gain (≥2 metabolic equivalents compared with <2 metabolic equivalents) was associated with lower total AF recurrence in females (hazard ratio, 0.13 [95% CI, 0.05–0.30]) but not in males (hazard ratio, 0.63 [95% CI, 0.38–1.04]; P=0.002). There was a trend toward more reversal from persistent to paroxysmal AF in males compared with females (21.8% versus 14.0%; P=0.079). CONCLUSIONS: Males and females with AF demonstrate a similar degree of weight loss and fitness gain through structured risk factor management. However, fitness had a much greater benefit for total arrhythmia recurrence in females compared with males, whereas there was a trend toward more AF reversal in males. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Longer and better lives for patients with atrial fibrillation: the 9th AFNET/EHRA consensus conference

Author

Linz, Dominik, primary, Andrade, Jason G, additional, Arbelo, Elena, additional, Boriani, Giuseppe, additional, Breithardt, Guenter, additional, Camm, A John, additional, Caso, Valeria, additional, Nielsen, Jens Cosedis, additional, De Melis, Mirko, additional, De Potter, Tom, additional, Dichtl, Wolfgang, additional, Diederichsen, Søren Zoega, additional, Dobrev, Dobromir, additional, Doll, Nicolas, additional, Duncker, David, additional, Dworatzek, Elke, additional, Eckardt, Lars, additional, Eisert, Christoph, additional, Fabritz, Larissa, additional, Farkowski, Michal, additional, Filgueiras-Rama, David, additional, Goette, Andreas, additional, Guasch, Eduard, additional, Hack, Guido, additional, Hatem, Stéphane, additional, Haeusler, Karl Georg, additional, Healey, Jeff S, additional, Heidbuechel, Hein, additional, Hijazi, Ziad, additional, Hofmeister, Lucas H, additional, Hove-Madsen, Leif, additional, Huebner, Thomas, additional, Kääb, Stefan, additional, Kotecha, Dipak, additional, Malaczynska-Rajpold, Katarzyna, additional, Merino, José Luis, additional, Metzner, Andreas, additional, Mont, Lluís, additional, Ng, Ghulam Andre, additional, Oeff, Michael, additional, Parwani, Abdul Shokor, additional, Puererfellner, Helmut, additional, Ravens, Ursula, additional, Rienstra, Michiel, additional, Sanders, Prashanthan, additional, Scherr, Daniel, additional, Schnabel, Renate, additional, Schotten, Ulrich, additional, Sohns, Christian, additional, Steinbeck, Gerhard, additional, Steven, Daniel, additional, Toennis, Tobias, additional, Tzeis, Stylianos, additional, van Gelder, Isabelle C, additional, van Leerdam, Roderick H, additional, Vernooy, Kevin, additional, Wadhwa, Manish, additional, Wakili, Reza, additional, Willems, Stephan, additional, Witt, Henning, additional, Zeemering, Stef, additional, and Kirchhof, Paulus, additional

Published
2024
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30. Reply

Author

Ariyaratnam, Jonathan P., primary, Elliott, Adrian D., additional, and Sanders, Prashanthan, additional

Published
2024
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31. Procedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry

Author

Kattel, Sharma, primary, Tan, Zhen, additional, Lin, Zhenqiu, additional, Mszar, Reed, additional, Sanders, Prashanthan, additional, Zeitler, Emily P, additional, Zei, Paul C, additional, Bunch, Thomas Jared, additional, Mansour, Moussa, additional, Akar, Joseph G, additional, Curtis, Jeptha P., additional, Friedman, Daniel J., additional, and Freeman, James V., additional

Published
2024
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32. Initial clinical experience with the balloon-in-basket pulsed field ablation system: acute results of the VOLT CE mark feasibility study.

Author

Sanders, Prashanthan, Healy, Stewart, Emami, Mehrdad, Kotschet, Emily, Miller, Amber, and Kalman, Jonathan M

Abstract

Aims Pulsed field ablation (PFA) for the treatment of atrial fibrillation (AF) potentially offers improved safety and procedural efficiencies compared with thermal ablation. Opportunities remain to improve effective circumferential lesion delivery, safety, and workflow of first-generation PFA systems. In this study, we aim to evaluate the initial clinical experience with a balloon-in-basket, 3D integrated PFA system with a purpose-built form factor for pulmonary vein (PV) isolation. Methods and results The VOLT CE Mark Study is a pre-market, prospective, multi-centre, single-arm study to evaluate the safety and effectiveness of the Volt™ PFA system for the treatment of paroxysmal (PAF) or persistent AF (PersAF). Feasibility sub-study subjects underwent phrenic nerve evaluation, endoscopy, chest computed tomography, and cerebral magnetic resonance imaging. Study endpoints were the rate of primary serious adverse event within 7 days and acute procedural effectiveness. A total of 32 subjects (age 61.6 ± 9.6 years, 65.6% male, 84.4% PAF) were enrolled and treated in the feasibility sub-study and completed a 30-day follow-up. Acute effectiveness was achieved in 99.2% (127/128) of treated PVs (96.9% of subjects, 31/32) with 23.8 ± 4.2 PFA applications/subject. Procedure, fluoroscopy, LA dwell, and transpired ablation times were 124.6 ± 28.1, 19.8 ± 8.9, 53.0 ± 21.0, and 48.0 ± 19.9 min, respectively. Systematic assessments of initial safety revealed no phrenic nerve injury, pulmonary vein stenosis, or oesophageal lesions causally related to the PFA system and three subjects with silent cerebral lesions (9.4%). There were no primary serious adverse events. Conclusion The initial clinical use of the Volt PFA System demonstrates acute safety and effectiveness in the treatment of symptomatic, drug refractory AF. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Pre‐stroke anticoagulation for atrial fibrillation in primary English speakers and non‐primary English speakers: a multicentre retrospective cohort study.

Author

Bacchi, Stephen, Kovoor, Joshua G., Goh, Rudy, Gupta, Aashray K., Tan, Sheryn, Ovenden, Christopher D., To, Minh‐Son, Moey, Andrew, Sanders, Prashanthan, Chew, Derek P., Schultz, David, Kovoor, Pramesh, Kleinig, Timothy, and Jannes, Jim

Subjects
ANTICOAGULANTS, LANGUAGE & languages, PATIENT compliance, PRIMARY health care, RETROSPECTIVE studies, LONGITUDINAL method, ODDS ratio, ATRIAL fibrillation, RESEARCH, MEDICAL records, ACQUISITION of data, STROKE, DRUGS, STROKE patients, CONFIDENCE intervals
Abstract

Background: Anticoagulation can prevent most strokes in individuals with atrial fibrillation (AF); however, many people presenting with stroke and known AF are not anticoagulated. Language barriers and poor health literacy have previously been associated with decreased patient medication adherence. The association between language barriers and initiation of anticoagulation therapy for AF is uncertain. Aims: The aims of this study were to determine whether demographic factors, including non‐English primary language, were (1) associated with not being initiated on anticoagulation for known AF prior to admission with stroke, and (2) associated with non‐adherence to anticoagulation in the setting of known AF prior to admission with stroke. Methods: A multicentre retrospective cohort study was conducted for consecutive individuals admitted to the three South Australian tertiary hospitals with stroke units over a 5‐year period. Results: There were 6829 individuals admitted with stroke. These cases included 5835 ischaemic stroke patients, 1333 of whom had pre‐existing AF. Only 40.0% presenting with ischaemic stroke in the setting of known pre‐existing AF were anticoagulated. When controlling for demographics, socioeconomic status and past medical history (including the components of the CHADS2VASC score and anticoagulation contraindications), having a primary language other than English was associated with a lower likelihood of having been commenced on anticoagulant for known pre‐stroke AF (odds ratio: 0.52, 95% confidence interval: 0.36–0.77, P = 0.001), but was not associated with a differing likelihood of anticoagulation adherence. Conclusions: A significant proportion of patients with stroke have pre‐existing unanticoagulated AF; these rates are substantially higher if the primary language is other than English. Targeted research and interventions to minimise evidence‐treatment gaps in this cohort may significantly reduce stroke burden. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Atrial fibrillation progression after cryoablation vs. radiofrequency ablation: the CIRCA-DOSE trial.

Author

Andrade, Jason G, Deyell, Marc W, Khairy, Paul, Champagne, Jean, Leong-Sit, Peter, Novak, Paul, Sterns, Lawrence, Roux, Jean-Francois, Sapp, John, Bennett, Richard, Bennett, Matthew, Hawkins, Nathaniel, Sanders, Prashanthan, and Macle, Laurent

Subjects
ATRIAL fibrillation, CATHETER ablation, CRYOSURGERY, HEART failure, ARRHYTHMIA
Abstract

Background and Aims Atrial fibrillation (AF) is a chronic progressive disorder. Persistent forms of AF are associated with increased rates of thromboembolism, heart failure, and death. Catheter ablation modifies the pathogenic mechanism of AF progression. No randomized studies have evaluated the impact of the ablation energy on progression to persistent atrial tachyarrhythmia. Methods Three hundred forty-six patients with drug-refractory paroxysmal AF were enrolled and randomly assigned to contact-force–guided RF ablation (CF-RF ablation, 115), 4 min cryoballoon ablation (CRYO-4, 115), or 2 min cryoballoon ablation (CRYO-2, 116). Implantable cardiac monitors placed at study entry were used for follow-up. The main outcome was the first episode of persistent atrial tachyarrhythmia. Secondary outcomes included atrial tachyarrhythmia recurrence and arrhythmia burden on the implantable monitor. Results At a median of 944.0 (interquartile range [IQR], 612.5–1104) days, 0 of 115 patients (0.0%) randomly assigned to CF-RF, 8 of 115 patients (7.0%) assigned to CRYO-4, and 5 of 116 patients (4.3%) assigned to CRYO-2 experienced an episode of persistent atrial tachyarrhythmia (P =.03). A documented recurrence of any atrial tachyarrhythmia ≥30 s occurred in 56.5%, 53.9%, and 62.9% of those randomized to CF-RF, CRYO-4, and CRYO-2, respectively; P =.65. Compared with that of the pre-ablation monitoring period, AF burden was reduced by a median of 99.5% (IQR 94.0%, 100.0%) with CF-RF, 99.9% (IQR 93.3%–100.0%) with CRYO-4, and 99.1%% (IQR 87.0%–100.0%) with CRYO-2 (P =.38). Conclusions Catheter ablation of paroxysmal AF using radiofrequency energy was associated with fewer patients developing persistent AF on follow-up. [ABSTRACT FROM AUTHOR]

Published
2024
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36. LB-469803-01 LEADR IN DEFIBRILLATION: GLOBAL PIVOTAL TRIAL RESULTS OF A NOVEL, SMALL-DIAMETER DEFIBRILLATION LEAD DESIGNED FOR RELIABILITY

Author

Crossley, George H., Sanders, Prashanthan, Hansky, Bert, De Filippo, Paolo, Shah, Maully J., Shoda, Morio, Khelae, Surinder K., Richardson, Travis D., Philippon, Francois, Zakaib, John S., Tse, Hung-Fat, Sholevar, Darius P., Stellbrink, Christoph, Pathak, Rajeev K., Milasinovic, Goran R., Chinitz, Jason S., Tsang, Bernice, West, Michael B., Ramza, Brian, Han, Xuebin, Bozorgnia, Babak, Carta, Roberto, Geelen, Tessa, Himes, Adam, Platner, Megan, Thompson, Amy, and Mason, Pamela K.

Published
2024
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43. PO-03-160 IS THERE A FUTURE FOR THE 90-DAY BLANKING PERIOD AFTER PULSED FIELD ABLATION: EARLY RECURRENCES IN THE PULSED AF TRIAL

Author

Boersma, Lucas V., Natale, Andrea, Haines, David E., De Lurgio, David B., Sood, Nitesh, Marchlinski, Francis E., Calkins, Hugh, Hoyt, Robert H., Sanders, Prashanthan, Irwin, James, Packer, Douglas L., Mittal, Suneet, Durrani, Sarfraz, Di Biase, Luigi, Sangrigoli, Robert M., Tada, Hiroshi, Sasano, Tetsuo, Tomita, Hirofumi, Yamane, Teiichi, Kuck, Karl-Heinz, Wazni, Oussama M., Tarakji, Khaldoun G., Cerkvenik, Jeffrey, van Bragt, Kelly A., Abeln, Bob, and Verma, Atul

Published
2024
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44. PO-03-121 THE EFFECT OF DIAGNOSIS TO ABLATION TIME IN PATIENTS UNDERGOING CATHETER ABLATION FOR PERSISTENT ATRIAL FIBRILLATION

Author

Crowley, Rose, Chieng, David, Sugumar, Hariharan, Ling, Liang-Han, Segan, Louise, William, Jeremy, Prabhu, Sandeep, Voskoboinik, Aleksandr, Wong, Geoffrey R., Morton, Joseph B., Lee, Geoffrey, McLellan, Alex J., Wong, Michael, Pathak, Rajeev K., Sterns, Laurence D., Ginks, Matthew R., Sanders, Prashanthan, Kistler, Peter M., and Kalman, Jonathan M.

Published
2024
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45. PO-03-104 ATRIAL FIBRILLATION RECURRENCE IS MOST OFTEN PAROXYSMAL FOLLOWING CATHETER ABLATION FOR PERSISTENT ATRIAL FIBRILLATION

Author

Crowley, Rose, Chieng, David, Sugumar, Hariharan, Ling, Liang-Han, Segan, Louise, William, Jeremy, Prabhu, Sandeep, Voskoboinik, Aleksandr, Wong, Geoffrey R., Morton, Joseph B., Lee, Geoffrey, McLellan, Alex J., Wong, Michael, Pathak, Rajeev K., Sterns, Laurence D., Ginks, Matthew R., Sanders, Prashanthan, Kalman, Jonathan M., and Kistler, Peter M.

Published
2024
Full Text
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