Atrial Fibrillation

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Atrial Fibrillation

NIH - Medical Enyclopedia: Atrial fibrillation/flutter

"Atrial fibrillation/flutter is a heart rhythm disorder (arrhythmia). It usually involves a rapid heart rate, in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner."

Highlighted Article

Atrial fibrillation. (Mt Sinai J Med. 2006)

"Diabetes, hypertension, congestive heart failure, valvular disease, and myocardial infarction are all risk factors in the development of atrial fibrillation. And the diagnosis confers a five-fold increase in the incidence of stroke."

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Atrial Fibrillation

General Information

NEWS:

Atrial Fibrillation Predisposes to Dementia, Early Death "The incidence of dementia, relatively high in the years following a first diagnosis of atrial fibrillation, further increases the mortality rate associated with atrial fibrillation alone, according to the results of a longitudinal, community-based cohort study. Cross-sectional studies have shown that patients with atrial fibrillation are at increased risk of cognitive dysfunction."

Death risk high soon after arrhythmia diagnosis "The researchers found several factors strongly associated with death in atrial fibrillation patients including faster heart rate at diagnosis, being thin, history of chronic kidney disease, and malignancy."

ARTICLES:

JAMA patient page. Atrial fibrillation. “Atrial fibrillation occurs when the electrical impulses that cause the heart to beat in a regular rhythmic manner become disorganized, causing the heart to beat irregularly and often too fast with too little force. The irregular pulse can be felt and can be seen on an electrocardiogram. An electrocardiogram (ECG or EKG) is a recording of the electrical activity of the heart made from electrodes (electrical conductors) placed on the surface of the skin, usually on each arm and leg and across the chest. On a normal ECG, the electrical activity of the heart appears as regular peaks and valleys. On an ECG of a person with atrial fibrillation, the peaks and valleys are not regular and often are closer together, representing a faster heartbeat. Atrial fibrillation decreases the efficiency of the pumping action of the heart. It also increases the risk of formation of blood clots inside the heart. These blood clots can break off and go to other parts of the body, including the brain where they can cause a stroke.”

JOURNAL ARTICLES:

A cross-sectional study of hypertension in an elderly population (75 years and over) with atrial fibrillation: secondary analysis of data from the Birmingham Atrial Fibrillation in the Aged (BAFTA) randomised controlled trial. (Int J Cardiol. 2007) "CONCLUSIONS: Hypertension is more commonly diagnosed in older patients with atrial fibrillation than in the general population. The mean systolic blood pressure is slightly lower, but the mean diastolic blood pressure substantially higher in older patients in atrial fibrillation, compared to the general population."

A National Survey of the Prevalence, Incidence, Primary Care Burden and Treatment of Atrial Fibrillation in Scotland. (Heart. 2007)

Absence of correlation between symptoms and rhythm in "symptomatic" atrial fibrillation. (Ann Thorac Surg. 2007) "CONCLUSIONS: Patient-reported symptoms of atrial fibrillation had poor correlation with actual rhythm. The lack of correlation between symptoms and rhythm underscores the importance of continuous home monitoring for accurately quantifying preoperative atrial fibrillation burden and for postoperative follow-up."

Age and Risk of Stroke in Atrial Fibrillation: Evidence for Guidelines? (Neuroepidemiology. 2007) "The risk of stroke increased by increasing age at baseline."

Atrial fibrillation. (Med J Aust. 2007)

Atrial fibrillation and risk of dementia in non-demented elderly subjects with and without mild cognitive impairment (MCI). (Arch Gerontol Geriatr. 2007)

Atrial Fibrillation, Stroke, and Cognition. A Longitudinal Population-Based Study of People Aged 85 and Older. (Stroke. 2007) "CONCLUSIONS: AF is a significant and preventable risk factor for stroke but not for dementia in the very old. The etiology of dementia syndrome in the very old is multifactorial. Both Alzheimer disease pathology and vascular pathology, particularly multiple small infarcts, contribute to cognitive decline."

Atrial fibrillation-related cardiomyopathy: a case report. (J Med Case Reports. 2007)

Coronary ischemic events after first atrial fibrillation: risk and survival. (Am J Med. 2007) "CONCLUSIONS: First AF marks a high risk for new coronary ischemic events in both men and women. AF conferred additional risk for coronary events beyond conventional risk prediction in women only. The excess mortality risk associated with the development of coronary events was significantly greater in women."

Early Recurrence of Ischemic Stroke in Japanese Patients: The Japan Standard Stroke Registry Study. (Cerebrovasc Dis. 2007) "Conclusions: This study was based on a large number of Japanese patients and confirmed that hypertension and atrial fibrillation contribute to early ischemic stroke recurrence."

Effect of hypertension on anticoagulated patients with atrial fibrillation. (Eur Heart J. 2007) "Conclusion Hypertension contributes to increased stroke and SEE in AF. Event rates markedly increase at SBP levels of >/=140 mmHg. The higher stroke rates observed in SPORTIF III compared with SPORTIF V may be related to the greater proportion of subjects with SBP >/= 140 mmHg during the trial."

Essential polyunsaturated fatty acids, inflammation, atherosclerosis and cardiovascular diseases. (Subcell Biochem. 2007)

Frequent Atrial Premature Beats Predict Paroxysmal Atrial Fibrillation in Stroke Patients. An Opportunity for a New Diagnostic Strategy. (Stroke. 2007) "CONCLUSIONS: In patients with acute ischemic stroke, frequent APBs (>/=70/24 hours) are a marker for individuals who are at greater risk to develop or have paroxysmal AF. For such patients, we propose a diagnostic workup with repeated prolonged ECG monitoring to diagnose paroxysmal AF."

Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on Atrial Fibrillation. (J Am Coll Cardiol. 2007) "CONCLUSIONS: Women with AF had more comorbidities, more HF with preserved systolic function, and a lower QoL than men. In the large group with atypical or no symptoms, women were treated appropriately more conservatively with less rhythm control than men. Women had a higher chance for stroke. Long-term QoL changes and other morbidities and mortality were similar."

High Prevalence of Paroxysmal Atrial Fibrillation and/or Atrial Flutter in Metabolic Syndrome. (Circ J. 2007)

Increased mortality in paroxysmal atrial fibrillation: report from the Stockholm Cohort-Study of Atrial Fibrillation (SCAF). (Eur Heart J. 2007) "Conclusion PxAF is associated with increased mortality, which mostly appears to be related to concomitant cardiovascular risks. Treatment with warfarin is associated with improved survival in PxAF patients."

Independent predictors of stroke in patients with atrial fibrillation (NEUROLOGY 2007) "Conclusions: Four clinical features (prior stroke/TIA, advancing age, hypertension, diabetes) are consistent independent risk factors for stroke in atrial fibrillation patients. Prior stroke/TIA is the most powerful risk factor and reliably confers a high stroke risk (>5% per year, averaging 10% per year). Absolute stroke rates associated with other individual risk factors are difficult to precisely estimate from available data."

Lack of Association Between Infectious Burden and Carotid Atherosclerosis in Japanese Patients. (J Stroke Cerebrovasc Dis. 2007)

Long-term prognosis after cardioversion of the first episode of symptomatic atrial fibrillation: a condition believed to be benign revised. (Clin Res Cardiol. 2007)

Long-term progression and outcomes with aging in patients with lone atrial fibrillation: a 30-year follow-up study. (Circulation. 2007)

Non-valvular atrial fibrillation and cognitive decline: a longitudinal cohort study. (Age Ageing. 2007) "CONCLUSIONS: there was no association between overall cognitive decline and NVAF after 3 years' follow-up, nor any apparent effect of anti-thrombotic therapy. This is consistent with our baseline results, but conflicts with previous studies. Cognitive decline is probably multifactorial and any influence of NVAF was not identified in this study."

[Pharmacological therapy of atrial fibrillation after cardiac surgery] (Kyobu Geka. 2007) "Atrial fibrillation (AF) is one of the most common complications following cardiac surgery. AF is associated with an increased risk of stroke, prolonged hospitalization and increased medical costs. Risk factors of post-operative AF are valvular surgery, advanced age, and pre-operative history of AF. Postoperative AF occurs most frequently at 2 days after the surgery and rarely after 7 post-operative days. Most of post-operative AF is short-lived and terminates until discharge. Because of short-lived nature, rate control with beta-blockers or Ca antagonists is the treatment of choice. Beta-blockers, amiodarone and sotalol are effective in preventing post-operative AF when given before the surgery and for 7 days post-operatively."

Predictors of arrhythmia recurrence in patients with lone atrial fibrillation. (Europace. 2007 ) "Conclusions The recurrence rate in lone AF patients is high. The presence of previous episodes and a mildly enlarged anteroposterior LA diameter increase the probability of relapse of lone AF."

[Prevalence of atrial fibrillation in the spanish population aged 60 years or more. The PREV-ICTUS study] (Rev Esp Cardiol. 2007) "CONCLUSIONS: In this cross-sectional population-based study of elderly individuals, the prevalence of atrial fibrillation was 8.5%, and was strongly associated with existing cardiovascular disease, hypertension, age and left ventricular hypertrophy."

Pro- and antiarrhythmic properties of a diet rich in fish oil (Cardiovascular Research 2007)

Risk for the development of atherosclerosis in women with a high level of dental plaque and severe gingival inflammation. (Int J Dent Hyg. 2007) "Conclusions: The present results indicate that a high amount of dental plaque, severe gingival inflammation as well as periodontitis seem to be associated with the development of atherosclerotic lesions in women already at its early and subclinical stages."

Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. (J Am Coll Cardiol. 2007)

[Significance of permanent atrial fibrillation in idiopathic dilated cardiomyopathy.] (Ann Cardiol Angeiol (Paris). 2007)

Stroke Prevention in Atrial Fibrillation (Stroke. 2007) " All patients with atrial fibrillation at increased risk for stroke should be continued on long-term anticoagulation even if they appear to have been successfully restored to sinus rhythm."

The Impact of New-Onset Atrial Fibrillation on In-hospital Mortality Following Cardiac Surgery. (Chest. 2007) "CONCLUSION: NAF following cardiac surgery is not associated with increased IHM."

The metabolic syndrome and subclinical carotid atherosclerosis: the northern Manhattan study. (J Cardiometab Syndr. 2007)

Transient Atrial Fibrillation Complicating Acute Inferior Myocardial Infarction: Implications for Future Risk of Ischemic Stroke. (Chest. 2007) "Conclusion Transient AF complicating acute inferior MI is associated with an increased future risk of AF occurrence and ischemic stroke in patients with preserved LVEF, despite the use of anti-platelet therapy."

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