Cognitive Issues, Heart Disease / 19.05.2014

T. Jared Bunch, MD Medical director for Heart Rhythm Services Director of Heart Rhythm research Intermountain Medical Center, Utah MedicalResearch.com Interview with T. Jared Bunch, MD Medical director for Heart Rhythm Services Director of Heart Rhythm research Intermountain Medical Center, Utah MedicalResearch: What are the main findings of the study? Dr. Bunch: The main findings of the study are: 1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia. 2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding. 3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years). (more…)
Author Interviews, Exercise - Fitness, Heart Disease, Karolinski Institute / 16.05.2014

MedicalResearch.com Interview with: Dr Nikola Drca Department of Cardiology at the Karolinska Institute, Karolinska University Hospital Stockholm Sweden MedicalResearch: What are the main findings of the study? Dr. Nikola Drca: We found that intense physical activity like leisure-time exercise of more than five hours per week at the age of 30 increased the risk of developing atrial fibrillation later in life by 19%. In contrast, moderate-intensity physical activity like walking or bicycling of more than 1 hour per day at older age (age 60) decreased the risk by 13%. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute, Kidney Disease / 04.03.2014

Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden. MedicalResearch.com Interview with: Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.   MedicalResearch.com: Why did you choose to study this particular question? Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation. (more…)
Author Interviews, Heart Disease, JAMA / 22.02.2014

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC Professor Department of Medicine, Cardiology Division Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship Arrhythmia & Pacing Service McMaster University-HHSC Director Syncope and Autonomic Disorder Unit Senior Investigator, Arrhythmia & Global Health, Population Health Research Institute Hamilton, ON, Canada MedicalResearch.com Interview with: Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC Professor Department of Medicine, Cardiology Division Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship ,Hamilton, ON, Canada MedicalResearch.com: What are the main findings of the study? Dr. Morillo: The main findings were that Ablation of atrial fibrillation was superior to conventional antiarrythmic drug therapy in patients with Paroxysmal atrial fibrillation that had not been treated with Antiarrhythmic medications. Ablation extended the time to first recurrence of atrial fibrillation within the 2 year follow-up of the study and significantly reduced the recurrence of repeated episodes of AF. (more…)
Author Interviews, Heart Disease / 31.01.2014

Professor Gregory Y.H. Lip MD, FRCP (London, Edinburgh, Glasgow), DFM, FACC, FESCUniversity of Birmingham, Centre for Cardiovascular Sciences, City Hospital Consultant Cardiologist & Professor of Cardiovascular Medicine, Director - Haemostasis Thrombosis & Vascular Biology Unit Birmingham, United Kingdom MedicalResearch.com Interview with: Professor Gregory Y.H. Lip MD, FRCP Consultant Cardiologist & Professor of Cardiovascular Medicine, Director - Haemostasis Thrombosis & Vascular Biology Unit Birmingham, United Kingdom MedicalResearch.com: What are the main findings of the study? [GYHL] In this large-scale nationwide cohort study, we found that switching to dabigatran increased the risk of MI compared to continued warfarin usage in the early period after switching. Caution may be warranted especially when switching prior VKA-experienced patients with atrial fibrillation to dabigatran. This risk was not evident in the warfarin-naïve cohort newly started on dabigatran. (more…)
Author Interviews, Heart Disease, Kidney Disease / 31.12.2013

Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com Interview with: Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com: What are the main findings of the study? This was the first long-term study in individuals with atrial fibrillation to consider the impact of renal function, as measured by eGFR, on stroke/thromboembolism, mortality and bleeding in the same population concurrently. Answer: There were three main findings of our study.
  • First, patients with worsening renal function had more severe risk factor profiles and had higher rates of stroke/thromboembolism, mortality and bleeding.
  • Second, individuals receiving oral anticoagulation had lower rates of stroke/thromboembolism and mortality than those not receiving anticoagulation at all levels of renal function measured by eGFR, suggesting that anticoagulation has benefit in even patients with low eGFR.
  • Third, renal function was not an independent predictor of stroke/thromboembolism at 1 year after adjustment for baseline characteristics. (more…)
Author Interviews, Heart Disease, JAMA, Weight Research / 21.11.2013

MedicalResearch.com Interview with: Prof. Prashanthan Sanders MedicalResearch.com Interview with: Prof. Prashanthan Sanders Director, Centre for Heart Rhythm Disorders University of Adelaide | Royal Adelaide Hospital | SAHMRI NHMRC Practitioner Fellow Centre for Heart Rhythm Disorders Department of Cardiology | Royal Adelaide Hospital Adelaide 5000 | Australia MedicalResearch.com: What are the main findings of the study? Answer: Aggressive treatment of risk factors and weight reduced the symptom burden associated with atrial fibrillation. It is therefore important that in a similar manner to how we treat coronary artery disease, in atrial fibrillation there should be management directed at the reasons why these individuals got AF in the first place. (more…)
Author Interviews, Heart Disease, JAMA, Wake Forest / 05.11.2013

Elsayed Z Soliman MD, MSc, MS, FAHA, FACC Director, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Medical Center Blvs, Winston Salem, NC 27157 MedicalResearch.com Interview with: Elsayed Z Soliman MD, MSc, MS, FAHA, FACC Director, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Medical Center Blvs, Winston Salem, NC 27157 Atrial Fibrillation and the Risk of Myocardial Infarction MedicalResearch.com: What are the main findings of the study? Dr. Soliman: Using data from the REGARDS study, one of the largest US cohorts, we examined the risk of incident myocardial infarction (MI) associated with atrial fibrillation (AF). Overall, AF was associated with almost double the risk of MI. When we adjusted for common cardiovascular risk factors and potential confounders, the risk remained significantly high; about 70% increased risk. When we looked at women, men, blacks, and whites separately, we found significant differences between races and sex. AF in women and blacks was associated with more than double the risk of MI. This compares to less than 50% increased risk of heart attack associated with AF in men and whites . So AF is basically bad for all, but the risk of MI associated with AF is more pronounced in women and blacks. (more…)
Author Interviews, Heart Disease / 18.10.2013

Dr. med. Jelena Kornej Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany & University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom MedicalResearch.com Interview with: Dr. med. Jelena Kornej Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany & University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: The main finding of our analysis was that thromboembolic events after atrial fibrillation (AF) catheter ablation are rare, but all three stroke risk stratification scores, i.e. CHADS2, CHA2DS2-VASc, and R2CHADS2 were associated with thromboembolic risk in anticoagulated population. Furthermore, patients with AF recurrences had increased risk for thromboembolic complications. (more…)
Author Interviews, Heart Disease / 15.09.2013

MedicalResearch.com Interview with: Elisa Ebrille, MD Department of Cardiology, School of Medicine Fiorenzo Gaita, M.D. Director Division of Cardiology Department of Medical Sciences University of Turin, Turin, Italy MedicalResearch.com What are the main findings of the study? Answer: We evaluated 33 patients with long-standing atrial fibrillation and valvular heart disease who underwent valve surgery and concomitant cryoablation (pulmonary veins isolation, mitral isthmus and roof line lesions) from 2000 to 2002. The surgically created ablation lesion was validated with electroanatomic mapping. Percutaneous radiofrequency ablation was performed in cases with lesion incompleteness and these patients were followed for over 10 years.
  • A hybrid approach, combining surgical ablation procedure consisting of pulmonary veins isolation and creation of left atrial linear lesions (mitral isthmus and roof lines), along with endocardial ablation, when necessary, led to a significant clinical improvement in patients with long-standing atrial fibrillation and valvular heart disease during a long-term follow-up (> 10 years).
  • With the hybrid approach, pulmonary veins isolation and transmural left atrial linear lesions were obtained in a high percentage of patients (79%). When achieved and electrophysiologically demonstrated, the complete ablation scheme was effective in more than 80% of patients in maintaining sinus rhythm throughout follow-up. (more…)