Prevalence of unknown atrial fibrillation in patients with risk factors

Europace: December 20, 2012 Aims Atrial fibrillation (AF) is the most common cardiac arrhythmia. ‘Silent’, undiagnosed AF is often only detected with the first complication, e.g. a stroke. Detection of ‘silent’ AF prior to the first cerebrovascular event would be valuable to institute adequate therapy and prevent complications related to AF. We performed a simple electrocardiography (ECG) […]

2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

Ahajournals: 12/19/12 It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection, management, or prevention of disease states. Rigorous and expert analysis of the available data documenting absolute and relative benefits and risks of those procedures and therapies can produce helpful […]

Importance of proper patient selection and endpoint selection in evaluation of new therapies in acute stroke: further analysis of the SENTIS trial

Jnis.bmj: January 3, 2013 Background The magnitude of treatment effect in acute stroke depends on several factors, including time from symptom onset (TFSO) to treatment and severity of the initial insult. Objective To report further evaluation of NeuroFlo therapy, focusing on the effect of time and stroke severity. Methods SENTIS was a prospective randomized trial (N=515) comparing standard medical […]

Concomitant Use of Antiplatelet Therapy with Dabigatran or Warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY®) Trial

CIRCULATIONAHA: December 27, 2012 Background—RE-LY showed that dabigatran etexilate 150 mg bid (DE150) was superior, and 110 mg bid (DE110) non-inferior to warfarin in preventing stroke and systemic embolism (SSE) in patients with atrial fibrillation (AF). In this subgroup analysis, we assess the efficacy and safety of dabigatran in patients who did and didn’t receive concomitant […]

Maximizing what we learn from clinical trials: NINDS Common Data Elements

Ninds.nih.gov: 12/26/12 The NINDS mission is to reduce the burden of neurological disorders through research. Patient studies, including clinical trials that test or compare treatments, can provide important insights for understanding disease, lead to better treatments, and are essential to fulfilling our mission.  Many clinical research data sets, however, are only used to address the researchers’ […]

Discerning the Incidence of Symptomatic and Asymptomatic Episodes of Atrial Fibrillation Before and After Catheter Ablation (DISCERN AF)

A Prospective, Multicenter Study JAMA: December 24, 2012 Background  The DISCERN AF study (Discerning Symptomatic and Asymptomatic Episodes Pre and Post Radiofrequency Ablation of Atrial Fibrillation) monitored atrial fibrillation (AF) using an implantable cardiac monitor (ICM) to assess the incidence and predictors of asymptomatic AF before and after catheter ablation. Methods  Patients with symptomatic AF underwent implantation […]

Omega-3 Fatty Acids for the Prevention of Recurrent Symptomatic Atrial Fibrillation

American College of Cardiology Foundation: December 1, 2012 Results of the FORWARD (Randomized Trial to Assess Efficacy of PUFA for the Maintenance of Sinus Rhythm in Persistent Atrial Fibrillation) Trial Objectives  The aim of this study was to evaluate the efficacy of polyunsaturated fatty acids (n-3 PUFA) for the prevention of recurrent atrial fibrillation (AF) in patients […]

Selection for delayed intravenous alteplase treatment based on a prognostic score

Wiley: JAN 7, 2013 Background and Purpose Approved use of intravenous alteplase for ischemic stroke offers net benefit. Pooled randomized controlled trial analysis suggests additional patients could benefit but others be harmed with treatment initiated beyond 4·5 h after stroke onset. We proposed prognostic scoring methods to identify a strategy for patient selection. Methods We selected 500 […]

Statin Therapy and Outcome After Ischemic Stroke

STROKEAHA: January 3, 2013 Background—Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. Methods—The primary analysis investigated statin therapy at stroke onset (prestroke statin use) […]

Subarachnoid Hemorrhage in a Multimodal Approach Heavily Weighted Toward Mechanical Thrombectomy With Solitaire Stent in Acute Stroke

STROKEAHA: January 3, 2013 Background and Purpose—Subarachnoid hemorrhage (SAH) may appear on computerized tomography scans after mechanical thrombectomy for acute ischemic stroke. The incidence and prognosis of this observation remain unknown. We investigated the frequency and clinical consequences of SAH after treating acute ischemic stroke with multimodal approach heavily weighted toward mechanical thrombectomy with Solitaire stent. […]

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