Hyperthyroidism increases AF risk
PATIENTS with subclinical hyperthyroidism carry an increased risk of developing atrial fibrillation (AF) compared to those with normal thyroid function, a general practice-based study confirms.
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atrial fibrillation
The following articles have the tag atrial fibrillation
Caution with switching warfarin to dabigatran
DOCTORS should exercise caution when changing patients to dabigatran (Pradaxa, Boehringer Ingelheim), an expert has warned, after research found the risks of thrombosis and bleeding were increased in previous warfarin users.
New guide clarifies role of ablation in AF
THE increasing prevalence of atrial fibrillation (AF), together with some confusion about the optimal use of catheter ablation, has prompted the development of Australia’s first consensus statement to guide treatment of AF.
New guide clarifies catheter ablation
CONFUSION about the optimal use of catheter ablation and the increasing prevalence of atrial fibrillation (AF) has prompted the development of Australia’s first consensus statement to guide treatment.
Trial results reinforce dabigatran safety in AF
AN FDA safety advisory and new clinical trial results are reassuring and add further weight to calls for Pradaxa (dabigatran) to be PBS listed for atrial fibrillation, experts say.
Little impact made on stroke burden: study
DESPITE improved treatment of atrial fibrillation (AF), there is little evidence any impact has been made on stroke burden, a study suggests.
Subclinical hyperthyroidism increases risk of AF
SUBCLINICAL hyperthyroidism (SCH) is associated with a raised risk of incident atrial fibrillation (AF) and with death from coronary heart disease (CHD), a study suggests.
AF without stroke raises risk of dementia
EVEN without a stroke, atrial fibrillation (AF) raises the risk of cognitive and functional decline, according to an analysis of two randomised controlled trials of treatments to reduce cardiovascular disease.
Many over-40s living with undiagnosed AF time bomb
AT LEAST 50,000 Australians aged 40 years or more may have atrial fibrillation (AF) without knowing it, new data suggest.
Dismay at drug company push for govt subsidy
A DRUG company push to enlist doctors and patients into pressuring the federal government to subsidise the warfarin alternative dabigatran has been branded “appalling” and “inappropriate”.
Modelling shows dabigatran benefit
MODELLING suggests the anticoagulant dabigatran offers a positive benefit compared to warfarin in the management of non-valvular atrial fibrillation (AF), researchers say.
Anticoagulant under-prescribing may raise stroke risk in AF
MORTALITY rates from stroke in patients with atrial fibrillation (AF) are excessively high and a contributing factor may be the under-prescribing of anticoagulants, Australian experts say. Researchers from the University of New South Wales (UNSW) and the Ingham Institute looked at nearly 27,000 cases of ischaemic stroke occurring between 2000 and 2006 in the Program of Research Informing Stroke Management (PRISM) study, and found that a quarter were due to atrial fibrillation (AF). Patients with AF were twice as likely to die in hospital and had mortality rates of nearly 40% ...
Concern over drug familiarisation programs for patients
EXPERTS in ethics and quality use of medicines have voiced concern over the continued use of patient familiarisation programs, suggesting they are more about pitching to consumers than good clinical practice. The comments follow last week's announcement by Boehringer Ingelheim that doctors will be able to enrol their atrial fibrillation patients in a program that will see them receive free dabigatran (Pradaxa). The national product familiarisation program (PFP) will allow doctors to enrol up to 10 patients to receive the drug - ahead of any PBS listing. Professor Paul Komesaroff, chair of the ethics committee at ...
Dabigatran approved for initial PBS listing
THE oral thrombin inhibitor dabigatran has been approved for listing on the PBS for use in patients with atrial fibrillation (AF) under a new pilot, fast-track regulatory process. Dabigatran (Pradaxa) reimbursement was approved at the March meeting of the Pharmaceutical Benefits Advisory Committee (PBAC) for use in patients with AF at risk of stroke on the basis of “acceptable cost-effectiveness”. However, TGA approval was granted only today, a Health Department spokesperson confirmed. Dabigatran was one of a number of drugs approved as part of a pilot run by the department, allowing for expedited reimbursement review, a spokesman ...
Strong family ties linked to the development of AF
Patients with any first-degree relative with atrial fibrillation (AF) have a significantly increased risk of developing the condition themselves, independently of traditional AF risk factors, experts say. Results from a US community-based prospective study of 4421 people free of AF at baseline show that those with a first-degree relative with AF had a 40% greater risk of developing AF themselves during an eight year follow-up. This increased risk was not attenuated after adjusting for age, sex, BMI, blood pressure, treatment for hypertension, heart murmur and heart failure, or having any of the four common AF-related genetic variants. ...
The rising rate of AF
A decade ago, atrial fibrillation was considered an emerging epidemic – has it now reached its peak? Kate Woods looks at the rise and rise of AF.
High cost of atrial fibrillation needs greater public awareness
A NEW report has highlighted the need for public awareness campaigns to improve knowledge of atrial fibrillation (AF), which experts say is under-diagnosed and often inadequately managed. The Economic Costs of Atrial Fibrillation in Australia report, prepared on behalf of the National Stroke Foundation, revealed AF costs the Australian health system more than $1.2 billion annually based on related hospitalisations, strokes, cardiovascular events and loss of productivity. According to the report, patients with AF had a seven times greater risk of stroke compared to the general population, and a three- times greater risk of heart failure. ...
Serious risks of AF are widely misunderstood
MAJOR gaps exist in the knowledge of the cardiovascular risks associated with atrial fibrillation (AF), according to a recent international study which found that both patients and cardiologists may underestimate the seriousness of the condition. A survey of more than 1600 cardiologists and patients with AF in 11 countries, including Australia, revealed only 43% of cardiologists and 55% of patients considered AF to be life-threatening, despite the condition doubling the risk of death, and having a five times greater risk of stroke. Cardiologists also underestimated their patient’s understanding of the benefits of AF treatments and overestimated ...
Central sleep apnoea link to AF confirmed
THE link between central sleep apnoea and atrial fibrillation (AF) has been firmly established in older men, US research shows. Backing previous research in younger populations, the study of 2911 older men (mean age 73 years) showed those with central sleep apnoea were more than twice as likely to suffer from AF, compared to 27% greaterrisk in those with obstructive sleep apnoea. In contrast, complex ventricular ectopy (CVE) was more strongly linked to obstructive sleep apnoea and overnight hypoxia. Associate Professor Ian Wilcox, a cardiologist at Sydney’s Royal Prince Alfred Hospital, said GPs needed to ask ...
High BP and heart rate predict microalbuminuria
A HIGH resting heart rate in patients with hypertension is a significant predictor of microalbuminuria, experts say, and patients should be screened for its presence. An international observational study of patients with hypertension (1705 patients with atrial fibrillation, 18,900 without AF) in 26 countries including Australia found the prevalence of microalbuminuria was closely associated with resting heart rate. Microalbuminuria was present in more than 80% of patients with AF with a heart rate of more than 100 beats per minute. However, the prevalence was increased in all patients with a higher resting heart rate (>80bpm) with or ...
Exercise shows promise for reversing atrial fibrillation
EXERCISE could be enough to revert patients with atrial fibrillation to sinus rhythm, a small Australian pilot study shows. Researchers, examining 18 patients in whom cardioversion was planned, found more than a quarter successfully reverted to sinus rhythm after a median of 10 minutes performing an exercise stress test. While the mechanism for the effect was unclear, they speculated that exercise could induce changes in autonomic tone affecting the atrium. Study author Associate Professor Alexander Black, director of cardiology at Geelong hospital, said there might be a role for exercise stress tests in reversion of atrial ...
AF risk predictor could hold the key to prevention
A NEW risk score that predicts the likelihood of developing atrial fibrillation (AF) could pave the way for interventions to reduce this risk, experts say. An algorithm developed by US researchers can predict a patient’s AF risk for up to 10 years by using a range of markers readily accessible in general practice. These include age, sex, BMI, systolic blood pressure, treatment for hypertension, PR interval, significant cardiac murmur and heart failure. In an accompanying editorial, Australian cardiologists said the tool was the first step in moving prediction of AF from the “fanciful ...
Bisphosphonate-AF risk concern unjustified: study
CONCERN that bisphosphonates may be associated with an increased risk of atrial fibrillation (AF) has been contradicted by a large US study. A US Food and Drug Administration safety review of nearly 47,000 patients found no increased risk in the bisphosphonate treatment cohort. Previous studies had suggested there was an increased risk of AF in patients who used alendronate (though this was not statistically significant) or zoledronic acid. The researchers said those using bisphosphonates were older and had higher rates of cardiovascular disease at baseline. The authors suspected this might account for the increased risk of ...
US continues investigation of AF-bisphosphonate link
THE safety profile of bisphosphonates remains unclear, with the US Food and Drug Administration (FDA) yet to finalise its safety recommendations. In the latest release from its ongoing review of the drugs, the FDA said it was “aware of discordant results from the literature and from other epidemiological studies about the incidence and course of atrial fibrillation (AF) in patients taking bisphosphonates”. The agency is considering whether to conduct additional epidemiological studies on the link between bisphosphonates and AF. The review commenced in October 2007 after two studies found women aged between 65 and 89 years ...
Bisphosphonates and AF risk
Q: Can bisphosphonates cause atrial fibrillation? A: Zoledronic acid and alendronate possibly increase the risk of atrial fibrillation. 1-4 The biological plausibility of this adverse effect is uncertain and remains to be confirmed. In two trials involving postmenopausal women with osteoporosis, the overall incidence of atrial fibrillation with zoledronic acid or alendronate did not differ significantly to placebo; however, serious events (i.e. life-threatening or resulting in hospitalisation or disability) were more common in women receiving the bisphosphonate. 1,2 In the HORIZON Pivotal Fracture Trial, a once-yearly infusion of ...
Moderate exercise cuts AF risk in elderly
REGULAR walks at moderate pace may significantly reduce the risk of new-onset atrial fibrillation (AF) in elderly patients. US researchers have completed the first analyses of the relationship between undertaking regular light to moderate physical activities and its effect on AF incidence. Among more than 5400 adults aged 65 years or older, 1061 new-onset AF cases were identified over a 12-year period. Adults who engaged in moderate exercise such as walking had a 28% reduced risk of AF, compared to those who did not exercise. Increased exercise, walking distance and pace were also associated with a ...