Time Trends of Ischemic Stroke Incidence and Mortality in Patients Diagnosed With First Atrial Fibrillation in 1980 to 2000 Report of a Community-Based Study
Background and Purpose— With the changes in management of atrial fibrillation (AF) over time, it is possible that the time trends of post-AF stroke incidence and mortality have changed. We sought to determine whether the incidence and survival of ischemic stroke after AF diagnosis have improved. Methods— We identified the Olmsted County, Minn, residents who developed first AF from 1980 to 2000 and followed them in medical records to 2004. The outcomes were first ischemic stroke and death. Results— Of the 4117 subjects diagnosed with first AF and without previous stroke, 446 (11%) sustained a first ischemic stroke during a mean follow-up time of 5.5±5.0 years. The age- and sex-adjusted incidence of stroke decreased, on average, by 3.4% per year (P=0.0001), concurrent with an increase in warfarin and aspirin use (both P<0.0001) and reduction of systolic blood pressure (P<0.001). The age-adjusted ischemic stroke incidence was higher in women (P=0.039), but not after adjusting for systolic blood pressure (P=0...
The Copenhagen City Heart Study is a population-based cohort study. Using baseline data from 3 cohort examinations (1976 to 1978, 1981 to 1983, and 1991 to 1994), we analyzed the gender-specific effect of atrial fibrillation (AF) on the risk of stroke and cardiovascular death during 5 years of follow-up. Baseline data from 29,310 subjects were included. AF was documented in 276 subjects (110 women and 166 men). During a mean follow-up of 4.7 years, 635 strokes were identified, 35 of which occurr...
Background. Despite the significant beneficial effects of antithrombotic therapy in primary prevention of stroke in patients with chronic nonvalvular atrial arrhythmia, this prevention therapy is underutilized. We conducted this population-based study to determine the rates and the trends of utilization of antithrombotic therapy for stroke patients with atrial fibrillation before stroke onset, and to evaluate indirectly the impact of medical recommendations on physician practice. Our aim was not...
Background Atrial fibrillation is the most common cardiac arrhythmia associated with significant medical complications. We examined trends in the medical therapy of atrial fibrillation in the United States from 1991 through 2000. Methods Data from 1355 visits among patients with atrial fibrillation were obtained from the National Ambulatory Medical Care Survey, a nationally representative assessment of office-based practice. We assessed trends in medication use for ventricular rate control (digo...
ContextPrior risk stratification schemes for atrial fibrillation (AF) have been based on randomized trial cohorts or Medicare administrative databases, have included patients with established AF, and have focused on stroke as the principal outcome.ObjectiveTo derive risk scores for stroke alone and stroke or death in community-based individuals with new-onset AF.Design, Setting, and ParticipantsProspective, community-based, observational cohort in Framingham, Mass. We identified 868 participants...
ContextPrior analyses of National Health and Nutrition Examination Survey (NHANES) data through 1991 have suggested that hypertension prevalence is declining, but more recent self-reported rates of hypertension suggest that the rate is increasing.ObjectiveTo describe trends in the prevalence, awareness, treatment, and control of hypertension in the United States using NHANES data.Design, Setting, and ParticipantsSurvey using a stratified multistage probability sample of the civilian noninstituti...
OBJECTIVE To determine the prevalence of atrial fibrillation in England and Wales, and examine trends in its treatment with warfarin and aspirin between 1994 and 1998. DESIGN Analysis of data from the general practice research database. SETTING England and Wales. PATIENTS 1.4 million patients registered with 211 general practices. MAIN OUTCOME MEASURES Age and sex specific prevalence rates of atrial fibrillation; percentage of patients with atrial fibrillation treated with oral anticoagulants or...
ContextAtrial fibrillation is the most common arrhythmia in elderly persons and a potent risk factor for stroke. However, recent prevalence and projected future numbers of persons with atrial fibrillation are not well described.ObjectiveTo estimate prevalence of atrial fibrillation and US national projections of the numbers of persons with atrial fibrillation through the year 2050.Design, Setting, and PatientsCross-sectional study of adults aged 20 years or older who were enrolled in a large hea...
Data Synthesis: Sixteen trials included a total of 9874 participants (mean follow-up, 1.7 years). Adjusted-dose warfarin (six trials, 2900 participants) reduced stroke by 62% (95% CI, 48% to 72%); absolute risk reductions were 2.7% per year for primary prevention and 8.4% per year for secondary prevention. Major extracranial bleeding was increased by warfarin therapy (absolute risk increase, 0.3% per year). Aspirin (six trials, 3119 participants) reduced stroke by 22% (CI, 2% to 38%); absolute r...
#2Bruce M. Psaty(UW: University of Washington)H-Index: 193
Last. Teri A. Manolio(NIH: National Institutes of Health)H-Index: 117
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Background: Several recent randomized clinical trials have demonstrated that warfarin sodium treatment, and to a lesser extent aspirin, reduces risk of stroke and death compared with placebo in persons with atrial fibrillation. Insufficient documentation exists on the extent to which the use of these therapies following trial publications has continued to increase in the elderly with atrial fibrillation. Methods: We used data from the Cardiovascular Health Study, a study of 5888 community-dwelli...
Plasmin-a2-antiplasmin complex (PAP) is an index of recent fibrinolytic activity. We examined PAP levels in patients with atrial fibrillation (AF) to determine whether these levels are correlated with clinical characteristics associated with stroke risk. We obtained blood for measurement of PAP in a non-random sample of 586 patients with AF on entering the Stroke Prevention in Atrial Fibrillation III Study. PAP levels were measured with an ELISA assay. PAP values were transformed with a natural ...
Introduction:Recently, stroke is becoming the major public health problem in developing countries including Ethiopia. Atrial fibrillation patients are the most vulnerable group for the occurrence o...
Background: Presence of left atrial low voltage substrate in bipolar voltage mapping is associated with increased arrhythmia recurrences following pulmonary vein isolation for atrial fibrillation (AF). Besides local myocardial fibrosis, bipolar voltage amplitudes may be influenced by inter-electrode spacing and bipole-to-wavefront-angle. It is unclear to what extent these impact low voltage areas (LVA) in the clinical setting. Alternatively, unipolar electrogram voltage is not affected by these ...
#1Deborah Nairn(KIT: Karlsruhe Institute of Technology)H-Index: 1
#2Daniel Hunyar(KIT: Karlsruhe Institute of Technology)
Last. Axel Loewe(KIT: Karlsruhe Institute of Technology)H-Index: 13
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Atrial fibrillation can be treated using low voltage (LV) (amplitude of intracardiac electrogram 1 mm) in diseased tissue. Electrode size needs to be accounted for when determining LV areas using different catheters.
Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and has unfavorable consequences such as stroke, heart failure (HF), and death. HF is the most common adverse event following AF and the leading cause of death. Therefore, identifying the association between AF and HF is important to establish risk stratification for HF in AF. Recent studies suggested that left atrial and ventricular fibrosis is an important link between AF and HF, and the prognostic impact may differ wit...
Last. Amy Yx Yu(U of T: University of Toronto)H-Index: 1
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Background and aimAtrial fibrillation is associated with increased risk of ischemic stroke and its global prevalence is increasing. We aimed to describe the contemporary temporal trends in hospital...
Last. Axel Loewe(KIT: Karlsruhe Institute of Technology)H-Index: 13
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Catheter ablation targeting low voltage areas (LVA) is commonly being used to treat atrial fibrillation (AF) in patients with persistent AF. However, it is not always certain that the areas marked as low voltage (LV) are correct. This can be related to how the voltage is calculated. Therefore, this paper focuses on comparing different calculation methods, specifically, with regards to spatial distribution.Two voltage maps obtained in AF were used, removing points which did not meet the required ...
Left atrial (LA) volume is known as a robust predictor of heart failure (HF) development in patients with sinus rhythm. However, among patients with atrial fibrillation (AF), the utility of LA volume for prediction of HF development has not been determined. The objective of this study was to investigate the utility of LA volume for prediction of HF development in patients with AF. Among adult patients who were referred for transthoracic echocardiography, those with AF at the baseline echocardiog...
Background: Understanding atrial fibrillation (AF) management in Scotland was identified as a key priority at the Cross Party Group (CPG) for Heart Disease and Stroke, which meets regularly at the Scottish Parliament. Therefore, a national inquiry was launched to provide clear recommendations to government to improve health for people living with AF. Methods: An advisory panel was convened comprising major third-sector representatives, academics, clinicians, Members of Scottish Parliament (MSPs)...