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Background: Smartphone technologies have been recently developed to assess heart rate and rhythm, but their role in accurately detecting atrial fibrillation (AF) remains unknown. Objective: We sought to perform a meta-analysis using prospective studies comparing Smartwatch technology with current monitoring standards for AF detection (ECG, Holter, Patch Monitor, ILR). Methods: We performed a comprehensive literature search for prospective studies comparing Smartwatch technology simultaneously with current monitoring standards (ECG, Holter, and Patch monitor) for AF detection since inception to November 25th, 2019. The outcome studied was the accuracy of AF detection. Accuracy was determined with concomitant usage of ECG monitoring, Holter monitoring, loop recorder, or patch monitoring. Results: A total of 9 observational studies were included comparing smartwatch technology, 3 using single-lead ECG monitoring, and six studies using photoplethysmography with routine AF monitoring strategies. A total of 1559 patients were enrolled (mean age 63.5 years, 39.5% had an AF history). The mean monitoring time was 75.6 days. Smartwatch was non-inferior to composite ECG monitoring strategies (OR 1.06, 95% CI 0.93 - 1.21, p=0.37), composite 12 lead ECG/Holter monitoring (OR 0.90, 95% CI 0.62 - 1.30, p=0.57) and patch monitoring (OR 1.28, 95% CI 0.84 - 1.94, p=0.24) for AF detection. The sensitivity and specificity for AF detection using a smartwatch was 95% and 94%, respectively. Conclusions: Smartwatch based single-lead ECG and photoplethysmography appear to be reasonable alternatives for AF monitoring. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the predictors of warfarin use in patients with non-valvular atrial fibrillation (AF). This study was the first to be conducted in a Turkish population. Materials and methods: Patients who presented to our outpatient clinic with the diagnosis of AF between September 2008 and October 2009 were enrolled. The patients were classified according to the CHADS2 risk scoring system recommended by the AHA/ACC/ESC guidelines for the classification of stroke risk in non-valvular AF patients. The probable variables influencing the use of warfarin were determined as age, sex, income level, healthcare coverage, lifestyle, place of residence, classification of AF, hypertension, diabetes mellitus, coronary artery disease, thyrotoxicosis, cardiac insufficiency, left ventricular dysfunction, stroke risk stratification, and history of stroke or systemic embolism (SE). Results: Among the 570 patients enrolled in the study, 144 were excluded because of insufficient patient information or refusal to participate, while 101 patients were excluded due to valvular AF. Thus, the evaluation was based on 325 patients (133 males and 192 females; mean age: 65 ± 10). According to the CHADS2 scoring, 62.2% of the patients were at high risk, 26.8% were at moderate risk, and 11.1% were at low risk. Only 19.7% of the patients were on warfarin treatment. In the logistic regression analysis, a history of stroke or SE, high income level, and the presence of persistent and permanent AF were found to be positive predictors of warfarin use, while advanced age was a negative predictor of warfarin use. Conclusion: This study demonstrated that a history of stroke or SE, high income level, presence of persistent and permanent AF, and advanced age are independent predictors of warfarin use in non-valvular AF patients. [ABSTRACT FROM AUTHOR]

A patient underwent the LARIAT left atrial appendage (LAA) ligation procedurewith persistent atrial fibrillation history. The procedure was done successfully. A transthoracic echocardiography did not show pericardial effusion. The patient was examined under fluoroscopy where the tip of the drain was not in the pericardial space and contrast injection pericardial drain confirmed its location in the inferior vena cava. [ABSTRACT FROM AUTHOR]

With the expanding integration of complementary and alternative medicine (CAM) practices in conjunction with modern medicine, yoga has quickly risen to being one of the most common CAM practices across the world. Despite widespread use of yoga, limited studies are available, particularly in the setting of dysrhythmia. Preliminary studies demonstrate promising results from integration of yoga as an adjunct to medical therapy for management of dysrhythmias. In this review, we discuss the role of autonomic nervous system in cardiac arrhythmia,interaction of yoga with autonomic tone and its subsequent impact on these disease states. The role of yoga in specific disease states, and potential future direction for studies assessing the role of yoga in dysrhythmia. [ABSTRACT FROM AUTHOR]