Atrial Fibrillation

This agent has a large number of drug-drug and drug-food interactions, and there is a need for increased INR monitoring.

Oral apixaban for acute VTE was superior to enoxaparin followed by warfarin.

Syncope accompanied by a sensation of coldness preceded a fall in this 67-year-old woman. She had a similar experience 6 months earlier.

Pulmonary embolism was the diagnosis in these 3 women, each of whom presented with positional right flank pain.

Novel anticoagulants have a half life much shorter than warfarin and so adherence and medication error are significant issues.

Oral anticoagulation with rivaroxaban must continue while initiating a switch to warfarin. Duration of overlap will be variable.

Direct thrombin inhibitor dabigatran or factor Xa inhibitor apixaban or rivaroxaban? All are good choices for specific patient types.

Adult-onset psoriasis is uncommon without a precipitating factor. In this patient’s case, an oral beta-blocker precipitated the psoriasis.

New oral anticoagulants require careful initiation and follow-up. A new guide is offered by the European Heart Rhythm Association.

HAS-BLED, HEMORRHAGES, OBRI: Risk calculators to assess potential for bleeding in AF patients before anticoagulation.

Periprocedural dabigatran increases the risk of bleeding and thromboembolic complications compared with warfarin during radiofrequency ablation of AF.

The CHA2DS2-VASc score improves risk determination by incorporating age 65 to 74 years, female sex, and history of vascular disease.

Aldosterone antagonists, eg, eplerenone, decrease adverse cardiovascular outcomes in patients with HF and AF.

Acute renal infarction most often causes flank pain associated with nausea, vomiting, abdominal pain and, less frequently, fever.

Colesevelam helps reduce serum glucose levels and also lowers LDL-C in patients with type 2 diabetes. Bromocriptine reduces the relative risk of cardiovascular events in patients with type 2 diabetes.

CD4+ count and viral load were complementary and were independently associated with increased incidence of AF.

Interruption of anticoagulation with rivaroxaban or warfarin should be bridged with an agent such as low-molecular weight heparin.

Could the left atrial appendage closure device, known as the Watchman, become an alternative to oral anticoagulation for select patients? Here, more on the 2 trials that have introduced the possibility.

Here: how omega-3 fatty acids may help reduce the risk of atrial fibrillation (AF) in postcardiac surgery patients; how incident HF can help predict adverse outcomes in patients with AF; and why an old gout drug may help reduce the risk of AF in patients with heart failure.

Female CV mortality lags behind male mortality; lifetime risk assessment, not 10-year risk, is a better estimation tool for women

Antidepressants and pre-term delivery; annual BP check?; stroke before age 50; niacin questioned; incretins and pancreatic disease

Depending on the specific type of event, stroke at age 50 years or younger increased mortality at least 3-fold.

PREVAIL study of Watchman left atrial appendage closure device confirms device safety and meets primary safety endpoint.

Rivaroxaban rejected;HIV cure; EHR complaints; primary care errors; patient safety imperatives.

The strategy of catheter ablation–based rhythm control in patients with long-standing persistent atrial fibrillation (AF) plus heart failure (HF) was found superior to pharmacologic rate control for improving cardiopulmonary exercise capacity, quality of life, and neurohormonal status in this small, randomized study.