Quinicline plus verapamil vs. quinidine alone to prevent recurrences of atrial fibrillation

Hosp Veneravel Ordem Terceira da Penitencia Rio d, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Abordagem da fibrilaçao atrial na emergência: controle do ritmo ou da frequência?

A fibrilaçao atrial caracteriza-se por desorganizaçao da atividade elétrica e da contraçao atrial. Clinicamente, está relacionada com aumento de Acidente Vascular Cerebral (AVC) e da mortalidade cardiovascular. Frequentemente é responsável por levar à emergência pacientes cujo manejo baseia-se no controle direto da arritmia e na prevençao de eventos tromboembólicos. Entretanto, existe controvérsia na escolha entre o controle do ritmo ou da frequência cardíaca para o tratamento desta modalidade de arritmia no serviço de emergência

Abordagem da fibrilaçao atrial na emergência: controle do ritmo ou da frequência?

A fibrilaçao atrial caracteriza-se por desorganizaçao da atividade elétrica e da contraçao atrial. Clinicamente, está relacionada com aumento de Acidente Vascular Cerebral (AVC) e da mortalidade cardiovascular. Frequentemente é responsável por levar à emergência pacientes cujo manejo baseia-se no controle direto da arritmia e na prevençao de eventos tromboembólicos. Entretanto, existe controvérsia na escolha entre o controle do ritmo ou da frequência cardíaca para o tratamento desta modalidade de arritmia no serviço de emergência

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Correlation of accessory pathway location with gender and their manifest or concealed presentation

Background: Atrioventricular reentrant tachycardias account for approximately one third of cases referred for electrophysiological study (EPS). The anatomical substrate responsible for the reentry is an accessory pathway (AP) able to conduct the electrical stimulus in an anterograde, retrograde or bidirectional manner. Objective: To evaluate the correlation of AP location with the male and female genders and AP clinical presentation, whether manifest or concealed. Methods: Retrospective observational study including 942 consecutive patients, all diagnosed with EPS-confirmed AP from January 1994 to December 2008. APs were classified into eight anatomical groups: left lateral (LL), left posterior (LP), left posteroseptal (LPS), right posteroseptal (RPS), right midseptal (RMS), right anteroseptal (RAS), right lateral (RL), and right posterior (RP). Results: Of the 942 patients, 52.6% were males. The mean age was 31.2 +/- 13.8 years. As regards gender, APs were more prevalent among men. However, a statistically significant difference was observed only in the LPS (p = 0.029) and RL (p = 0.003) regions. In relation to the form of presentation of AP, the manifest form was more frequent than the concealed form in six of the eight regions studied, except for the LL and LPS regions. Conclusion: AP predominated in males and the manifest form was more frequent than the concealed form inmost of the regions studied. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Univ Fed Alagoas, Univ Hosp Alagoas, F3, BR-57046361 Maceio, Alagoas, BrazilUniv Estadual Ciencias Saude Alagoas, Cardiol, Maceio, AL, BrazilUniv Fed Sao Paulo, Cardiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Cardiol, Sao Paulo, BrazilWeb of Scienc