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Absence of protective effect of renin-angiotensin system inhibitors on atrial fibrillation development: insights from the Canadian Trial of Atrial Fibrillation (CTAF).

https://arctichealth.org/en/permalink/ahliterature155217
Source
Can J Cardiol. 2008 Sep;24(9):709-13
Publication Type
Article
Date
Sep-2008
Author
Maryse Palardy
Anique Ducharme
Stanley Nattel
Jean-Claude Tardif
Michel White
Normand Racine
Karine Tétreault
Farida Dabouz
Mario Talajic
Denis Roy
Author Affiliation
Department of Medicine, Montreal Heart Institute, Montreal, Canada.
Source
Can J Cardiol. 2008 Sep;24(9):709-13
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Aged
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy
Canada
Female
Humans
Male
Middle Aged
Multivariate Analysis
Propafenone - therapeutic use
Prospective Studies
Recurrence - prevention & control
Renin - antagonists & inhibitors
Renin-Angiotensin System - drug effects
Sotalol - therapeutic use
Abstract
Antiarrhythmic agents have modest efficacy in preventing atrial fibrillation (AF) recurrence. Although retrospective analyses have suggested a preventive effect of inhibitors of the renin-angiotensin system (RAS) on AF development in patients with congestive heart failure or hypertension, the value of these agents has not been evaluated in patients with AF but without a high prevalence of hypertension or heart failure.
A retrospective analysis of the Canadian Trial of Atrial Fibrillation (CTAF) was conducted. CTAF demonstrated the superiority of amiodarone (A) over sotalol or propafenone (SP) in maintaining sinus rhythm in patients with AF. Of the 403 patients randomly assigned in CTAF, 11.7% of the A group and 12.7% of the SP group were receiving a RAS inhibitor at baseline. By multivariate analysis (including all the risk factors known to be associated with AF available in the database), the use of RAS blockers in addition to antiarrhythmic agents was not associated with additional benefit against AF development. There was a recurrence of AF in 59 patients (38.3%) and 14 patients (29.8%) of groups A and A-RAS, respectively, while 93 patients (61.6%) and 32 patients (62.8%) of the SP and SP-RAS groups, respectively, experienced recurrent AF.
Blocking the RAS did not provide additional benefit against AF recurrence in CTAF patients treated with an antiarrhythmic drug. These results underscore the need for randomized clinical trials to clearly define the role of RAS inhibitors in treating AF.
Notes
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PubMed ID
18787722 View in PubMed
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Analysis of cause-specific mortality in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.

https://arctichealth.org/en/permalink/ahliterature17828
Source
Circulation. 2004 Apr 27;109(16):1973-80
Publication Type
Article
Date
Apr-27-2004
Author
Jonathan S Steinberg
Ara Sadaniantz
Jack Kron
Andrew Krahn
D Marty Denny
James Daubert
W Barton Campbell
Edward Havranek
Katherine Murray
Brian Olshansky
Gearoid O'Neill
Magdi Sami
Stanley Schmidt
Randle Storm
Miguel Zabalgoitia
John Miller
Mary Chandler
Elaine M Nasco
H Leon Greene
Author Affiliation
Division of Cardiology, St Luke's-Roosevelt Hospital Center and Columbia University, New York, NY 10025, USA. jss7@columbia.edu
Source
Circulation. 2004 Apr 27;109(16):1973-80
Date
Apr-27-2004
Language
English
Publication Type
Article
Keywords
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy - mortality
Follow-Up Studies
Humans
Proportional Hazards Models
Research Support, U.S. Gov't, P.H.S.
Survival Analysis
Abstract
BACKGROUND: Expectations that reestablishing and maintaining sinus rhythm in patients with atrial fibrillation might improve survival were disproved in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. This report describes the cause-specific modes of death in the AFFIRM treatment groups. METHODS AND RESULTS: All deaths in patients enrolled in AFFIRM underwent blinded review by the AFFIRM Events Committee, and a mode of death was assigned. In AFFIRM, 2033 patients were randomized to a rhythm-control strategy and 2027 patients to a rate-control strategy. During a mean follow-up of 3.5 years, there were 356 deaths in the rhythm-control patients and 310 deaths in the rate-control patients (P=0.07). In the rhythm-control group, 129 patients (9%) died of a cardiac cause, and in the rate-control group, 130 patients (10%) died (P=0.95). Both groups had similar rates of arrhythmic and nonarrhythmic cardiac deaths. The numbers of vascular deaths were similar in the 2 groups: 35 (3%) in the rhythm-control group and 37 (3%) in the rate-control group (P=0.82). There were no differences in the rates of ischemic stroke and central nervous system hemorrhage. In the rhythm-control group, there were 169 noncardiovascular deaths (47.5% of the total number of deaths), whereas in the rate-control arm, there were 113 noncardiovascular deaths (36.5% of the total number of deaths) (P=0.0008). Differences in noncardiovascular death rates were due to pulmonary and cancer-related deaths. CONCLUSIONS: Management of atrial fibrillation with a rhythm-control strategy conferred no advantage over a rate-control strategy in cardiac or vascular mortality and may be associated with an increased noncardiovascular death rate.
Notes
Comment In: Circulation. 2004 Sep 14;110(11):e307-8; author reply e307-815364827
PubMed ID
15051639 View in PubMed
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Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature150959
Source
Europace. 2009 Jul;11(7):886-91
Publication Type
Article
Date
Jul-2009
Author
Søren Skøtt Andersen
Morten Lock Hansen
Gunnar H Gislason
Tina Ken Schramm
Fredrik Folke
Emil Fosbøl
Steen Z Abildstrøm
Mette Madsen
Lars Køber
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Hellerup, Copenhagen DK-2900, Denmark. ssa@heart.dk
Source
Europace. 2009 Jul;11(7):886-91
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Survival Analysis
Survival Rate
Treatment Outcome
Abstract
To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF).
All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment with flecainide, 3745 (2.6%) propafenone, 23,346 (16.5%) sotalol, and 10,376 (7.3%) amiodarone. Annualized mortality rates were 2.54, 4.25, 5.29, and 7.42 per year per 100 person years for flecainide, propafenone, sotalol, and amiodarone, respectively. Multivariable Cox proportional-hazard models did not show increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00).
In an unselected cohort of patients with AF, antiarrhythmic treatment with flecainide, propafenone, sotalol, or amiodarone was not associated with increased risk of death. From a safety perspective, this indicates appropriate selection of patients for AAD therapy.
Notes
Comment In: Europace. 2009 Jul;11(7):840-119546183
Comment In: Europace. 2009 Jul;11(7):837-919546182
PubMed ID
19443433 View in PubMed
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Association between salivary flow rate and the use of systemic medication among 76-, 81-, and 86-year-old inhabitants in Helsinki, Finland.

https://arctichealth.org/en/permalink/ahliterature222669
Source
J Dent Res. 1992 Dec;71(12):1875-80
Publication Type
Article
Date
Dec-1992
Author
T O Närhi
J H Meurman
A. Ainamo
J M Nevalainen
K G Schmidt-Kaunisaho
P. Siukosaari
J. Valvanne
T. Erkinjuntti
R. Tilvis
E. Mäkilä
Author Affiliation
Department of Prosthetic Dentistry, University of Helsinki, Finland.
Source
J Dent Res. 1992 Dec;71(12):1875-80
Date
Dec-1992
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Anti-Arrhythmia Agents - therapeutic use
Antidepressive Agents - therapeutic use
Antihypertensive Agents - therapeutic use
Cohort Studies
Digitalis Glycosides - therapeutic use
Drug Therapy - classification
Female
Finland
Humans
Hypnotics and Sedatives - therapeutic use
Male
Nitrates - therapeutic use
Prospective Studies
Saliva - secretion
Secretory Rate - drug effects
Sex Factors
Tranquilizing Agents - therapeutic use
Abstract
The aim of this study was to examine salivary flow rate and its association with the use of medication in a representative sample of 76-, 81-, and 86-year-old subjects, totaling 368. In this study, 23% (n = 80) of the subjects were unmedicated. From one to three daily medications were used by 47% (n = 168) and more than four medications by 30% (n = 104). The most commonly used medications were nitrates, digitalis or anti-arrhythmic drugs (47.7%), analgesics and antipyretics (32.6%), and diuretics (29.5%). The mean number used daily was significantly higher in 86-year-olds than in the two younger age groups (p
PubMed ID
1452886 View in PubMed
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Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure.

https://arctichealth.org/en/permalink/ahliterature263532
Source
Heart. 2015 May;101(9):706-11
Publication Type
Article
Date
May-2015
Author
C. Nyboe
M S Olsen
J E Nielsen-Kudsk
V E Hjortdal
Source
Heart. 2015 May;101(9):706-11
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anti-Arrhythmia Agents - therapeutic use
Anticoagulants - therapeutic use
Atrial Fibrillation - epidemiology - etiology
Cardiac Catheterization - statistics & numerical data
Cohort Studies
Denmark - epidemiology
Female
Heart Septal Defects, Atrial - epidemiology - surgery
Humans
Male
Middle Aged
Postoperative Complications - epidemiology - etiology
Risk factors
Stroke - epidemiology - etiology
Abstract
To estimate the risk of atrial fibrillation (AF) and stroke and the impact of closure in patients with atrial septal defect (ASD) compared with a general population cohort.
All adult Danish patients (>18 years) diagnosed with ASD from 1977 to 2009 (N=1168) were identified through population-based registries. Using Cox regression, we compared ASD patients' risk of AF and stroke with an age-matched and gender-matched comparison cohort. We computed prevalence proportions of anticoagulation and antiarrhythmic medicine use before and after closure and described stroke-related mortality.
Median follow-up was 9.6 years (range 1-33 years). Patients with ASD had a higher risk of first-time AF (adjusted HR 8.2; 95% CI 6.6 to 10.2) after closure than the comparison cohort, but with no difference between transcatheter and surgical closure (HR 1.5, 95% CI 0.6 to 3.5). Patients without prevalent AF had a 10-year cumulative incidence of AF of 11% (95% CI 9% to 14%) after closure compared with 2% (95% CI 1.8% to 2.5%) in the comparison cohort. Patients with ASD with prevalent AF continued to use anticoagulation medicine after closure/diagnosis. Patients with ASD had increased risk of stroke without closure (adjusted HR 2.6; 95% CI 1.4 to 3.0) and with closure (adjusted HR 2.0; 95% CI 1.4 to 2.7). Risk of stroke after closure was related to AF (HR adjusted for AF 1.3; 95% CI 0.9 to 1.9).
Patients with ASD had a higher risk of first-time AF after closure than the comparison cohort. There was no effect of closure on the use of AF-related medicine in patients with prevalent AF.
PubMed ID
25691512 View in PubMed
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Atrial fibrillation pharmacotherapy after hospital discharge between 1995 and 2004: a shift towards beta-blockers.

https://arctichealth.org/en/permalink/ahliterature86387
Source
Europace. 2008 Apr;10(4):395-402
Publication Type
Article
Date
Apr-2008
Author
Hansen Morten Lock
Gadsbøll Niels
Gislason Gunnar H
Abildstrom Steen Z
Schramm Tina K
Folke Fredrik
Friberg Jens
Sørensen Rikke
Rasmussen Søren
Poulsen Henrik E
Køber Lars
Madsen Mette
Torp-Pedersen Christian
Author Affiliation
Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark. mlh@heart.dk
Source
Europace. 2008 Apr;10(4):395-402
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Aged, 80 and over
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy
Calcium Channel Blockers - therapeutic use
Denmark
Digoxin - therapeutic use
Drug Therapy - trends
Female
Humans
Logistic Models
Longitudinal Studies
Male
Middle Aged
Patient Discharge
Registries
Retrospective Studies
Sotalol - therapeutic use
Abstract
AIMS: To study evolvement in pharmacotherapy of atrial fibrillation from 1995 to 2004. METHODS AND RESULTS: All Danish patients were discharged following first-time atrial fibrillation and their pharmacotherapy was identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. A total of 108 791 patients survived 30 days after discharge and were included. In 1995-1996, 7.4% of the patients received beta-blockers, increasing to 44.3% in 2003-2004. The corresponding figures for amiodarone were 2.9 and 5.4%. In contrast, use of nondihydropyridine calcium-channel blockers, digoxin, sotalol, and class 1C antiarrhythmics decreased from 20.6, 63.9, 21.3, and 4.0% in 1995-1996 to 12.6, 43.8, 4.2, and 1.3% in 2003-2004, respectively. Notably, patients receiving anticoagulants increased from 29.8 to 43.5%. Multivariate logistic regression analysis revealed females to be associated with more use of digoxin, but less use of amiodarone and oral anticoagulants than males. Patients above 80 years received less pharmacotherapy, apart from digoxin treatment that was more commonly used in elderly. CONCLUSION: Pharmacotherapy of atrial fibrillation has changed towards increased beta-blocker use with a coincident decrease in the use of other rate-limiting drugs and sotalol. Treatment with amiodarone or class 1C antiarrhythmics remained very low. Oral anticoagulant therapy increased considerably, but women and elderly were apparently undertreated.
PubMed ID
18258807 View in PubMed
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[Cardiac electrostimulation methods in the treatment, drug therapy selection and assessment of their antirelapse effect in atrial flutter]

https://arctichealth.org/en/permalink/ahliterature54284
Source
Lik Sprava. 1998 Oct-Nov;(7):138-41
Publication Type
Article
Author
V O Bobrov
H M Solov'ian
O I Frolov
I B Martsynkovs'kyi
I V Halychans'kyi
Source
Lik Sprava. 1998 Oct-Nov;(7):138-41
Language
Ukrainian
Publication Type
Article
Keywords
Adult
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Flutter - diagnosis - therapy
Cardiac Pacing, Artificial - methods - statistics & numerical data
Electrocardiography
English Abstract
Female
Humans
Male
Middle Aged
Pacemaker, Artificial
Recurrence
Abstract
Preliminary preparation of patients with atrial flutter (AF) using antiarrhythmic drugs permits enhancing efficiency of electrocardiostimulating method to arrest AF (up to 93.75%). The size of the amplitude F in transesophageal electrogramme (TEEG) and duration of the cycle of auricular contractions permit the results of the electrocardiostimulating arrest of AF to be predicted. AF of low amplitude wave F in TEEG turns, as a rule, to atrial fibrillation.
PubMed ID
10050484 View in PubMed
Less detail

[Certain problems of intensive therapy of patients with acute myocardial infarct].

https://arctichealth.org/en/permalink/ahliterature252354
Source
Kardiologiia. 1975 Apr;15(4):25-31
Publication Type
Article
Date
Apr-1975
Author
V S Gasilin
A I Romanov
I I Bykov
V I Palii
Source
Kardiologiia. 1975 Apr;15(4):25-31
Date
Apr-1975
Language
Russian
Publication Type
Article
Keywords
Acute Disease
Aged
Anti-Arrhythmia Agents - therapeutic use
Arrhythmias, Cardiac - prevention & control
Cardiac Glycosides - therapeutic use
Coronary Care Units
Death, Sudden
Electric Countershock
Electrocardiography
Female
Heart Conduction System - physiopathology
Humans
Length of Stay
Male
Middle Aged
Moscow
Myocardial Infarction - complications - physiopathology - therapy
Resuscitation
Abstract
The communication is based on the observation of 573 patients with acute and sub-acute myocardial infarction. The arrangement of intensive care units and wards permitted to render timely and qualified aid to the patients with myocardial infarction, to reduce the percentage of complications, and in cases of the development of the signs of clinical death to undertake immediate resuscitation measures. Of the 123 patients in whom clinical death was recorded, 34 were successfully resuscitated (27.6%). The problems of the management, prognosis and prevention of clinical death are discussed. The great importance of a proper arrangement of the intensive care units, of the qualification of the staff on duty and of continuous monitoring is emphasized. Electroimpulse therapy of acute rhythm disorders is highly praised as well as the employment of anti-arrhythic agents (lidocaine, hilurithamal, novocainamide, panangin) in such situations. The tactics in cases of atrioventricular block developing in such patients is described.
PubMed ID
1142628 View in PubMed
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53 records – page 1 of 6.