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Clinical Articles, Lead Article

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February 21, 2017

Atrial fibrillation and CKD

Chronic kidney disease (CKD), however we measure it, “signifies poor outcomes in atrial fibrillation patients”. This was a key message from Dr Ami Banerjee (University College London). Drawing on recent European Society of Cardiology guidelines,1 he outlined how atrial fibrillation (AF) is present in 15–20% of CKD patients (10–20 times higher than the general population). These patients have an increased stroke rate, and there is also a higher risk of bleeding in CKD. The big question in terms of non-valvular AF and kidney disease is: how are they related?

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February 21, 2017

Targeting uric acid

The conference’s keynote lecture, delivered by Professor Austin Stack (University Hospital, Limerick, Ireland), homed in on the idea that serum uric acid directly contributes to increased cardiovascular disease. This was shown in his team’s work published in 2013,1 which used retrospective data to identify a direct correlation between raised serum uric acid concentrations and increased risk of developing cardiovascular disease.

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February 21, 2017

SGLT-2 inhibitors: a game changer?

The results of the long awaited EMPA-REG (Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes) trial were discussed by Dr Amar Puttanna (Young Diabetologists and Endocrinologists Forum, and West Midlands Deanery), then later mentioned in both the cardiology and renal trials updates, by Professor John Cleland (Imperial College, London) and Dr Patrick Mark (Queen Elizabeth University Hospital, Glasgow), respectively.

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February 21, 2017

Novel functional imaging techniques

An interesting talk regarding new imaging techniques based around magnetic resonance (MR), was led by Dr Aghogho Odudu (University of Manchester). The use of MR in cardiac and renal imaging is clearly growing, and the use of gadolinium to enhance both blood and extracellular fluid is a testament to the effectiveness of functional MR imaging.

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November 8, 2016

Healthcare costs and innovative solutions for arrhythmia care

In an increasingly difficult economic climate, it is more important than ever to develop innovative solutions to the rising cost of healthcare. Professor Richard Schilling, President Elect of the British Heart Rhythm Society (Barts Health NHS Trust, London), proposed novel solutions to the rising cost of arrhythmia care during the plenary session. He highlighted the need to simplify the patient journey by empowering paramedics to treat supraventricular tachycardias (SVTs) and reduce hospital admissions; having a national online resource for patients with intelligent information delivery.

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November 8, 2016

Improving outcomes from VT ablation

Some of the most innovative technologies being employed to treat patients with ventricular tachycardia (VT) were discussed during this session. Dr Charlotte Manisty (Bart’s Health NHS Trust, London) described the use of peri-procedural imaging using computed tomography (CT) and magnetic resonance imaging (MRI) to create 3D maps of scar in the heart, identify optimal ablation targets and help decide the approach to VT ablation. Some investigators are working on developing interventional cardiac MRI platforms using active and passive tracking catheters to gain real-time information and optimise VT ablation using imaging guidance.

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November 8, 2016

NOACs: translating latest clinical and cardioversion data into practice

In the latest ESC 2016 guidelines for the management of patients with atrial fibrillation (AF), it is now a Class 1A recommendation to use a non-vitamin K oral anticoagulant (NOAC) in preference to warfarin where a patient would otherwise be eligible for a NOAC for non-valvular AF. Warfarin is currently still recommended in patients with moderate-to-severe mitral stenosis and mechanical heart valves.

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November 8, 2016

Young Investigator Award

‘Lifelong endurance athletes – what is the burden of arrhythmias in this group?’ This was the question addressed by the winner of the Young Investigator Award (Clinical Science) – Dr Ahmed Merghani (St George’s Hospital, London). In an elegant study, he analysed 152 athletes >40 years age with >10 years of endurance exercise with age, sex and ethnicity matched veteran controls (<150 mins exercise/week). All participants underwent a 24hr Holter monitor, cardiac magnetic resonance imaging (MRI) scan and cardiac computed tomography (CT) scan. Interestingly, in veteran athletes, there was a higher incidence of narrow complex tachycardias, pauses >2.5s and runs of non-sustained ventricular tachycardia.

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October 19, 2016

ENSURE AF: edoxaban allows prompt cardioversion in AF

Patients with atrial fibrillation (AF) who need anticoagulation before undergoing cardioversion may benefit from treatment with the non-vitamin K antagonist oral anticoagulant (NOAC), edoxaban, compared to best possible conventional therapy (warfarin and enoxaparin), according to results from the ENSURE-AF study presented during a hotline session at the meeting.

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October 19, 2016

Commentary on ENSURE-AF

British Junior Cardiologists Association (BJCA) President, Dr Jubin Joseph, who is also British Heart Foundation Clinical Research Fellow, at St Thomas’ Hospital, London, discussed ENSURE AF in our podcast (click here to view).

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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