The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)  

Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC  

Endorsed by the European Stroke Organisation (ESO)

/pdf/2016-esc-guidelines-for-the-management-of-atrial-ba0601yb9m.pdf

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

/pdf/2016-esc-guidelines-for-the-management-of-atrial-36b2cidm1x.pdf

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO)

Supplementary Table 9, column 'Edoxaban', row 'eGFR category', '95 mL/min' (page 15). The cell should be coloured green instead of yellow. It should also read "60 mg"instead of "60 mg (use with caution in 'supranormal' renal function)."In the above-indicated cell, a footnote has also been added to state: "Edoxaban should be used in patients with high creatinine clearance only after a careful evaluation of the individual thromboembolic and bleeding risk."Supplementary Table 9, column 'Edoxaban', row 'Dose reduction in selected patients' (page 16). The cell should read "Edoxaban 60 mg reduced to 30 mg once daily if any of the following: creatinine clearance 15-50 mL/min, body weight <60 kg, concomitant use of dronedarone, erythromycin, ciclosporine or ketokonazole"instead of "Edoxaban 60 mg reduced to 30 mg once daily, and edoxaban 30 mg reduced to 15mg once daily, if any of the following: creatinine clearance of 30-50 mL/min, body weight <60 kg, concomitant us of verapamil or quinidine or dronedarone."

/pdf/2020-esc-guidelines-for-the-diagnosis-and-management-of-38dpic1xu8.pdf

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).

ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

Background: Rheumatic heart disease is the commonest cardiovascular disease in children and young adults in developing countries. There is very limited data on the prevalence of cardiac murmurs and acute rheumatic fever in schoolchildren in rural Nepal beyond Kathmandu valley. Methods:Sixhundred three schoolchildren, agedbetween 5 and 12 years, fromprimary schools from 6 different rural towns in Nepal were examined. Average number of students was 100.5± 14.0 per school. The average distance of the schools from Kathmandu city was 150.3± 93.4 km. A clinical survey formwas completed following an interview with the student and parent by a locally trained communitymedical assistant. Each schoolchildwasexaminedbya doctor, with particular focus on the cardiovascular system. A second doctor verified every murmur. Results: Thirty (5.0%) schoolchildren had cardiac murdrugs at baseline selected from a community population. Subjects were classified into risk groups according to the CDC recommendations (hs-CRP 3mg/L). We determined the coefficient of variation (CV) and change in CRP risk group from baseline to 18 and 36 months. We compared these changes to LDL-cholesterol levels.

Prevalence of Cardiac Murmurs and Acute Rheumatic Fever in Schoolchildren in Rural Nepal

Wagener–Barker classification) (Fig. 1b). Blood smear revealed evidence of microangiopathic haemolytic anaemia. Renal function was markedly impaired with oliguria, haematuria, proteinuria and a serum creatinine level of 574.6 mmol/L. Computed tomography of the brain showed diffuse oedema of the white matter, which significantly compressed ventricles and subarachnoid spaces (Fig. 1a). Diagnostic biopsy of the left kidney disclosed occlusion of preglomerular and interlobular arteries by fibrin deposits with endothelial thickening. Replacement of smooth muscle cells of the arterial wall by proteinaceous material, a typical change in thrombotic microangiopathies, was observed in high power view (Fig. 1e). Diffuse mesangial deposition of IgA was detected by immunofluorescence microscopy, consistent with IgA nephropathy (Fig. 1f). Screening for other causes of secondary hypertension was negative. Effective control of blood pressure led to improvement of renal function (creatinine 194.5 mmol/L) and recovery of haemolysis and thrombocytopenia. Papilloedema and cerebral oedema subsided within one month (Figs 1d and c). Idiopathic IgA nephropathy is a major cause of malignant hypertension, accounting for one-third of all secondary causes. Thrombotic microangiopathy, a microvascular occlusive disorder, is a pivotal pathogenetic mechanism. Therefore, renal biopsy is both essential for diagnosis and of prognostic significance. Effective antihypertensive therapy leads to immediate and impressive clinico-laboratory improvement, significantly improves prognosis and is essential before renal biopsy is undertaken.

The need to improve organ donation and transplantation rates in Australia

We evaluated time efficiency and patient satisfaction of a “car park clinic” (CPC) compared to traditional face‐to‐face (F2F) during the COVID‐19 pandemic.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jce.15922

Development of a carpark cardiac implantable electronic device clinic to improve time efficiency and patient satisfaction in the context of restrictions imposed by the COVID‐19 pandemic

Commotio Cordis in Non–Sport-Related Events

Background and Purpose: Research into the temporal relationship between atrial tachyarrhythmias (atrial tachycardia [AT] and atrial fibrillation [AF]) and stroke has produced conflicting findings. Systematic categorization of stroke subtypes may help clarify the discussion. Objectives: The objective of the study was to examine the presence and timing of AT/AF in relation to ischemic stroke subtypes, categorized as either cardioembolic (CE) or non-CE. Methods: Consecutive patients presenting to the Austin Hospital with acute stroke from 2012 to 2019 and a cardiac implantable electronic device (CIED) were identified. Using a case-control design, the temporal proximity of AT/AF episodes in the 90 days prior to stroke was compared in the CE and non-CE stroke groups. Results: 5,591 patients presented to the Austin Hospital with acute stroke from 2012 to 2019, of whom 31 patients with an ischemic stroke and a CIED with ≥90 days of monitoring were identified. Twelve strokes were adjudicated as CE and 19 as non-CE by a stroke neurologist. Six of the 12 CE stroke patients (50%) experienced AT/AF within 30 days preceding their stroke, while none of the 19 non-CE stroke patients recorded any AT/AF in the same period (p = 0.001). Four CE stroke patients (33%) had no AT/AF preceding their strokes at any time. The odds ratio for CE stroke was highest (39; 95% confidence interval [CI]: 1.92–791.5) when AT/AF occurred in the 30 days prior, declining to 20.65 (95% CI: 1.00–427.66) and 6.07 (95% CI: 0.94–39.04) in the subsequent 31–60- and 61–90-day windows, respectively. Conclusions: CE strokes were associated with a significantly higher proportion of preceding AT/AF compared with non-CE strokes. These findings support a potential temporal relationship between AT/AF and CE stroke and demonstrate that stroke subtyping can better characterize the relationship between AF and ischemic stroke. However, this study’s findings are limited by its sample size and small number of informative cases.

Han S. Lim

Papers

Prevalence of Cardiac Murmurs and Acute Rheumatic Fever in Schoolchildren in Rural Nepal

The need to improve organ donation and transplantation rates in Australia

Development of a carpark cardiac implantable electronic device clinic to improve time efficiency and patient satisfaction in the context of restrictions imposed by the COVID‐19 pandemic

Commotio Cordis in Non–Sport-Related Events

Atrial Tachyarrhythmias and Stroke: Temporal Relationship and Stroke Subtypes