Anticoagulation in atrial fibrillation and flutter

Scholten, Marcoen F.; Thornton, Andrew; Mekel, Joris; Koudstaal, Peter J.; Jordaens, Luc

doi:10.1016/j.eupc.2005.05.012

Cited by 28 publications

(13 citation statements)

References 90 publications

(70 reference statements)

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“…It is appropriate to prescribe oral anticoagulant before and to re-initiate it after the procedure [13]. Healthcare providers should encourage patients to monitor their pulse for irregularity, and this may serve as an initial screening tool for asymptomatic AF episodes [11].…”

Section: Discussionmentioning

confidence: 99%

“…Following the previous relative literature[1, 8, 9, 11–13], a structured questionnaire was accordingly designed specifically for patients with AF undergoing RFCA based on face to face interview results of 30 patients with AF undergoing RFCA and the advice by experts and panel discussions. These allowed us to check if the questions were well understood and all pertinent to our project.…”

Section: Methodsmentioning

confidence: 99%

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Knowledge, attitude, and behavior in patients with atrial fibrillation undergoing radiofrequency catheter ablation

Sun

Zheng

et al. 2010

J Interv Card Electrophysiol

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PurposeCatheter ablation for atrial fibrillation (AF) has become a widely accepted procedure in most of the large cardiac centers throughout the world. However, little is known regarding the knowledge, attitude, and behavior (KAB) of AF patients undergoing radiofrequency catheter ablation (RFCA). Our purpose is to investigate the status and influencing factors of KAB in these patients.MethodsWe conducted a KAB survey utilizing specifically designed questionnaires among hospitalized AF patients undergoing RFCA from July 2008 to April 2009.ResultsA total of 116 AF participants were enrolled and 113 were effective sample, the response rate was 97%. Only 47% of the participants answered questions regarding knowledge about AF correctly. Knowledge deficits were greater in male patients, poorly educated and first-time RFCA patients. With regard to attitude, 45% of participants considered daily pulse examination to be unnecessary. Higher knowledge scores, persistent AF and AF recurrence were positive predictors of attitude. Despite adherence to take medication was high, more than half of the participants demonstrated poor monitor behavior. Knowledge, attitude, and the number of previous attempts at RFCA were factors affecting the self-management behavior.ConclusionsAF patients undergoing RFCA have knowledge deficits in general and there is a lack of consistency among their KAB. In order to establish a better attitude and self-management behavior, AF patients undergoing RFCA need comprehensive education by the KAB questionnaire according to the KAB theory.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Knowledge, attitude, and behavior in patients with atrial fibrillation undergoing radiofrequency catheter ablation

Sun

Zheng

et al. 2010

J Interv Card Electrophysiol

View full text Add to dashboard Cite

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“…No clear recommendations are available regarding the use of anticoagulation after a successful pulmonary vein isolation procedure, but it seems logical to continue oral anticoagulant drugs for some time: experienced groups continue anticoagulation for at least three to six months after successful ablation [2,3,17]. Withdrawal of anticoagulant drugs after the procedure can be considered after ruling out recurrences of paroxysmal atrial fibrillation and after follow-up TEE confirmation of thrombus absence.…”

Section: Discussionmentioning

confidence: 96%

Regression of warfarin-resistant left atrial appendage thrombus after ablation of atrial fibrillation and permanent pacing

Oneglia¹,

Gardini²,

Benedini³

et al. 2006

Journal of Cardiovascular Medicine

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Atrial fibrillation is the most common rhythm disturbance and can also occur in absence of true cardiac disease. However, also in these cases, it can generate left atrial appendage thrombi with systemic embolic potential. A regular and well conducted anticoagulant therapy with dicoumarol derivatives, as indicated in these patients, is not always successful. We report the case of a patient with lone atrial fibrillation and a left atrial appendage thrombus resistant to anticoagulant therapy with warfarin, which disappeared after catheter ablation of atrial fibrillation by electrical disconnection of the pulmonary veins, restoration of sinus rhythm and dual-chamber pacemaker implantation.

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“…VKAs are effective for the prevention and treatment of many thrombotic disorders such as atrial fibrillation 5. However, their management is difficult because of their narrow therapeutic index and a high risk of bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…A report obtained from the nearby hospital confirmed the flutter ablation 3 months after the development of the atrial flutter. On the basis of this information, considering the patient's poor knowledge of his VKA therapy and in accordance with the treatment recommendations following flutter ablation, the pharmacy resident suggested that the anticoagulant should be stopped and antiplatelet treatment (aspirin 75 mg once a day) be commenced 5. The patient's general practitioner and cardiologist were informed and gave their agreement.…”

Section: Case Descriptionmentioning

confidence: 99%

Promoting pharmaceutical care services: a case report: Table 1

et al. 2012

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To illustrate the potential benefits of ward-based clinical pharmacy, the case is reported of a patient who benefited from three successful pharmaceutical interventions. The patient visited the emergency department with an epigastric pain and a vitamin K antagonist overdose was suspected. Prothrombin complex concentrates were prescribed by the emergency physician. Analysis of the patient's parameters did not show evidence of any sign of major bleeding so the order was cancelled after the intervention of the on-call pharmacy resident. Medication reconciliation performed by another resident showed two major unintended discrepancies: vigabatrin prescription had been omitted and sotalol was prescribed at the wrong dose. The physician was informed and the prescription order corrected. Eventually the pharmacy resident responsible for anticoagulant therapy education visited the patient. Careful investigation of the patient's medical chart led him to suggest discontinuation of the anticoagulant therapy. This intervention resulted in the immediate discharge of the patient. This case report highlights the added value of pharmaceutical care performed on the ward and illustrates both the clinical benefit for the patient and the economic benefit for the hospital. This topic is rarely discussed in case reports. This paper demonstrates its value and argues to extend its practice.

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Anticoagulation in atrial fibrillation and flutter

Cited by 28 publications

References 90 publications

Knowledge, attitude, and behavior in patients with atrial fibrillation undergoing radiofrequency catheter ablation

Knowledge, attitude, and behavior in patients with atrial fibrillation undergoing radiofrequency catheter ablation

Regression of warfarin-resistant left atrial appendage thrombus after ablation of atrial fibrillation and permanent pacing

Promoting pharmaceutical care services: a case report: Table 1

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