Effect of antidiabetic drugs on the risk of atrial fibrillation: mechanistic insights from clinical evidence and translational studies

2020 ◽  
Author(s):  
Ting-Wei Lee ◽  
Ting-I. Lee ◽  
Yung-Kuo Lin ◽  
Yao-Chang Chen ◽  
Yu-Hsun Kao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Evidence ◽  
Antidiabetic Drugs ◽  
Translational Studies

Clinical evidence of autonomic dysfunction due to atrial fibrillation: implications for rhythm control strategy

2019 ◽  
Vol 54 (3) ◽  
pp. 299-307 ◽  
Author(s):  
Varun Malik ◽  
Douglas J. McKitrick ◽  
Dennis H. Lau ◽  
Prashanthan Sanders ◽  
Leonard F. Arnolda
Keyword(s):  
Atrial Fibrillation ◽  
Autonomic Dysfunction ◽  
Control Strategy ◽  
Clinical Evidence ◽  
Rhythm Control

Pharmacological treatment of dementia

2013 ◽  
Author(s):  
Roy W. Jones
Keyword(s):  
Atrial Fibrillation ◽  
Low Dose ◽  
Clinical Evidence ◽  
Scientific Progress ◽  
Cognitive Symptoms ◽  
Pharmacological Treatments ◽  
Behavioural Disturbance ◽  
Carotid Disease ◽  
Dose Aspirin ◽  
Low Dose Aspirin

This chapter summarises the available clinical evidence for specific pharmacological treatments for dementia with a particular emphasis on practical considerations and realistic expectations of currently available anti-dementia drugs. It covers the treatment of both cognitive and non-cognitive symptoms. The search for specific treatments for dementia has inevitably concentrated on Alzheimer’s disease (AD), partly because it is the commonest cause of dementia and partly because scientific progress has provided more potential therapeutic targets for AD than other dementias. AD is treated with AChEIs (donepezil, galantamine or rivastigmine) and the goals of treatment should be explained at the commencement of treatment. For DLB use AChEI, especially for hallucinations and other behavioural disturbance and consider memantine or increasing dose if BPSD symptoms persist. For VaD look for sources of emboli (e.g. carotid disease) and consider anticoagulation for atrial fibrillation and low dose aspirin. Ensure other relevant conditions (e.g. hypertension and diabetes) are being managed appropriately.

Vernakalant hydrochloride in the treatment of atrial fibrillation: a review of the latest clinical evidence

2011 ◽  
Vol 1 (4) ◽  
pp. 579-588 ◽  
Author(s):  
Alessandro Marinelli ◽  
Iacopo Ciccarelli ◽  
Alessandro Capucci
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Evidence

scholarly journals The Key Role of Uric Acid in Oxidative Stress, Inflammation, Fibrosis, Apoptosis, and Immunity in the Pathogenesis of Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Yawen Deng ◽  
Fei Liu ◽  
Xiaolei Yang ◽  
Yunlong Xia
Keyword(s):  
Oxidative Stress ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Clinical Evidence ◽  
Scientific Evidence ◽  
Critical Role ◽  
Adverse Outcomes

Atrial fibrillation (AF) is a highly prevalent cardiac arrhythmia that leads to numerous adverse outcomes including stroke, heart failure, and death. Hyperuricemia is an important risk factor that contributes to atrium injury and AF, but the underlying molecular mechanism remains to be elucidated. In this review, we discussed the scientific evidence for clarifying the role of hyperuricemia in the pathogenesis of AF. Experimental and Clinical evidence endorse hyperuricemia as an independent risk factor for the incidence of AF. Various in vivo and in vitro investigations showed that hyperuricemia might play a critical role in the pathogenesis of AF at different UA concentrations through the activation of oxidative stress, inflammation, fibrosis, apoptosis, and immunity.

scholarly journals Clinical Experience of Dabigatran and Rivaroxaban in Electrical Cardioversion of Atrial Fibrillation

2015 ◽  
Vol 4 ◽  
pp. 71 ◽  
Author(s):  
Charlène Coquard ◽  
Ghassan Moubarak ◽  
Mathilde Baudet ◽  
Damien Logeart ◽  
Jean-Guillaume Dillinger ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trials ◽  
Gastrointestinal Bleeding ◽  
Clinical Experience ◽  
Clinical Evidence ◽  
Oral Anticoagulants ◽  
Transoesophageal Echocardiography ◽  
Daily Practice ◽  
Electrical Cardioversion ◽  
Efficacy And Safety

<p>Patients scheduled for atrial fibrillation (AF) cardioversion were excluded from clinical trials of novel oral anticoagulants (NOACs).</p><p>We evaluated efficacy and safety of NOACs in patients undergoing electrical cardioversion for AF.</p><p>We performed a monocentric study of all patients on NOACs who underwent elective electrical cardioversion for non-valvular AF between January 2012 and December 2014. We analyzed incidence of stroke and bleeding  at 30 days.</p><p>Fifty patients were included, 28 receiving dabigatran, 22 rivaroxaban. Mean age was 65 ± 12 years. Mean CHADS2-VA2SC and HASBLED scores were 3 ± 1.8 and 2.2 ± 1.1 respectively. Transoesophageal echocardiography was performed in 41 (79%) patients, revealing a thrombus in 2 (5%). No clinical evidence of stroke occurred in the 30 days, 1 major gastrointestinal bleeding (2%) in patient on rivaroxaban (led to premature discontinuation) and 3 minor bleedings.</p><p>NOACs seem to be safe in daily practice of electrical cardioversion in our population.</p>

scholarly journals Natriuretic Peptides as Predictors of Atrial Fibrillation Recurrences Following Electrical Cardioversion

2013 ◽  
Vol 2 (2) ◽  
pp. 109 ◽  
Author(s):  
Theodoros A Zografos ◽  
Demosthenes G Katritsis ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Natriuretic Peptide ◽  
Left Atrial ◽  
Clinical Evidence ◽  
Electrical Cardioversion ◽  
Left Atrial Size ◽  
Atrial Myocardium ◽  
Atrial Size ◽  
Mechanical Stretching

Electrical cardioversion (ECV) can be effective in restoring sinus rhythm (SR) in the majority of patients with atrial fibrillation (AF). Several factors that predispose to AF recurrences, such as age, AF duration and left atrial size have been used to guide a decision for cardioversion, but increasing evidence suggests that they may be rather poor markers of left atrial structural remodeling that determines the long-term success of a rhythm control strategy. In this context, the use of easily obtainable biomarkers, such as the levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), to predict AF recurrences may be preferable. Since ANP production is associated with the extent of functional atrial myocardium, and both ANP and BNP reflect atrial pressure and mechanical stretching, these peptides are good candidate biomarkers to assess predisposition to AF recurrences. In this review we focus on the pathophysiological mechanisms and the available clinical evidence regarding the prediction of AF recurrences following successful ECV from pre-procedural ANP and BNP levels.

Clinical evidence for a dynamic atrial fibrillation substrate in sleep apnea

2019 ◽  
Vol 24 (4) ◽  
pp. 1657-1659
Author(s):  
Dominik Linz ◽  
Kadhim Kadhim ◽  
Jonathan M. Kalman ◽  
Prashanthan Sanders
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Clinical Evidence

scholarly journals The Intrinsic Autonomic Nervous System in Atrial Fibrillation: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Bo He ◽  
Benjamin J. Scherlag ◽  
Hiroshi Nakagawa ◽  
Ralph Lazzara ◽  
Sunny S. Po
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Clinical Evidence ◽  
Critical Role ◽  
Pulmonary Veins ◽  
Atrial Remodeling ◽  
Success Rates ◽  
Minimally Invasive Surgical ◽  
Wolff Parkinson White Syndrome

The procedure of catheter ablation for the treatment of drug resistant atrial fibrillation (AF) has evolved but still relies on lesion sets intended to isolate areas of focal firing, mainly the myocardial sleeves of the pulmonary veins (PVs), from the rest of the atria. However the success rates for this procedure have varied inversely with the type of AF. At best success rates have been 20 to 30% below that of other catheter ablation procedures for Wolff-Parkinson-White syndrome, atrioventricular junctional re-entrant tachycardia and atrial flutter. Basic and clinical evidence has emerged suggesting a critical role of the ganglionated plexi (GP) at the PV-atrial junctions in the initiation and maintenance of the focal form of AF. At present the highest success rates have been obtained with the combination of PV isolation and GP ablation both as catheter ablation or minimally invasive surgical procedures. Various lines of evidence from earlier and more recent reports provide that both neurally based and myocardially based forms of AF can separately dominate or coexist within the context of atrial remodeling. Future studies are focusing on non-pharmacological, non-ablative approaches for the prevention and treatment of AF in order to avoid the substantive complications of both these regimens.

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