scholarly journals The efficacy and safety of a nurse-led electrical cardioversion service for atrial fibrillation over a two-year time period

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
P Purkayastha ◽  
A Ibrahim ◽  
D Haslen ◽  
R Gamma
Keyword(s):  
Atrial Fibrillation ◽  
Success Rate ◽  
Atrial Flutter ◽  
Dramatic Improvement ◽  
Success Rates ◽  
Funding Sources ◽  
Hospital Readmission Rate ◽  
Direct Current Cardioversion ◽  
Significant Difference ◽  
Chi Squared

Abstract Funding Acknowledgements Type of funding sources: None. Background & Purpose Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide, with a significant impact on morbidity, mortality and utilisation of healthcare resources. Electrical direct-current cardioversion (DCCV) is offered to patients with ongoing symptoms despite medical management. In this study we aim to evaluate the safety and efficacy of a specialised nurse-led DCCV cardioversion service.  Methods This was a retrospective cohort study analysing the outcome of patients presenting with atrial fibrillation or flutter, who were subsequently referred for a nurse-led DCCV procedure between August 2017 and December 2019.  Results Analysis included a total of 341 patients (mean age = 68.37; STDV = 10.96) who presented with either atrial fibrillation (N = 267; 78.30%) or atrial flutter (N = 74; 21.70%). Approximately 30% of patients were female (N = 101); and 70% were male (N = 240). Of the 341 patients who underwent DCCV, 299 were successfully cardioverted (87.68%), whilst 42 patients remained in AF (12.32%). Of those patients successfully cardioverted, 167 remained in sinus rhythm after 6 weeks (55.85%); 93 patients reverted back to AF (31.10%). 38 patients were lost to follow up (12.71%). Of all 341 patients who underwent DCCV, only 24 patients were admitted to hospital during the subsequent 3 month period (7.04%). Of these admissions, 11 were due to persistent AF (45.83%), and 13 were due to other non-related reasons (54.17%). Importantly, no patients were admitted as a direct complication of the DCCV procedure.  Using a Chi-squared analysis, we found a significant difference in cardioversion success rates between patients presenting with atrial flutter (97% success rate) versus those in atrial fibrillation (85% success rate) (χ2 = 8.089; p = 0.004; α<0.05). We did not find a significant difference in cardioversion success rates between males and females (χ2 = 1.651; p = 0.199; α<0.05); nor did we witness a significant impact from the presence of ischaemic heart disease (χ2 = 1.545; p = 0.214; α<0.05) or hypertension (χ2 = 2.075; p = 0.150; α<0.05). Similarly, we found negligible impact of LV ejection fraction (χ2 = 1.494; p = 0.684; α<0.05) or LA size (χ2 = 1.310; p = 0.727; α<0.05) upon cardioversion success rates.  We witnessed a dramatic improvement in DC cardioversion success rates in patients taking antiarrhythmic medication in preference to a rate control strategy alone (χ2 = 11.825; p = 0.008; α<0.05).  Conclusion Overall, data gathered from this study provides positive evidence to support the use of a nurse-led DCCV service. In addition to obtaining very successful cardioversion rates, we found low remission rates, with a very low hospital readmission rate for AF related issues after successful DCCV.

scholarly journals Benefits of catheter ablation of typical cavotricuspid isthmus-dependent atrial flutter using half-normal saline

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
N Vecchio ◽  
C Militello ◽  
JC Lopez Diez ◽  
N Schnetzer ◽  
J Dorado ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Success Rate ◽  
Atrial Flutter ◽  
Normal Saline ◽  
Anatomical Variation ◽  
Safe Procedure ◽  
Test Analysis ◽  
Cavotricuspid Isthmus ◽  
Funding Sources ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background Radiofrequency catheter ablation (RFA) of cavotricuspid isthmus–dependent atrial flutter (AFL) is a procedure with a high success rate and a low complication rate. The anatomical variation and irregularity of the isthmus, with the high local blood flow, can reduce the effectiveness of the lesion and consequently of the procedure. Recent data suggests that deeper ablation lesions can be created using open-irrigated catheters (CA) with half-normal saline (HNS). Purpose To assess the acute efficacy and safety of RFA of AFL with half-normal saline (HNS). Compare the results with CA irrigated with normal saline (NS). Methods Randomized, prospective, observational and single-center study. Consecutive patients with first AFL RFA between June 2019 and December 2020 were included. CA with HNS or NS were used, with a limit of 40 watts  and 40° C. An RFA line was performed under fluoroscopic guidance or electroanatomic mapping. If necessary, the lesion was repeated until the arrhythmia was interrupted and the bidirectional block was achieved (success). Acute success, total radiofrequency time (RT), number of radiofrequency applications, and complications were analyzed. Results   38 patients with RFA of AFL were analyzed. 19 in the HNS and 19 in the NS group. There were no significant differences between the baseline characteristics of each group. (Table 1) The accute success rate was 100% with a median of 2 RFA applications in both groups. The mean RT in HNS was 7:10 vs 09:16 min in NS group; the t-test analysis did not show a significant difference (p = .2). A subanalysis was performed in those patients who required more than 2 lines of RFA; a mean of 4 in the HNS group vs 6 in the NS group (p = .4). In the HNS group, RT was significantly shorter; 8:17 vs 13:17 min in the NS group (p = .011). (Figure 1) There was a steam pop in the HNS group and no complications or steam pop in the NS group (p = .53). Conclusions   RFA of AFL using HNS is an effective and safe procedure. In patients with unfavorable anatomy who required a greater number of applications, the radiofrequency time was significantly shorter using HNS. Baseline characteristicsHNS (19 p)NS(19 p)pAge56 ± 12.3 years61 ± 10.8 years.22Male16 p (84%)16 p (84%)1Heart Disease7 p (36.8%)5 p (26.3%).68Ejection Fraction57.1 ± 11%56 ± 14.3%.49Ejection Fraction < 50%2 p (10.5%)2 p (10.5%)1Electroanatomic mapping10 p (52.6%)8 p (42.1%).7Abstract Figure. Fugure 1

scholarly journals Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

2016 ◽  
Vol 59 (1) ◽  
pp. 10-13
Author(s):  
Elif Ersoy Callioglu ◽  
A. Sami Bercin ◽  
Hayati Kale ◽  
Togay Muderris ◽  
Sule Demirci ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Success Rate ◽  
Middle Ear ◽  
Success Rates ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
Patient Groups ◽  
The Difference ◽  
Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

Cost-effectiveness of digoxin, pacing, and direct current cardioversion for conversion of atrial flutter in neonates

2018 ◽  
Vol 28 (5) ◽  
pp. 725-729
Author(s):  
Deepa Prasad ◽  
Joni Steinberg ◽  
Christopher Snyder
Keyword(s):  
Cost Effectiveness ◽  
Atrial Flutter ◽  
Direct Current ◽  
Efficient Method ◽  
Meta Analysis ◽  
Cost Effective ◽  
Success Rates ◽  
Direct Current Cardioversion ◽  
Neonatal Icu ◽  
The Cost

AbstractIntroductionNewborn atrial flutter can be treated by medications, pacing, or direct current cardioversion. The purpose is to compare the cost-effectiveness of digoxin, pacing, and direct current cardioversion for the treatment of atrial flutter in neonates.Materials and methodsA decision tree model was developed comparing the efficacy and cost of digoxin, pacing, and direct current cardioversion based on a meta-analysis of published studies of success rates of cardioversion of neonatal atrial flutter (age<2 months). Patients who failed initial attempt at cardioversion progressed to the next methodology until successful. Data were analysed to assess the cost-effectiveness of these methods with cost estimates obtained from 2015 Medicare reimbursement rates.ResultsThe cost analysis for cardioversion of atrial flutter found the most efficient method to be direct current cardioversion at a cost of $10 304, pacing was next at $11 086, and the least cost-effective was digoxin at $14 374. The majority of additional cost, regardless of method, was from additional neonatal ICU day either owing to digoxin loading or failure to covert. Direct current cardioversion remains the most cost-effective strategy by sensitivity analyses performed on pacing conversion rate and the cost of the neonatal ICU/day. Direct current cardioversion remains cost-effective until the assumed conversion rate is below 64.6%.ConclusionThe most cost-efficient method of cardioverting a neonate with atrial flutter is direct current cardioversion. It has the highest success rates based on the meta-analysis, shorter length of stay in the neonatal ICU owing to its success, and results in cost-savings ranging from $800 to $4000 when compared with alternative approaches.

P1417Short and long term efficiency of different therapeutic approaches to perimitral atrial flutter

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Kupo ◽  
R Pap ◽  
G Bencsik ◽  
L Saghy
Keyword(s):  
Retrospective Study ◽  
Atrial Flutter ◽  
Pulmonary Vein ◽  
Success Rates ◽  
Therapeutic Approaches ◽  
Significant Difference ◽  
Mitral Isthmus ◽  
Short And Long Term ◽  
Left Pulmonary Vein

Abstract Introduction Catheter ablation of perimitral flutter can be challenging, owing to difficult anatomy. The most commonly applied procedure is the creation of a mitral isthmus line (between the lower left pulmonary vein and the mitral anulus) or an anteroseptal line (between the upper right pulmonary vein and the anterior mitral anulus). Purpose Our study aimed to compare the short and long term efficacy of two different ablation methods. Methods In our retrospective study 45 consecutive patients diagnosed with perimitral flutter were included between 2009 and 2018. Results Radiofrequency ablation was performed in 48 cases in 31 patients (mitral isthmus line (n = 25, 52.1%); anteroseptal line (n = 23, 47.9%)). Arrhythmia-termination and sinus rhythm restoration could be achieved in 64.6% of the cases (mitral isthmus line: 16/25 (64.0%), anteroseptal line: 15/23 (65.2%). Comparing two different techniques, there was no significant difference (p = 0.85) in acute success rates. During 24.3 months of follow-up period, in 60.0% of the patients no recurrence occurred. The arrhythmia recurred in 6 cases (40.0%) after anteroseptal line ablation, and in 8 cases (53.3%) after mitral isthmus line ablation. No difference was found in the long term efficiency of two  different ablation techniques (p = 0.211). Conclusion In our retrospective study we found no significant difference in the short and long term efficiency of two different therapeutic approaches to perimitral atrial flutter.

scholarly journals Role of silicone stenting in endoscopic dacryocystorhinostomy

2020 ◽  
Vol 6 (2) ◽  
pp. 248
Author(s):  
Abdussalam M. Jahan ◽  
Yousef M. Eldanfur ◽  
Abdulhakim B. Ghuzi
Keyword(s):  
Success Rate ◽  
Medical Center ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
P Value ◽  
Success Rates ◽  
Duct Obstruction ◽  
Significant Difference ◽  
Silicone Stent ◽  
Endoscopic Dcr

<p class="abstract"><strong>Background:</strong> Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.</p><p class="abstract"><strong>Methods:</strong> Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction.<strong> </strong>These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test.  </p><p class="abstract"><strong>Results:</strong> 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is &gt;0.05).</p><p><strong>Conclusions:</strong> Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.</p>

scholarly journals Comparing single approaches success in index atrial fibrillation ablation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
R Caldeira Da Rocha ◽  
R Carvalho ◽  
A Ferreira ◽  
T Rodrigues ◽  
G Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Success Rate ◽  
High Rate ◽  
Single Shot ◽  
Single Center ◽  
Event Free Survival ◽  
Free Survival ◽  
Af Ablation ◽  
Significant Difference ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial Fibrillation (AF) ablation can be performed by inducing pulmonary vein electrical isolation. There are two widely used approaches: point-by-point and single-shot.  Catheter AF ablation is effective in restoring and maintaining sinus rhythm. However, efficacy is limited by high rate of AF recurrence, after an initially successful procedure. Purpose To evaluate AF index ablation successfulness using single-shot techniques and compare them to conventional one (point-by-point using irrigated- tip ablation catheter). Methods We analyzed, from a single center, all patients submitted to an index AF ablation procedure and its successfulness. The last was defined as AF, atrial tachycardia or flutter recurrence (with a duration superior to 30seconds) event- free survival, determined by holter and/or event recorder. These exams were performed after 6 and 12months and then annually, until 5years post procedure were accomplished. Results From November 2004 to November 2020, 821patients were submitted to first AF ablation (male patients 67,2%(N = 552), mean age of 59 ± 12years old). Paroxysmal AF(PAF) was present in 62,9%(N = 516), with short-duration persistent AF in 21,8%(N = 179) and long-standing persistent in 15,3%(N = 126). Ablation techniques were irrigated tip catheter point-by-point (PbP)ablation in 266 patients (32,4%) and single-shot (SS)techniques on the remaining 555(67,6%), including PVAC in 294(35,8%),225(27,4%) submitted to cryoablation and 36(4,4%) to nMARQ. Globally, AF ablation had one-year success rate of 72,5%, and 56,2% at 3 years. A significant difference between AF duration type was found: Arrhythmic recurrence risk was 58% higher in persistent AF(PeAF) (HR 1.58;95%IC 1,22-2,04; p &lt; 0.001). In patients presenting with PAF prior to the procedure, success was significantly higher in those submitted to SS technique(HR:0.69;95%CI 0,47-0,90;p = 0.046), while those with PeAF had similar results. Conclusion In this single center analysis almost three-quarters had achieved one-year event-free survival, and more than a half reached long-term freedom from atrial arrhythmia. Patients with paroxysmal atrial fibrillation submitted to single-shot procedure presented with a higher success-rate. Moreover, our study confirmed previous data on the importance of atrial fibrillation classification to postprocedural outcomes. Abstract Figure. Survival Curves

scholarly journals Different implication in dementia between patients with atrial flutter and atrial fibrillation: a national cohort study

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
YL Chen
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Research Database ◽  
Funding Sources ◽  
Valvular Surgery ◽  
Previous Stroke ◽  
Included Patient ◽  
National Cohort ◽  
History Of ◽  
The Difference

Abstract Funding Acknowledgements Type of funding sources: None. Importance Atrial fibrillation (AF) has been reported with increasing the risk of stroke and dementia. Atrial flutter (AFL) is also a risk of stroke with different discrepancies in clinical outcome. Little is known about the difference in the risk of dementia between AF and AFL. Objective To investigate if the risk of dementia is difference between AF and AFL. Methods The patients with newly diagnosed AF and AFL during 2001–2013 was retrieved from Taiwan’s National Health Insurance Research Database. Patients with missing information, aged &lt;20 years, history of valvular surgery, rheumatic heart disease, hyperthyroidism, and history of dementia were excluded. Propensity score matching (PSM) between AF and AFL was performed, which included patient comorbidities, past medical history, medications, and index date stratified by age. Primary outcome was defined as dementia at follow-up. Results A total of 232,425 AF and 7,569 AFL were eligible for analysis. After 4:1 PSM, we included 30,276 AF (aged 67.3 ± 15.7 years) and 100,065 AFL (aged 67.4 ± 16.0 years) for analysis. The risk of dementia was higher in AF patients compared with AFL patients (subdistribution HR (SHR)=1.52, 95% CI 1.39 - 1.66; p &lt;0.0001) before PSM and still higher in AF patients (SHR = 1.14, 95% CI 1.04 to 1.25; p = 0.0064). The risk was higher in AF patients without previous stroke after PSM and there was no difference between AF and AFL patients with previous stroke history. Conclusions and relevance Our finding supports that risk of dementia is higher in AF patients than AFL patients. However, the risk of dementia between patients with AF and AFL varies depending on whether there is a previous stroke history.

scholarly journals Safety and acute clinical outcomes of atrial fibrillation catheter ablation in octogenarians: a multicentre evaluation with a matched younger cohort

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
N Karim ◽  
N Kozhuharov ◽  
J Jarman ◽  
S Furniss ◽  
R Veasey ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
De Novo ◽  
Lv Function ◽  
P Value ◽  
Complication Rates ◽  
Success Rates ◽  
Af Ablation ◽  
Funding Sources ◽  
Procedural Success

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Sven Knecht and the International Octogenarian AF ablation group Background Octogenarians are a fast-growing demographic with a high burden of atrial fibrillation (AF). There are limited data on procedural safety and acute outcomes of catheter ablation (CA) for AF in this group. Purpose Investigation of complications & outcomes in octogenarians undergoing CA for AF. Methods Data on all octogenarian patients who underwent AF ablation at nine European cardiology centres between 2013 and 2019 were retrospectively analysed and matched with control patients aged &lt;80 years.  The characteristics used for matching were type of AF, type of procedure (de novo or redo), & the year of procedure. Results 216 octogenarians (81.9 ± 1.9 years; 52.8% females) underwent an AF ablation procedure, and were matched with 216 patients aged &lt;80 years (62.4 ± 9.5 years, 34.7% females), p &lt;0.001 for both. The proportion of paroxysmal and persistent AF was 43.5% & 56.5% respectively in both groups, and 79.3% of the procedures were de novo. RF ablation made up 75.4% & 75.9% (p = 0.90) procedures in octogenarians and controls respectively.  17 complications occurred in 14 (7.9%) octogenarian patients and 11 in 11 (5.1%) patients in the younger matched cohort (p = 0.07). There were 4.2% & 1.9% major complications (p= 0.17) and 3.7% & 3.2% minor complications (p= 0.77) in the octogenarian & younger cohorts respectively. Complications in octogenarians consisted of groin complications (n = 6), pneumonia (n = 3), pericardial effusion (n = 2), phrenic nerve injury (n = 2), pulmonary oedema (n = 1), gastroparesis (n = 1), stroke (n = 1). Acute procedural success rates were 99.1% & 99.5% (p = 0.62) The complication rates were similar for RF; 6.0% vs 5.4% (p = 0.79) and Cryoballoon; 14.0% vs 4.1% (p = 0.09) in both octogenarians and younger cohort respectively. Conclusion In spite of significantly higher overall risk profile of octogenarians undergoing AF ablation, there is no difference in acute procedural success and complication rates as compared to younger patients Catheter ablation of AF in octogenerians Octogenarians n = 216 Matched Controls (aged &lt; 80yrs) n = 216 P value Age (yrs), mean (SD)s 81.9 (1.9) 62.4(9.5) &lt; 0.0001 Females, (%) 52.8 34.7 0.0002 CHA2DS2-VASc, mean (SD) 3.6 (1.2) 1.4 (1.3) &lt; 0.0001 Mean LA size, mm 42.8 ± 8.3mm 45.8 ± 16.2 0.062 Impaired LV function, (%) 23.7 17.9 0.206 IHD, (%) 20.7 5.9 &lt; 0.0001 Procedural time (mins), mean (sd) 150.6 (69.7) 148.9 (64.4) 0.914 All complications, n (%) 17 (7.9) 11 (5.1) 0.073

Abstract P532: Does Atrial Fibrillation Impact Rate of Symptomatic Intracranial Hemorrhage in Acute Ischemic Stroke Patients Treated With rt-PA and/or Endovascular Treatment?

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Reza Bavarsad Shahripour ◽  
Benjamin Shifflett ◽  
Edward Labin ◽  
Morgan Figurelle ◽  
Anna Barminova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Intracranial Hemorrhage ◽  
Smoking Status ◽  
Intravenous Thrombolysis ◽  
Significant Difference ◽  
Chi Squared ◽  
Symptomatic Intracranial Hemorrhage

Background: Patients with acute ischemic stroke (AIS) due to atrial fibrillation (afib) may have increased complications from intravenous thrombolysis or endovascular treatment (ET) compared to other stroke subtypes. The purpose of this study was to compare the rates of symptomatic intracranial hemorrhage (sICH) in patients with and without a history of a fib treated with IV rt-PA and/or ET. Methods: Consecutive stroke code activations were retrospectively analyzed from January 2004-June 2020 at an academic comprehensive stroke center. Patients were included if they were treated with IV rt-PA and/or ET within 24 hours of stroke onset. Patients were stratified into the six groups:1-No hx of a fib with ET only, 2-Hx of a fib with ET only, 3-No hx of a fib with IV rt-PA plus ET, 4-Hx of a fib with IV rt-PA plus ET, 5-No hx of a fib with IV rt-PA only, 6-Hx of a fib with IV rt-PA only. Primary outcome was defined as any sICH within 72 hours of treatment using the NINDS definition. Baseline demographics were compared. Chi squared was used to assess differences in sICH rates and logistic regression to compare individual groups. Analyses were both unadjusted and adjusted for baseline NIHSS, age, sex, baseline blood pressure, pre-stroke mRS, smoking status, and baseline glucose. Results: We identified 720 AIS patients who received acute treatment (IV rt-PA: n=578; ET: n=100; IV rt-PA+ET:n=18). There was a significant difference in sex (p=0.005); Hispanic ethnicity (p=0.002); current smoking (p=<0.001); current alcohol use (p=0.03), CHF (p=0.01); and age (p<0.0001) between groups. Baseline NIHSS was significantly higher in Group 4 (23, SD 8, p=<0.001).In adjusted analysis, there was no significant difference in sICH in patients with a fib after receiving IVtPA (OR 1.53, CI 0.47-4.99, p=0.48), ET (OR 0.93 , CI 0-∞, p=1.00), or both (OR 0.25,CI 0.00-9.07, p=0.45) compared to those without afib. There was no significant difference in sICH in adjusted analyses in patients with and without a fib overall (OR 0.93, CI 0-∞, p=1.00). Conclusion: In this study, atrial fibrillation did not have a significant impact on rates of sICH in AIS patients treated with IV rt-PA, ET, or both. This study supports the safety of IV rt-PA, ET, and combination therapy in the atrial fibrillation population.

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