New Risk Factors for Afib, Duration of Anticoagulation for AVR

We have two new risks for atrial fibrillation and an intriguing study on the duration of anticoagulation after bioprosthetic aortic valve. So first up is a study from the women's health initiative that, as we know, randomized women to receive estrogen, with or without progesterone, depending on whether they did or did not have had a hysterectomy.

And this analysis looked over about a six-year follow-up period. To see the incidence of new atrial fibrillation that they found was modestly increased by about twelve percent overall, and this sum is a new finding, combined with other risks that have previously been seen of pulmonary, embolism, VTE and indeed cardiovascular events and so another factor to consider.

When thinking about estrogen replacement therapy, next up is a study from the Framingham risk study looking at low magnesium, that was also seen to be a risk factor for incidence of atrial fibrillation looking at the lowest quartile.

That is less than one point: seven, seven milligrams per deciliter. They found about a one and a half fold higher risk of developing atrial fibrillation compared with the highest quartile, which was above to this, is something we've known about.

We check in hospital but looks like it may have some relevance and so something worth checking the number one pick this week is an intriguing registry study from the Danish national registry. Looking at patients who had undergone bioprosthetic a ortak valve replacement and looked at the duration of anticoagulation, often it's recommended for three months.

But they compared people getting six months or longer as compared with shorter durations and found that there was a a half the risk of cardiovascular death, thromboembolic event or stroke in those who had six months of anticoagulation as compared with shorter durations.

This is an observational study. They tried to adjust for the differences, it's a moderate-sized study, looking at about 4,500 4,000 patients and one that they argue should be looked at by the guidelines committee and other databases evaluated to see whether we should be extending the duration of anticoagulation. Following bioprosthetic.

A ortak valve implantation and this would of course be in patients without other indications such as atrial fibrillation. So for this week's cardiology countdown on Chris cannon, you

Comments

A-FIB VERSUS JUNCTIONAL RHYTHMS

. ATRIAL FIBRILLATION: On your rhythm strip, the two most important characteristics are: . 1) A rhythm that’s IRREGULARLY irregular (meaning there’s no way to predict the next beat) 2) No discernible P waves . In fact, if you notice an irregularly irregular rhythm and you’re having to convince yourself that you see P waves... it’s probably A-fib (multifocal atrial arrhythmias like WAP/MAT could fit the differential) . *In my opinion: Don’t get caught up in using fibrillation waves as an absolute criteria. Very fine A-fib can sometimes produce a near isoelectric line between beats. . JUNCTIONAL RHYTHMS: The pacemaker cells surrounding the AV junction are capable of initiating regular impulses but at a slightly slower natural rate than their sinus and atrial superiors. The heart is built this way so that when the pacemaker cells with the fastest intrinsic rates are in action, those below are suppressed and function primarily to pass along the impulse from above. . For these reasons, we s

The Pathway of Blood

Here’s a great illustration on the pathway of blood flow through the heart. It may seem easy...but you should know this cold as well as the cardiac anatomy, both of which will make procedures and understanding hemodynamics easier. . . . 💙VENOUS BLOOD- Blood flows into the heart (into the right atrium) through two major veins (the superior and inferior vena cava) as well as from the coronary sinus (cardiac venous blood from the coronaries) and then out through the first AV valve (tricuspid valve) into the right ventricle. From there blood flows into the right ventricular outflow tract, across the first semilunar valve (pulmonic valve) and into the main and then left and right pulmonary arteries. Blood then enters the lungs to become oxygenated. . . . ❤️ARTERIAL BLOOD- now that blood is oxygenated flow goes from the lungs into the left atrium through 4 veins (usually) called the pulmonary veins. From the left atrium blood flows across the other AV valve (mitral valve) and into the left

What is The Cardiac Cycle ?

The cardiac cycle refers to the sequence of events that occur and repeat with each heartbeat. It can be divided into two main stages: Systole and diastole, each of which is divided into several small steps When systole and diastole are not specified otherwise refers to ventricular contraction and relaxation Respectively, Reminder Blood flows from low to low pressure Compression increases the pressure in a Chamber, while relaxation reduces the pressure. When the AVT valves open the anterior pressures are higher than the ventricular pressures and Off when the pressure gradient is reversed. Similarly, Semiluna valves open when ventricular pressure exceeds submerged /, pulmonary pressure And stop. If the opposite is true, The cycle was started by firing shots at the SA node, which encouraged the atria to lower . Learn here Atrial Fibrillation Treatment It is represented by p-waves in the ECG Shortly after the onset of the P-wave atrial contraction begins and increases the

Best Cardiologist in London

Search This Blog