1,721,471 research outputs found
ESC and EHRA lead a path towards integrated care for multimorbid atrial fibrillation patients: the Horizon 2020 EHRA-PATHS project
No full textTransforming health care is a difficult task: although physicians know which evidence-based treatments work, delivering those in a unified fashion as integrated management often lacks adequate implementation. European heart rhythm association (EHRA) and european society of cardiology (ESC) have been entrusted by the European Commission to lead a consortium with the aim to do just that
Atrial Fibrillation Beyond the Electrocardiogram:Towards Understanding and Preventing Progression
Full text linkAtrial fibrillation (AF) is a common cardiac arrhythmia that usually starts in a paroxysmal nature and often progresses to permanent AF. This transition is often referred to as AF progression. AF progression is associated with a higher rate of complications, including stroke. In part 1 of the thesis, we focused on identifying factors associated with AF progression. First, we describe that even patients with young-onset AF often have underlying heart and vascular disease. Secondly, the risk profile between men and women differs significantly, but this does not result in a difference in AF progression rate between sexes.In several cohorts, we aimed to identify risk factors for AF progression and found left atrial size, left ventricular hypertrophy, elevated blood pressure and 2 blood biomarkers (PAI-1, involved in coagulation and NT-proBNP, a marker of ventricular stretch) to be associated with AF progression. Furthermore, patients with a higher number of heart and vascular disease, had longer episodes of AF.In part 2, we focused on potential manners to prevent AF progression. In RACE 3, targeted therapy of underlying diseases was associated with a higher proportion of patients in sinus rhythm at 1 year. Similarly, quality of life was better in these patients, compared to usual care. Future studies will have to determine which combination of interventions is effective in preventing AF progression and thereby improving the prognosis of AF patients
Novel insights into determinants and prevention of atrial fibrillation progression
Full text linkAtrial fibrillation (AF) is the most prevalent arrhythmia, and its prevalence is expected to continue to rise. This is alarming, since incident AF and AF progression are associated with major adverse events such as heart failure, stroke, impaired quality of life and mortality. AF is a progressive disease, usually starting with short lasting, paroxysmal self-terminating episodes, that often progresses to more frequent, non-self-terminating and longer episodes (persistent or permanent AF). The mechanisms and processes that underlie AF and AF progression are complex and not completely understood. Various mechanisms, caused by risk factors and comorbidities, such as hypertension, obesity, and diabetes, lead to atrial remodelling. Determinants of AF progression are not optimally studied. In this thesis potential new determinants for AF progression are studied. In addition to clinical factors (risk factors, electrocardiogram, echocardiography, cardiac computed tomography), blood biomarkers are also studied in search for potential determinants of AF progression. Further, AF progression is studied in a unique way by using continuous rhythm monitoring with an implantable looprecorder. This thesis also examines the effect of treatment of known risk factors and comorbidities of AF for the prevention of AF progression on short and long-term follow-up. This thesis provides insight into current treatment of risk factors and comorbidities and its impact on prevention of AF progression. Additionally, this thesis may help to better understand mechanisms and processes underlying AF progression, possibly predict which patients will have AF progression, and give the possibility of early and more aggressive treatment to prevent AF progression
Risk factors for atrial fibrillation incidence and progression
Full text linkDuring atrial fibrillation (AF) irregular activation of the hearts atria occur, causing an irregular heart rate and altered blood flow. AF is the most common heart rhythm disorder, causing stroke, heart failure, dementia, reduced quality of life and high health care expences. AF is diagnosed increasingly frequent, at increasingly young age. Treatment requires knowledge on factors that may cause AF, which may help prevent occurence of AF and AF progression. AF progression is the proces by which scar tissue forms in the atria, which goes hand-in-hand with increased episodes of AF and AF-related complications. Examples of traditional risk factors for AF are hypertension, heart infarction and heart failure. However risk factors are changing because of improved treatment, increasing age of the population and changing lifestyle. We investigated risk factors for AF incidence and progression. We found that obesity nowadays has become an important risk factor for atrial fibrillation occurrence, at both younger age (<60 years) and older age. At younger age heritable factors seem to be more important than at older age, conversely, some traditional risk factors are less important at younger age. Furthermore, presence of AF related symtoms (e.g. shortness of breath) may be a sign of present risk factors, more AF related complications and therefore AF progression. Finally, we found that even in young patients with AF and obesity, atrial function is reduced, which is an early sign of scar tissue formation. This again underlines that AF treatment should embrace lifestyle change and weightloss
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Surgical minimally invasive pulmonary vein isolation for lone atrial fibrillation: midterm results of a multicenter study
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