scholarly journals Surveys and Registries on Catheter Ablation of Atrial Fibrillation

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Riccardo Cappato ◽  
Hussam Ali
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Observational Studies ◽  
Anticoagulation Therapy ◽  
Daily Practice ◽  
Special Populations ◽  
Safety And Efficacy ◽  
Comprehensive Review ◽  
The Past ◽  
The Subject

Surveys and registries are widely used in medicine as valuable tools to integrate the information from randomized and observational studies. Early after its introduction in daily practice and parallel to its escalating popularity, catheter ablation of atrial fibrillation has been the subject of several surveys and registries. Over the years, relevant aspects associated with atrial fibrillation ablation have been investigated using these tools, including procedural safety and efficacy, discontinuation of anticoagulation therapy and risk of stroke postablation, and outcomes in special populations. The aim of this article is to provide a comprehensive review of the contributions offered by surveys and registries in catheter ablation of atrial fibrillation over the past 15 years.

scholarly journals Digestive involvement in COVID-19: what we have learned in the past 12 months

2021 ◽  
Author(s):  
Vladimir Posmag ◽  
Liliana David ◽  
Dan L. Dumitrascu
Keyword(s):  
Observational Studies ◽  
Digestive System ◽  
Literature Search ◽  
Gastrointestinal Symptoms ◽  
Clinical Findings ◽  
Treatment Schedule ◽  
Gastrointestinal Involvement ◽  
Comprehensive Review ◽  
The Past ◽  
The Relationship

Background and aim. The year 2020 will remain in the medical history as the year of COVID-19 pandemic. Although COVID-19 is considered mainly a respiratory disease, it is well known now that SARS-CoV-2 can affect major organs including the digestive system. This is a comprehensive review on gastrointestinal involvement in the SARS-CoV-2 infection, also the digestive damage due to COVID-19. Methods. A literature search was undertaken in main databases of medical publications following the search items digestive or gastrointestinal or gastric or enteral and SARS-CoV-2 or COVID-19.  Data on gastrointestinal symptoms and alterations in this viral condition were collected and presented. Only observational studies were included. Results. In this review we discuss the recent information on the relationship between COVID-19 and the digestive system. The putative underlying pathogenic mechanisms of COVID-19 as well as the clinical findings in relation to gastrointestinal changes are presented. Conclusions. SARS-CoV-2 virus can affect any part of the digestive system. Patients with chronic diseases are at greatest risk of adverse out-comes. There is a considerable risk for drug-drug interactions in patients who require a large treatment schedule.

Abstract 18881: New Oral Anticoagulants for Periprocedural Management of Anticoagulation in Patients Undergoing Radiofrequency Catheter Ablation for Atrial Fibrillation: a Meta-analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Abdul Shokor Parwani ◽  
Daniel Blaschke ◽  
Alexander Wutzler ◽  
Martin Huemer ◽  
Phillip Attanasio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Odds Ratio ◽  
Observational Studies ◽  
Radiofrequency Catheter Ablation ◽  
Statistical Significance ◽  
Oral Anticoagulants ◽  
Current Evidence ◽  
Minor Bleeding ◽  
Warfarin Group

Introduction: Thromboembolic events are the most feared complication of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). The traditional periprocedural anticoagulation approach is discontinuation of vitamin K antagonist and bridging with heparin. Newly procedures are done under therapeutic INR 2-3. Recent studies used periprocedural new direct oral anticoagulants (NOACs). Hypothesis: We evaluated the available evidence on the efficacy and safety of NOACs for periprocedural anticoagulation during RFCA of AF. Methods: Pubmed, Embase and Cochrane Central were searched. Retrospective and prospective studies published as peer-reviewed full-size articles were included if they reported embolic events and major and minor bleeding. Results: Fifteen studies were identified (14 observational studies, 1 small randomized trial). A total of 7050 patients were included (NOACs group: 2887 ). A total of 37 thromboembolic complications occurred (0,5%) with 17 events in the NOAC group (0,6%) and 20 in the warfarin group (0,5%) (odds ratio 0.97, 95% confidence interval (CI) 0.48 to 1.99). Major bleeding were numerically higher in the warfarin group compared to the NOACs group. However, the difference did not reach statistical significance (odds ratio 0.69, CI 0.43 to 1.10). Subgroup analysis did not reveal any differences in event rates. Conclusions: Our review suggests that dabigatran etexilate and rivaroxaban are as effective and safe as warfarin for periprocedural anticoagulation in patients undergoing RFCA of AF. However, it has to be acknowledged that the current evidence is mainly based on observational studies.

scholarly journals 1052-220 Safety and efficacy of catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter

2004 ◽  
Vol 43 (5) ◽  
pp. A114 ◽  
Author(s):  
Chandrasekhar R Vasamreddy ◽  
Vinod Jayam ◽  
Lars Lickfett ◽  
David Bradley ◽  
Khurram Nasir ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ablation Catheter ◽  
Safety And Efficacy

Factors associated with silent cerebral events during catheter ablation for atrial fibrillation in the era of uninterrupted oral anticoagulation therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Harada ◽  
Y Nomura ◽  
A Nishimura ◽  
Y Motoike ◽  
M Koshikawa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Vitamin K ◽  
Oral Anticoagulation ◽  
Brain Mri ◽  
Anticoagulation Therapy ◽  
Surrogate Marker ◽  
Brain Magnetic Resonance Imaging ◽  
Vitamin K Antagonist ◽  
Factors Associated

Abstract Background A silent cerebral event (SCE), detected by brain magnetic resonance imaging (MRI), is defined as an acute new brain lesion without clinically apparent neurological deficit, and is frequently observed after catheter ablation in atrial fibrillation (AF) patients. Although the small number of SCEs does not cause neurocognitive dysfunction, the greater volume and/or larger number of SCE lesions are reportedly related to neuropsychological decline; SCE incidence may be a surrogate marker for the potential thromboembolic risk. Thus, strategies to reduce SCEs would be beneficial. Uninterrupted oral anticoagulation strategy for peri-procedural period reportedly reduced the risk of SCEs, but the incidence hovers at 10% to 30%. We sought factors associated with SCEs during catheter ablation for AF in patients with peri-procedural uninterrupted oral anticoagulation (OAC) therapy. Methods AF patients undergoing catheter ablation were eligible (n=255). All patients took non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for peri-procedural OAC (>4 weeks) without interruption during the procedure. Brain MRI was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure-related parameters were compared between patients with and without SCEs. Results SCEs were detected in 59 patients (23%, SCE[+]) but not in 196 patients (77%, SCE[-]). Average age was higher in SCE[+] than SCE[-] (66±10 years vs. 62±12 years, p<0.05). Persistent AF prevalence, CHADS2/CHA2DS2-VASc scores, and serum NT-ProBNP levels increased in SCE[+] vs. SCE[-]. In transthoracic/transesophageal echocardiography, left-atrial dimension (LAD) was larger and AF rhythm/spontaneous echo contrast were more frequently observed in SCE[+] than SCE[-]. SCE[+] had lower initial activated clotting time (ACT) before unfractionated heparin (UFH) injection and longer time to reach optimal ACT (>300 sec) before trans-septal puncture than SCE [-]. In multivariate analysis, LAD, initial ACT before UFH injection, and time to reach optimal ACT were predictors for SCEs. Conclusions LAD and intra-procedural ACT kinetics affect SCEs during the procedure in patients with uninterrupted OAC for AF ablation. Shortening time to achieve optimal ACT during the procedure may reduce the risk of SCEs. Funding Acknowledgement Type of funding source: None

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