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AtrialFibrillation

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Sinaiem dark
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8

slow-and-steady

75 y/o M with a past medical history of atrial fibrillation presents to the ED not feeling well for several days. He has some diarrhea but has continued to take his medications. He is mildly hypotensive. While IV access is established, you are shown his ECG….  
sinaiem.org
over 6 years ago
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KT Evidence Bite: Cardioversion and Thromboembolism - CanadiEM

What is the incidence of and risk factors for thromboembolic events after ED cardioversion of acute atrial fibrillation? Early cardioversion (<12hrs) is  
boringem.org
over 6 years ago
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10

The Case of the Irregular Irregularity - EM Nerd

We have proven ourselves highly capable of managing atrial fibrillation in the Emergency Department. In recent years, a number of prospective cohorts have demonstrated that with the use of IV anti-arrhythmic medication and electrical cardioversion, patients presenting to the Emergency Department with new onset atrial fibrillation can be successfully discharged in sinus rhythm consistently and with minimal adverse events. In 2010, Steill et al published a case series of 660 patients who were cardioverted in the Emergency Department (1). What they coined the “Ottawa Aggressive Protocol” consisted of chemically managed rate control followed by a trial of procainamide loaded over an hour and, if this failed to convert the patient, DC electrical cardioversion. Using this protocol, Steill et al cite the number of patients who were discharged home in normal sinus rhythm to be 595 (90.2%). In a recent systematic review published in the European Journal of Emergency Medicine, Coll-Vinent et al found that in patients who underwent Emergency Department cardioversion, 78.2%-100% were discharged home in a normal sinus rhythm (2).  
emnerd.com
over 6 years ago
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0
16

A 56 year old woman with syncope, weakness, and refractory hypotension

A 56 year old woman with hypothyroidism after total thyroidectomy presented to the emergency department after an episode of near syncope. When she arrived she had hypotension and atrial fibrillation, with a rapid ventricular response. She reported a history of progressive weakness, weight loss, polyuria, polydipsia, anorexia, and fatigue. Urine analysis was positive for leucocyte esterase and pyuria. She was admitted to the intensive care unit with a diagnosis of severe sepsis of urinary source and atrial fibrillation with a rapid ventricular response. After aggressive fluid resuscitation and the administration of intravenous antibiotics, her heart spontaneously converted to a normal rhythm and she appeared well perfused but remained hypotensive. Review of her medical record showed that her therapeutic thyroxine replacement had recently been decreased because of low thyrotrophin. On perusal of her records from an another facility it was noted that she had undergone pituitary mass resection and irradiation 20 years earlier.  
feeds.bmj.com
over 6 years ago
Www.bmj
0
20

A 56 year old woman with syncope, weakness, and refractory hypotension

A 56 year old woman with hypothyroidism after total thyroidectomy presented to the emergency department after an episode of near syncope. When she arrived she had hypotension and atrial fibrillation, with a rapid ventricular response. She reported a history of progressive weakness, weight loss, polyuria, polydipsia, anorexia, and fatigue. Urine analysis was positive for leucocyte esterase and pyuria. She was admitted to the intensive care unit with a diagnosis of severe sepsis of urinary source and atrial fibrillation with a rapid ventricular response. After aggressive fluid resuscitation and the administration of intravenous antibiotics, her heart spontaneously converted to a normal rhythm and she appeared well perfused but remained hypotensive. Review of her medical record showed that her therapeutic thyroxine replacement had recently been decreased because of low thyrotrophin. On perusal of her records from an another facility it was noted that she had undergone pituitary mass resection and irradiation 20 years earlier.  
feeds.bmj.com
over 6 years ago
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0
12

Patients can self monitor oral anticoagulation, study shows

The study, reported in the British Journal of General Practice, included 296 patients requiring oral anticoagulation who had bought a device to self monitor their international normalised ratio (INR). Most patients (97%) had warfarin prescribed, and this was for a range of conditions including thrombosis (35.8%), having a mechanical heart valve (32.8%), atrial fibrillation (23.0%), and …  
feeds.bmj.com
over 6 years ago
Www.bmj
0
19

Patients can self monitor oral anticoagulation, study shows

The study, reported in the British Journal of General Practice, included 296 patients requiring oral anticoagulation who had bought a device to self monitor their international normalised ratio (INR). Most patients (97%) had warfarin prescribed, and this was for a range of conditions including thrombosis (35.8%), having a mechanical heart valve (32.8%), atrial fibrillation (23.0%), and …  
feeds.bmj.com
over 6 years ago
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10

Journal Update - Beta Blocker vs. Calcium Channel Blocker for Rate Control in Atrial Fibrillation - R.E.B.E.L. EM - Emergency Medicine Blog

Is diltiazem or metroprolol the more effective agent for rate control in Atrial Fibrillation (AF) with RVR in the ED?  
rebelem.com
over 6 years ago
Www.bmj
0
7

Sudden onset double vision

An 83 year old woman was admitted to the acute stroke unit with sudden onset double vision that had lasted for three hours. She had a medical history of monoclonal gammopathy of uncertain significance and atrial fibrillation, for which she was not receiving anticoagulation because of an adverse reaction to warfarin. She had no history of transient ischaemic attack or stroke. She had diplopia only when looking through her right. On examination she was unable to adduct her left eye, with nystagmus in her right eye when she attempted to do this. Her neurological examination was otherwise normal. Computed tomography of the head on admission was normal, as was magnetic resonance imaging of the head, which was requested the next day. Figure 1⇓ shows T2 weighted (A) and diffusion weighted (B) sequences at the level of the upper pons.  
feeds.bmj.com
over 6 years ago
Www.bmj
0
18

Retrospective cohort studies: advantages and disadvantages

Researchers investigated whether differences exist between the sexes in the risk of ischaemic stroke in patients with atrial fibrillation.1 A nationwide retrospective cohort study design was used. Data were taken from the Swedish national discharge register. Participants were 100 802 patients with a first diagnosis of atrial fibrillation between 1 July 2005 and 31 December 2008, with a total follow-up of 139 504 years at risk (median 1.2). Information about drug treatment was taken from the Swedish drug register. Patients were excluded if at baseline they were prescribed warfarin, had mitral stenosis, or had previous valvular surgery. Patients who died less than 14 days from baseline were also excluded.  
feeds.bmj.com
over 6 years ago
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5

Real world effectiveness of warfarin among ischemic stroke patients with atrial fibrillation: observational analysis from Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) study

Objective To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice.  
feeds.bmj.com
over 6 years ago
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0
3

The Atrial Fibrillation Daily

The Atrial Fibrillation Daily, by StopAfib.org: updated automatically with a curated selection of articles, blog posts, videos and photos.  
linkis.com
over 6 years ago
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3

AFib Matters - Atrial Fibrillation

This is educational website designed by health professionals and patients for people suffering from Atrial Fibrillation, as well as their families and caregivers.  
fibrilacion-auricular.org
over 6 years ago
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5

Association between pulmonary vein orientation and atrial fibrillation-free survival in patients undergoing endoscopic laser balloon ablation

Aims Obtaining optimal pulmonary vein (PV) occlusion with the endoscopic laser balloon ablation system (EAS) can be difficult, hypothetically influenced by PV geometry. The aim of this study was to determine the impact of PV orientation on atrial fibrillation (AF)-free survival after PV isolation (PVI) using the EAS.  
ehjcimaging.oxfordjournals.org
over 6 years ago
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4

First-Line Ablation Works for Atrial Fibrillation Patients - Consult QD

Cleveland Clinic researchers have found that catheter ablation is more helpful and results in better success rates when performed earlier in patients with atrial fibrillation.  
consultqd.clevelandclinic.org
over 6 years ago
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2

Preventing Atrial Fibrillation - Consult QD

Atrial fibrillation (AF) affects more than 33 million individuals worldwide. In the United States and other industrial nations, the lifetime risk of developing AF is one in four from the age of 40. AF increases stroke risk fivefold, and there is also a twofold increased risk of dementia and increased risks of myocardial infarction (MI), heart failure and death.  
consultqd.clevelandclinic.org
over 6 years ago
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1

New Evidence That Ablation May Be Best Option for AFib in Heart Failure - Consult QD

The recently presented AATAC-AF in Heart Failure study shows that performing catheter ablation for persistent atrial fibrillation in patients with heart failure appears to be worth the risks, according to Cleveland Clinic electrophysiologist Walid Saliba, MD.  
consultqd.clevelandclinic.org
over 6 years ago
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0
3

First-Line Ablation Works for Atrial Fibrillation Patients - Consult QD

Cleveland Clinic researchers have found that catheter ablation is more helpful and results in better success rates when performed earlier in patients with atrial fibrillation.  
consultqd.clevelandclinic.org
over 6 years ago
Preview
0
5

Preventing Atrial Fibrillation - Consult QD

Atrial fibrillation (AF) affects more than 33 million individuals worldwide. In the United States and other industrial nations, the lifetime risk of developing AF is one in four from the age of 40. AF increases stroke risk fivefold, and there is also a twofold increased risk of dementia and increased risks of myocardial infarction (MI), heart failure and death.  
consultqd.clevelandclinic.org
over 6 years ago
Preview
0
1

New Evidence That Ablation May Be Best Option for AFib in Heart Failure - Consult QD

The recently presented AATAC-AF in Heart Failure study shows that performing catheter ablation for persistent atrial fibrillation in patients with heart failure appears to be worth the risks, according to Cleveland Clinic electrophysiologist Walid Saliba, MD.  
consultqd.clevelandclinic.org
over 6 years ago