After Lariat LAA Ligater Disappoints in aMAZE, is a Path Ahead Still Possible?
Adjunctive left atrial appendage (LAA) ligation failed to increase the efficacy of catheter pulmonary vein isolation (PVI) in the aMAZE trial, though it appeared safe enough for further clinical investigation. In a population of people with nonparoxysmal atrial fibrillation (Afib), LAA ligation plus PVI was associated with no better primary effectiveness by 12 months — […]
Serious Issues With Slow Heartbeat Flagged for Afib Patients on Antiarrhythmics
Old concerns about the safety of rhythm control drugs for atrial fibrillation (Afib or AF) resurfaced in a contemporary large Korean population-based study. Afib patients prescribed antiarrhythmic drugs (AADs) had several-fold higher risks of cardiac events believed to be related to a decline in heart rate. Compared with other Afib patients, these AAD users showed […]
Caffeine Effects on PVC Frequency: A Self-Experiment
Palpitations due to premature beats, either ventricular contractions (PVCs) or atrial contractions (PACs), can be extremely vexing even when we know they are benign. For many individuals, these extra-systoles come in waves that are seemingly random and inexplicable. This unpredictability can add to the anxiety they create. A reader recently shared his attempt to sort […]
DOAC Cuts Stroke Risk From Subclinical Afib
PHILADELPHIA — For patients with subclinical atrial fibrillation (Afib, AF) detected by their pacemaker or defibrillator, direct oral anticoagulation brought their already low stroke risk even lower — but at a cost in bleeding events, the ARTESiA trial showed. Apixaban (Eliquis) treatment cut risk of stroke or systemic embolism 37% compared with low-dose aspirin over […]
Consequences of Oral Anticoagulant Choice Magnified in the Frail
Older adults with atrial fibrillation (Afib, or AF), especially those with frailty, had better patient-centered outcomes taking apixaban (Eliquis) than other common oral anticoagulants (OACs), Medicare records showed. Compared with apixaban, rivaroxaban (Xarelto) was associated with significantly increased risk of spending more than 14 days in the hospital or a skilled nursing facility during follow-up […]
Amulet vs Watchman Comparison Still Muddy Any Which Way LAA Leaks Are Defined
SAN FRANCISCO — Two mainstream devices for percutaneous left atrial appendage (LAA) closure continued to lead to similar clinical outcomes in the SWISS-APERO trial. Among patients randomized to the Amplatzer Amulet and the Watchman 2.5/FLX, the incidence of patent LAAs at 13 months reached 53.6% and 48.8%, respectively, on coronary CT angiography (risk ratio [RR] […]
Ablation, CRT Boost Survival in Permanent Afib With Narrow QRS
A “pace-and-ablate” strategy substantially boosted survival for permanent atrial fibrillation (Afib) patients with a narrow QRS across the range of left ventricular ejection fraction (LVEF), the APAF-CRT trial showed. While relatively small with 133 patients after being stopped early for efficacy at a median 29 months of follow-up, the trial showed a relative 74% survival […]