scholarly journals The importance of adherence and persistence in the elderly atrial fibrillation patient

2020 ◽  
Vol 22 (Supplement_I) ◽  
pp. I38-I42
Author(s):  
Elaine M Hylek
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Medication Adherence ◽  
Natural History ◽  
Atrial Fibrillation Patient ◽  
The Elderly ◽  
Medical System ◽  
Age Group ◽  
History Of

Abstract Older adults with atrial fibrillation are at the highest risk of ischaemic stroke yet are the least likely to be prescribed anticoagulant therapy, adhere to this therapy, and maintain long-term persistence with this therapy. The reasons for this under treatment are multifactorial and include patient-driven factors, physician-driven factors, medical system complexities, and current unknowns regarding the biology and natural history of AF. Understanding these challenges to stroke prevention and addressing identified barriers to medication adherence and persistence in this vulnerable age group will improve outcomes related to AF.

scholarly journals The Significance of Detective Arrhythmia by Using the Long- Term Ecg Monitoring in the Elderly “so Called” Healthy People: A Screening Study

2021 ◽  
Author(s):  
Rongsheng Xie ◽  
Siting Hong ◽  
Guoliang Gao ◽  
Jiaoyue Zhong ◽  
Lixin Geng ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrioventricular Block ◽  
Previous History ◽  
The Elderly ◽  
Healthy People ◽  
Ecg Monitoring ◽  
Adhesive Patch ◽  
Screening Study ◽  
History Of

Abstract BackgroundArrhythmias are potential harmful diseases to human beings, especially atrial fibrillation and ventricular arrhythmia, for causing serious consequences such as acute stroke or even sudden cardiac death. Recently the screening of asymptomatic atrial fibrillation by using the long-term ECG monitoring has been widely noticed. The study is to evaluate the significance of detective arrhythmia by using the long-term ECG monitoring in the elderly “so called” healthy people who never have the symptoms of palpitation, short breath or deny previous history of arrhythmia.MethodsWe enrolled a screening study of 1056 participants who were the elderly “so called” healthy people and ready to have a healthy examination from three different communities. They all underwent a long-term ECG monitoring（an adhesive patch）to evaluate cardiac arrhythmia. Inclusion criterias were 1) without any symptoms, 2) age ≥55, and 3) denying previous history of arrhythmia. We excluded patients with prior arrhythmias and who carried the patch for less than one day due to various factors. Then we compared the detected arrhythmia events in the first 24 hours and the total wearing time. ResultsOut of 1056 participants (69.8±12.0 years, 620 males), supraventricular tachycardia (SVT) was present in 538 subjects (44% VS 54%, 24 hours VS after 24 hours, P>0.05), atrial fibrillation (AF) was detected in 69 subjects (75% VS 25%, 24 hours VS after 24 hours, P<0.001), second degree type II atrioventricular block/third degree atrioventricular block (AVB) and sinus arrest were detected in 9 subjects(22% VS 78%, 24 hours VS after 24 hours, P<0.001),ventricular tachycardia was detected in 29 subjects (31% VS 69%, 24 hours VS after 24 hours, P<0.001). The adhesive patch monitor detected 32.10%（339/1056）arrhythmia events over the first 24 hours compared with arrhythmia events over the total wearing time of the devices, 61.08%（645/1056）(P<0.001). ConclusionsThe long-term adhesive patch monitor (APM) can improve the diagnosis of conceal arrhythmias which have high risks for life quality and lifespan in the elderly “so called ” healthy people, and the diagnostic advantage in bradycardia and ventricular arrhythmias are more obvious.

P1014The natural history of atrial fibrillation after the first clinical episode: a prospective observational study via implantable loop recorders

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Papakonstantinou ◽  
E Simantirakis ◽  
E Kanoupakis ◽  
F Parthenakis ◽  
P Vardas
Keyword(s):  
Atrial Fibrillation ◽  
Natural History ◽  
Clinical Significance ◽  
Loop Recorder ◽  
Clinical Episode ◽  
History Of ◽  
Second Year ◽  
Af Recurrence

Abstract Funding Acknowledgements The study was supported by Medtronic Inc Background The natural history of paroxysmal atrial fibrillation (AF) after the first clinical AF episode is not well known. AF burden is of clinical significance as it may have clinical implications concerning the long-term management of the arrhythmia and the decision-making on AF patients.  Purpose To observe the natural history of AF in patients after their first clinical paroxysmal AF episode.  Methods Thirty consecutive patients (age 66.9 ± 10 years; 14 men) received an implantable loop recorder (ILR) after their first symptomatic paroxysmal AF episode. We recorded the AF recurrences and burden (clinical and subclinical AF) during a follow-up period of three years. We excluded patients with persistent or permanent AF and patients with an episode of AF attributed to reversible or transient causes.  Results Eight patients (26.6%) did not present any AF recurrence during the first year of the follow-up period. Five patients (16.6%) did not also suffer any AF episode during the second year, while in three patients (10%) no AF episode was recorded during the three-year follow-up period. In 16 patients (53.3%) the AF burden was increased during the second year of follow-up period while in 9 patients (30%) the AF burden was decreased. During the third year of follow-up period the AF burden was increased in 19 patients (63.3%), decreased in 7 patients (23.3%) and remained almost the same in 4 patients (13.3%). Five patients (16.6%) presented at least one episode of persistent AF during the follow-up period. Seven patients (23.3%) suffered only from symptomatic AF episodes, while in nine patients (30%) only asymptomatic AF episodes were recorded. Eleven patients (36.7%) had both types of AF episodes (symptomatic and asymptomatic).  Conclusions The AF recurrence and burden increased in most AF patients during the three-year follow-up period. However, some patients did not suffer any AF recurrence or they presented a decrease in AF burden. Paroxysmal AF clinical profile differs among the AF patients significantly and this indicates that an individualized approach via long-term rhythm monitoring may be of clinical significance, at least in some newly diagnosed AF patients.

scholarly journals Clinical characteristics of COVID-19 in older adults. A retrospective study in long-term nursing homes in Catalonia

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255141
Author(s):  
Uxío Meis-Pinheiro ◽  
Francesc Lopez-Segui ◽  
Sandra Walsh ◽  
Anton Ussi ◽  
Sebastia Santaeugenia ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Nursing Homes ◽  
Natural History ◽  
Predictive Value ◽  
Multivariate Logistic Regression Analysis ◽  
Molecular Characteristics ◽  
History Of

The natural history of COVID-19 and predictors of mortality in older adults need to be investigated to inform clinical operations and healthcare policy planning. A retrospective study took place in 80 long-term nursing homes in Catalonia, Spain collecting data from March 1st to May 31st, 2020. Demographic and clinical data from 2,092 RT-PCR confirmed cases of SARS-CoV-2 infection were registered, including structural characteristics of the facilities. Descriptive statistics to describe the demographic, clinical, and molecular characteristics of our sample were prepared, both overall and by their symptomatology was performed and an analysis of statistically significant bivariate differences and constructions of a logistic regression model were carried out to assess the relationship between variables. The incidence of the infection was 28%. 71% of the residents showed symptoms. Five major symptoms included: fever, dyspnea, dry cough, asthenia and diarrhea. Fever and dyspnea were by far the most frequent (50% and 28%, respectively). The presentation was predominantly acute and symptomatology persisted from days to weeks (mean 9.1 days, SD = 10,9). 16% of residents had confirmed pneumonia and 22% required hospitalization. The accumulated mortality rate was 21.75% (86% concentrated during the first 28 days at onset). A multivariate logistic regression analysis showed a positive predictive value for mortality for some variables such as age, pneumonia, fever, dyspnea, stupor refusal to oral intake and dementia (p<0.01 for all variables). Results suggest that density in the nursing homes did not account for differences in the incidence of the infection within the facilities. This study provides insights into the natural history of the disease in older adults with high dependency living in long-term nursing homes during the first pandemic wave of March-May 2020 in the region of Catalonia, and suggests that some comorbidities and symptoms have a strong predictive value for mortality.

The natural history of pituitary apoplexy: long term follow-up study

2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  
Keyword(s):  
Natural History ◽  
Pituitary Apoplexy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of

scholarly journals Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

2021 ◽  
Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial Appendage ◽  
Systemic Embolism ◽  
Long Term Outcomes ◽  
Increased Risk ◽  
History Of ◽  
One Year ◽  
The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

scholarly journals Long‐term individual and population functional outcomes in older adults with atrial fibrillation

2021 ◽  
Author(s):  
Anna L. Parks ◽  
Sun Y. Jeon ◽  
W. John Boscardin ◽  
Michael A. Steinman ◽  
Alexander K. Smith ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Functional Outcomes

scholarly journals Long-term Natural History of Dry Eye Disease from the Patient's Perspective

Ophthalmology ◽  
2016 ◽  
Vol 123 (2) ◽  
pp. 425-433 ◽  
Author(s):  
Jeffrey P. Lienert ◽  
Laura Tarko ◽  
Miki Uchino ◽  
William G. Christen ◽  
Debra A. Schaumberg
Keyword(s):  
Natural History ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Patient’S Perspective ◽  
History Of

The Natural History of Long-Term Cardiac Pacing

1977 ◽  
Vol 23 (6) ◽  
pp. 550-554 ◽  
Author(s):  
William S. Stoney ◽  
Frederick E. Finger ◽  
William C. Alford ◽  
George R. Burrus ◽  
Robert A. Frist ◽  
...  
Keyword(s):  
Natural History ◽  
Cardiac Pacing ◽  
History Of
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