Global rising trends of atrial fibrillation: a major public health concern

Patel, Nileshkumar; Atti, Varunsiri; Mitrani, Raul D.; Viles-González, Juan F.; Goldberger, Jeffrey J.

doi:10.1136/heartjnl-2018-313350

Cited by 69 publications

(54 citation statements)

References 8 publications

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“…We evaluated the following clinical outcomes: (1) recurrence of AF, (2) procedure time, (3) fluoroscopy time, and (4) complications. We used the longest available follow-up data from individual studies for our analysis.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…Atrial fibrillation (AF) is the most common arrhythmia worldwide and the estimated global age‐adjusted prevalence was 0.5% in 2010, representing nearly 33.5 million individuals . The prevalence is still underestimated as a large proportion of asymptomatic individuals and those having transient symptoms remain undiagnosed . Hypertension is the most common comorbidity that coexists with AF .…”

Section: Introductionmentioning

confidence: 99%

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Renal sympathetic denervation improves clinical outcomes in patients undergoing catheter ablation for atrial fibrillation and history of hypertension: A meta‐analysis

Atti

Turagam

Garg

et al. 2019

Cardiovasc electrophysiol

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Background Currently, there is limited data regarding the impact of adjunctive renal sympathetic denervation (RSDN) with pulmonary vein isolation (PVI) in hypertensive patients with atrial fibrillation (AF). Methods A comprehensive literature search for studies comparing RSDN + PVI vs PVI alone for AF and history of hypertension until 1 January 2019 was performed. The results were expressed as risk ratio (RR) for the categorical variables and mean difference (MD) for the continuous variables with 95% confidence intervals (CIs). Results A total of six eligible (four randomized and two prospective nonrandomized) studies consisting of 432 patients (306 paroxysmal AF and 126 persistent AF) were included (RSDN + PVI group: 186 patients and PVI group: 246 patients). Follow‐up is more than or equal to 1 year. Compared with PVI, RSDN + PVI significantly decreased the risk of AF recurrence (RR = 0.58, 95% confidence interval [CI] = 0.47‐0.72, P < 0.00001) on follow‐up. Fluoroscopy (MD = +5.53 minutes, 95% CI = 0.76‐10.31, P = 0.02) and procedure time (MD = +34.85 minutes, 95% CI = 23.55‐46.16, P < 0.00001) was significantly longer with the PVI + RSDN group compared with PVI alone. There were no significant differences in complications between both groups. Test of heterogeneity was low for all clinical outcomes (I2 = 0%). Conclusion Our meta‐analysis demonstrates that RSDN as an adjunct to PVI appears to be safe and improves clinical outcomes in both paroxysmal and persistent AF and history of hypertension

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Section: Clinical Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Renal sympathetic denervation improves clinical outcomes in patients undergoing catheter ablation for atrial fibrillation and history of hypertension: A meta‐analysis

Atti

Turagam

Garg

et al. 2019

Cardiovasc electrophysiol

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“…Atrial fibrillation (AF) is the most common arrhythmia worldwide with an estimated global age adjusted prevalence of 0.5% affecting nearly 33.5 million persons . AF is associated with a multitude of comorbid conditions including coronary artery disease (CAD) which is one of the most common encountered conditions affecting nearly one‐third of the patients with AF .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of single vs dual antiplatelet therapy in patients on anticoagulation undergoing percutaneous coronary intervention: A systematic review and meta‐analysis

Atti

Turagam

Garg

et al. 2019

Cardiovasc electrophysiol

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Background Selection of an appropriate antithrombotic regimen in patients requiring oral anticoagulation (OAC) undergoing percutaneous coronary intervention (PCI) still remains a challenge. An ideal 9–2regimen should balance the risk of bleeding against ischemic benefit. Methods A comprehensive literature search for studies comparing triple antithrombotic therapy (TAT) vs double antithrombotic therapy (DAT) in patients requiring OAC undergoing PCI was performed in clinicalTrials.gov, PubMed, Web of Science, EBSCO Services, Cochrane Central Register of Controlled Trials, Google Scholar, and various scientific conference sessions from inception to May 1st, 2019. A meta‐analysis was performed using random‐effects model to calculate risk ratio (RR) and 95% confidence interval (CI). Results Fifteen studies were eligible and included 13 967 patients, of which 7349 received TAT and 6618 received DAT. Compared with DAT, TAT was associated with lower risk of myocardial infarction (RR, 0.82; 95%CI, 0.69–0.98; P = .03) and stent thrombosis (RR, 0.66; 95%CI, 0.46–0.96; P = .03). There was no difference in risk of trial defined major adverse cardiac events, all‐cause mortality, and stroke between two groups. Compared with DAT, TAT was associated with higher risk of trial defined major bleeding (RR, 1.67; 95%CI, 1.38–2.01; P < .00001), including thrombolysis in myocardial infarction major bleeding (RR, 1.81; 95%CI, 1.47–2.24; P < .00001) but no significant difference in risk of intracranial bleeding. Conclusion In patients requiring OAC undergoing PCI, TAT was associated with a lower risk of myocardial infarction but with a significantly higher risk of major bleeding when compared with DAT.

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“…In a companion editorial, Patel and colleagues2, discuss this study in the context of the global rising trends of AF prevalence. ‘This underscores the urgent need for healthcare systems around the world to develop and implement programmes for preventing AF and new paradigms to optimise identification and treatment of patients with AF.’…”

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confidence: 99%