Relevant bibliographies by topics / Atrial fibrillation; stroke; thrombogenesis

Academic literature on the topic 'Atrial fibrillation; stroke; thrombogenesis'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Atrial fibrillation; stroke; thrombogenesis"

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Goette, Andreas, and Uwe Lendeckel. "Atrial Cardiomyopathy: Pathophysiology and Clinical Consequences." Cells 10, no. 10 (September 30, 2021): 2605. http://dx.doi.org/10.3390/cells10102605.

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Around the world there are 33.5 million patients suffering from atrial fibrillation (AF) with an annual increase of 5 million cases. Most AF patients have an established form of an atrial cardiomyopathy. The concept of atrial cardiomyopathy was introduced in 2016. Thus, therapy of underlying diseases and atrial tissue changes appear as a cornerstone of AF therapy. Furthermore, therapy or prevention of atrial endocardial changes has the potential to reduce atrial thrombogenesis and thereby cerebral stroke. The present manuscript will summarize the underlying pathophysiology and remodeling processes observed in the development of an atrial cardiomyopathy, thrombogenesis, and atrial fibrillation. In particular, the impact of oxidative stress, inflammation, diabetes, and obesity will be addressed.
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Contractor, Tahmeed, and Atul Khasnis. "Left Atrial Appendage Closure in Atrial Fibrillation: A World without Anticoagulation?" Cardiology Research and Practice 2011 (2011): 1–7. http://dx.doi.org/10.4061/2011/752808.

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Atrial Fibrillation (AF) is a common arrhythmia with an incidence that is as high as 10% in the elderly population. Given the large proportion of strokes caused by AF as well as the associated morbidity and mortality, reducing stroke burden is the most important part of AF management. While warfarin significantly reduces the risk of AF-related stroke, perceived bleeding risks and compliance limit its widespread use in the high-risk AF population. The left atrial appendage is believed to be the “culprit” for thrombogenesis in nonvalvular AF and is a new therapeutic target for stroke prevention. The purpose of this review is to explore the evolving field of percutaneous LAA occlusion. After briefly highlighting the risk of stroke with AF, problems with warfarin, and the role of the LAA in clot formation, this article discusses the feasibility and efficacy of various devices which have been developed for percutaneous LAA occlusion.
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D’Alessandro, Elisa, Joris Winters, Frans A. van Nieuwenhoven, Ulrich Schotten, and Sander Verheule. "The Complex Relation between Atrial Cardiomyopathy and Thrombogenesis." Cells 11, no. 19 (September 22, 2022): 2963. http://dx.doi.org/10.3390/cells11192963.

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Heart disease, as well as systemic metabolic alterations, can leave a ‘fingerprint’ of structural and functional changes in the atrial myocardium, leading to the onset of atrial cardiomyopathy. As demonstrated in various animal models, some of these changes, such as fibrosis, cardiomyocyte hypertrophy and fatty infiltration, can increase vulnerability to atrial fibrillation (AF), the most relevant manifestation of atrial cardiomyopathy in clinical practice. Atrial cardiomyopathy accompanying AF is associated with thromboembolic events, such as stroke. The interaction between AF and stroke appears to be far more complicated than initially believed. AF and stroke share many risk factors whose underlying pathological processes can reinforce the development and progression of both cardiovascular conditions. In this review, we summarize the main mechanisms by which atrial cardiomyopathy, preceding AF, supports thrombogenic events within the atrial cavity and myocardial interstitial space. Moreover, we report the pleiotropic effects of activated coagulation factors on atrial remodeling, which may aggravate atrial cardiomyopathy. Finally, we address the complex association between AF and stroke, which can be explained by a multidirectional causal relation between atrial cardiomyopathy and hypercoagulability.
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Huang, Taiyuan, Schurr Patrick, Louisa Katharina Mayer, Björn Müller-Edenborn, Martin Eichenlaub, Martin Allgeier, Jürgen Allgeier, et al. "Echocardiographic and Electrocardiographic Determinants of Atrial Cardiomyopathy Identify Patients with Atrial Fibrillation at Risk for Left Atrial Thrombogenesis." Journal of Clinical Medicine 11, no. 5 (February 28, 2022): 1332. http://dx.doi.org/10.3390/jcm11051332.

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Objective: Atrial cardiomyopathy (ACM) is associated with development of AF, left atrial (LA) thrombogenesis, and stroke. Diagnosis of ACM is feasible using both echocardiographic LA strain imaging and measurement of the amplified p-wave duration (APWD) in digital 12-lead-ECG. We sought to determine the thresholds of LA global longitudinal strain (LA-GLS) and APWD that identify patients with AF at risk for LA appendage (LAA) thrombogenesis. Methods: One hundred and twenty-eight patients with a history of AF were included. Left atrial appendage maximal flow velocity (LAA-Vel, in TEE), LA-GLS (TTE), and APWD (digital 12-lead-ECG) were measured in all patients. ROC analysis was performed for each method to determine the thresholds for LA-GLS and the APWD, enabling diagnosis of patients with LAA-thrombus. Results: Significant differences in LA-GLS were found during both rhythms (SR and AF) between the thrombus group and control group: LA-GLS in SR: 14.3 ± 7.4% vs. 24.6 ± 9.0%, p < 0.001 and in AF: 11.4 ± 4.2% vs. 16.1 ± 5.0%, p = 0.045. ROC analysis revealed a threshold of 17.45% for the entire cohort (AUC 0.82, sensitivity: 84.6%, specificity: 63.6%, Negative Predictive Value (NPV): 94.3%) with additional rhythm-specific thresholds: 19.1% in SR and 13.9% in AF, and a threshold of 165 ms for APWD (AUC 0.90, sensitivity: 88.5%, specificity: 75.5%, NPV: 96.2%) as optimal discriminators of LAA-thrombus. Moreover, both LA-GLS and APWD correlated well with the established contractile LA-parameter LAA-Vel in TEE (r = 0.39, p < 0.001 and r = −0.39, p < 0.001, respectively). Conclusion: LA-GLS and APWD are valuable diagnostic predictors of left atrial thrombogenesis in patients with AF.
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Seo, Woo-Keun, Jin-Man Jung, Ji Hyun Kim, Seong-Beom Koh, Oh Young Bang, and Kyungmi Oh. "Free Fatty Acid Is Associated with Thrombogenicity in Cardioembolic Stroke." Cerebrovascular Diseases 44, no. 3-4 (2017): 160–68. http://dx.doi.org/10.1159/000478895.

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Background: Recently, the role of free fatty acids (FFAs) in thromboembolism has re-emerged in the context of cardioembolic stroke. Therefore, we attempted to determine the role of FFAs in embolic risk in various potential sources of cardioembolism (PSCE). We hypothesized that if elevated FFA levels in stroke patients are associated with thrombogenesis, then patients with a well-known high risk of embolic sources would have high FFA levels. Methods: Data collected from 2 hospital-based stroke registries were analyzed to investigate the association between FFA and PSCE. Results: A total of 2,770 acute stroke patients, including 539 with cardioembolic stroke, were selected for analysis. FFA was an independent predictor for cardioembolism (OR 2.755, 95% CI 2.221-3.417, p < 0.001). Among the PSCE, FFA levels were significantly associated with high risk of atrial fibrillation (AF), valvular heart disease, congestive heart failure with low ejection fraction, left atrial thrombus, left ventricular thrombus, left atrial smoke, and ventricular wall motion abnormality. FFA levels increased with the number of PSCE per patient without interaction with the presence of AF. Conclusions: Among acute stroke patients, FFA levels increased in groups with higher risk of cardioembolic stroke irrespective of the presence of AF. These results suggest that enhanced thrombogenicity could be the main mechanism to explain the elevated FFA levels in patients with cardioembolic stroke.
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Cerveró, Jorge, Víctor Segura, Alfonso Macías, Juan Gavira, Ramón Montes, and José Hermida. "Atrial fibrillation in pigs induces left atrial endocardial transcriptional remodelling." Thrombosis and Haemostasis 108, no. 10 (2012): 742–49. http://dx.doi.org/10.1160/th12-05-0285.

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SummaryThe leading cause of cardioembolic stroke is atrial fibrillation (AF), which predisposes to atrial thrombus formation. Although rheological alterations promote a hypercoagulable environment, as yet undefined factors contribute to thrombogenesis. The role of the endocardium has barely been explored. To approach this topic, rapid atrial pacing (RAP) was applied in four pigs to mimic A F. Left and right endocardial cells were isolated separately and their gene expression pattern was compared with that of four control pigs. The AF-characteristic rhythm disorders and endothelial nitric oxide synthase down-regulation were successfully reproduced, and validated RAP to mimic A F. A change was observed in the transcriptomic endocardial profile after RAP: the expression of 364 genes was significantly altered (p<0.01), 29 of them having passed the B>0 criteria. The left atrial endocardium [325 genes (7 genes, B>0)] was largely responsible for such alterations. Blood coagulation, blood vessel morphogenesis and inflammatory response are among the most significant altered functions, and help to explain the activation of coagulation observed after RAP: D-dimer, 0.49 (1.63) vs. 0.23 (0.24) mg/l [median (interquartile range)] in controls, p=0.02. Furthermore, three genes directly related to thrombotic processes were differentially expressed after RAP: FGL2 [fold change (FC)=0.85; p=0.007], APLP2 (FC=-0.47; p=0.005) and ADAMTS-18 (FC=-0.69; p=0.004). We demonstrate for the first time that AF induces a global expression change in the left atrial endocardium associated with an activation of blood coagulation. The nature of some of the altered functions and genes provides clues to identify new therapeutic targets.
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Park, Hyungjong, and Joonsang Yoo. "Use of Non-Vitamin K Dependent Oral Anticoagulant in Ischemic Stroke." Journal of the Korean Neurological Association 40, no. 1 (February 1, 2022): 1–14. http://dx.doi.org/10.17340/jkna.2022.1.1.

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Atrial fibrillation (AF) is associated with an increased incidence of ischemic stroke and transient ischemic attack. A confluence of various factors such as blood stasis, endothelial dysfunction, and prothrombotic state could be contributing to the thrombogenesis in AF. Anticoagulation is the first-line therapy for the prevention of thromboembolism by AF. In current days, non-vitamin K dependent oral anticoagulants (NOAC) are considered as the preferred choice of anticoagulants to prevent ischemic stroke in patients with AF. NOACs have comparable good efficacy and better safety with a predictable anticoagulant effect without the routine coagulation monitoring compared to vitamin K dependent oral anticoagulant. However, the proper use of NOACs needs a careful approach to many practical aspects for balancing the preventing thromboembolic events and bleeding risk. Thus, understanding the drug metabolism and indication of NOAC for a specific situation is essential. In this article, we review major clinical trials, the mechanism, and the use of NOACs in the actual clinical setting of managing ischemic stroke patients.
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Regazzoli, Damiano, Francesco Ancona, Nicola Trevisi, Fabrizio Guarracini, Andrea Radinovic, Michele Oppizzi, Eustachio Agricola, et al. "Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target." BioMed Research International 2015 (2015): 1–13. http://dx.doi.org/10.1155/2015/205013.

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Atrial fibrillation (AF) is the most common clinically relevant cardiac arrhythmia. AF poses patients at increased risk of thromboembolism, in particular ischemic stroke. The CHADS2 and CHA2DS2-VASc scores are useful in the assessment of thromboembolic risk in nonvalvular AF and are utilized in decision-making about treatment with oral anticoagulation (OAC). However, OAC is underutilized due to poor patient compliance and contraindications, especially major bleedings. The Virchow triad synthesizes the pathogenesis of thrombogenesis in AF: endocardial dysfunction, abnormal blood stasis, and altered hemostasis. This is especially prominent in the left atrial appendage (LAA), where the low flow reaches its minimum. The LAA is the remnant of the embryonic left atrium, with a complex and variable morphology predisposing to stasis, especially during AF. In patients with nonvalvular AF, 90% of thrombi are located in the LAA. So, left atrial appendage occlusion could be an interesting and effective procedure in thromboembolism prevention in AF. After exclusion of LAA as an embolic source, the remaining risk of thromboembolism does not longer justify the use of oral anticoagulants. Various surgical and catheter-based methods have been developed to exclude the LAA. This paper reviews the physiological and pathophysiological role of the LAA and catheter-based methods of LAA exclusion.
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Springer, Adrian, Ruben Schleberger, Florian Oyen, Boris A. Hoffmann, Stephan Willems, Christian Meyer, Florian Langer, et al. "Genetic and Clinical Predictors of Left Atrial Thrombus: A Single Center Case-Control Study." Clinical and Applied Thrombosis/Hemostasis 27 (January 1, 2021): 107602962110211. http://dx.doi.org/10.1177/10760296211021171.

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Left atrial (LA) thrombus formation is the presumed origin of thromboembolic complications in patients with atrial fibrillation (AF). Beyond clinical risk factors, the factors causing formation of LA thrombi are not well known. In this case-control study, we analyzed clinical characteristics and genetic thrombophilia markers (factor V Leiden (FVL), prothrombin G20210A (FIIV), Tyr2561 variant of von Willebrand factor (VWF-V)) in 42 patients with AF and LA thrombus (LAT) and in 68 control patients with AF without LAT (CTR). Patients with LAT had more clinical conditions predisposing to stroke (mean CHA2DS2-VASc-score 3.4 ± 1.5 vs. 1.9 ± 1.4; P < 0.001), a higher LA volume (96 ± 32 vs. 76 ± 21 ml, P = 0.002) and lower LA appendage emptying velocity (0.21 ± 0.11vs. 0.43 ± 0.19 m/s, P < 0.001). Prevalence of FVL, FIIV and VWF-V mutations was not different, but in the subgroup of patients <65 years (y) there was a tendency for a higher incidence of VWF-V with a prevalence of 27% (LAT <65 y) vs. 7% (CTR <65 y, P = 0.066). These findings warrant further investigation of the VWF-V as a risk factor for LA thrombogenesis in younger patients.
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Paulinska, P., A. Spiel, and B. Jilma. "Role of von Willebrand factor in vascular disease." Hämostaseologie 29, no. 01 (2009): 32–38. http://dx.doi.org/10.1055/s-0037-1616936.

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SummaryPlasma levels of von Willebrand factor (VWF) are increased in patients with cardiovascular risk factors. Various studies aimed to elucidate the relation of VWF with thrombo - embolic cardiovascular events, ischaemic stroke as well as with peripheral arterial occlusive disease. In the general population, there is only a weak association between VWF levels and future cardiovascular events or stroke. In contrast, VWF levels are predictive in patients with documented vascular disease. Those patients with increased VWF suffer a higher incidence of major adverse cardiac events including death. The extent of the VWF release and its levels independently predict clinical outcome in patients with acute coronary syndromes. Elevated VWF levels have also been observed in patients with atrial fibrillation compared to controls and predict outcome. This may at least in part be attributable to the association of VWF with underlying cardiovascular risk factors. Hence, VWF correlates with Framingham and CHADS stroke risk stratification score and can be used as a marker in patients with AF. However, VWF is not only a predictor; it also plays a crucial role in thrombogenesis. This fact has made VWF a promising target for research into new antiplatelet therapies that specifically inhibit VWF.This review focuses on the role of VWF in ACS, ischaemic stroke and peripheral arterial disease and the relevance of therapeutic interventions targeting VWF for ACS patients.
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Dissertations / Theses on the topic "Atrial fibrillation; stroke; thrombogenesis"

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Kamath, Sridhar. "A study of platelets in atrial fibrillation." Thesis, University of Birmingham, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270055.

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Khoo, Chee Wah. "The relationship between left atrial remodelling, atrial fibrillation burden and thrombogenesis." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6847/.

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Contemporary pacemakers allow quantification of atrial high-rate episodes (AHREs) and atrial fibrillation burden (AFB) accurately. It is generally believed that left atrial (LA) remodelling may precede the development of atrial arrhythmias (AA), and AHRE precede the clinical manifestation of atrial flutter or fibrillation. However, the relationship between LA remodelling with AHRE has not been studied. Furthermore, the relationship of AFB to progressive LA remodelling and how this relates to indices of thrombogenesis is unclear. The aim of my study is to investigate the inter-relationship between LA remodelling, AA burden and indices of thrombogenesis in patients with pacemakers. My findings suggest that the incidence of AHRE was 35%. Increased frequency of right ventricular pacing is associated with LA enlargement and reduced global left and right ventricular function. However, there was no clear association between the right atrial pacing with cardiac remodelling. The cumulative percentage right ventricular pacing and increased LA volume are associated with the development of AHREs, but AFB is independently associated with changes in LA function, left ventricular diastolic function and indices of platelet activation and thrombosis. In addition, I demonstrated the feasibility and reproducibility of a novel method of IACT measurement in patients with permanent pacemakers.
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Själander, Sara. "Stroke prevention in atrial fibrillation." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-124951.

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Background: The Framingham Study from 1991 showed a clear correlation between atrial fibrillation (AF) and ischemic stroke, where patients with AF had an almost fivefold increase in risk of stroke compared with patients without AF. Since then, several trials have evaluated different antithrombotic treatments to reduce the risk of stroke in patients with AF. Other trials have investigated factors that increase the risk of stroke in patients with AF and risk score systems have been developed to categorize patients into low or increased risk of stroke to help clinicians to decide which patients benefit from antithrombotic treatment and in whom it can be abstained, not to expose patients with low stroke risk to an increased risk of bleeding conferred by antithrombotic treatment. The aims of this thesis were: [1] to evaluate if a warfarin dosing algorithm can increase hit rate and decrease mean error compared with manually changed doses; [2] to assess the prevalence and net clinical benefit of aspirin as monotherapy for stroke prevention in AF; [3] to investigate the risk of thromboembolic and haemorrhagic complications within 30 days after electrical cardioversion (ECV) of AF in patients with and without oral anticoagulation (OAC) pre-treatment; and [4] to assess the proportion of patients discontinuing OAC after pulmonary vein isolation (PVI), identify factors predicting stroke after PVI and to investigate risk of complications after PVI with and without OAC. Materials and methods: All studies are retrospective and based on data from Swedish national quality registries. In paper I, data from Auricula was used to compare the resulting INR values after algorithmic warfarin dose suggestions and manually changed doses. In paper II data was extracted from the Swedish National Patient Register, the Dispensed Drugs Register and the Cause of Death Register. Patients with aspirin treatment were compared with patients without any antithrombotic treatment regarding risk of thromboembolic and haemorrhagic complications. In paper III data was collected from the Swedish National Patient Register and the Dispensed Drugs Register to examine risk of complications (thromboembolic and haemorrhagic events) within 30 days after cardioversion, comparing patients with and without oral anticoagulation pre-treatment. In paper IV data from six different Swedish national quality registries were used (Swedish Catheter Ablation Register, Auricula, Swedish National Patient Register, Dispensed Drugs Register, Cause of Death Register and Riksstroke). Patients undergoing pulmonary vein isolation (PVI) were investigated for adherence to guidelines regarding oral anticoagulation, predictors for stroke after PVI, as well as risk of ischemic stroke or intracranial haemorrhage after PVI in patients with and without treatment. Results: Paper I showed that a computerized dosing algorithm for warfarin in most cases perform as well or better compared with doses that have been changed manually, with a better hit-rate (0.72 vs. 0.67) and a lower mean error (0.44 vs. 0.48). Paper II showed that 32% of 182.678 patients with a diagnosis of AF were on monotherapy with aspirin for stroke prevention. A total of 115.185 patients were included, 58.671 with aspirin treatment and 56.514 without antithrombotic treatment at baseline. After stratification after CHA2DS2-VASc score and after multivariable adjustment, aspirin treatment did not confer a decrease in thromboembolic events. After propensity score mathcing, rate of ischemic stroke was 7.4%/year (95% CI 7.1-7.6) in aspirin treated patients and 6.6%/year (95% CI 6.4-6.9) in patients without antithrombotic treatment. In paper III 22.874 patients undergoing electrical cardioversion were included, 10.722 with and 12.152 without OAC pre-treatment. In patients with low stroke risk (CHA2DS2-VASc 0-1), no thromboembolic complication was seen within 30 days after cardioversion. In patients with CHA2DS2-VASc ≥2, the risk of thromboembolic complications was increased when no oral anticoagulation pre-treatment was used, results that remained after propensity score matching. No difference regarding haemorrhagic complications was seen. Paper IV included a total of 1585 patients undergoing PVI with a mean follow up of 2.6 years. Adherence to current guidelines regarding oral anticoagulation was good in patients with CHA2DS2-VASc ≥2. Previous ischemic stroke was a predictor for a new stroke after PVI. In patients with CHA2DS2-VASc ≥2 stroke risk was increased in patients discontinuing OAC compared to those continuing OAC (1,60%/year vs. 0.34%/year). Conclusion: Oral anticoagulation is still underutilized for prevention of stroke and systemic embolism in patients with atrial fibrillation. Patients with risk factors for stroke (CHA2DS2-VASc ≥2p) benefit from continuous oral anticoagulation treatment to prevent stroke, also in conjunction with electrical cardioversion and after pulmonary vein isolation. If warfarin is chosen, a computerised dosing algorithm can facilitate and standardize warfarin dosing and lead to better resulting INR values than manually changed doses. Aspirin should not be used for stroke prevention in patients with atrial fibrillation.
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Guttmann, O. P. "Stroke and atrial fibrillation in hypertrophic cardiomyopathy." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1497024/.

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Hypertrophic cardiomyopathy (HCM) is an inherited myocardial disease associated with atrial fibrillation (AF) and thromboembolism (TE), which are related to adverse clinical outcomes and reduced survival. Current ESC and ACCF/AHA guidelines recommend anticoagulation in all patients with HCM and atrial fibrillation but the absolute risk of thromboembolism in patients with and without documented AF is unclear. The primary aim of this study was to derive and validate a model for estimating the risk of TE in HCM. Analyses were performed to determine predictors of AF and TE. Exploratory analyses assessed the performance of the CHA2DS2-VASc score and outcome with vitamin K antagonists (VKA). A further aim was to investigate the effect of AF on mortality and the efficacy of antiarrhythmic therapy in the development of AF.
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Watson, Timothy J. "Circulating progenitor cells in atrial fibrillation : Relationship to endothelial dysfunction, thrombogenesis and inflammation." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1253/.

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Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with rapidly rising prevalence and incidence predominantly due to advancing age in Western populations. Of particular concern however is the strong relationship between AF and stroke. This relates to a number of factors, but there is an emerging body of evidence to suggest that AF confers a hypercoagulable state. Disruption of endothelial homeostasis (damage vs. repair) is thought to be central to this process. The endothelium appears to be damaged both by AF and various other vascular diseases (e.g. hypertension) that frequently co-exist with the arrhythmia, with similar disruption to endothelial repair (normally effected by endothelial progenitor cells). Endothelial damage seems to be an essential prerequisite to thrombogenesis in AF. Significantly, the endothelium also links a number of processes including inflammation, growth factors, the renin-angiotensin-aldosterone system among others, which may directly or indirectly lead to activation of the coagulation cascade. This thesis investigates the relationship between the temporal pattern of AF (paroxysmal, persistent, permanent) and established markers of endothelial dysfunction (vonWillebrand factor, vWf; soluble E-selectin, sEsel), angiogenesis (vascular Endothelial Growth Factor, VEGF), apoptosis (soluble Fas/Fas ligand, sFas/sFasL) and inflammation (C-reactive protein, CRP; Interleukin-6, IL-6) in AF with particular reference to circulating progenitor cells (CPCs) as a novel marker of endothelial health/angiogenesis. Additionally the impact of restoration of sinus rhythm using electrical cardioversion on these indices and the relevance of the AF arrhythmia burden in influencing these markers is investigated. In conclusion, the endothelium seems to be a central link through which all three components of Virchow’s triad interact in AF. This thesis finds a possible link for CPCs to interact with various other reported aberrancies of the hypercoagulable state in this process. Also reported is a modest alteration in CPC counts following restoration of sinus rhythm, however, only limited numbers of patients were assessed and this requires examination with a more in depth study. Finally, the thesis has also examined the role of paroxysmal AF in influencing surrogate markers of the hypercoagulable state, but failed to find any significant differences on the basis of the arrhythmia burden. These findings must however been considered in light of numerous study limitations, the most notable of which is limited statistical power.
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Hendrikx, Tijn. "Catch Atrial Fibrillation, Prevent Stroke : Detection of atrial fibrillation and other arrhythmias with short intermittent ECG." Doctoral thesis, Umeå universitet, Allmänmedicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100497.

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Background: Atrial fibrillation (AF) is the most common arrhythmia in the adult population, affecting about 5% of the population over 65 years. Occurrence of AF is an independent risk factor for stroke, and together with other cardiovascular risk factors (CHADS2/CHA2DS2- VASc), the stroke risk increases. Since AF is often paroxysmal and asymptomatic (silent) it may remain undiagnosed for a long time and many AF patients are not discovered before suffering a stroke. Aims: To estimate the prevalence of previously undiagnosed AF in an out-of-hospital population with CHADS2 ≥1, in patients with an enlarged left atrium (LA) and of total AF prevalence in sleep apnea (SA) patients, conditions that have been associated with AF. To compare the efficacy of short intermittent ECG with continuous 24h Holter ECG in detecting arrhythmias. Methods: Patients without known AF recorded 10−30 second handheld ECG (Zenicor-EKG®) registrations during 14−28 days at home, both regular, asymptomatic registrations twice daily and when having cardiac symptoms. Recordings were transmitted through the in-built SIM card to an internet-based database. Patients with palpitations or dizziness/presyncope referred for 24h Holter ECG were asked to additionally record 30-second handheld ECG registrations during 28 days at home. Results: In the out-of-hospital population with increased stroke risk, previously unknown AF was diagnosed in 3.8% of 928 patients. Comparing AF detection in patients with an enlarged LA versus normal LA showed that eleven of 299 patients had AF. Five of these had an enlarged LA (volume/BSA). No statistical difference in AF prevalence was found between patients with enlarged and normal LA, 3.3% and 3.2% respectively, (p = 0.974). AF occurred in 7.6% of 170 patients with sleep apnea, in 15% of patients with sleep apnea ≥60 years, and in 35% of patients with central sleep apnea. AF prevalence was also associated with severity of sleep apnea, male gender and diabetes. Comparing the efficacy of arrhythmia detection in 95 patients with palpitations or dizziness/presyncope with continuous 24h Holter and short intermittent ECG, 24h Holter found AF in two and AV-block II in one patient, resulting in 3.2% relevant arrhythmias detected. Short intermittent ECG diagnosed nine patients with AF, three with PSVT and one with AV-block II, in total 13.7% relevant arrhythmias. (p = 0.0094). Conclusions: Screening in the out-of-hospital patient population (mean age 69.8 years) yielded almost 4% AF, making it seem worthwhile to screen older patients with increased stroke risk for AF with this method. Screening patients with LA enlargement (mean age 73.1 years) did not result in higher detection rates compared with the general out-of-hospital population. AF occurred in 7.6% of patients with sleep apnea, (mean age 57.6 years) and was associated with severity of sleep apnea, presence of central sleep apnea, male gender, age ≥60 years, and diabetes. Short intermittent ECG is more effective in detecting relevant arrhythmias than 24h Holter ECG in patients with palpitations or dizziness/presyncope.
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Sudlow, Christopher Mark. "The prevalence of atrial fibrillation in the UK and of suitability for warfarin treatment amongst those with atrial fibrillation." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301176.

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Hijazi, Ziad. "New Risk Markers in Atrial Fibrillation." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-198833.

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Atrial fibrillation (AF) confers an independent increased risk of stroke and death. The stroke risk is very heterogeneous and current risk stratification models based on clinical variables, such as the CHADS2 and CHA2DS2VASc score, only offer a modest discriminating value. The aims of this thesis were to study cardiac biomarkers, cardiac troponin and natriuretic peptides e.g. N-terminal prohormone-B-type natriuretic peptide (NT-proBNP), and describe levels in AF patients, investigate the association with stroke or systemic embolism, cardiovascular event, major bleeding and mortality, and to assess how levels of cardiac biomarkers change over time. Cardiac troponin was analyzed with contemporary assays and high sensitivity assays. The study populations consisted of patients with atrial fibrillation and one risk factor for stroke included in the RE-LY (n=6189) and the ARISTOTLE (n=14892) biomarker substudies. Median follow-up time was 2.2 years and 1.9 years, respectively. In a subset of participants (n=2514) data from repeated measurements was available at three months. Cardiac troponin was detectable in 57.0% with the contemporary assay and 99.4% with the high sensitivity assay. NT-proBNP was elevated in approximately three quarters of the participants. In Cox models adjusted for established risk factors the cardiac biomarkers levels was independently associated with stroke or systemic embolism, cardiovascular events, and mortality. Only cardiac troponin was associated with major bleeding. In ROC analyses the prediction of stroke or systemic embolism, cardiovascular events, and mortality increased significantly by addition of cardiac troponin or NT-proBNP to the models. Persistent detectable cardiac troponin (contemporary assay) and elevated NT-proBNP levels were found in a large number of participants. Persistent detectable or elevated levels conferred significantly higher risk for stroke or systemic embolism, cardiovascular events, and mortality. By using both cardiac biomarkers simultaneously the risk stratification improved even further for all outcomes. In conclusion the analyses for the first time display that elevation of troponin I and NT-proBNP are common in patients with AF and independently related to increased risks of stroke, cardiovascular events and mortality. Persistent elevation of troponin and NT-proBNP indicate a worse prognosis than transient elevations or no elevations of either marker. The cardiac biomarkers added substantial improvements to existing risk stratification models.
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Kuo, I. fan. "Physician and patient preferences for stroke prophylaxis in atrial fibrillation." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/46554.

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Albertsson, Kenth. "Contraindications for anticoagulation therapy among patients with atrial fibrillation associated stroke." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-48548.

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Books on the topic "Atrial fibrillation; stroke; thrombogenesis"

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Li-Saw-Hee, Foo Leong. A study of thrombogenesis in atrial fibrillation. Birmingham: University of Birmingham, 1999.

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Flaker, Greg. Stroke Prevention in Atrial Fibrillation. Elsevier - Health Sciences Division, 2018.

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Stroke Prevention in Atrial Fibrillation. Elsevier, 2019. http://dx.doi.org/10.1016/c2017-0-00331-2.

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Stroke, Dementia and Atrial Fibrillation. MDPI, 2020. http://dx.doi.org/10.3390/books978-3-03936-673-6.

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Saw, Jacqueline, Saibal Kar, and Matthew J. Price. Left Atrial Appendage Closure: Mechanical Approaches to Stroke Prevention in Atrial Fibrillation. Humana, 2016.

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Saw, Jacqueline, Saibal Kar, and Matthew J. Price. Left Atrial Appendage Closure: Mechanical Approaches to Stroke Prevention in Atrial Fibrillation. Springer, 2015.

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Saw, Jacqueline, Saibal Kar, and Matthew J. Price. Left Atrial Appendage Closure: Mechanical Approaches to Stroke Prevention in Atrial Fibrillation. Humana Press, 2015.

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Stroke In Atrial Fibrillation An Issue Of Cardiac Electrophysiology Clinics. Elsevier - Health Sciences Division, 2014.

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Asirvatham, Samuel J. Stroke in Atrial Fibrillation, an Issue of Cardiac Electrophysiology Clinics. Elsevier - Health Sciences Division, 2014.

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Waldo, Albert L. Rate versus rhythm control therapy for atrial fibrillation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0511.

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Based on data from several clinical trials, either rate control or rhythm control is an acceptable primary therapeutic strategy for patients with atrial fibrillation. However, since atrial fibrillation tends to recur no matter the therapy, rate control should almost always be a part of the treatment. If a rhythm control strategy is selected, it is important to recognize that recurrence of atrial fibrillation is common, but not clinical failure per se. Rather, the frequency and duration of episodes, as well as severity of symptoms during atrial fibrillation episodes should guide treatment decisions. Thus, occasional recurrence of atrial fibrillation despite therapy may well be clinically acceptable. However, for some patients, rhythm control may be the only strategy that is acceptable. In short, for most patients, either a rate or rhythm control strategy should be considered. However, for all patients, there are two main goals of therapy. One is to avoid stroke and/or systemic embolism, and the other is to avoid a tachycardia-induced cardiomyopathy. Also, because of the frequency of atrial fibrillation recurrence despite the treatment strategy selected, patients with stroke risks should receive anticoagulation therapy despite seemingly having achieved stable sinus rhythm. For patients in whom a rate control strategy is selected, a lenient approach to the acceptable ventricular response rate is a resting heart rate of 110 bpm, and probably 90 bpm. The importance of achieving and maintaining sinus rhythm in patients with atrial fibrillation and heart failure remains to be clearly established.
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Book chapters on the topic "Atrial fibrillation; stroke; thrombogenesis"

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de Carvalho, Antonio Carlos Camargo, Renato D. Lopes, and Angelo A. V. de Paola. "Atrial Fibrillation and Stroke Prevention." In Prevention of Cardiovascular Diseases, 261–76. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-22357-5_25.

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Foong, Oi-Mean, Suziah Sulaiman, and Aimi Amirah Khairuddin. "Atrial Fibrillation for Stroke Detection." In Computational Statistics and Mathematical Modeling Methods in Intelligent Systems, 136–43. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-31362-3_14.

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Phillips, Karen P. "Atrial Fibrillation and Stroke Epidemiology." In Contemporary Cardiology, 3–16. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-16280-5_1.

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Narayanan, Maya, and Paul R. Sutton. "Stroke Prophylaxis in Atrial Fibrillation." In Chalk Talks in Internal Medicine, 53–58. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-34814-4_9.

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Rozenman, Yoseph, and Yuri Gluzman. "Novel Oral Anticoagulants for Stroke Prevention in Patients with Non-valvular Atrial Fibrillation." In Atrial Fibrillation Therapy, 55–89. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-5475-4_3.

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Seo, Woo-Keun. "Atrial Fibrillation and Other Cardiac Dysfunctions Related with Stroke." In Stroke Revisited: Pathophysiology of Stroke, 113–23. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-10-1430-7_10.

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Gillum, R. F., J. Thomas, and C. L. Curry. "Atrial Fibrillation, Heart Disease, and Ischemic Stroke in Blacks." In Stroke in Blacks, 129–41. Basel: KARGER, 1998. http://dx.doi.org/10.1159/000062902.

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Wiener, Michelle. "Stroke and Other Complications of Atrial Fibrillation." In Contemporary Cardiology, 61–66. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-31386-3_6.

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Bergmann, Martin W. "Background: Stroke Prevention in Patients with Atrial Fibrillation." In Clinical Cases in LAA Occlusion, 1–12. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-51431-4_1.

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Dalen, James E. "Atrial Fibrillation and Stroke: The View from Cardiology." In The New Dimensions of Warfarin Prophylaxis, 279–82. Boston, MA: Springer US, 1987. http://dx.doi.org/10.1007/978-1-4757-5985-3_27.

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Conference papers on the topic "Atrial fibrillation; stroke; thrombogenesis"

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Kalisnik, J. M., A. Balbierer, G. Santarpino, J. Zibert, F. Pollari, J. Sirch, F. Vogt, and T. Fischlein. "Left Atrial Appendage Amputation for Stroke Prevention in Atrial Fibrillation Patients." In 50th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1725814.

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Di Martino, Elena S., Chiara Bellini, Dale J. Ward, Nicolas Brown, and David Schwartzman. "Porcine Left Atrial Wall Stress After Ventricular Tachypacing Mimicking the Effects of Early Atrial Fibrillation." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19528.

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Atrial Fibrillation (AF) is the cardiac arrhythmia most commonly encountered in clinical practice. Current statistics referring to the US population indicate a prevalence of AF up to 2.2 million people, projected to increase to 2.66 million by the end of 2010. AF has a high impact on society in terms of human costs, with an annual mortality rate of 11,438 patients. AF also increases the risk of ischemic stroke at least by a factor of 4 and it is responsible for at least 15% of all ischemic strokes, which represent the main cause of long-term disability and one of the main contributors to health care costs [1]. AF results from the synergic action of electrophysiological, biochemical and structural remodeling. Ventricular tachypacing (VTP) has been successfully used in animal models to reproduce relevant features observed in patients suffering from AF, such as ion-channel alterations, fibrosis development and atrial dilatation [2] [3].
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Akbik, F., A. Alawieh, C. Cawley, B. Howard, F. Tong, F. Nahab, O. Samuels, et al. "E-064 Differential response of atrial fibrillation associated stroke with thrombolysis and mechanical thrombectomy." In SNIS 17TH ANNUAL MEETING. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2020. http://dx.doi.org/10.1136/neurintsurg-2020-snis.100.

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Jarrar, Rawand. "79 Qualitative study on influences on anticoagulant prescribing for stroke prevention in atrial fibrillation." In British Cardiovascular Society Annual Conference, ‘100 years of Cardiology’, 6–8 June 2022. BMJ Publishing Group Ltd and British Cardiovascular Society, 2022. http://dx.doi.org/10.1136/heartjnl-2022-bcs.79.

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Jarrar, Rawand. "79 Qualitative study on influences on anticoagulant prescribing for stroke prevention in atrial fibrillation." In British Cardiovascular Society Annual Conference, ‘100 years of Cardiology’, 6–8 June 2022. BMJ Publishing Group Ltd and British Cardiovascular Society, 2022. http://dx.doi.org/10.1136/heartjnl-2022-bcs.79.

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Akbik, F., A. Alawieh, C. Cawley, B. Howard, F. Tong, F. Nahab, F. Nahab, et al. "LB-002 Bridging therapy increases hemorrhagic complications without improving functional outcomes in atrial fibrillation associated stroke." In SNIS 17TH ANNUAL MEETING. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2020. http://dx.doi.org/10.1136/neurintsurg-2020-snis.274.

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Kong, Che Him Dicken, Jiandong Zhou, Sharen Lee, Keith Sai Kit Leung, Tong Liu, Abhishek C. Sawant, John Corbelli, et al. "193 Edoxaban versus warfarin on stroke risk in patients with atrial fibrillation: a territory-wide cohort study." In British Cardiovascular Society Virtual Annual Conference, ‘Cardiology and the Environment’, 7–10 June 2021. BMJ Publishing Group Ltd and British Cardiovascular Society, 2021. http://dx.doi.org/10.1136/heartjnl-2021-bcs.189.

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Königsbrügge, O., H. Meisel, S. Schmaldienst, R. Klauser-Braun, M. Lorenz, M. Auinger, J. Kletzmayr, et al. "Anticoagulation for stroke prevention in patients with atrial fibrillation on hemodialysis is associated with net-clinical harm." In 65th Annual Meeting of the Society of Thrombosis and Haemostasis Research. Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1728085.

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Reis, Ana Luísa Lopes Espínola da Costa, Leonardo Henrique Gandolfi de Souza, and Vitor Roberto Pugliesi Marques. "Ischemic stroke with agraphestesia signal focus." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.470.

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Introduction: The ischemic stroke is one of the main causes of death and disability in Brazil. Among the main risk factors are age, atrial fibrillation (AF), diabetes, dyslipidemia and physical inactivity. The main etiology of stroke is cardioembolic, resulting in obstruction of the cerebral arteries by a thrombus of cardiac origin. The artery most affected in ischemic strokes is the middle cerebral artery. The stroke has main characteristics, with emphasis on the sudden onset of symptoms, involvement of a focal area, ischemia caused by obstruction of a vessel and neurological deficits depending on the affected area. Graphesthesia is defined as a cutaneous sensory ability to recognize letters or numbers traced on the skin. The loss of this sensory ability is known as agraphesthesia. Case Report: M.A.F.O. female, 78a, arrived at the UPA complaining of mental confusion. Patient denies previous stroke. Personal history of systemic arterial hypertension. Upon physical examination, the patient was conscious, self and disoriented and inattentive. He was able to repeat and evoke words, without measurable motor déficits. Left upper limb with agraphestesia. Computed tomography was requested, which showed an extensive hypodense area in the right parietoccipital region, which leads to the erasure of the furrows between the adjacent gyres, which may correspond to a recent ischemic event. Magnetic resonance imaging, diffusion-restricted area with correspondence on the ADC map, located in the right temporoparietal region inferring an acute ischemic event. An electrocardiogram was also requested, which showed an irregular rhythm, characteristic of atrial fibrillation, resulting in a diagnostic hypothesis of cardioembolic ischemic stroke. Discussion: The involvement of post-central ischemic gyrus lesions may correspond to paresthesia, anesthesia, hypoesthesia; the involvement of secondary and terciary areas of sensitivity in the upper parietal lobe, especially in the active movements of the hand and in the modalities of integrated sensitivity, their lesions may be clinically affected by: apraxias, dysgraphias, hemineglect, agraphestesia, stereoagnosia and spacial disorientation.
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Holm, Mikayle A., Alex Deakyne, Erik Gaasedelen, Weston Upchurch, and Paul A. Iaizzo. "Classification of Left Atrial Appendage Morphology Using Deep Learning." In 2020 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/dmd2020-9018.

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Abstract Atrial fibrillation, a common cardiac arrhythmia, can lead to blood clots in the left atrial appendage (LAA) of the heart, increasing the risk of stroke. Understanding the LAA morphology can indicate the likelihood of a blood clot. Therefore, a classification convolutional neural network was implemented to predict the LAA morphology. Using 2D images of 3D models created from MRI scans of fixed human hearts and a pre-trained network, an 8.7% error rate was achieved. The network can be improved with more data or expanded to classify the LAA from the automatically segmented DICOM datasets and measure the LAA ostia.
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Reports on the topic "Atrial fibrillation; stroke; thrombogenesis"

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Yang, Shengyi, Min Huang, Ge Ge, Junyue Yang, Yingchao Tan, Jieqiong Guan, Wenjing Song, and Lina Wang. Atrial fibrillation burden and risk of stroke: a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2020. http://dx.doi.org/10.37766/inplasy2020.10.0032.

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Sanders, Gillian D., Angela Lowenstern, Ethan Borre, Ranee Chatterjee, Adam Goode, Lauren Sharan, Nancy M. Allen LaPointe, et al. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update. Agency for Healthcare Resarch and Quality (AHRQ), October 2018. http://dx.doi.org/10.23970/ahrqepccer214.

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Oh, SangHyeon, Seoyong Choi, and Jee-Eun Chung. Comparative efficacy and safety of reduced dose of DOACs in patients with atrial fibrillation. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2022. http://dx.doi.org/10.37766/inplasy2022.8.0073.

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Review question / Objective: To compare the risk of stroke/systemic embolism (S/SE), mortality and bleeding in AF patients with reduced-dose DOACs. Rationale: Although each DOAC has its dose reduction criteria, many physicians still prefer to prescribe the reduced-dose DOACs, regardless of label adherence. However, inappropriate administration of DOACs is an important clinical problem because patients may not benefit from the recommended DOAC dose to prevent stroke and systemic embolism. Therefore, this study aims to investigate the risk of stroke/systemic embolism (S/SE) and mortality in AF patients with reduced-dose DOACs. Condition being studied: Adult patients with AF taking DOACs or Warfarin.
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Tan, Xin. The efficacy and safety of insertable cardiac monitor on atrial fibrillation detection in patients with ischemic stroke: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2021. http://dx.doi.org/10.37766/inplasy2021.10.0108.

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Preventing Stroke in Patients with Atrial Fibrillation - Evidence Update for Clinicians. Patient-Centered Outcomes Research Institute (PCORI), May 2020. http://dx.doi.org/10.25302/eu13.2020.5.

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Patients with atrial fibrillation have a higher risk for stroke than the general population, and that risk increases markedly with age. Anticoagulation therapy lowers the risk of stroke and improves all-cause mortality. Warfarin has been the mainstay of anticoagulation therapy for decades but has an increased risk of major bleeding and requires a complicated administration regimen. A recent update of research adds to the evidence about the relative benefits and harms of newer anticoagulation therapies and tools to predict stroke related to atrial fibrillation and bleeding risk. This evidence on the newer therapies, along with recently updated guidelines on managing nonvalvular atrial fibrillation, can help inform clinician and patient decisions on anticoagulant use and may potentially reduce the risk of stroke and its consequences.
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Reducing Risk of Stroke When You Have Atrial Fibrillation - Evidence Update for Patients. Patient-Centered Outcomes Research Institute (PCORI), May 2020. http://dx.doi.org/10.25302/eu12.2020.5.

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People with atrial fibrillation (AFib) or atrial flutter are five times more likely to experience a stroke compared with people who have a normal heart rhythm. The risk of stroke increases with age. Medicines that keep the blood from clotting, called anticoagulants, lower the risk of stroke but can also cause serious bleeding.
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