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Patients with atrialfibrillation, particularly older patients, are frequently at a high risk of bleeding. Ruff, MD, MPH, senior investigator of TIMI Group, director GeneralCardiology, Brigham and Women's Hospital, and associate professor, Harvard Medical School. in the low risk category to 21.2%
Affecting 60 million people worldwide 1 , the prevalence of atrialfibrillation (AFib) is expected to increase by 60% by 2050 due to an aging population and rising cardiometabolic risk factors 2. In addition, the Centers for Disease Control and Prevention (CDC) estimates that more than 12 million Americans will have AFib by 2030 3.
A potentially serious drug interaction between diltiazem and apixaban or rivaroxaban has been reported in US Medicare patients taking these drugs together for atrialfibrillation. The study compared serious bleeding risk for new users of apixaban or rivaroxaban with atrialfibrillation treated with diltiazem or metoprolol.
In an earlier post on Embolic Stroke of Undetermined Source (ESUS) , I had mentioned about ARCADIA trial (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke) which was testing whether there is role for apixaban compared to aspirin for prevention of recurrent stroke in ESUS.
They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. Atrialfibrillation and Brugada syndrome. mV or R/q ≥ 0.75. Heart Rhythm. 2016 Oct;13(10):e295-324.
Left ventricular hypertrophy, left atrial enlargement, QRS axis deviation (left more than right), conduction abnormalities like increased P-R interval and bundle branch block may be noted. Mid cavity obstruction in HCM is associated with apical aneurysm, systemic embolism, and arrhythmias. Doppler echo showing LVOT gradient in HCM.
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