scholarly journals Considerations for the Assessment of Substrates, Genetics and Risk Factors in Patients with Atrial Fibrillation

2021 ◽  
Vol 10 (3) ◽  
pp. 132-139
Author(s):  
Dominik Linz ◽  
Sander Verheule ◽  
Aaron Isaacs ◽  
Ulrich Schotten
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Treatment Strategies ◽  
Diagnostic Techniques ◽  
Diagnostic Tools ◽  
Multidisciplinary Teams ◽  
Molecular Pathways ◽  
Clinical Implementation ◽  
Genetic Mechanisms ◽  
Personalised Treatment

Successful translation of research focussing on atrial arrhythmogenic mechanisms has potential to provide a mechanism-tailored classification and to support personalised treatment approaches in patients with AF. The clinical uptake and clinical implementation of new diagnostic techniques and treatment strategies require translational research approaches on various levels. Diagnostic translation involves the development of clinical diagnostic tools. Additionally, multidisciplinary teams are required for collaborative translation to describe genetic mechanisms, molecular pathways, electrophysiological characteristics and concomitant risk factors. In this article, current approaches for AF substrate characterisation, analysis of genes potentially involved in AF and strategies for AF risk factor assessment are summarised. The authors discuss challenges and obstacles to clinical translation and implementation into clinical practice.

scholarly journals Personalized Medicine in the Treatment of Atrial Fibrillation: Myth or Reality?

2019 ◽  
Vol 15 (1) ◽  
pp. 90-94
Author(s):  
V. I. Podzolkov ◽  
A. I. Tarzimanova
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Molecular Genetic ◽  
Modern Medicine ◽  
Therapeutic Drug ◽  
Genetic Studies ◽  
Genomic Studies ◽  
Familial Atrial Fibrillation ◽  
Life Threatening ◽  
Genetic Mechanisms

Due to the spectacular progress made in human genomic studies, molecular biology and genetics have become an essential part of modern medicine making it possible to early detect the risk factors and select the personalized treatment. The genetic studies have been widely used in the diagnosis and treatment of arrhythmias. Significant advances in the study of electrophysiological and genetic mechanisms of life-threatening arrhythmias have been achieved through studies of familial conditions with high risk of sudden cardiac death. However, the area of special interest for a practitioner is the identification of mutations associated with atrial fibrillation (AF). The novel methods enable us to study histological, structural, cellular and molecular causes of this arrhythmia. The two main directions of molecular genetic studies of AF are the identification of genetic mutations causing familial atrial fibrillation and the study of different genes polymorphism predisposing to arrhythmia in general population. Gene polymorphism screening helps both identify AF risk factors and predict its evolution from paroxysmal to chronic type. Emerging genetic studies provided explanation for the variable efficacy of antiarrhythmic drugs. It can be assumed that the clinical use of genetic methods will allow accurate and personalized selection of antiarrhythmics. Currently, therapeutic drug monitoring is widely recommended for a number of medications including cytostatics, aminoglycosides, anticonvulsants, and, by some researchers, antiarrhythmic and anticoagulant drugs. Medicine from the very beginning was intended to be personalized, but until recently it was a little more than a myth. The discovery of the human genome makes it possible to choose the most effective treatment with minimal adverse drug reactions for a particular patient.

scholarly journals How to Prevent, Detect and Manage Complications Caused by Cryoballoon Ablation of Atrial Fibrillation

2018 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Nitin Kulkarni ◽  
Wilber Su ◽  
Richard Wu ◽  
◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Best Practice ◽  
Treatment Strategies ◽  
Cryoballoon Ablation ◽  
Correct Treatment ◽  
Alternative Treatment Option ◽  
Risk Patients ◽  
High Index Of Suspicion ◽  
Maintain Sinus Rhythm

Atrial fibrillation is the most common cardiac arrhythmia and the prevalence is increasing every year. Patients who fail to maintain sinus rhythm with use of anti-arrhythmic drug therapy are referred for catheter ablation. Cryoballoon (CB) ablation has emerged as an effective and alternative treatment option to traditional point-by-point radiofrequency ablation, but there can be complications. This article reviews the incidence, presentation, risk factors, management and preventative strategies of three major complications associated with CB ablation: phrenic nerve injury, atrial oesophageal fistula and bronchial injury. Although these complications are rare, electrophysiologists should institute measures to identify high-risk patients, implement best-practice techniques to minimise risks and maintain a high index of suspicion to recognise the complications quickly and implement correct treatment strategies.

scholarly journals Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Giovanni Peretto ◽  
Alessandro Durante ◽  
Luca Rosario Limite ◽  
Domenico Cianflone
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Ventricular Arrhythmias ◽  
Sinus Node ◽  
Recovery Period ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
Preventive Strategy ◽  
Incidence Risk

Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias.

Brain–body communication in stroke

Neuroforum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Katarzyna Winek ◽  
Daniel Cuervo Zanatta ◽  
Marietta Zille
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Stroke Risk ◽  
Treatment Strategies ◽  
The Body ◽  
Cns Injury ◽  
Stroke Risk Factors ◽  
The Central Nervous System ◽  
New Treatment ◽  
The Brain

Abstract Stroke is a leading cause of death and disability worldwide with limited therapeutic options available for selected groups of patients. The susceptibility to stroke depends also on systemic parameters, and some stroke risk factors are modifiable, such as atrial fibrillation (AF) or hypertension. When considering new treatment strategies, it is important to remember that the consequences of stroke are not limited to the central nervous system (CNS) injury, but reach beyond the boundaries of the brain. We provide here a brief overview of the mechanisms of how the brain communicates with the body, focusing on the heart, immune system, and gut microbiota (GM).

scholarly journals Prevalence, risk factors, challenges, and the currently available diagnostic tools for the determination of helminths infections in human

2020 ◽  
Vol 18 ◽  
pp. 205873922095991
Author(s):  
Muhammad Riaz ◽  
Nosheen Aslam ◽  
Rida Zainab ◽  
Aziz-Ur-Rehman ◽  
Ghulam Rasool ◽  
...  
Keyword(s):  
Risk Factors ◽  
Digital Libraries ◽  
Diagnostic Techniques ◽  
Population Based ◽  
Physical Growth ◽  
Diagnostic Tools ◽  
Parasitic Infections ◽  
Open Access Journals ◽  
Specificity And Sensitivity ◽  
Review Study

Soil transmitted helminthes (STH) are among the major public health issues in tropical and sub-tropical countries infecting more than 2 billion humans worldwide. STH causes considerable morbidity in children, affecting their cognitive development and physical growth. Endemic areas with poor sanitation and limited access to good quality water supply have the highest burden of STH infection. Various approaches to reduce and control the worm infections include the intermittent deworming of children with anti-helminthic drugs. Individual patient management and population based studies can only be successful upon using the diagnostic techniques with high accuracy. The lack of reliable tools for the provision of correct diagnostic results about the status and intensity of infection is a major challenge, as these factors varies considerably in areas of low infection intensities. The techniques currently available for the diagnosis of parasitic infections show limited specificity and sensitivity and as such several techniques in combination are normally used in diagnosing the variety of parasite species infection. This review article was planned to study the prevalence, risk factors, and the available diagnostic techniques for soil and water transmitted helminthes infections in humans. This article also discussed the challenges in diagnosis, treatment, and management of worm infections particularly helminthes. The articles available online on important portals like google scholar, PubMed, Digital Libraries, PakMediNet, Science direct, and the Directory of Open Access Journals (DOAJ) were searched for inclusion of the data in this review study. Duplicate studies and irrelevant reports describing the general aspects of parasite infections were excluded. This review study provides a comprehensive report on the prevalence, accurate diagnostic, and chemotherapeutic protocols to reduce the burden of worms infections. WHO suggests the chemotherapy for worm infections as feasible and cost effective strategy in schools due to the lack of proper policy for the prevention of intestinal worms.

New Trends and Developments in Patients with Severe Aortic Stenosis – Towards Optimal Treatment?

2009 ◽  
Vol 5 (2) ◽  
pp. 81 ◽  
Author(s):  
Martijn WA van Geldorp ◽  
Johanna JM Takkenberg ◽  
Ad JJC Bogers ◽  
A Pieter Kappetein ◽  
◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Treatment Modalities ◽  
Diagnostic Tools ◽  
Number Of Patients ◽  
Transcatheter Valve

Over the next few decades the number of patients diagnosed with aortic stenosis is expected to rise as the population ages and the use of several diagnostic tools expands. This will result in a growing need for both medical and surgical treatment and stimulate the development of new diagnostic and surgical techniques. This article briefly describes the prevalence, pathogenesis and clinical presentation of patients with aortic stenosis and focuses on developments in diagnostic tools, treatment strategies and treatment modalities: the use of echocardiography, tissue Doppler imaging, stress testing and biomarkers is discussed, as well as timing of surgery and the role microsimulation can play in prosthesis selection. Furthermore, newly developed transcatheter valve implantation techniques and their possible role in treating ‘inoperable’ or ‘elderly’ patients are discussed.

Optimizing Heart Rate and Controlling Symptoms in Atrial Fibrillation

2016 ◽  
Vol 10 (1) ◽  
pp. 26
Author(s):  
Pragnesh Parikh ◽  
◽  
KL Venkatachalam ◽  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Rate Control ◽  
Stroke Risk ◽  
Symptom Control ◽  
Review Article ◽  
Rhythm Control ◽  
Ventricular Rate ◽  
Control Methods ◽  
Novel Approaches

Atrial fibrillation (AF) is the most common arrhythmia noted in clinical practice and its incidence and prevalence are on the rise. The single most important intervention is the evaluation and treatment of stroke risk. Once the risk for stroke has been minimized, controlling the ventricular rate and treating symptoms become relevant. In this review article, we emphasize the importance of confirming and treating the appropriate arrhythmia and correlating symptoms with rhythm changes. Furthermore, we evaluate some of the risk factors for AF that independently result in symptoms, underlining the need to treat these risk factors as part of symptom control. We then discuss existing and novel approaches to rate control in AF and briefly cover rhythm control methods.

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

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