Cardiology

Atrial Fibrillation

Questions discussed in this category

What is your approach to secondary stroke prevention in patients with atrial fibrillation and intracranial stenosis (>70%)?

4 Answers available

Would you consider lifelong versus short-term (i.e. several months) course of anticoagulation for patients with elevated CHADSVASc score presenting with newly diagnosed paroxysmal atrial fibrillation triggered in the setting of acute illness (i.e. tachyarrhythmias with COVID-19 or bacterial pneumonia)?

2 Answers available

What continuous duration of device defined atrial fibrillation burden warrants initiation of anticoagulation if the patient qualifies by CHA2DS2-vasc score?

2 Answers available

For patients who have undergone ablation for atrial fibrillation with elevated bleeding risk, what is your risk/benefit approach when deciding to continue oral anticoagulation long-term?

1 Answer available

What are the current clinical practices for TEE to guide cardioversion and anticoagulation duration post-cardioversion for Afib/flutter in patients following left atrial appendage closure?

4 Answers available

In what situations/patient population would you consider placing an implantable cardiac monitor in favor of external monitors for long-term dynamic monitoring of atrial fibrillation?

What are the real-life implications of the MONITOR-AF study to the routine management of AF?

1 Answer available

Given recent trials for the management of atrial fibrillation with an early ablation strategy (for example, EAST-AFNET 4, EARLY-AF, PROGRESSIVE-AF, STOP-AF), what is your approach to determining the appropriate timing for ablation in patients with atrial fibrillation?

And how do patient characteristics affect your decisions?

5 Answers available

When would you consider proceeding with antiarrhythmic drug load concurrently with DCCV as opposed to DCCV alone in patients with new-onset atrial fibrillation?

1 Answer available

Would you start an amiodarone load for new onset atrial fibrillation with RVR intermittently in normal sinus rhythm to further suppress AF recurrence in the acute setting?

2 Answers available

What is your outpatient approach to patients with new-onset paroxysmal atrial fibrillation in the setting of acute illness but who are otherwise asymptomatic with normal sinus rhythm post-hospital discharge?

Specifically, what is your approach to outpatient monitoring to assess atrial fibrillation burden for patients with CHADS2Vasc score>2?

2 Answers available

What percentage of patients with non-sustained focal atrial tachycardia detected on an outpatient Holter develop paroxysmal atrial fibrillation, and how should we identify and treat patients at the highest risk of progressing to PAF?

2 Answers available

Do you ever utilize lacosimide in patients with atrial fibrillation?

1 Answer available

How do you approach a patient with atrial fibrillation on apixaban who has a new cardioembolic stroke?

3 Answers available

In patients with Afib on anticoagulation and concurrent intracranial atherosclerotic disease, would you consider adding an anti-platelet to anticoagulation if there are recurrent events that could be related to the ICAD?

1 Answer available

Is it sufficient to maintain patients with atrial fibrillation and established PAD on a DOAC or VKA alone, or is there an additional benefit to adding an antiplatelet agent for CVD benefit?

If so, would you prefer a P2Y12i over low-dose aspirin?

1 Answer available

Does the presence and location of cerebral microbleeds affect your decision for antithrombotic treatment in patients with atrial fibrillation?

Do you distinguish between primary and secondary prevention? Wilson et al., PMID 31130428 is helpful, but curious how people apply this data in practi...

3 Answers available

What is a reasonable atrial fibrillation percentage burden that would benefit from systemic anticoagulation for a patient with an elevated CHA₂DS₂-VASc score?

2 Answers available

What is your preferred rate control agent for atrial fibrillation with rapid ventricular rate, and why?

1 Answer available

When would you consider obtaining a cardiac CT in lieu of standard TEE for the detection of a left atrial appendage thrombus in atrial fibrillation?

2 Answers available

Would you empirically elective to anticoagulate patients with a remote (i.e. >10 year) history of paroxysmal atrial fibrillation presenting with newly diagnosed CVA, presumed cardioembolic in etiology, without any documented recurrence of AF?

3 Answers available

Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?

3 Answers available

Do you change management in patients that are taking bisphosphonates and develop atrial fibrillation?

1 Answer available

When do you start anticoagulation in a patient with cardioembolic CVA secondary to new onset atrial fibrillation with hemorrhagic conversion?

1 Answer available

How does evidence of cerebral amyloid angiopathy/microbleeds affect choices for secondary stroke prevention in patients with a history of ischemic stroke and atrial fibrillation?

How do you approach secondary stroke prevention for patients with ischemic stroke, atrial fibrillation, and signs of cerebral amyloid angiopathy/micro...

1 Answer available

Do you start anticoagulation in a patient with infective endocarditis who also has atrial fibrillation and stroke?

1 Answer available

For patients with atrial fibrillation on DOAC, when should they resume DOAC after a thalamic bleed without intraventricular bleed?

How does presence of intraventricular hemorrhage change your recommendations?

2 Answers available

When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?

1 Answer available

How do you determine the timing of anticoagulation for patients with large MCA strokes secondary to atrial fibrillation?

1 Answer available

Papers discussed in this category

Stroke, 2020 Aug 06

Anticoagulation Type and Early Recurrence in Cardioembolic Stroke: The IAC Study.

Ann Neurol, 2020 Aug 05

Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.

Stroke, 2021 May 24

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.

JAMA neurology, 2019-04-01

Association of Apolipoprotein E With Intracerebral Hemorrhage Risk by Race/Ethnicity: A Meta-analysis.

Lancet Neurol, 2019 May 23

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.

JAMA Neurol,

Assessment of Incidence and Risk Factors of Intracerebral Hemorrhage Among Participants in the Framingham Heart Study Between 1948 and 2016.

Lancet Neurol, 2018 Jan 10

The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study.

J Am Coll Cardiol, 2019 Jan 28

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.

Stroke, 2019-06

Perioperative/Postoperative Atrial Fibrillation and Risk of Subsequent Stroke and/or Mortality.

J Am Coll Cardiol, 2014 Mar 28

2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.

N Engl J Med, 2019 Mar 18

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation.

European heart journal, 2017-05-01

Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT.

Circulation, 2018-01-16

Treatment of Subclinical Atrial Fibrillation: Does One Plus One Always Equal Two?

N Engl J Med, 2012 Jan 12

Subclinical atrial fibrillation and the risk of stroke.

Journal of the American College of Cardiology, 2013-07-23

Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation.

Lancet, 2021 Aug 27

Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial.

N Engl J Med, 2018 Feb 01

Catheter Ablation for Atrial Fibrillation with Heart Failure.

Cardiovasc Drugs Ther, 2021 Sep 07

Is It Safe (and When) to Stop Oral Anticoagulation After Ablation for Atrial fibrillation? (Do We Have Enough Evidence to Solve the Dilemma?).

JAMA, 2001-05-09

Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.

The American journal of cardiology, 2015-12-15

Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation.

Journal of electrocardiology, 2018

Frequent premature atrial complexes as a predictor of atrial fibrillation: Systematic review and meta-analysis.

The New England journal of medicine, 2011-09-15

Apixaban versus warfarin in patients with atrial fibrillation.

The New England journal of medicine, 2011 Aug 10

Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.

The New England journal of medicine, 2009 Aug 30

Dabigatran versus warfarin in patients with atrial fibrillation.

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