Elderly Patients With Advanced Heart Failure and Atrial Fibrillation Benefit from Cardiac Tissue Ablation at the Time of Structural Heart Repair

2011 ◽  
Vol 17 (8) ◽  
pp. S45
Author(s):  
Mark A. Groh ◽  
Ben I. Groh ◽  
Oliver A. Binns ◽  
Alan M. Johnson ◽  
Stephen W. Ely ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Cardiac Tissue ◽  
Advanced Heart Failure ◽  
Tissue Ablation ◽  
Heart Repair

Abstract P369: Polypharmacy, Adverse Outcomes, and Treatment Effectiveness in Elderly Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Aniqa Alam ◽  
Nemin Chen ◽  
Pamela L Lutsey ◽  
Richard MacLehose ◽  
J'Neka Claxton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Rate Control ◽  
Treatment Effectiveness ◽  
Adverse Outcomes ◽  
Pharmacy Claims ◽  
Increased Risk ◽  
The Impact

Background: Polypharmacy is highly prevalent in elderly individuals with chronic conditions, including atrial fibrillation (AF). The impact of polypharmacy on adverse outcomes and on treatment effectiveness in elderly AF patients remains unaddressed. Methods: We studied 338,810 AF patients ≥75 years of age with 1,761,660 active prescriptions [mean (SD), 5.1 (3.8) per patient] enrolled in the MarketScan Medicare Supplemental database in 2007-2015. Polypharmacy was defined as ≥5 active prescriptions at AF diagnosis based on outpatient pharmacy claims. AF treatments (oral anticoagulation, rhythm and rate control) and cardiovascular endpoints (ischemic stroke, bleeding, heart failure) were defined based on inpatient, outpatient and pharmacy claims. Multivariable Cox models were used to estimate associations of polypharmacy with cardiovascular endpoints and the interaction between polypharmacy and AF treatments in relation to cardiovascular endpoints. Results: Prevalence of polypharmacy was 52% (176,007 of 338,810). Patients with polypharmacy had increased risk of major bleeding [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.12, 1.20] and heart failure (HR 1.33, 95%CI 1.29, 1.36), but not of ischemic stroke (HR 0.96, 95%CI 0.92, 1.00), compared to those not with polypharmacy (Table). Polypharmacy status did not consistently modify the effectiveness of oral anticoagulants. However, rhythm control (vs. rate control) was more effective in preventing heart failure hospitalization in patients not with polypharmacy (HR 0.87, 95%CI 0.76, 0.99) than among those with polypharmacy (HR 0.98, 95%CI 0.91, 1.07, p for interaction = 0.02). Conclusion: Polypharmacy is frequent among elderly patients with AF, associated with adverse outcomes, and potentially affecting the effectiveness of AF treatments. Optimizing management of polypharmacy in elderly AF patients may lead to improved outcomes.

Concomitant Atrial Fibrillation in Elderly Patients with Decompensated Heart Failure on Admission Does Not Influence Clinical Courses

2017 ◽  
Vol 23 (10) ◽  
pp. S66
Author(s):  
Noboru Oda ◽  
Akane Tsuchiya ◽  
Arinori Takeuchi ◽  
Tasuku Higashihara ◽  
Michiaki Nagai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Decompensated Heart Failure

Effect of nebivolol on outcome in elderly patients with heart failure and atrial fibrillation: insights from SENIORS

2012 ◽  
Vol 14 (10) ◽  
pp. 1171-1178 ◽  
Author(s):  
Bart A. Mulder ◽  
Dirk J. van Veldhuisen ◽  
Harry J.G.M. Crijns ◽  
Michael Böhm ◽  
Alain Cohen-Solal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Patients With Heart Failure

Early outcome of initiating amiodarone for atrial fibrillation in advanced heart failure

2000 ◽  
Vol 19 (7) ◽  
pp. 638-643 ◽  
Author(s):  
Mark S Weinfeld ◽  
Mark H Drazner ◽  
William G Stevenson ◽  
Lynne W Stevenson
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Advanced Heart Failure ◽  
Early Outcome

Long term effects of an aggressive rhythm control strategy in patients with permanent atrial fibrillation and advanced heart failure

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S116 ◽  
Author(s):  
Gaetano M. De Ferrari ◽  
Barbara Petracci ◽  
Folco Frattini ◽  
Roberto Rordorf ◽  
Francesco Cantù ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Control Strategy ◽  
Advanced Heart Failure ◽  
Rhythm Control ◽  
Long Term Effects ◽  
Permanent Atrial Fibrillation

Diurnal variation of ventricular response to atrial fibrillation in patients with advanced heart failure

1995 ◽  
Vol 129 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Bernhard Frey ◽  
Gottfried Heinz ◽  
Thomas Binder ◽  
Michael Wutte ◽  
Barbara Schneider ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Diurnal Variation ◽  
Advanced Heart Failure ◽  
Ventricular Response
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