Presentation
When these clots shoot off and block arteries in the brain, they can cause a stroke. (2) AF can present in different ways. [sciencedaily.com]
Methods: We present an analysis of the Polish cohort of the multicenter, multinational RHYTHM-AF registry. [journals.viamedica.pl]
However, if feasible, and if pulmonary vein potentials were present at its ostium, the right inferior pulmonary vein also was isolated. [circ.ahajournals.org]
Conclusions: Among patients presenting with PAF who are still alive at 10 years of follow-up, approximately 35% will have developed PersAF. The strongest predictor of progression to PersAF is a left atrial diameter 45 mm. [acc.org]
This pattern of AFib is referred to as Long Standing Persistent AFib, and typically AFib has been present for over a year. For a deeper look into the different types of Atrial Fibrillation, check out this video of Dr. [vacardio.com]
Entire Body System
-
Rigor
In contrast to population studies, where it can be difficult to detect and verify all strokes, all events in the trial were rigorously detected and adjudicated. [sciencedaily.com]
These results, which were observed during 18 months of follow-up with rigorous monitoring, held across the primary outcome and all secondary outcomes. [nejm.org]
Patient follow-up was long (18 months) with rigorous rhythm monitoring (systematic weekly transtelephonic monitoring and in case of symptoms), patients were unaware of the implemented ablation technique and a second procedure was allowed at 3–6 months [link.springer.com]
-
Hunting
[…] investigators, Italy References Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S, Smith SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Halperin JL, Hunt [bmccardiovascdisord.biomedcentral.com]
Respiratoric
-
Aspiration
In one patient in the group assigned to isolation plus electrograms, a procedure-related atrioesophageal fistula developed that was complicated by stroke; this was successfully treated by esophageal stenting, but the patient died 3 months later of aspiration [nejm.org]
Abbreviations: AADT, antiarrhythmic drug therapy; AF, atrial fibrillation; AP, aspiration pneumonia; CA, catheter ablation; CFAE, complex fractionated atrial electrograms; CT, cardiac tamponade; DR, drug resistant; FH, femoral hematoma; H, hematomas; [dovepress.com]
Neurologic
-
Lethargy
The symptoms of persistent AFib include fatigue, lethargy and shortness of breath. When an episode lasts longer than 7 days, the person is unlikely to come out of AFib without treatment. [vacardio.com]
Workup
Diagnostic workup At the first presentation of AF or in an AF episode with an uncontrolled ventricular response (above 80 bpm), expect the diagnostic workup to include a complete blood count, thyroid panel, hepatic panel, renal function tests, echocardiography [medical-bucuresti.ro]
Treatment
If the AF episodes last for more than 7 days, it is unlikely that they will stop on their own, and they are then known as persistent AF episodes which necessitate treatment with pharmacological or electrical cardioversion. [experts.umich.edu]
Expert commentary: Treatment to prevent AF recurrences is suboptimal, particularly in patients with persistent AF. [ncbi.nlm.nih.gov]
Next, they divided the patients into two groups: A control group received standard treatment for the 12-week period, while the other received standard treatment plus yoga. At the end of the study, the researchers examined the patients once again. [medicaldaily.com]
Authors' conclusions: There is limited evidence to suggest that CA may be a better treatment option compared to medical therapies in the management of persistent AF. This review was also unable to recommend the best CA method. [cochrane.org]
It doesn’t stop without treatment. Normal rhythm may be achieved with medication or electric shock treatment. Chronic or permanent AFib is ongoing for many years. [healthline.com]
Prognosis
Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis de Vos, C.B.; Pisters, R.; Nieuwlaat, R.; Prins, M.H.; Tieleman, R.G.; Coelen, R.J.; van den Heijkant, A.C.; Allessie, M.A.; Crijns, H.J. [deepdyve.com]
Sandercock P, Bamford J, Dennis M, Burn J, Slattery J, Jones L, et al: Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis. BMJ 1992;305:1460–1465. [karger.com]
These patients have a favourable prognosis with respect to thromboembolic events and mortality. [af-ablation.org]
This category has been developed primarily to indicate the overall favorable prognosis with respect to thromboembolism and mortality. [dovepress.com]
Prognosis depends on the patient's underlying medical condition. Any atrial arrhythmia can cause a tachycardia-induced cardiomyopathy. [patient.info]
Etiology
Classifying fractionated electrograms in human atrial fibrillation using monophasic action potentials and activation mapping: evidence for localized drivers, rate acceleration, and nonlocal signal etiologies. Heart Rhythm 2011; 8:244–253. [innovationsincrm.com]
Potential etiologies also include restrictive cardiomyopathies (e.g., amyloidosis, hemochromatosis, and endomyocardial fibrosis), cardiac tumors, and constrictive pericarditis. [af-ablation.org]
Electrophysiology [ edit ] Conduction Sinus rhythm Atrial fibrillation There are multiple theories about the etiology of atrial fibrillation. [en.wikipedia.org]
Epidemiology
Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study Chugh, S.S.; Havmoeller, R.; Narayanan, K. [deepdyve.com]
Lip G, Beevers D: ABC of atrial fibrillation: history, epidemiology, and importance of atrial fibrillation. BMJ 1995;311:1361–1363. [karger.com]
Norwegian Journal of Epidemiology 2001. 11: 31-36 23. Begaud B. Dangoumau J. Pharmacoepidemiology: definitions, problems, methodology. Therapie 2000. 55(1): 113-117 24. Miyasaka Y., Barnes M.E., Gersh B.J. et al. [rpcardio.com]
This epidemiological survey found an overall AF prevalence of 2.5%, which was much higher in those aged 70-79 years (6.6%) and in those aged 80 or over (10.4%). Prevalence was, however, low in younger individuals (1.6% for those aged 60-69 years). [elsevier.pt]
"Epidemiology of atrial fibrillation: European perspective". Clinical Epidemiology. 6 : 213–20. doi : 10.2147/CLEP.S47385. PMC 4064952. PMID 24966695. a b c d e f Anumonwo, JM; Kalifa, J (November 2014). [en.wikipedia.org]
Pathophysiology
The complex pathophysiology of persistent atrial fibrillation has fuelled the concept of adjunctive substrate modification on top of pulmonary vein isolation. [link.springer.com]
This possibility has been mentioned in studies raising concerns about the role of non-PVI sources providing the mechanism for relapse. 9 In persistent AF, invasive treatment remains challenging due to its diverse pathophysiology. [revespcardiol.org]
Pathophysiology of persistent atrial fibrillation AF is a progressive disorder, and basic research has led to the hypothesis that “AF begets AF,” meaning that the changes in the atrial substrate caused by AF lead to persistence of AF. [innovationsincrm.com]
Pathophysiology Pathophysiology of AF is complex and at present, despite research advancement due to catheter ablation strategy it is not yet well defined. [af-ablation.org]
"Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes". Circulation Research (Review). 120 (9): 1501–17. doi : 10.1161/CIRCRESAHA.117.309732. PMC 5500874. [en.wikipedia.org]
Prevention
In addition, the effects of eplerenone and/or traditional Chinese medicines in preventing the paroxysmal-to-persistent AF transition will be compared. [puuma.org]
Expert commentary: Treatment to prevent AF recurrences is suboptimal, particularly in patients with persistent AF. [ncbi.nlm.nih.gov]
The proposed model can be further personalized to assist clinicians by identifying patients that are at high risk of developing persistent AF episodes in order to deliver proactive treatment therapies that can prevent worsening their physiological state [experts.umich.edu]
It is possible that more strokes could be prevented if some well people who had never been diagnosed with AF were invited to be tested for AF in an organised manner as part of a “screening program”. [spcr.nihr.ac.uk]
Keywords: Aortic Valve Stenosis, Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Remodeling, Hypertrophy, Left Ventricular, Electrocardiography, Echocardiography, Heart Conduction System, Mitral Valve Insufficiency, Primary Prevention, Risk Factors [acc.org]