Disclosure Statement of Financial Interest
|
|
|
- Ronald Maxwell
- 5 years ago
- Views:
Transcription
1 Antoine MILHEM
2 2 Disclosure Statement of Financial Interest I currently have, or have had over the last two years, an affiliation or financial interests or interests of any order with a company or I receive compensation or fees or research grants with a commercial company : Speaker's name: Antoine, Milhem, La Rochelle Je n'ai pas de lien d'intérêt potentiel à déclarer
3 3 CATHETER ABLATION OF ATRIAL FIBRILLATION Indicated to cure symptomatic atrial fibrillation refractory to antiarrhythmic medication Improves quality of life Exposes to potentially severe complication
4 4 EXCLUSION OF INTRA ATRIAL THROMBUS Transesophageal echography : the «gold standard»
5 5 WHAT IS KNOWN ABOUT THE RISK OF ATRIAL THROMBUS? Risk of atrial thrombus before catheter ablation of atrial fibrillation Date Author Puwanant Scherr Yamashita McCready Wallace Calvo Type of trial Monocentric Monocentric Monocentric Monocentric Monocentric Monocentric Systematic TEE Yes Yes Yes Yes Yes Yes Patients Incidence of atrial thrombus 6 (0.6%) 12 (1.6%) 13 (2.9%) 12 (1.9%) 7 (3.6%) 6 (1.47%) Puwanant S, J Am Coll Cardiol Nov 24;54(22): Scherr D, J Cardiovasc Electrophysiol Apr;20(4): Yamashita E, Circ J Off J Jpn Circ Soc Jun;74(6): McCready JW, Eur opace 2010 Jul;12(7): Wallace TW, J Cardiovasc Electrophysiol Aug 1;21(8): Calvo N, Europace 2011 Apr;13(4):
6 6 WHAT IS KNOWN ABOUT THE RISK OF ATRIAL THROMBUS? Independant factors associated with thrombus: Age > 75 years Hypertension Heart disease Persistant atrial fibrillation Left atrial diameter LVEF < 35% Heart failure CHADS2 score 53/56 thrombus despite effective anticoagulation 11/56 thrombus in patients with paroxysmal atrial fibrillation
7 7 GUIDELINES Wide variation among the Task Force Members concerning TEE use prior to AF ablation : 50% perform TEE in all patients undergoing AF ablation regardless of presenting rhythm and CHADS2 or CHA2DS2VASc score. Another 20% only performs TEE if a patient presents an AF of unknown duration or more than 48 hours duration and has not been systemically received anticoagulation for at least four weeks. 1/3 employs clinical judgment and decides on a case-by-case basis whether to perform a TEE.
8 GUIDELINES 8
9 D-DIMERS 9
10 73 consecutive patients with persistant atrial fibrillation undergoing electric cardioversion Transesophageal echography D-dimer assay Results: 9 thrombus (12.3%) Cut-off value : 600 ng/ml NPV = 98% Somlói M, Am J Cardiol Jul 1;92(1):85 7.
11 925 patients, non valvular atrial fibrillation Transesophageal echography D-dimer assay Results : 83 thrombus (8.97%) Cut-off value : 1,150 ng/ml NPV = 97% Habara S,. Eur Heart J Sep;28(18):
12 12 HYPOTHESIS 1) We should optimize the negative predictive value of d-dimers by choosing a lower cut-off value. 2 ) A score combining d-dimer assay and clinical criteria should have better diagnostic performance than d-dimer assay or clinical score alone.
13 13 EXCLUSION OF INTRA-ATRIAL THROMBUS BEFORE CATHETER ABLATION OF ATRIAL FIBRILLATION BY D-DIMER ASSAY Consecutive patients referred for catheter ablation of atrial fibrillation or left atrial tachycardia Transesophageal echography D-dimer assay (VIDAS and LIATEST) Medical history, anticoagulation treatment The primary endpoint was the presence of intra atrial thrombus diagnosed by transesophageal echography
14 14 EXCLUSION OF INTRA-ATRIAL THROMBUS BEFORE CATHETER ABLATION OF ATRIAL FIBRILLATION BY D-DIMER ASSAY Private hospital University hospital General hospital
15 15 RESULTS From August 2014 to January ,506 patients included in the trial 12 excluded because of missing key data 2,494 patients retained for analysis The completeness rate of the data was 100% for all the items except LVEF (166 missing)
16 16 DESCRIPTION OF THE STUDY POPULATION Baseline characteristics Age, yrs 60.7 ± 10.7 Female gender 676 (27.1) Paroxysmal AF 1,335 (53.5) Persistent AF 996 (39.9) Left atrial tachycardia 163 (6.5) LVEF*, % 57.4 ± 10.0 Medical history Previous left atrial ablation 593 (23.8) Hypertension 916 (36.7) Diabetes mellitus 227 (9.1) Heart failure 304 (12.2) Stroke 115 (4.6) Venous thromboembolism Inflammatory disease 45 (1.8) 34 (1.4) Neoplasia 25 (1.0) Infectious disease 6 (0.2) Recent surgery 4 (0.2) Anticoagulation No anticoagulant 235 (9.4) DABIGATRAN 269 (10.8) RIVAROXABAN 596 (23.9) APIXABAN 321 (12.9) Effective VKA 814 (32.6) Non effective VKA 245 (9.8) Other 14 (0.6)
17 17 RESULTS Primary endpoint: 48 thrombus diagnosed Incidence : 1.92% (95% CI : 1.42%-2.54%) Consistent with the literature data
18 18 D-DIMERS VIDAS : lowest measurable value was 45ng/mL LIATEST : lowest measurable value was 270 ng/ml The values ranging from 45 to 270 ng/ml were all considered as < 270 AUROC = 0,658 The cut-off value of 270 ng/ml was used to favor the negative predictive value
19 19 UNIVARIATE ANALYSIS OF VARIABLES ASSOCIATED WITH ATRIAL THROMBUS Atrial thrombus (N=48) No atrial thrombus (N=2,446) p Value* Atrial thrombus (N=48) No atrial thrombus (N=2,446) p Value* Age, yrs 66.4 ± ± 10.7 < Age ( 75 yrs) 8 (16.7) 148 (6.1) Female gender 15 (31.3) 661 (27.0) 0.51 Persistent fibrillation 28 (58.3) 968 (39.6) Hypertension 30 (62.5) 886 (36.2) Diabetes mellitus 9 (18.8) 218 (8.9) CHADS2 score < (10.4) 1,277 (52.2) 1 20 (41.7) 744 (30.4) 2 13 (27.1) 299 (12.2) 3 10 (20.8) 126 (5.2) Heart failure 19 (39.6) 285 (11.7) < LVEF, % 46.7 ± ± 9.7 < History of stroke 6 (12.5) 109 (4.5) Previous left atrial ablation 9 (18.8) 584 (23.9) 0.50 Anticoagulation prior to ablation 47 (97.9) 2,212 (90.4) D-dimers (> 270 ng/ml) Atrial thrombus (N=48) No atrial thrombus (N=2,446) p Value* 30 (62.5) 930 (38.0)
20 20 MULTIVARIATE ANALYSIS ORa 95% CI p Value Hypertension ; Heart failure ; 7.18 < History of stroke ; D-dimers (> 270 ng/ml) ; c-index for model fit = 0.774
21 ATRIAL THROMBUS EXCLUSION SCORE (ATE) Condition Points History of stroke 1 Congestive heart failure 1 D-dimer level>270ng/ml 1 Hypertension 1 Total 4 ATE score (N=2,494) N Thrombus % Incidence of thrombus (%) ATE score 21
22 22 ATRIAL THROMBUS EXCLUSION SCORE (ATE) ATE score = 0 Negative predictive value = 100% ATE score CHADS2 score Se, % Se, % p Value (95%CI: ) (95%CI: )
23 23 CONCLUSIONS Before catheter ablation of AF: intra atrial thrombus incidence rate = 1.92%. The risk of thrombus exists even if: * the AF is paroxysmal * the anticoagulant treatment seems well conducted * the CHADS2 score is low
24 24 CONCLUSIONS D-dimer level history of stroke hypertension heart failure independantly associated with intra atrial thrombus ATE score = 0 Condition Points History of stroke 1 Congestive heart failure 1 D-dimer level>270ng/ml 1 Hypertension 1 associated with a negative predictive value of 100% in this population, significantly better than CHADS2 score to exclude the diagnosis of intra atrial thrombus
25 25 PERSPECTIVES These results need to be confirmed before use in clinical practice. A confirmatory study should start in EXTRALUCID-d CS 3000 patients will be included in 25 centers in France and Europe.
26 26 THANKS TO Sélim ABBEY Jean-Philippe DARMON Jacques MANSOURATI Alain AL ARNAOUT Christian DE CHILLOU Philippe MAURY Caroline ALLIX-BEGUEC Jean-Claude DEHARO Dominique PAVIN Walid AMARA Antoine DOMPNIER Olivier PIOT Mathieu AMELOT Cécile DUPLANTIER-DUCHENE Philippe RIVAT Marius ANDRONACHE Fabrice EXTRAMIANA Antoine ROUX Frédéric ANSELME Jean-Paul FAUGIER Nikki SABOURIN-GIBBS Nicolas BADENCO Charles GUENANCIA Frédéric SACHER Hugues BADER Jérôme HORVILLEUR Yannick SALUDAS Clément BARS Pierre INGRAND Arnaud SAVOURE Lucile BECOULET François JOURDA Julien SEITZ Paul BRU Virginie LAURENÇON Jérôme TAIEB Olivier CESARI Gabriel LAURENT Frederic TREGUER Philippe CHEVALIER Nicolas LELLOUCHE Pierre François WINUM Antoine DA COSTA Isabelle MAGNIN POULL Noura ZANNAD Financial support from
SUPPLEMENTARY INFORMATION
Table S1 Sex- specific differences in rate- control and rhythm- control strategies in observational studies Study region Study period Total sample size Sex- specific results Ozcan (2001) 1 Mayo Clinic,
Updates in Atrial Fibrillation
Updates in Atrial Fibrillation Michael Curley, MD Cardiac Electrophysiologist Wheaton Franciscan Medical Group #1 Most common heart rhythm disturbance 1 in 4 Americans over 40 will be diagnosed 3,500,000
Invasive and Medical Treatments for Atrial Fibrillation. Thomas J Dresing, MD Section of Electrophysiology and Pacing Cleveland Clinic
Invasive and Medical Treatments for Thomas J Dresing, MD Section of Electrophysiology and Pacing Cleveland Clinic Disclosures Fellow s advisory panel for St Jude Medical Speaking honoraria from: Boston
Catheter ablation is not a class I indication after failed antiarrhythmic drugs
Catheter ablation is not a class I indication after failed antiarrhythmic drugs Martin Jan Schalij Department of Cardiology Leiden University Medical Center Disclosure: Research grants from: Boston Scientific
Atrial Fibrillaiton and Heart Failure: Anticoagulation therapy in all cases?
Atrial Fibrillaiton and Heart Failure: Anticoagulation therapy in all cases? Nicolas Lellouche Fédération de Cardiologie Hôpital Henri Mondor Créteil Disclosure Statement of Financial Interest I currently
In Whom and When Should Atrial Fibrillation Ablation be Considered?
In Whom and When Should Atrial Fibrillation Ablation be Considered? Christian de Chillou, MD, PhD Department of Cardiology University Hospital Nancy, France ESC 2010 Stockholm, August 30. 2010 2 In Whom?
Rivaroxaban in Arrhythmology from Evidence Based Medicine to Real Life Experience: Patients Undergoing Cardioversion
Rivaroxaban in Arrhythmology from Evidence Based Medicine to Real Life Experience: Patients Undergoing Cardioversion Riccardo Cappato Arrhythmia and Electrophysiology Research Center, IRCCS Humanitas Research
Raphael Rosso MD, Yuval Levi Med. Eng., Sami Viskin MD Tel Aviv Sourasky Medical Center
Radiofrequency Ablation of Atrial Fibrillation: Comparison of Success Rate of Circular Ablation vs Point-by-Point Ablation with Contact Force Assessment in Paroxysmal and Persistent Atrial Fibrillation
Treatment of Atrial Fibrillation in Heart Failure
Stockholm, September 1st 2010 Treatment of Atrial Fibrillation in Heart Failure Rhythm control: Which drugs? Stefan H. Hohnloser J.W. Goethe University Frankfurt, Germany Presenter disclosure information:
EVATEL Study. Remote follow-up of patients implanted with an ICD The prospective randomized EVATEL study
EVATEL Study Remote follow-up of patients implanted with an ICD The prospective randomized EVATEL study Philippe Mabo, Pascal Defaye, Nicolas Sadoul, Jean Marc Davy, Jean-Claude Deharo, Salem Kacet, Eric
8/16/2016. Disclosures. Is Uninterrupted OAC Standard of Care for AF Ablation? CHRS 2016, San Francisco. Risk of Stroke Peri-Ablation
Disclosures Is Uninterrupted OAC Standard of Care for AF Ablation? CHRS 2016, San Francisco Atul Verma, MD FRCPC FHRS Director, Heart Rhythm Program Southlake Regional Health Centre Newmarket, Ontario,
What s new with DOACs? Defining place in therapy for edoxaban &
What s new with DOACs? Defining place in therapy for edoxaban & Use of DOACs in cardioversion Caitlin M. Gibson, PharmD, BCPS Assistant Professor, Department of Pharmacotherapy University of North Texas
AF Ablation in 2015 Why, Who, What and How? Steve Wilton ACC Rockies, Banff March 10, 2015
AF Ablation in 2015 Why, Who, What and How? Steve Wilton ACC Rockies, Banff March 10, 2015 Disclosures Research grant: St. Jude medical Speaking: Boehringer-Ingelheim Consulting: Arca Biopharma Learning
Prof. Fiorenzo Gaita
Adavances in Cardiac Arrhythmias and Great Innovations in Cardiology Turin 2014 Can rhythm control strategy reduce the risk of clinical and silent cerebral ischemia? Prof. Fiorenzo Gaita Director of the
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
C. Jilek, S. Fichtner, H. L. Estner, T. Reents, S. Ammar, J. Wu, T. Meyer, E. Hendrich, C. Kolb, J. Hausleiter, G. Hessling, I.
Dual-Source cardiac computed tomography for the detection of left atrial appendage thrombus prior to ablation of atrial fibrillation: Single-center experience and analysis of literature C. Jilek, S. Fichtner,
ACCP Cardiology PRN Journal Club
ACCP Cardiology PRN Journal Club Dr. Lianjie Xiong Dr. Xiong is a PGY2 cardiology pharmacy resident at Vanderbilt University Medical Center in Nashville, TN. She went to Nova Southeastern University and
Papel da imagem na estratificac ão de risco e na predic ão do risco tromboemboĺico
Imagiologia na Fibrilhac ão Auricular Papel da imagem na estratificac ão de risco e na predic ão do risco tromboemboĺico Mª João Andrade Diagnosis and timely detection of atrial fibrillation Echo-machines
3/23/2017. Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate Europace Oct;14(10): Epub 2012 Aug 24.
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
Ruolo della ablazione della fibrillazione atriale nello scompenso cardiaco
Ruolo della ablazione della fibrillazione atriale nello scompenso cardiaco Matteo Anselmino Division of Cardiology Città della Salute e della Scienza Hospital University of Turin, Italy Disclosure: Honoraria
Atrial Fibrillation Management in the ED. J Fisher May 2014"
Atrial Fibrillation Management in the ED J Fisher May 2014" A 48 yr old man presents with palpitations. He had a big night last night with old mates. ECG How will you manage him? Why important? Common
Κατάλυση παροξυσμικής κολπικής μαρμαρυγής Ποια τεχνολογία και σε ποιους ασθενείς; Χάρης Κοσσυβάκης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ.
Κατάλυση παροξυσμικής κολπικής μαρμαρυγής Ποια τεχνολογία και σε ποιους ασθενείς; Χάρης Κοσσυβάκης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ. ΓΕΝΝΗΜΑΤΑΣ» Rhythm control antiarrhythmic drugs vs catheter ablation Summary
ΚΑΤΑΛΥΣΗ ΚΟΛΠΙΚΗΣ ΜΑΡΜΑΡΥΓΗΣ. ΥΠΕΡ. Michalis Efremidis MD Second Department of Cardiology Evangelismos General Hospital
ΚΑΤΑΛΥΣΗ ΚΟΛΠΙΚΗΣ ΜΑΡΜΑΡΥΓΗΣ. ΥΠΕΡ. Michalis Efremidis MD Second Department of Cardiology Evangelismos General Hospital Rate control versus Rhythm control for Atrial Fibrillation AFFIRM N Engl J Med 2002;347:1825-33
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute Disclosures Research Support/P.I. Employee Leo Pharma
Atrial Fibrillation and Heart Failure: A Cause or a Consequence
Atrial Fibrillation and Heart Failure: A Cause or a Consequence Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania November
Management of atrial fibrillation a holistic view - Prof. Dr. Martin Borggrefe Mannheim
a holistic view - Prof. Dr. Martin Borggrefe Mannheim Patients with atrial fibrillation (millions) 16 14 12 10 8 6 4 2 0 Management of atrial fibrillation Expected prevalence of apparent AF 5,1 5,1 5,9
The 5 Most Important Things You Need to Know About Atrial Fibrillation. John D. Day, MD Director, Intermountain Heart Rhythm Specialists
The 5 Most Important Things You Need to Know About Atrial Fibrillation John D. Day, MD Director, Intermountain Heart Rhythm Specialists None Disclosures The 5 Most Important Things You Need to Know About
Atrial Fibrillation. 2 nd Annual National Hospitalist Conference San Antonio, TX September 7, 2018
2 nd Annual National Hospitalist Conference San Antonio, TX September 7, 2018, MSc, FACP, SFHM Division of Hospital Medicine Henry Ford Hospital Detroit, USA Clinical Associate Professor of Medicine Wayne
How atrial fibrillation should be treated in the heart failure patient?
Advances in Cardiac Arrhhythmias and Great Innovations in Cardiology Torino, 13/15 Ottobre 2016 How atrial fibrillation should be treated in the heart failure patient? Matteo Anselmino Dipartimento Scienze
ABLATION OF CHRONIC AF
ABLATION OF CHRONIC AF A PISAPIA ST JOSEPH HOSPITAL MARSEILLE MEET 2008 Atrial Fibrillation The most common significant heart rhythm disturbance Incidence increases with age and the development of structural
Special Conditions of NOAC PCI 가톨릭의대 순환기내과 장성원
Special Conditions of NOAC PCI 가톨릭의대 순환기내과 장성원 Issues on Patients with NOAC PCI Peri-procedural management CKD or dialysis Cardioversion Neurological situations Dual Antiplatelet Therapy with Oral Anticoagulants
Progression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro
Progression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro Jerónimo Farré MD, Madrid, ES AF: the kingdom of wishful thinking In AF we
MMS/Mass Coalition Program, Nov. 4, 2008 Patients with AF: Who Should be on Warfarin?
MMS/Mass Coalition Program, Nov. 4, 2008 Patients with AF: Who Should be on Warfarin? Daniel E. Singer, MD Massachusetts General Hospital Harvard Medical School 1 Speaker Disclosure Information DISCLOSURE
Current Guideline for AF Treatment. Young Keun On, MD, PhD, FHRS Samsung Medical Center Sungkyunkwan University School of Medicine
Current Guideline for AF Treatment Young Keun On, MD, PhD, FHRS Samsung Medical Center Sungkyunkwan University School of Medicine Case 1 59 year-old lady Sudden palpitation and breathlessness for 12 hours
La terapia non anticoagulante nel paziente con FA secondo le Linee Guida F. CONROTTO
La terapia non anticoagulante nel paziente con FA secondo le Linee Guida F. CONROTTO Rhythm or rate control strategy? N Engl J Med 2002;347:1834 40 Rate Control versus Electrical Cardioversion for Persistent
The 5 Most Important Things You Need to Know About Atrial Fibrillation. John D. Day, MD
The 5 Most Important Things You Need to Know About Atrial Fibrillation John D. Day, MD Disclosures Consulting with St. Jude Medical, Boston Scientific, and Biotronik The 5 Most Important Things You Need
Catheter Ablation of Atrial Fibrillation Strategy and Outcome Predictors Shih-Ann Chen MD
Catheter Ablation of Atrial Fibrillation Strategy and Outcome Predictors Shih-Ann Chen MD Taipei Veterans General Hospital, Taiwan Outline of AF Ablation 1. Strategy for Catheter Ablation of AF 2. Substrate
IS THERE STILL A PLACE FOR VITAMINE K ANTAGONISTS?
IS THERE STILL A PLACE FOR VITAMINE K ANTAGONISTS? J.Y. LE HEUZEY Georges Pompidou Hospital, René Descartes University, Paris H E G P Munich, August 27, 2012 Disclosure Consultant / Conferences / Advisory
requesting information regarding atrial fibrillation in NHS Ashford Clinical Commissioning Group
October 2015 Our Ref: FOI.15.ASH0149 requesting information regarding atrial fibrillation in NHS Ashford Clinical Commissioning Group Original Request Survey attached. Question 1: Between 1 July 2014 and
Question 1: Between 1 July 2014 and 30 June 2015, in the area covered by your CCG:
Atrial Fibrillation in Your Area Question 1: Between 1 July 2014 and 30 June 2015, in the area covered by your CCG: a) What was the prevalence of atrial fibrillation (AF)? 6636 (as of 22/10/2015) 2.1%
Atrial fibrillation and advanced age
Atrial fibrillation and advanced age Prof. Fiorenzo Gaita Director of the Cardiology School University of Turin, Italy Prevalence of AF in the general population Prevalence and age distribution in patients
Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.
Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United
Peri-cardioversion and peri-ablation anticoagulation. Giuseppe Patti Campus Bio-Medico University of Rome
Peri-cardioversion and peri-ablation anticoagulation Giuseppe Patti Campus Bio-Medico University of Rome What 2016 ESC guidelines recommend Causes of TE events after cardioversion 1 Preexisting LA thrombosis
Basics of Atrial Fibrillation. By Mini Thannikal NP-BC Mount Sinai St Luke s Hospital New York, NY
Basics of Atrial Fibrillation By Mini Thannikal NP-BC Mount Sinai St Luke s Hospital New York, NY Atrial Fibrillation(AF) is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation
Modern management of atrial fibrillation, from blood pressure control to anticoagulation
Modern management of atrial fibrillation, from blood pressure control to anticoagulation Adel Khalifa S. Hamad, BMS, MD, FRCP(Canada) Consultant Cardiologist & Interventional Cardiac Electrophysiologist
Mohammad Zubaid, MB, ChB, FRCPC, FACC
Management and one year outcome of atrial fibrillation in Middle Eastern cohort enrolled in the observational Gulf Survey of Atrial Fibrillation Events (Gulf SAFE) Mohammad Zubaid, MB, ChB, FRCPC, FACC
Spontaneous Atrial Fibrillation and Noacs and Reversal agents
Spontaneous Atrial Fibrillation and Noacs and Reversal agents Laurent Lewkowiez, MD Regional Service Chief, Hospital Cardiology CPMG Cardiac Electrophysiology Educational Goals relationship between atrial
Page 1. Current Trends in the Management of Atrial Fibrillation: Left Atrial Appendage Occlusion. Atrial fibrillation: Scope of the problem
Current Trends in the Management of Atrial Fibrillation: Left Atrial Appendage Occlusion Benjamin A. D Souza, MD, FACC, FHRS Assistant Professor of Clinical Medicine Penn Presbyterian Medical Center Cardiac
Can the UK afford ablation for persistent AF? cost efficacy analysis. Dr Derick Todd Liverpool Heart & Chest Hospital
Can the UK afford ablation for persistent AF? cost efficacy analysis Dr Derick Todd Liverpool Heart & Chest Hospital Conflicts of Interest Speaker fees / Consultancy / Travel support: Bayer Boehringer
Cases & Panel Discussion
TSOACs What s the difference anyway? Controversies in selection and complications Augustus Hough, PharmD, BCPS (AQ-Cardiology) Clinical Pharmacy Specialist West Palm Beach VA Medical Center Larry Lopez
Old and New Anticoagulants For Stroke Prevention Benefits and Risks
Old and New Anticoagulants For Stroke Prevention Benefits and Risks September 15, 2014 Jonathan L. Halperin, M.D. The Cardiovascular Institute Mount Sinai Medical Center Disclosure Relationships with Industry
Role of LAA isolation in AF cure
MAM 2017, Zurich Role of LAA isolation in AF cure Sakis Themistoclakis, MD Director, Unit of Electrophysiology and Cardiac Pacing Department of Cardiothoracic & Vascular Medicine Ospedale dell Angelo,
Primary Care Atrial Fibrillation Update: Anticoagulation and Left Atrial Appendage Occlusion. Greg Francisco, MD, FACC
Primary Care Atrial Fibrillation Update: Anticoagulation and Left Atrial Appendage Occlusion Greg Francisco, MD, FACC DISCLOSURES None to declare Estimated 33.5million have AF worldwide (6-7million in
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It. Chandra Kumbar MD FACC FHRS The Heart Group, Evansville IN
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It Chandra Kumbar MD FACC FHRS The Heart Group, Evansville IN Disclosures Consultant Advisory Board, Medtronic Atrial fibrillation
Initial assessment of patient with AF in primary care DR BRUCE TAYLOR GPwSI Cardiology SCN Merseyside and Cheshire Clinical Lead Primary care
Initial assessment of patient with AF in primary care DR BRUCE TAYLOR GPwSI Cardiology SCN Merseyside and Cheshire Clinical Lead Primary care 11 th and 25 th September 2014 3 KEY OBJECTIVES OF TALK 1.
Managing Stroke Prevention in AF: A Closer Look at Non-surgical Interventions
Managing Stroke Prevention in AF: A Closer Look at Non-surgical Interventions Riccardo Cappato, MD Humanitas University Electrophysiology & Arrhythmia Center Humanitas Research Institute, Milan & Gavazzeni
Study period Total sample size (% women) 899 (37.7%) Warfarin Aspirin
Table S2 Sex- specific differences in oral anticoagulant prescription for stroke prevention in AF Total sample size (% women) Anticoagulant(s) studied Gage (2000) 1 Missouri, USA Discharged during 597
Left Atrial Appendage Closure
Left Atrial Appendage Closure Matthew J. Price MD Director, Cardiac Catheterization Laboratory Scripps Clinic La Jolla, CA, USA price.matthew@scrippshealth.org Risk Factors for Stroke From The Perspective
AF :RHYTHM CONTROL BY DR-MOHAMMED SALAH ASSISSTANT LECTURER CARDIOLOGY DEPARTMENT
AF :RHYTHM CONTROL BY DR-MOHAMMED SALAH ASSISSTANT LECTURER CARDIOLOGY DEPARTMENT 5-2014 Atrial Fibrillation therapeutic Approach Rhythm Control Thromboembolism Prevention: Recommendations Direct-Current
Update in the Management of Atrial Fibrillation
Update in the Management of Atrial Fibrillation Gregory M Marcus, MD, MAS Associate Professor of Medicine Division of Cardiology University of California, San Francisco Disclosures Research: Gilead, Medtronic,
Dipen Shah Cardiology Service, University Hospitals, Geneva Switzerland
Dipen Shah Cardiology Service, University Hospitals, Geneva Switzerland Disclosures Research Grants: Biosense Webster, St. Jude, Bard, Endosense, Biotronik Speakers Honoraria: Biosense Webster, Endosense,
ESC. Update of the ESC Guidelines on Medical Therapy. John Camm. ICM Internationales Congress Center München
ESC 2012 ICM Internationales Congress Center München Update on Consensus Statements on Management of Atrial Fibrillation European Heart Rhythm Association Update of the ESC Guidelines on Medical Therapy
Left Atrial Appendage Occlusion
Left Atrial Appendage Occlusion A new strategy to prevent stroke in atrial fibrillation Ashok Talreja MD and Arijit Chanda MD VHVI symposium 24th February 2018 Outline of presentation 1. Risk of stroke
Post-ablation Management: Drug therapy, Anticoagulation and long-term Monitoring
Catheter Ablation of Atrial Fibrillation: State of the Art Post-ablation Management: Drug therapy, Anticoagulation and long-term Monitoring Dipen Shah Service de Cardiologie Hospital Cantonal de Genève
Understanding Atrial Fibrillation Management. Roy Lin, MD
Understanding Atrial Fibrillation Management Roy Lin, MD Disclosure None Definition of atrial fibrillation Atrial fibrillation is a supraventricular tachyarrhythmia characterized by uncoordinated atrial
Arrhythmia 341. Ahmad Hersi Professor of Cardiology KSU
Arrhythmia 341 Ahmad Hersi Professor of Cardiology KSU Objectives Epidemiology and Mechanisms of AF Evaluation of AF patients Classification of AF Treatment and Risk stratification of AF Identify other
Direct Oral Anticoagulant Use in Valvular Atrial Fibrillation
Direct Oral Anticoagulant Use in Valvular Atrial Fibrillation September 14, 2018 Nina Maguire, PharmD PGY1 Pharmacy Resident Seton Healthcare Family Christina.maguire@ascension.org ASCENSION TEXAS Direct
Dysrhythmias 11/7/2017. Disclosures. 3 reasons to evaluate and treat dysrhythmias. None. Eliminate symptoms and improve hemodynamics
Dysrhythmias CYDNEY STEWART MD, FACC NOVEMBER 3, 2017 Disclosures None 3 reasons to evaluate and treat dysrhythmias Eliminate symptoms and improve hemodynamics Prevent imminent death/hemodynamic compromise
Digoxin And Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter?
Digoxin And Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter? Renato D. Lopes, MD, PhD, FACC on behalf of the ARISTOTLE Investigators
Surgical AF Ablation : Lesion Sets and Energy Sources. What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan
Surgical AF Ablation : Lesion Sets and Energy Sources What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan Disclosures Consultant/Advisory Board: Abbott, Edwards Lifesciences
A Patient with Chest Pain and Atrial Fibrillation
A Patient with Chest Pain and Atrial Fibrillation Kurt Huber, Vienna, Austria Declaration of Interest Lecturing & Consulting Activities: AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi
Atrial Fibrillation and the NOAC s. John Raymond MS, PA-C, MHP February 10, 2018
Atrial Fibrillation and the NOAC s John Raymond MS, PA-C, MHP February 10, 2018 Pathogenesis EPIDEMIOLOGY Arrhythmia-related hospitalisations in the US Ventricular fibrillation 2% Atrial fibrillation 34%
ROUVIERE Héloïse, DE MEESTER Antoine, DESCAMPS Olivier, NICAISE Grégory, MARCOVITCH Olivier,BADOT Damien, TUTUS Caroline, BENAHMED Ahmed
Left atrial appendage thrombus detection in patients with atrial fibrillation: Comparison between multidetector computed tomography and transesophageal echocardiography ROUVIERE Héloïse, DE MEESTER Antoine,
Atrial Fibrillation Ablation: in Whom and How
Update on Consensus Statement on Management of Atrial Fibrillation: EHRA 2012 Atrial Fibrillation Ablation: in Whom and How Update of HRS/EHRA AF/ECAS Ablation Document 2012 Anne M Gillis MD FHRS Professor
NOAC vs. Warfarin in AF Catheter Ablation
KHRS 2013 2013-Jun-15 NOAC vs. Warfarin in AF Catheter Ablation Jin-Seok Kim, MD Department of Cardiology Sejong General Hospital Bucheon, Republic of Korea Clinical Burden of AF Rhythm Disturbance Thromboembolic
Novità in Tema di NOACs Cardioversione Riccardo Cappato, MD
Novità in Tema di NOACs Cardioversione Riccardo Cappato, MD Electrophysiology & Arrhythmia Center IRCCS Humanitas Research Institute, Milan & Gavazzeni Clinics, Bergamo - Italy Disclosure Statement of
ESC Congress 2012, Munich
ESC Congress 2012, Munich Anticoagulation in Atrial Fibrillation 2012: Which Anticoagulant for Which Patient? Stefan H. Hohnloser J.W. Goethe University Frankfurt am Main S.H.H. has served as a consultant,
EP WIRE on Management Preexcitation syndromes
EP WIRE on Management Preexcitation syndromes 1. Is your Institution: A University Hospital 70.7% 41 A Private Hospital 13.8% 8 Other Type of Hospital 15.5% 9 Institution name: 50 answered question 58
Catheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes
Catheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes Francis Marchlinski, MD Richard T and Angela Clark President s Distinguished Professor Director Cardiac Electrophysiolgy University
» A new drug s trial
» A new drug s trial A placebo-controlled, double-blind, parallel arm Trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular Hospitalization or death from any cause
Ablation Should Not Be Used as Primary Therapy for Treatment of Patients with Atrial Fibrillation
Ablation Should Not Be Used as Primary Therapy for Treatment of Patients with Atrial Fibrillation 25 October 2008 Update in Electrocardiography and Arrhythmias Zian H. Tseng, M.D., M.A.S. Assistant Professor
Management of ATRIAL FIBRILLATION. in general practice. 22 BPJ Issue 39
Management of ATRIAL FIBRILLATION in general practice 22 BPJ Issue 39 What is atrial fibrillation? Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in primary care. It is often
Lessons from recent antithrombotic studies and trials in atrial fibrillation
Lessons from recent antithrombotic studies and trials in atrial fibrillation Thromboembolism cause of stroke in AF Lars Wallentin Uppsala Clinical Research Centre (UCR) Uppsala Disclosures for Lars Wallentin
ATRIAL FIBRILLATION AROUND THE WORLD/ CONTINENTAL PERSPECTIVES AND SPECIFICITIES: SOUTH AMERICA. LUIS AGUINAGA MD, PhD, FESC,FACC Argentina
ATRIAL FIBRILLATION AROUND THE WORLD/ CONTINENTAL PERSPECTIVES AND SPECIFICITIES: SOUTH AMERICA LUIS AGUINAGA MD, PhD, FESC,FACC Argentina 2010 Global Burden of Disease Study Chugh, S. S. et al. Circulation,
Increased Levels of D-dimer in Atrial Fibrillation Identify Patients With Higher Risk of Thromboembolic Events and Death
Increased Levels of D-dimer in Atrial Fibrillation Identify Patients With Higher Risk of Thromboembolic Events and Death Christina Christersson, Malin Schollin, John H. Alexander, Bernand J. Gersh, John
Atrial Fibrillation and Common Supraventricular Tachycardias. Sunil Kapur MD
Atrial Fibrillation and Common Supraventricular Tachycardias Sunil Kapur MD Cardiac Electrophysiology Brigham and Women s Hospital Instructor, Harvard Medical School No disclosures Cardiac Conduction:
Rate or Rhythm Control? Epidemiology. Relevant Advances in Atrial Fibrillation 6/20/2011. Stroke Prophylaxis
Relevant Advances in Atrial Fibrillation Stroke Prophylaxis Managing Atrial Fibrillation: Tips for the Generalist Antiarrhythmic Drug Therapy Ablation Gregory M Marcus, MD, MAS Assistant Professor of Medicine
Secondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012
Secondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012 Professor Dan Atar Head, Dept. of Cardiology Councillor of the ESC,
Should AF patients (after ablation) have anticoagulation forever? Can we ever stop it?
The 12 International Dead Sea Symposium - Jerusalem March 3-5 /2014 Should AF patients (after ablation) have anticoagulation forever? Can we ever stop it? Antonio Raviele, MD, FESC, FHRS Past Director
Atrial Fibrillation. Ivan Anderson, MD RIHVH Cardiology
Atrial Fibrillation Ivan Anderson, MD RIHVH Cardiology Outline Definition and Pathophysiology Rate versus rhythm control Rate control thresholds (how much is enough) Anti-coagulation CHADS2VASc score HASBLED
On behalf of the RE-CIRCUIT Investigators. March 19, :45 am 10:55 am. Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Safety and Efficacy of Uninterrupted Anticoagulation with Dabigatran Etexilate versus in Patients Undergoing Catheter Ablation of Atrial Fibrillation: The RE-CIRCUIT Study Hugh Calkins, M.D., 1 Stephan
Catheter Ablation of Atrial Fibrillation Persistent Atrial Fibrillation Catheter Ablation : where are we?
Catheter Ablation of Atrial Fibrillation Persistent Atrial Fibrillation Catheter Ablation : where are we? F. HIDDEN-LUCET francoise.hidden-lucet@aphp.fr Pitié-Salpétrière APHP FRANCE Disclosure Statement
Individual Therapeutic Selection Of Anti-coagulants And Periprocedural. Miguel Valderrábano, MD
Individual Therapeutic Selection Of Anti-coagulants And Periprocedural Management Miguel Valderrábano, MD Outline Does the patient need anticoagulation? Review of clinical evidence for each anticoagulant
Stroke Prevention in AF: How will it change in the next 5 years? Jeff Healey MD, MSc, FHRS Population Health Research Institute McMaster University
Stroke Prevention in AF: How will it change in the next 5 years? Jeff Healey MD, MSc, FHRS Population Health Research Institute McMaster University Disclosures Research Grants and speaking fees St. Jude
Management of Atrial Fibrillation in the Hospitalized Patient
Management of Atrial Fibrillation in the Hospitalized Patient Gregory M Marcus, MD, MAS Associate Professor of Medicine Division of Cardiology University of California, San Francisco Disclosures Research:
AF Ablation in Patients with Heart Failure
AF Ablation in Patients with Heart Failure Christian de Chillou, MD, PhD Department of Cardiology University Hospital Nancy, France 28ème Journée Internationale du Centre Cardio-Thoracique de Monaco Monaco,
Surgical Ablation of Atrial Fibrillation. Gregory D. Rushing, MD. Assistant Professor, Division of Cardiac Surgery
Surgical Ablation of Atrial Fibrillation Gregory D. Rushing, MD Assistant Professor, Division of Cardiac Surgery Midwestern Conference on Optimizing Electrophysiology Patient Care and Procedural Success
NUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni. Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna
NUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna Two major concerns Atrial Fibrillation: Epidemiology The No. 1 preventable
Atrial fibrillation: why it's important to make opportunities diagnosis in single chamber ICD patients
ADVANCES IN CARDIAC ARRHYTHMIAS and GREAT INNOVATIONS IN CARDIOLOGY Turin October 13-15, 2016 Atrial fibrillation: why it's important to make opportunities diagnosis in single chamber ICD patients Dott.
Atrial Fibrillation and Fibrosis: Still a strict link? Johannes Brachmann
Klinikum Coburg Atrial Fibrillation and Fibrosis: Still a strict link? Johannes Brachmann Prof. Dr. med. J. Brachmann Bologna 16 th February 2017 Disclosures Study Grants: Biotronik, Medtronic, SJM, Abbott,