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  1. Article ; Online: From Bench to Bedside-Implementing the New ABC Approach for Atrial Fibrillation in an Emergency Department Setting.

    Gupta, Sophie / Lutnik, Martin / Niederdöckl, Jan / Schnaubelt, Sebastian

    International journal of environmental research and public health

    2022  Volume 19, Issue 8

    Abstract: Atrial fibrillation (AF) is a globally evolving medical challenge with, currently, 4% prevalence in the European Union's population [ ... ]. ...

    Abstract Atrial fibrillation (AF) is a globally evolving medical challenge with, currently, 4% prevalence in the European Union's population [...].
    MeSH term(s) Atrial Fibrillation/epidemiology ; Atrial Fibrillation/therapy ; Emergency Service, Hospital ; Humans ; Prevalence
    Language English
    Publishing date 2022-04-15
    Publishing country Switzerland
    Document type Editorial ; Comment
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph19084797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Computed Tomography to Exclude Cardiac Thrombus in Atrial Fibrillation-An 11-Year Experience from an Academic Emergency Department.

    Gupta, Sophie / Lutnik, Martin / Cacioppo, Filippo / Lindmayr, Teresa / Schuetz, Nikola / Tumnitz, Elvis / Friedl, Lena / Boegl, Magdalena / Schnaubelt, Sebastian / Domanovits, Hans / Spiel, Alexander / Toth, Daniel / Varga, Raoul / Raudner, Marcus / Herkner, Harald / Schwameis, Michael / Niederdoeckl, Jan

    Diagnostics (Basel, Switzerland)

    2024  Volume 14, Issue 7

    Abstract: Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present ... ...

    Abstract Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality in recent years.
    Methods: This registry-based observational study was performed at the Department of Emergency Medicine at the Medical University of Vienna, Austria. We studied all consecutive patients with AF and AFL who underwent CT between January 2012 and January 2023 to rule out LAAT before cardioversion to sinus rhythm was attempted. Follow-ups were conducted by telephone and electronic medical records. The main variables of interest were the rate of LAAT and ischemic stroke at follow-up.
    Results: A total of 234 patients (143 [61%] men; median age 68 years [IQR 57-76], median CHA
    Conclusion: LAAT was rare in patients admitted to the ED with AF and AFL who underwent cardiac CT prior to attempted cardioversion. At follow-up, no patient had suffered an ischemic stroke. Prospective studies need to show whether this strategy is suitable for the acute treatment of symptomatic AF in the emergency setting.
    Language English
    Publishing date 2024-03-27
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics14070699
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department.

    Cacioppo, Filippo / Reisenbauer, Denise / Herkner, Harald / Oppenauer, Julia / Schuetz, Nikola / Niederdoeckl, Jan / Schnaubelt, Sebastian / Gupta, Sophie / Lutnik, Martin / Simon, Alexander / Spiel, Alexander O / Buchtele, Nina / Domanovits, Hans / Laggner, Anton N / Schwameis, Michael

    JAMA network open

    2022  Volume 5, Issue 10, Page(s) e2237234

    Abstract: Importance: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is ... ...

    Abstract Importance: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is unknown.
    Objective: To assess potassium and magnesium administration and SCV probability in AF and AFL in the emergency department.
    Design, setting, and participants: A registry-based cohort study was conducted in the Department of Emergency Medicine of the Medical University of Vienna, Austria. All consecutive patients with AF or AFL were screened between February 6, 2009, and February 16, 2020.
    Interventions: Intravenous administration of potassium, 24 mEq, and magnesium, 145.8 mg.
    Main outcomes and measures: The primary outcome was the probability of SCV during the patient's stay in the emergency department. Multivariable cluster-adjusted logistic regression was used to estimate the association between potassium and magnesium administration and the probability of SCV.
    Results: A total of 2546 episodes of nonpermanent AF (median patient age, 68 [IQR, 58-75] years, 1411 [55.4%] men) and 573 episodes of nonpermanent AFL (median patient age, 68 [IQR, 58-75] years; 332 [57.9%] men) were observed. In AF episodes, intravenous potassium and magnesium administration vs no administration was associated with increased odds of SCV (19.2% vs 10.4%; odds ratio [OR], 1.98; 95% CI, 1.53-2.57). In AFL episodes, in contrast, no association was noted for the probability of SCV with potassium and magnesium vs no administration (13.0% vs 12.5%; OR, 1.05; 95% CI, 0.65-1.69).
    Conclusions and relevance: The findings of this registry-based cohort study on intravenous administration of potassium and magnesium suggest an increased probability of SCV in nonpermanent AF, but not AFL, during a patients' stay in the emergency department.
    MeSH term(s) Male ; Humans ; Aged ; Female ; Atrial Flutter/drug therapy ; Atrial Flutter/epidemiology ; Atrial Flutter/complications ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/complications ; Magnesium ; Cohort Studies ; Treatment Outcome ; Emergency Service, Hospital ; Potassium
    Chemical Substances Magnesium (I38ZP9992A) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2022-10-03
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.37234
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study.

    Cacioppo, Filippo / Schwameis, Michael / Schuetz, Nikola / Oppenauer, Julia / Schnaubelt, Sebastian / Simon, Alexander / Lutnik, Martin / Gupta, Sophie / Roth, Dominik / Herkner, Harald / Spiel, Alexander Oskar / Laggner, Anton Norbert / Domanovits, Hans / Niederdoeckl, Jan

    International journal of environmental research and public health

    2022  Volume 19, Issue 11

    Abstract: Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the ... ...

    Abstract Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the cardioversion success of ibutilide and amiodarone in patients with post-ablation atrial tachyarrhythmia. We included all episodes of post-ablation atrial tachyarrhythmia in patients treated with either intravenous ibutilide or amiodarone at an academic emergency department from 2010 to 2018. The primary endpoint was the conversion to sinus rhythm. The conversion rates were stratified by arrhythmia type, and multivariable cluster-adjusted logistic regression was used to estimate the effect of ibutilide and amiodarone on cardioversion success, given as the odds ratio (OR) with 95% confidence intervals (95% CI). In total, 109 episodes of 72 patients were analyzed. The conversion rates were 37/49 (76%) for ibutilide and 16/60 (27%) for amiodarone. Compared to amiodarone, ibutilide was associated with higher odds of conversion (multivariable cluster-adjusted OR 5.6, 95% CI 1.3-24.3). The cardioversion success of ibutilide was the highest in atrial flutter (crude OR 19.5, 95% CI 3.4-112.5) and focal atrial tachycardia (crude OR 8.3, 95% CI 1.5-47.2), but it was less pronounced in atrial fibrillation (crude OR 4.5, 95% CI 1.2-17.2). Randomized trials are warranted to confirm our findings.
    MeSH term(s) Amiodarone/therapeutic use ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/drug therapy ; Atrial Flutter/drug therapy ; Cohort Studies ; Electric Countershock ; Humans ; Registries ; Sulfonamides ; Tachycardia/drug therapy ; Treatment Outcome
    Chemical Substances Anti-Arrhythmia Agents ; Sulfonamides ; ibutilide (2436VX1U9B) ; Amiodarone (N3RQ532IUT)
    Language English
    Publishing date 2022-05-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph19116606
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Prediction of Successful Pharmacological Cardioversion in Acute Symptomatic Atrial Fibrillation: The Successful Intravenous Cardioversion for Atrial Fibrillation (SIC-AF) Score.

    Niederdöckl, Jan Daniel / Simon, Alexander / Buchtele, Nina / Schütz, Nikola / Cacioppo, Filippo / Oppenauer, Julia / Gupta, Sophie / Lutnik, Martin / Schnaubelt, Sebastian / Spiel, Alexander / Roth, Dominik / Wimbauer, Fritz / Fegers-Wustrow, Isabel / Esefeld, Katrin / Halle, Martin / Scharhag, Jürgen / Laschitz, Thomas / Herkner, Harald / Domanovits, Hans /
    Schwameis, Michael

    Journal of personalized medicine

    2022  Volume 12, Issue 4

    Abstract: Background: Modern personalised medicine requires patient-tailored decisions. This is particularly important when considering pharmacological cardioversion for the acute treatment of haemodynamically stable atrial fibrillation and atrial flutter in a ... ...

    Abstract Background: Modern personalised medicine requires patient-tailored decisions. This is particularly important when considering pharmacological cardioversion for the acute treatment of haemodynamically stable atrial fibrillation and atrial flutter in a shared decision-making process. We aimed to develop and validate a predictive model to estimate the individual probability of successful pharmacological cardioversion using different intravenous antiarrhythmic agents. Methods: We analysed data from a prospective atrial fibrillation registry comprising 3053 cases of first-detected or recurrent haemodynamically stable, non-permanent, symptomatic atrial fibrillation presenting to an Austrian academic emergency department between January 2012 and December 2017. Using multivariable analysis, a prediction score was developed and externally validated. The clinical utility of the score was assessed using decision curve analysis. Results: A total of 1528 cases were included in the development cohort (median age 69 years, IQR 58−76; 43.9% female), and 1525 cases were included in the validation cohort (median age 68 years, IQR (58−75); 39.5% female). Finally, 421 cases were available for score development and 330 cases for score validation The weighted score included atrial flutter (8 points), duration of symptoms associated with AF (<24 h; 8 points), absence of previous electrical cardioversion (10 points), and the specific intravenous antiarrhythmic drug (amiodarone 10 points, vernakalant 11 points, ibutilide 13 points). The final score, the “Successful Intravenous Cardioversion for Atrial Fibrillation (SIC-AF) score,” showed good calibration (R2 = 0.955 and R2 = 0.954) and discrimination in both sets (c-indices: 0.68 and 0.66) and net clinical benefit. Conclusions: A predictive model was developed to estimate the success of intravenous pharmacological cardioversion using different antiarrhythmic agents in a cohort of patients with haemodynamically stable, non-permanent, symptomatic atrial fibrillation. External temporal validation confirmed good calibration, discrimination, and clinical usefulness. The SIC-AF score may help patients and physicians jointly decide on the appropriate treatment strategy for acute symptomatic atrial fibrillation. Registration: NCT03272620.
    Language English
    Publishing date 2022-03-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12040544
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: The ABC-Stroke Score Refines Stroke Risk Stratification in Patients With Atrial Fibrillation at the Emergency Department.

    Niederdöckl, Jan / Oppenauer, Julia / Schnaubelt, Sebastian / Cacioppo, Filippo / Buchtele, Nina / Warenits, Alexandra-Maria / Laggner, Roberta / Schütz, Nikola / Bögl, Magdalena S / Ruzicka, Gerhard / Gupta, Sophie / Lutnik, Martin / Sheikh Rezaei, Safoura / Wolzt, Michael / Herkner, Harald / Domanovits, Hans / Laggner, Anton N / Schwameis, Michael / Hijazi, Ziad

    Frontiers in medicine

    2022  Volume 9, Page(s) 830580

    Abstract: Aims: To evaluate the performance of the ABC (Age, Biomarkers, Clinical history) and CHA: Methods and results: The performance of the biomarker-based ABC-stroke score and the clinical variable-based CHA: Conclusion: In a large, real-world cohort ... ...

    Abstract Aims: To evaluate the performance of the ABC (Age, Biomarkers, Clinical history) and CHA
    Methods and results: The performance of the biomarker-based ABC-stroke score and the clinical variable-based CHA
    Conclusion: In a large, real-world cohort of patients with acute atrial fibrillation in the emergency department, the ABC-stroke score was superior to the guideline-recommended CHA
    Language English
    Publishing date 2022-06-27
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2022.830580
    Database MEDical Literature Analysis and Retrieval System OnLINE

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