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Article ; Online: Rhythm Control of Atrial Fibrillation in Heart Failure with Reduced Ejection Fraction.

Burkman, Gregory / Naccarelli, Gerald V

2020 Volume 22, Issue 9, Page(s) 83

Abstract: Purpose of review: Atrial fibrillation and heart failure frequently co-exist with an increasing prevalence of atrial fibrillation as ejection fraction decreases. Atrial fibrillation is associated with increased mortality in patients with heart failure. ... ...

Abstract	Purpose of review: Atrial fibrillation and heart failure frequently co-exist with an increasing prevalence of atrial fibrillation as ejection fraction decreases. Atrial fibrillation is associated with increased mortality in patients with heart failure. This article will review rhythm and rate control options, ultimately supporting rhythm control via endocardial ablation. Recent findings: Randomized trials of a rhythm control strategy in patients with reduced ejection fraction heart failure have shown significant improvements in ejection fraction, oxygen consumption and also a significant reduction in mortality. The treatment of atrial fibrillation in patients with reduced ejection fraction heart failure should include an early rhythm control strategy via endocardial ablation.
MeSH term(s)	Atrial Fibrillation/surgery ; Catheter Ablation ; Heart Failure/surgery ; Heart Rate ; Humans ; Stroke Volume ; Ventricular Dysfunction, Left
Keywords	covid19
Language	English
Publishing date	2020-07-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055373-0
ISSN	1534-3170 ; 1523-3782
ISSN (online)	1534-3170
ISSN	1523-3782
DOI	10.1007/s11886-020-01336-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5524: Show issues

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Article ; Online: Obese patients with new onset atrial fibrillation/flutter have higher risk of hospitalization, cardioversions, and ablations.

Norton, Jonathan / Foy, Andrew / Ba, Djibril M / Liu, Guodong / Leslie, Doug / Zhang, Yue / Naccarelli, Gerald V

American heart journal plus : cardiology research and practice

2024 Volume 40, Page(s) 100375

Abstract: Obesity significantly increases the risk of developing atrial fibrillation (AF) and atrial flutter (AFL) and evidence from randomized trials indicates that weight loss may reduce the burden of AF/AFL in obese patients; however, the relationship between ... ...

Abstract	Obesity significantly increases the risk of developing atrial fibrillation (AF) and atrial flutter (AFL) and evidence from randomized trials indicates that weight loss may reduce the burden of AF/AFL in obese patients; however, the relationship between obesity and healthcare resource utilization in AF/AFL patients is lacking. We sought to assess this relationship in patients with newly diagnosed AF/AFL in a nationally representative cohort of the United States by using the MarketScan® claims database. International Classification of Diseases, Tenth Revision [ICD 10] diagnosis codes were used to select individuals with a new diagnosis of AF/AFL in 2017 and 2018, adjudicate baseline variables and to classify them according to obesity status. Patients were followed for two years at which point all data was censored. The primary outcome of the study was hospitalizations due to AF/AFL. Cox proportional hazards regression models were used to assess the adjusted hazard ratio for obese versus non-obese patients. There were 55,271 patients with new onset AF/AFL, which included 43,314 (78.4 %) who were non-obese and 11,957 (21.6 %) who were obese. There were significantly more males than females among non-obese (65.3 % vs. 34.7 %) and obese individuals (62.3 % vs. 37.7 %). The average age (SD) was similar in the non-obese (54.5 (9.7)) and obese cohorts (54.7 (8.4)), respectively. The incidence of Emergency Department visits (4.0 % vs. 6.5 %), hospitalizations (5.5 % vs. 10.7 %), cardioversions (6.6 % vs. 12.7 %), and ablation procedures (5.3 % vs. 8.6 %) were significantly increased among obese patients.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2666-6022
ISSN (online)	2666-6022
DOI	10.1016/j.ahjo.2024.100375
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Article: Rhythm Control of Atrial Fibrillation in Heart Failure with Reduced Ejection Fraction

Burkman, Gregory / Naccarelli, Gerald V

Curr Cardiol Rep

Abstract: PURPOSE OF REVIEW: Atrial fibrillation and heart failure frequently co-exist with an increasing prevalence of atrial fibrillation as ejection fraction decreases. Atrial fibrillation is associated with increased mortality in patients with heart failure. ... ...

Abstract	PURPOSE OF REVIEW: Atrial fibrillation and heart failure frequently co-exist with an increasing prevalence of atrial fibrillation as ejection fraction decreases. Atrial fibrillation is associated with increased mortality in patients with heart failure. This article will review rhythm and rate control options, ultimately supporting rhythm control via endocardial ablation. RECENT FINDINGS: Randomized trials of a rhythm control strategy in patients with reduced ejection fraction heart failure have shown significant improvements in ejection fraction, oxygen consumption and also a significant reduction in mortality. The treatment of atrial fibrillation in patients with reduced ejection fraction heart failure should include an early rhythm control strategy via endocardial ablation.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32647927
Database	COVID19

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Article ; Online: Effect of dronedarone vs. placebo on atrial fibrillation progression: a post hoc analysis from ATHENA trial.

Blomström-Lundqvist, Carina / Naccarelli, Gerald V / McKindley, David S / Bigot, Gregory / Wieloch, Mattias / Hohnloser, Stefan H

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2023 Volume 25, Issue 3, Page(s) 845–854

Abstract: Aims: This post hoc analysis of the ATHENA trial (NCT00174785) assessed the effect of dronedarone on the estimated burden of atrial fibrillation (AF)/atrial flutter (AFL) progression to presumed permanent AF/AFL, and regression to sinus rhythm (SR), ... ...

Abstract	Aims: This post hoc analysis of the ATHENA trial (NCT00174785) assessed the effect of dronedarone on the estimated burden of atrial fibrillation (AF)/atrial flutter (AFL) progression to presumed permanent AF/AFL, and regression to sinus rhythm (SR), compared with placebo. Methods and results: The burden of AF/AFL was estimated by a modified Rosendaal method using available electrocardiograms (ECG). Cumulative incidence of permanent AF/AFL (defined as ≥6 months of AF/AFL until end of study) or permanent SR (defined as ≥6 months of SR until end of study) were calculated using Kaplan-Meier estimates. A log-rank test was used to assess statistical significance. Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were estimated using a Cox model, adjusted for treatment group. Of the 4439 patients included in this analysis, 2208 received dronedarone, and 2231 placebo. Baseline and clinical characteristics were well balanced between groups. Overall, 304 (13.8%) dronedarone-treated patients progressed to permanent AF/AFL compared with 455 (20.4%) treated with placebo (P < 0.0001). Compared with those receiving placebo, patients receiving dronedarone had a lower cumulative incidence of permanent AF/AFL (log-rank P < 0.001; HR: 0.65; 95% CI: 0.56-0.75), a higher cumulative incidence of permanent SR (log-rank P < 0.001; HR: 1.19; 95% CI: 1.09-1.29), and a lower estimated AF/AFL burden over time (P < 0.01 from Day 14 to Month 21). Conclusion: These results suggest that dronedarone could be a useful antiarrhythmic drug for early rhythm control due to less AF/AFL progression and more regression to SR vs. placebo, potentially reflecting reverse remodeling. Clinical trial registration: NCT00174785.
MeSH term(s)	Humans ; Amiodarone/adverse effects ; Anti-Arrhythmia Agents/adverse effects ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Atrial Flutter/diagnosis ; Atrial Flutter/drug therapy ; Atrial Flutter/epidemiology ; Dronedarone/adverse effects ; Hospitalization
Chemical Substances	Amiodarone (N3RQ532IUT) ; Anti-Arrhythmia Agents ; Dronedarone (JQZ1L091Y2)
Language	English
Publishing date	2023-02-08
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euad023
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Zs.A 5434: Show issues

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Article ; Online: The Increasing Role of Rhythm Control in Patients With Atrial Fibrillation: JACC State-of-the-Art Review.

Camm, A John / Naccarelli, Gerald V / Mittal, Suneet / Crijns, Harry J G M / Hohnloser, Stefan H / Ma, Chang-Sheng / Natale, Andrea / Turakhia, Mintu P / Kirchhof, Paulus

Journal of the American College of Cardiology

2022 Volume 79, Issue 19, Page(s) 1932–1948

Abstract: The considerable mortality and morbidity associated with atrial fibrillation (AF) pose a substantial burden on patients and health care services. Although the management of AF historically focused on decreasing AF recurrence, it evolved over time in ... ...

Abstract	The considerable mortality and morbidity associated with atrial fibrillation (AF) pose a substantial burden on patients and health care services. Although the management of AF historically focused on decreasing AF recurrence, it evolved over time in favor of rate control. Recently, more emphasis has been placed on reducing adverse cardiovascular outcomes using rhythm control, generally by using safe and effective rhythm-control therapies (typically antiarrhythmic drugs and/or AF ablation). Evidence increasingly supports early rhythm control in patients with AF that has not become long-standing, but current clinical practice and guidelines do not yet fully reflect this change. Early rhythm control may effectively reduce irreversible atrial remodeling and prevent AF-related deaths, heart failure, and strokes in high-risk patients. It has the potential to halt progression and potentially save patients from years of symptomatic AF; therefore, it should be offered more widely.
MeSH term(s)	Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/therapy ; Atrial Remodeling ; Catheter Ablation/adverse effects ; Humans ; Stroke/etiology ; Stroke/prevention & control ; Stroke/surgery ; Treatment Outcome
Chemical Substances	Anti-Arrhythmia Agents
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2022.03.337
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Zs.A 1846: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Relation of Obesity to New-Onset Atrial Fibrillation and Atrial Flutter in Adults.

Foy, Andrew J / Mandrola, John / Liu, Guodong / Naccarelli, Gerald V

The American journal of cardiology

2018 Volume 121, Issue 9, Page(s) 1072–1075

Abstract: Prospective cohort studies involving older adults report an association of obesity and new-onset atrial fibrillation and atrial flutter. To assess this relation, we performed a longitudinal cohort study from January 1, 2006 to December 31, 2013, using a ... ...

Abstract	Prospective cohort studies involving older adults report an association of obesity and new-onset atrial fibrillation and atrial flutter. To assess this relation, we performed a longitudinal cohort study from January 1, 2006 to December 31, 2013, using a national claims database that tracks all inpatient, outpatient, and pharmacy claims data. The primary end point of new-onset atrial fibrillation was compared between obese and nonobese cohorts. We used logistic regression to determine the strength of association between obesity and new-onset atrial fibrillation controlling for age, gender, hypertension, and diabetes. Overall, 67,278 subjects were included in the cohort, divided evenly between those with and without a diagnosis of obesity. Obese subjects were significantly more likely to have hypertension (29.5% vs 14.6%) and diabetes (12.7% vs 5.2%) at study onset. Over 8 years of follow-up, we recorded a new diagnosis of atrial fibrillation in 1,511 (2.2%) subjects. Obesity was strongly associated with a new diagnosis of atrial fibrillation after controlling for age, gender, hypertension, and diabetes (odds ratio 1.4, 95% confidence interval 1.3 to 1.6). In conclusion, this information contributes to the growing evidence supporting the causal relation between obesity and atrial fibrillation, and emphasizes the need of addressing obesity as part of our therapeutic strategy to prevent atrial fibrillation.
MeSH term(s)	Adult ; Atrial Fibrillation/epidemiology ; Atrial Flutter/epidemiology ; Cohort Studies ; Diabetes Mellitus/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Incidence ; Logistic Models ; Longitudinal Studies ; Male ; Multivariate Analysis ; Obesity/epidemiology ; Odds Ratio ; United States/epidemiology
Language	English
Publishing date	2018-02-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2018.01.019
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Residual stroke risk despite oral anticoagulation in patients with atrial fibrillation.

Carlisle, Matthew A / Shrader, Peter / Fudim, Marat / Pieper, Karen S / Blanco, Rosalia G / Fonarow, Gregg C / Naccarelli, Gerald V / Gersh, Bernard J / Reiffel, James A / Kowey, Peter R / Steinberg, Benjamin A / Freeman, James V / Ezekowitz, Michael D / Singer, Daniel E / Allen, Larry A / Chan, Paul S / Pokorney, Sean D / Peterson, Eric D / Piccini, Jonathan P

Heart rhythm O2

2022 Volume 3, Issue 6Part A, Page(s) 621–628

Abstract: Background: Oral anticoagulation (OAC) reduces the risk of thromboembolic events in patients with atrial fibrillation (AF); however, thromboembolism (TE) still can occur despite OAC. Factors associated with residual risk for stroke, systemic embolism, ... ...

Abstract	Background: Oral anticoagulation (OAC) reduces the risk of thromboembolic events in patients with atrial fibrillation (AF); however, thromboembolism (TE) still can occur despite OAC. Factors associated with residual risk for stroke, systemic embolism, or transient ischemic attack events despite OAC have not been well described. Objective: The purpose of this study was to evaluate the residual risk of thromboembolic events in patients with AF despite OAC. Methods: A total of 18,955 patients were analyzed in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF I and II) using multivariable Cox proportional hazard modeling. Mean age was 72 ± 10.7, and 42% were women. There were 451 outcome events. Results: The risk of TE despite OAC increased with CHA Conclusion: Patients with AF have a residual risk of TE with increasing CHA
Language	English
Publishing date	2022-09-28
Publishing country	United States
Document type	Journal Article
ISSN	2666-5018
ISSN (online)	2666-5018
DOI	10.1016/j.hroo.2022.09.018
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Article ; Online: Outcomes Associated with Dronedarone Use in Patients with Atrial Fibrillation.

Goehring, Earl L / Bohn, Rhonda L / Pezzullo, John / Tave, Arlene K / Jones, Judith K / Bozzi, Sylvie / Tamayo, Ret Capt Sally G / Sicignano, Nicholas / Naccarelli, Gerald V

The American journal of cardiology

2020 Volume 135, Page(s) 77–83

Abstract: The antiarrhythmic drug dronedarone was designed to reduce the extra-cardiac adverse effects associated with amiodarone use in treatment of patients with atrial fibrillation / atrial flutter (AF/AFL). This epidemiological study used a retrospective ... ...

Abstract	The antiarrhythmic drug dronedarone was designed to reduce the extra-cardiac adverse effects associated with amiodarone use in treatment of patients with atrial fibrillation / atrial flutter (AF/AFL). This epidemiological study used a retrospective cohort design to compare risk of cardiovascular-related hospitalizations and death in AF/AFL patients treated with dronedarone versus other antiarrhythmic drugs (AADs). AF/AFL patients with incident dronedarone fills were matched by propensity score (PS) to incident users of other AADs. The primary study outcome was hospitalization for cardiovascular (CV) causes within 24 months after the first study drug fill. A secondary composite outcome comprised hospitalization for CV causes or all-cause mortality during follow-up. In the AF/AFL patient cohort meeting eligibility criteria, 6,964 incident users of dronedarone and 25 607 incident users of other AADs were identified. The PS-matched cohort comprised 6,349 Dronedarone users (91.2% of all eligible) and 12,698 other AAD users. Dronedarone patients had a significantly lower risk of hospitalization for a CV event compared to Other AAD users (hazard ratio = 0.87; 95% confidence interval = 0.79 to 0.96). This was consistent with results for the composite outcome (hazard ratio=0.86; 95% confidence interval = 0.78 to 0.95). In conclusion, AF/AFL patients initiated on dronedarone versus other AADs had significantly lower risk of CV hospitalizations as well as the composite CV hospitalization / death from any cause.
MeSH term(s)	Aged ; Aged, 80 and over ; Anti-Arrhythmia Agents/adverse effects ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/drug therapy ; Atrial Flutter/drug therapy ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/mortality ; Cohort Studies ; Dronedarone/adverse effects ; Dronedarone/therapeutic use ; Epidemiologic Studies ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Treatment Outcome
Chemical Substances	Anti-Arrhythmia Agents ; Dronedarone (JQZ1L091Y2)
Language	English
Publishing date	2020-08-27
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2020.08.026
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Article: Health care reform: effects on electrophysiology and pacing.

Naccarelli, G V

Current opinion in cardiology

1997 Volume 12, Issue 1, Page(s) 1–2

MeSH term(s)	Arrhythmias, Cardiac/therapy ; Cardiac Pacing, Artificial ; Cardiology/economics ; Cardiology/manpower ; Cost Savings ; Electrophysiology ; Health Care Reform ; Humans ; Insurance, Health, Reimbursement ; Quality of Health Care ; United States
Language	English
Publishing date	1997-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	645186-x
ISSN	1531-7080 ; 0268-4705
ISSN (online)	1531-7080
ISSN	0268-4705
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Zs.A 2556: Show issues

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Article: Trends in subspecialty training in cardiac electrophysiology and pacing.

Naccarelli, G V

Pacing and clinical electrophysiology : PACE

1994 Volume 17, Issue 2, Page(s) 242–244

MeSH term(s)	Accreditation ; Cardiac Pacing, Artificial/economics ; Cardiac Pacing, Artificial/trends ; Cardiology/education ; Cardiology/trends ; Certification ; Credentialing ; Electrocardiography/economics ; Electrocardiography/trends ; Electrophysiology/education ; Humans ; Physicians/supply & distribution ; Reimbursement Mechanisms ; Workforce
Language	English
Publishing date	1994-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	424437-0
ISSN	1540-8159 ; 0147-8389
ISSN (online)	1540-8159
ISSN	0147-8389
DOI	10.1111/j.1540-8159.1994.tb01377.x
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Zs.MO 399: Show issues

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