Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

Kirchhof, Paulus; Lip, Gregory Y.H.; Gelder, Isabelle C. Van; Bax, Jeroen J.; Hylek, Elaine M.; Kääb, Stefan; Schotten, Ulrich; Wegscheider, Karl; Boriani, Giuseppe; Brandes, Axel; Ezekowitz, Michael D.; Diener, Hans‐Christoph; Haegeli, Laurent; Heidbüchel, Hein; Lane, Deirdre A.; Mont, Lluı́s; Willems, Stephan; Dorian, Paul; Aunes-Jansson, Maria; Blomström‐Lundqvist, Carina; Borentain, Maria; Breitenstein, Stefanie; Brueckmann, Martina; Cater, Nilo B.; Clemens, Andreas; Dobrev, Dobromir; Dubner, Sérgio; Edvardsson, Nils; Friberg, Leif; Goette, Andreas; Gulizia, Michele Massimo; Hatala, Róbert; Horwood, Jenny; Szumowski, Lukas; Kappenberger, Lukas; Kautzner, Josef; Leute, Angelika; Lobban, Trudie; Meyer, Ralf; Millerhagen, Jay; Morgan, John G.; Muenzel, Felix; Näbauer, Michael; Baertels, Christoph; Oeff, M.; Paar, D.; Polifka, Juergen; Ravens, Ursula; Rosin, Ludger; Stegink, Wim; Steinbeck, Gerhard; Vardas, Panos; Vincent, Alphons; Walter, M; Breithardt, G; Camm, A. John

doi:10.1093/europace/eur241

Cited by 206 publications

(184 citation statements)

References 234 publications

(187 reference statements)

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“…59 Some data indicate that atrial size may be larger in veteran endurance athletes than in age-matched sedentary controls. 64 Indeed, the left atrium may be enlarged in as many as 20% of competitive athletes, and this may be a predictor for atrial fibrillation. 59,64 In addition, complex ventricular ectopy, including ventricular tachycardia and rarely SCD, 11 occurs even in very fit individuals.…”

Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

“…64 Indeed, the left atrium may be enlarged in as many as 20% of competitive athletes, and this may be a predictor for atrial fibrillation. 59,64 In addition, complex ventricular ectopy, including ventricular tachycardia and rarely SCD, 11 occurs even in very fit individuals. 12,29 Despite the fact that these studies generally excluded athletes with findings suggestive of familial arrhythmogenic RV dysplasia, the VAs typically originate from a mildly dysfunctional RV and/or the interventricular Normal septum.…”

Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

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Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

O’Keefe

Patil

Lavie

et al. 2012

Mayo Clinic Proceedings

331

305

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A routine of regular exercise is highly effective for prevention and treatment of many common chronic diseases and improves cardiovascular (CV) health and longevity. However, long-term excessive endurance exercise may induce pathologic structural remodeling of the heart and large arteries. Emerging data suggest that chronic training for and competing in extreme endurance events such as marathons, ultramarathons, ironman distance triathlons, and very long distance bicycle races, can cause transient acute volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers, all of which return to normal within 1 week. Over months to years of repetitive injury, this process, in some individuals, may lead to patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, creating a substrate for atrial and ventricular arrhythmias. Additionally, long-term excessive sustained exercise may be associated with coronary artery calcification, diastolic dysfunction, and large-artery wall stiffening. However, this concept is still hypothetical and there is some inconsistency in the reported findings. Furthermore, lifelong vigorous exercisers generally have low mortality rates and excellent functional capacity. Notwithstanding, the hypothesis that long-term excessive endurance exercise may induce adverse CV remodeling warrants further investigation to identify at-risk individuals and formulate physical fitness regimens for conferring optimal CV health and longevity.

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Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

O’Keefe

Patil

Lavie

et al. 2012

Mayo Clinic Proceedings

331

305

View full text Add to dashboard Cite

show abstract

“…Суточное мониторирование ЭКГ по Холтеру показано при подозрении на аритмии и возможные эпизоды ишемии миокарда. Фибрилляция предсердий -очень частая и широко распространенная причина сердечно-сосудистых осложнений [153,154], особенно инсульта, у больных АГ [153]. Раннее выявление фибрилляции предсердий могло бы способствовать профилактике инсультов за счет назначения, по показаниям, соответ-ствующей антикоагулянтной терапии.…”

Section: признаки ожиренияunclassified

“…Даже высокое нормальное АД ассоциировано с развитием фибрил-ляции предсердий [562], а АГ, вероятно, является ее обратимым этиологическим фактором [154]. Связь АГ и антигипертензивной терапии с фибрилляцией предсердий недавно обсуждалась в опубликованном мнении рабочей группы ESH [563].…”

Section: фибрилляция предсердийunclassified

2013 Esh/Esc Guidelines for the Management of Arterial Hypertension

Mancia

Fagard²,

Redón³

et al. 2014

Russ J Cardiol

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Авторы/члены рабочей группы: Giuseppe Mancia (сопредседатель; италия)*, Robert Fagard (сопредседатель; бельгия)*, Krzysztof Narkiewicz (координатор секции, Польша), Josep Redón (координатор секции; испания), Alberto Zanchetti (координатор секции, италия), Michael Böhm

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“…Nonetheless, important aspects of comorbidities associated with thyroid disease need to be considered. For example, thyroid disease has been associated with atrial fibrillation, and this common arrhythmia has been associated with an increased risk of thromboembolism, and part of the holistic management of atrial fibrillation (AF) requires full assessment of all comorbidities (15). This is highly relevant, given that adequate thromboprophylaxis can markedly reduce the burden of stroke in AF (16)(17)(18).…”

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confidence: 99%

The even closer link between the thyroid and haemostasis

Franchini¹

2013

Thromb Haemost

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Invited Editorial FocusThe close relationship between thyroid hormones and the coagulation system has been known since the beginning of the past century and has been analysed over the decades by several investigators (1). Accordingly, various haemostatic abnormalities, involving both primary haemostasis and the coagulation/fibrinolytic system, have been reported in patients affected by a wide variety of endocrine disorders and range from subclinical laboratory abnormalities to clinically relevant haemorrhagic or thrombotic events (2-5). In particular, several studies have investigated the in vivo effect of overt and subclinical thyroid dysfunction on blood coagulation and fibrinolytic factors, suggesting that a procoagulant state is present in both overt and subclinical hyperthyroidism and in subclinical hypothyroidism (increased plasma levels of fibrinogen, von Willlebrand factor [VWF], factors VII-X and plasminogen activator inhibitor-1 [PAI-1]), while a bleeding tendency is observed in overt hypothyroidism (reduced plasma levels of VWF, factors VII-XII, PAI-1 and α 2 -antiplasmin) (3,(6)(7)(8)(9).A number of pathogenic mechanisms have been suggested to explain these relationships, including the effects of thyroid hormones on the synthesis of coagulation factors or thyroid-related autoimmune processes, also involving the haemostatic system. Although several hypotheses have been proposed, the exact underlying pathogenic mechanisms have not yet been elucidated and are still under investigation (10). In this context the three studies published in this and recent issues of Thrombosis and Haemostasis shed further light on the complex interaction between the thyroid and haemostasis.In the first study, Krysiak et al. prospectively investigated the haemostatic changes and response to levothyroxine and selenomethionine in 155 euthyroid patients with Hashimoto's thyroiditis (11). The 149 patients who completed the study were randomised to six months of treatment with levothyroxine and selenomethionine, alone or in combination, or placebo. All parameters analysed (prothrombin time [PT], activated partial thromboplastin time (aPTT), fibrinogen, factor VII, VWF, factor X and PAI-1) were abnormal at baseline and partially or completely corrected after treatment with levothyroxine and selenomethionine. The findings of this study are very interesting as they document for the first time that haemostatic disturbances may be present in patients with Hashimoto's thyroiditis, the most common thyroid disorder, independently of their thyroid hormone status and, most importantly, that they were reversed by treatment. Thus, while these results suggest that atherosclerosis may develop even at an early stage of chronic thyroiditis (i.e. without hypothyroidism), they also raise the question of when (and with which drugs) to start treatment in such patients to reduce their vascular risk.The role of the thrombin-activatable fibrinolysis inhibitor (TAFI), which represents a link between the coagulation and fibrinolytic systems, was explored...

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Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

Cited by 206 publications

References 234 publications

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

2013 Esh/Esc Guidelines for the Management of Arterial Hypertension

The even closer link between the thyroid and haemostasis

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