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2. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

Author

Giuseppe Boriani, Andreas Goette, Isabelle C. Van Gelder, Gerhard Steinbeck, Ursula Ravens, Carina Blomström-Lundqvist, Stephan Willems, Luis Mont, Paulus Kirchhof, Andreas Clemens, Nilo B. Cater, Robert Hatala, Axel Brandes, A. John Camm, Stefan Kääb, Jeroen J. Bax, Guenter Breithardt, Leif Friberg, Maria Borentain, Karl Wegscheider, Juergen Polifka, Dieter Paar, Michael Nabauer, Hein Heidbuchel, Michele Massimo Gulizia, Trudie Lobban, Ulrich Schotten, Josef Kautzner, Elaine M. Hylek, John M. Morgan, Wim Stegink, Lukas Szumowski, Paul Dorian, Jenny Horwood, Angelika Leute, Ralf Meyer, Alphons Vincent, Dobromir Dobrev, Deirdre A. Lane, Stefanie Breitenstein, Hans-Christoph Diener, Laurent M. Haegeli, Nils Edvardsson, Michael Oeff, Michael D. Ezekowitz, Lukas Kappenberger, Sergio Dubner, Gregory Y.H. Lip, Christoph Baertels, Panos E. Vardas, Martina Brueckmann, Maria Aunes-Jansson, Felix Muenzel, Maureen V Walter, Jay Millerhagen, Ludger Rosin, Kirchhof P, Lip GY, Van Gelder IC, Bax J, Hylek E, Kaab S, Schotten U, Wegscheider K, Boriani G, Brandes A, Ezekowitz M, Diener H, Haegeli L, Heidbuchel H, Lane D, Mont L, Willems S, Dorian P, Aunes-Jansson M, Blomstrom-Lundqvist C, Borentain M, Breitenstein S, Brueckmann M, Cater N, Clemens A, Dobrev D, Dubner S, Edvardsson NG, Friberg L, Goette A, Gulizia M, Hatala R, Horwood J, Szumowski L, Kappenberger L, Kautzner J, Leute A, Lobban T, Meyer R, Millerhagen J, Morgan J, Muenzel F, Nabauer M, Baertels C, Oeff M, Paar D, Polifka J, Ravens U, Rosin L, Stegink W, Steinbeck G, Vardas P, Vincent A, Walter M, Breithardt G, Camm AJ., Fysiologie, and RS: CARIM School for Cardiovascular Diseases

Subjects
Male, Heart disease, Medizin, antithrombotic therapy, Management of atrial fibrillation, outcomes, GLOMERULAR-FILTRATION-RATE, ATRIAL FIBRILLATION, BIOLOGICAL MARKERS, TREATMENT OUTCOME, Antithrombotic, Atrial Fibrillation, RADIOFREQUENCY CATHETER ABLATION, risk factors, rhythm control, early therapy, CARDIOVASCULAR INTERVENTIONS EAPCI, Atrial fibrillation, C-REACTIVE PROTEIN, VENTRICULAR SYSTOLIC DYSFUNCTION, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, Anti-Arrhythmia Agents, management, medicine.medical_specialty, Long QT syndrome, MEDLINE, Reviews, LONG-QT SYNDROME, Early Therapy, CARDIOLOGY WORKING GROUP, CEREBRAL AMYLOID ANGIOPATHY, Fibrinolytic Agents, Physiology (medical), medicine, Animals, Humans, STERILE PERICARDITIS MODEL, Intensive care medicine, LOBAR INTRACEREBRAL HEMORRHAGE, rate control, business.industry, medicine.disease, Rats, business, Risk Reduction Behavior, Fibrinolytic agent, Biomarkers
Abstract

While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper covers four chapters: (i) risk factors and risk markers for AF; (ii) pathophysiological classification of AF; (iii) relevance of monitored AF duration for AF-related outcomes; and (iv) perspectives and needs for implementing better antithrombotic therapy. Relevant published literature for each section is covered, and suggestions for the improvement of management in each area are put forward. Combined, the propositions formulate a perspective to implement comprehensive management in AF.

Published
2012
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3. Changes in medication preceding out-of-hospital cardiac arrest where resuscitation was attempted.

Author

Holmgren CM, Abdon NJ, Bergfeldt LB, Edvardsson NG, Herlitz JD, Karlsson T, Svensson LG, and Åstrand BH

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Out-of-Hospital Cardiac Arrest chemically induced, Out-of-Hospital Cardiac Arrest diagnosis, Sweden epidemiology, Time Factors, Cardiopulmonary Resuscitation trends, Drug Prescriptions, Out-of-Hospital Cardiac Arrest epidemiology, Registries
Abstract

Objective: To describe recent changes in medication preceding out-of-hospital cardiac arrest (OHCA) where resuscitation was attempted., Methods: OHCA victims were identified by the Swedish Cardiac Arrest Register and linked by means of their unique 10-digit personal identification numbers to the Prescribed Drug Register. We identified new claimed prescriptions during a 6-month period before the OHCA compared with those claimed in the period 12 to 18 months before. The 7-digit Anatomical Therapeutical Chemical codes of individual drugs were used. The study period was November 2007-January 2011., Results: OHCA victims with drugs were (1) older than those who did not claim any drugs in any period (70 ± 16 years vs. 54 ± 22 years, P < 0.001), (2) more often women (34% vs. 20%, P < 0.001), and (3) had more often a presumed cardiac etiology (67% vs. 54%, P < 0.001). The OHCA victims were less likely to have ventricular tachycardia/ventricular fibrillation as the first recorded rhythm (26% vs. 33%, P < 0.001) or to survive 1 month (9% vs. 17%, P < 0.0001). New prescriptions were claimed by 5122 (71%) of 7243 OHCA victims. The most frequently claimed new drugs were paracetamol (acetaminophen) 10.3%, furosemide 7.8%, and omeprazole 7.6%. Of drugs known or supposed to cause QT prolongation, ciprofloxacin was the most frequent (3.4%) altogether; 16% had a new claimed prescription of a drug included in the "qtdrugs.org" lists., Conclusions: Most OHCA victims had new drugs prescribed within 6 months before the event but most often intended for diseases other than cardiac. No claims can be made as to the causality.

Published
2014
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