scholarly journals Fentanyl compared to buprenorphine for atrial fibrillation ablation analgesia and sedation: a retrospective cross-sectional study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Teruhisa Kinoshita ◽  
Mitsunori Harada ◽  
Norio Takimoto ◽  
Daichi Shibata ◽  
Takashi Sakakibara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Conscious Sedation ◽  
Perioperative Period ◽  
Cross Sectional Study ◽  
Atrial Fibrillation Ablation ◽  
Group Differences ◽  
Fentanyl Citrate ◽  
Cross Sectional ◽  
Area Product ◽  
Sedative Drugs

Abstract Background The effects of general anesthesia with deep sedation and conscious sedation have been compared for sedation management in the perioperative period for radiofrequency catheter ablation of the heart to treat atrial fibrillation. However, there is no consensus as to which drug to use for conscious sedation. This study aimed to investigate analgesic and sedative drugs suitable for perioperative ablation. Methods We retrospectively examined 93 patients who underwent atrial fibrillation ablation at Kariya Toyoda General Hospital between December 2017 and April 2019 and investigated differences in the outcomes, such as depth of sedation and postoperative adverse events between the buprenorphine hydrochloride (n = 46) and fentanyl citrate (n = 47) groups. Results The depth of sedation was similar between the two groups, without significant between-group differences in postoperative vomiting. The number of additional injections of thiamylal sodium to manage discomfort and pain during ablation were significantly lower in the fentanyl group. Additionally, the cumulative area product, cumulative total air kerma, 1-year postoperative atrial fibrillation recurrence rate, and postoperative complications were not significantly different between the two groups. Conclusions Although there were no significant differences in the efficacy or safety between buprenorphine hydrochloride and fentanyl citrate as analgesics used during atrial fibrillation ablation, intraoperative body movements and patient discomfort could be reduced to a greater extent with the use of fentanyl.

scholarly journals Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study

2017 ◽  
Vol 9 (9) ◽  
pp. 213-229 ◽  
Author(s):  
Arduino A. Mangoni ◽  
Leena R. Baghdadi ◽  
E. Michael Shanahan ◽  
Michael D. Wiese ◽  
Sara Tommasi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Disease Activity Score ◽  
Augmentation Index ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Group Differences ◽  
Cross Sectional ◽  
Arterial Function

Background: Methotrexate (MTX) treatment in rheumatoid arthritis (RA) has been associated with lower cardiovascular risk compared to other disease-modifying antirheumatic drugs (DMARDs). We sought to identify whether the MTX-associated cardioprotection involves changes in blood pressure (BP) and/or arterial function. Methods: Clinic and 24-hour peripheral and central systolic and diastolic BP (SBP and DBP), augmentation index (AIx), pulse wave velocity (PWV) and plasma asymmetric dimethylarginine (ADMA) were assessed in RA patients on stable treatment with either MTX ± other DMARDs (MTX group, n = 56, age 61 ± 13 years, 70% females) or other DMARDs (non-MTX group, n = 30, age 63 ± 12 years, 76% females). Measurements were performed at baseline and after 8 months. Results: After adjusting for visit, age, gender, body mass index, folic acid use and 28-joint disease activity score, the MTX group had significantly lower clinic peripheral SBP (−7.7 mmHg, 95% CI −13.2 to −2.3, p = 0.006) and DBP (−6.1 mmHg, 95% CI −9.8 to −2.4, p = 0.001) and clinic central SBP (−7.8 mmHg, 95% CI −13.1 to −2.6, p = 0.003) and DBP (−5.4 mmHg, 95% CI −9.1 to −1.6, p = 0.005) versus the non-MTX group. Furthermore, the MTX group had significantly lower 24-hour peripheral and central SBP and DBP and PWV versus the non-MTX group ( p < 0.01 for all comparisons). By contrast, there were no significant between-group differences in AIx and ADMA. Conclusions: RA patients on MTX treatment had significantly lower clinic and 24-hour peripheral and central BP compared to those who did not take MTX. The lower BP with MTX may be related to differences in PWV, but not in AIx or ADMA concentrations. Further longitudinal studies including randomized controlled trials are warranted to confirm these findings, to identify other possible mechanisms responsible for the effects of MTX on BP and PWV, and to establish whether these effects might account for the reduced cardiovascular risk with MTX.

Frequency of Atrial Fibrillation in Heart Failure Patients

2021 ◽  
Vol 15 (11) ◽  
pp. 3261-3264
Author(s):  
Syed Mohammad Haleem ◽  
Muhammad Hashim Kalwar ◽  
Muhammad Hassan Butt ◽  
Jehangir Hasan ◽  
Javed Khurshed Shaikh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Demographic Data ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Heart Failure Patients ◽  
Cardiac Symptoms ◽  
Patients With Heart Failure

Background: An increasing number of people around the world suffer from cardiovascular diseases such as atrial fibrillation (AF) and heart failure (HF). Atrial fibrillation (AF) has been linked to poor prognosis in heart failure (HF) patients with mild to moderate LV dysfunction, and it is most prominent in these patients. Despite advancements in care and treatment options like catheter ablation, managing AF is still a therapeutic challenge even with these advances. Aim/Objective: To determine the frequency of atrial fibrillation in heart failure patients. Subjects and Methods: This cross-sectional study was conducted on 246 patients at Adult Cardiology, NICVD, Karachi for Six months after approval from 31-08-2019 till 29-02-2020. Patients' consent was obtained verbally before data were collected prospectively. There were 246 patients with heart failure who had been diagnosed and met the diagnostic criteria. An overview of the event's history was gathered, as well as demographic data. Qualitative variables were presented as frequency and percentages, while quantitative data were given as simple descriptive statistics such as mean and standard deviation. A p-value of 0.05 or lower is considered statistically significant. Results: A total of 246 patients with heart failure were included in this study. The mean age in our study was 56.78±2.81 years. Whereas, mean BNP and ejection fraction in our study was 1144±87.81 pg./ml and 34.65±4.14 %. 136 (55.3%) were male and 110 (44.7%) were female. Out of 246 patients with heart failure, 52 (21.1%) had atrial fibrillation and 194 (78.9%) did not have atrial fibrillation. Conclusion: The results of this research demonstrated that a large percentage of heart failure patients had atrial fibrillation. Thus, it is essential to focus on a comprehensive way of management of heart failure and its comorbidities rather than primarily treating the cardiac symptoms. Keywords: Heart failure and atrial fibrillation.

scholarly journals Pharmacological analgesia in neonates undergoing cardiac surgery

2008 ◽  
Vol 16 (4) ◽  
pp. 727-732 ◽  
Author(s):  
Mariana Bueno ◽  
Amélia Fumiko Kimura ◽  
Cibele Andrucioli de Mattos Pimenta
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Pain Control ◽  
Private Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Postoperative Pain Control ◽  
Fentanyl Citrate ◽  
Cross Sectional ◽  
The City

The objectives of this study were to verify the frequency of pharmacological analgesia and the occurrence of postoperative pain in neonates undergoing cardiac surgery. METHODS: This is a cross-sectional study and data were collected from 30 medical charts of neonates who underwent cardiac surgery in a private hospital in the city of São Paulo. RESULTS: The majority (96.6%) of neonates received analgesia: 18 (60.0%) received continuous analgesics, five (16.7%) received intermittent drugs, and six (20.0%) received a combination of continuous and intermittent analgesics. Fentanyl citrate was continuously administered to 24 (80.0%) neonates. Intermittent dipyrone and morphine was administered to ten (33.3%) and one (3.3%) neonates, respectively. Pain registers were observed in 17 (56.7%) medical charts and the occurrence of pain among neonates who received analgesics was 53.4%. CONCLUSION: There was no efficacy in pharmacological postoperative pain control in the neonates included in this study.

scholarly journals Role of inflammation in initiation and maintenance of atrial fibrillation in rheumatic mitral stenosis – An analytical cross‐sectional study

2020 ◽  
Vol 36 (6) ◽  
pp. 1007-1015
Author(s):  
Gautam Sharma ◽  
Nirmal Ghati ◽  
Mohd Sharique ◽  
Shruti Sharma ◽  
Sudhir Shetkar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Stenosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rheumatic Mitral Stenosis

scholarly journals Anticoagulation adherence and its associated factors in patients with atrial fibrillation: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029974
Author(s):  
Pei-Ti Chen ◽  
Tsae-Jyy Wang ◽  
Ming-Hsiung Hsieh ◽  
Ju-Chi Liu ◽  
Chieh-Yu Liu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Self Efficacy ◽  
Associated Factors ◽  
Anticoagulation Therapy ◽  
Cross Sectional Study ◽  
The Self ◽  
Perceived Barriers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Unit Increase

ObjectiveTo investigate anticoagulant adherence and its associated factors, including demographics, clinical variables, atrial fibrillation (AF) severity, knowledge, satisfaction with services, perceived barriers, perceived benefits, symptom severity and self-efficacy in patients with AF.DesignThis is a cross-sectional study.Participants and settingA convenient sample of patients with AF were recruited from cardiology clinics of two teaching hospitals in Taiwan.MeasuresData were collected using the study questionnaires, including the AF-related symptom subscale of the AF Severity Scale, the Knowledge of Warfarin Anticoagulation Treatment Scale, the Satisfaction Scale about Service and Warfarin Treatment, the perceived benefits subscale of the Beliefs about Anticoagulation Survey, the Concerns about Anticoagulation Therapy Scale, The Self-efficacy for Appropriate Medication Use Scale and the short-form Adherence to Refills and Medications Scale.ResultsA total of 151 patients with AF participated in the study; 53 treated with warfarin and 98 treated with novel oral anticoagulants (NOACs). The difference in adherence to warfarin (mean=8.6; SD=1.6) and NOACs (mean=8.9; SD=2.0) was statistically insignificant. Multiple linear regression analysis showed that perceived barriers (β=0.18, p=0.017) and self-efficacy (β=−0.48, p<0.001) were significant predictors of anticoagulation adherence. For every 1-unit increase in the perceived barriers, there will be a 0.18-unit increase in the adherence to anticoagulation therapy. For every 1-unit increase in the self-efficacy, there will be a 0.48-unit decrease in the adherence to anticoagulation therapy. Perceived barriers and self-efficacy collectively explained 34.0% of the variance in adherence to anticoagulation therapy (F(2,149)=38.11, p<0.001).ConclusionWe found no better adherence to NOACs compared with warfarin. Patients with greater self-efficacy and perceived fewer barriers showed better adherence to anticoagulation therapy.

Epidemiology of atrial fibrillation in northeast China: a cross-sectional study, 2017–2019

Heart ◽  
2019 ◽  
Vol 106 (8) ◽  
pp. 590-595 ◽  
Author(s):  
Liying Xing ◽  
Min Lin ◽  
Zhi Du ◽  
Li Jing ◽  
Yuanmeng Tian ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rural Areas ◽  
Northeast China ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Liaoning Province ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Difference ◽  
Urban And Rural Areas

ObjectiveTo evaluate the epidemiology of atrial fibrillation (AF) in northeast China.MethodsThis cross-sectional survey using a multistage, stratified and cluster random sampling method was conducted in Liaoning Province between September 2017 and March 2019. A total of 18 796 participants (28.9% urban, 71.1% rural) aged ≥40 years were included. All participants completed a questionnaire and underwent a physical examination and ECG. AF was diagnosed according to history and ECG findings.ResultsThe overall AF prevalence was 1.1%; it increased steeply with age. AF was more prevalent in men than in women (1.5% vs 0.9%, p<0.001); however, the difference between urban and rural areas was not significant (1.3% vs 1.1%, p=0.228). Among the AF population, the overall AF awareness rate was 52.6%, higher in women than in men (61.5% vs 44.1%, p=0.011); however, the difference between areas was not statistically significant (60.0% vs 49.0%, p=0.129). According to the CHA2DS-VASc score, almost all (90.2%, 194/215) of our subjects required oral anticoagulant (OAC) therapy; however, only 4.1% actually received it. Moreover, hypertension (66.5%), dyslipidaemia (32.6%) and diabetes (24.2%) were highly prevalent in patients with AF, but their control rates were unacceptably low (7.0%, 8.6% and 28.8%, respectively).ConclusionsThe burden of AF in northeast China was substantial. Underuse of OAC therapy and uncontrolled comorbidities will likely contribute to the cardiovascular outcomes of patients with AF in the coming decades. Long-term management strategies for AF and related risk factors are required in northeast China.

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