Atrial fibrillation (AF) is common in ICU patients and is associated with a two- to fivefold increase in mortality. This paper provides a reappraisal of the management of AF with a special focus on critically ill patients with haemodynamic instability. AF can cause hypotension and heart failure with subsequent organ dysfunction. The underlying mechanisms are the loss of atrial contraction and the high ventricular rate. In unstable patients, sinus rhythm must be rapidly restored by synchronised electrical cardioversion (ECV). If pharmacological treatment is indicated, clinicians can choose between the rate control and the rhythm control strategy. The optimal substance should be selected depending on its potential adverse effects. A beta-1 antagonist with a very short half-life (e.g., esmolol) is an advantage for ICU patients because the effect of beta-blockade on cardiovascular stability is unpredictable in those patients. Amiodarone is commonly used in the ICU setting but has potentially severe cardiac and noncardiac side effects. Digoxin controls the ventricular response at rest, but its benefit decreases in the presence of adrenergic stress. Vernakalant converts new-onset AF to sinus rhythm in approximately 50% of patients, but data on its efficacy and safety in critically ill patients are lacking. 1. Introduction Atrial fibrillation (AF) is the most common arrhythmia in patients hospitalised in intensive care units (ICUs) and is associated with increased morbidity and mortality [1–6]. In light of the improved understanding of the underlying pathophysiology, novel therapeutic options, and recently published guidelines for AF, this paper provides a reappraisal of the topic with a special focus on the management of AF in critically ill patients with haemodynamic instability. 2. Materials and Methods A search of the PubMed database and a review of bibliographies from selected articles was performed to identify original data relating to this topic. Articles were scrutinised regarding their study design, population evaluated, interventions, outcomes, and limitations. A special focus was on the literature available from critically ill patients. However, if such information was lacking, references from non-ICU patients were included in this narrative review. When evidence-based recommendations were not available at all personal recommendations were incorporated in this report (and highlighted accordingly) to assist the clinicians in the management of critically ill patients with AF. 3. Results and Discussion 3.1. Definition and Clinical Manifestation AF is a
References
[1]
E. G. Daoud, “Management of atrial fibrillation in the post-cardiac surgery setting,” Cardiology Clinics, vol. 22, no. 1, pp. 159–166, 2004.
[2]
G. Y. Lip and H.-F. Tse, “Management of atrial fibrillation,” The Lancet, vol. 370, no. 9587, pp. 604–618, 2007.
[3]
M. E. Sleeswijk, T. Van Noord, J. E. Tulleken, J. J. M. Ligtenberg, A. R. J. Girbes, and J. G. Zijlstra, “Clinical review: treatment of new-onset atrial fibrillation in medical intensive care patients: a clinical framework,” Critical Care, vol. 11, no. 6, article 233, 2007.
[4]
C. W. Khoo and G. Y. H. Lip, “Acute management of atrial fibrillation,” Chest, vol. 135, no. 3, pp. 849–859, 2009.
[5]
European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, A. J. Camm, et al., “Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC),” European Heart Journal, vol. 31, pp. 2369–2429, 2010.
[6]
A. J. Camm, G. Y. H. Lip, R. de Caterina, et al., “2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association,” European Heart Journal, vol. 33, pp. 2719–2747, 2012.
[7]
A. Rudiger, V.-P. Harjola, A. Müller et al., “Acute heart failure: clinical presentation, one-year mortality and prognostic factors,” European Journal of Heart Failure, vol. 7, no. 4, pp. 662–670, 2005.
[8]
D. L. Packer, G. H. Bardy, and S. J. Worley, “Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction,” The American Journal of Cardiology, vol. 57, no. 8, pp. 563–570, 1986.
[9]
G. Fenelon, W. Wijns, E. Andries, and P. Brugada, “Tachycardiomyopathy: mechanisms and clinical implications,” Pacing and Clinical Electrophysiology, vol. 19, no. 1, pp. 95–106, 1996.
[10]
A. Rudiger and G. Niedermaier, “Unmasking atrial flutter,” Schweizerische Medizinische Wochenschrift, vol. 130, no. 31-32, Article ID 1125, 2000.
[11]
A. J. Turley, S. Murray, and J. Thambyrajah, “Pre-excited atrial fibrillation triggered by intravenous adenosine: a commonly used drug with potentially life-threatening adverse effects,” Emergency Medicine Journal, vol. 25, no. 1, pp. 46–48, 2008.
[12]
R. L. Page, “Newly diagnosed atrial fibrillation,” The New England Journal of Medicine, vol. 351, no. 23, pp. 2408–2416, 2004.
[13]
S. Stewart, C. L. Hart, D. J. Hole, and J. J. V. McMurray, “Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study,” Heart, vol. 86, no. 5, pp. 516–521, 2001.
[14]
A. S. Go, E. M. Hylek, K. A. Phillips et al., “Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study,” Journal of the American Medical Association, vol. 285, no. 18, pp. 2370–2375, 2001.
[15]
Y. Miyasaka, M. E. Barnes, B. J. Gersh et al., “Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence,” Circulation, vol. 114, no. 2, pp. 119–125, 2006.
[16]
J. Heeringa, D. A. M. van der Kuip, A. Hofman et al., “Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study,” European Heart Journal, vol. 27, no. 8, pp. 949–953, 2006.
[17]
G. V. Naccarelli, H. Varker, J. Lin, and K. L. Schulman, “Increasing prevalence of atrial fibrillation and flutter in the United States,” The American Journal of Cardiology, vol. 104, no. 11, pp. 1534–1539, 2009.
[18]
D. M. Lloyd-Jones, T. J. Wang, E. P. Leip et al., “Lifetime risk for development of atrial fibrillation: the framingham heart study,” Circulation, vol. 110, no. 9, pp. 1042–1046, 2004.
[19]
I. Klein and K. Ojamaa, “Thyroid hormone and the cardiovascular system,” The New England Journal of Medicine, vol. 344, no. 7, pp. 501–509, 2001.
[20]
A. V. Samokhvalov, H. M. Irving, and J. Rehm, “Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis,” European Journal of Cardiovascular Prevention and Rehabilitation, vol. 17, no. 6, pp. 706–712, 2010.
[21]
A. J. Walkey, R. S. Wiener, J. M. Ghobrial, L. H. Curtis, and E. J. Benjamin, “Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis,” Journal of the American Medical Association, vol. 306, no. 20, pp. 2248–2255, 2011.
[22]
S. Goodman, T. Shirov, and C. Weissman, “Supraventricular arrhythmias in intensive care unit patients: short and long-term consequences,” Anesthesia and Analgesia, vol. 104, no. 4, pp. 880–886, 2007.
[23]
D. Annane, V. Sébille, D. Duboc et al., “Incidence and prognosis of sustained arrhythmias in critically III patients,” The American Journal of Respiratory and Critical Care Medicine, vol. 178, no. 1, pp. 20–25, 2008.
[24]
R. Meierhenrich, E. Steinhilber, C. Eggermann et al., “Incidence and prognostic impact of new-onset atrial fibrillation in patients with septic shock: a prospective observational study,” Critical Care, vol. 14, no. 3, article R108, 2010.
[25]
J. Schmitt, G. Duray, B. J. Gersh, and S. H. Hohnloser, “Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications,” European Heart Journal, vol. 30, no. 9, pp. 1038–1045, 2009.
[26]
J. P. Mathew, M. L. Fontes, I. C. Tudor et al., “A multicenter risk index for atrial fibrillation after cardiac surgery,” Journal of the American Medical Association, vol. 291, no. 14, pp. 1720–1729, 2004.
[27]
J. Auer, T. Weber, R. Berent, C.-K. Ng, G. Lamm, and B. Eber, “Risk factors of postoperative atrial fibrillation after cardiac surgery,” Journal of Cardiac Surgery, vol. 20, no. 5, pp. 425–431, 2005.
[28]
S. Stewart, C. L. Hart, D. J. Hole, and J. J. V. McMurray, “A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the renfrew/paisley study,” The American Journal of Medicine, vol. 113, no. 5, pp. 359–364, 2002.
[29]
U. Schotten, S. Verheule, P. Kirchhof, and A. Goette, “Pathophysiological mechanisms of atrial fibrillation: a translational appraisal,” Physiological Reviews, vol. 91, no. 1, pp. 265–325, 2011.
[30]
M. K. Chung, “Cardiac surgery: postoperative arrhythmias,” Critical Care Medicine, vol. 28, no. 10, pp. N136–N144, 2000.
[31]
C. W. Hague Jr., L. L. Creswell, D. D. Gutterman, and L. A. Fleisher, “Epidemiology, mechanisms, and risks: american College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery,” Chest, vol. 128, no. 2, pp. 9S–S16, 2005.
[32]
K. K. Christians, B. Wu, E. J. Quebbeman, and K. J. Brasel, “Postoperative atrial fibrillation in noncardiothoracic surgical patients,” The American Journal of Surgery, vol. 182, no. 6, pp. 713–715, 2001.
[33]
M. Allessie, J. Ausma, and U. Schotten, “Electrical, contractile and structural remodeling during atrial fibrillation,” Cardiovascular Research, vol. 54, no. 2, pp. 230–246, 2002.
[34]
T. T. Issac, H. Dokainish, and N. M. Lakkis, “Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data,” Journal of the American College of Cardiology, vol. 50, no. 21, pp. 2021–2028, 2007.
[35]
P. Korantzopoulos, T. Kolettis, K. Siogas, and J. Goudevenos, “Atrial fibrillation and electrical remodeling: the potential role of inflammation and oxidative stress,” Medical Science Monitor, vol. 9, no. 9, pp. RA225–RA229, 2003.
[36]
M. C. Wijffels, C. J. Kirchhof, R. Dorland, and M. A. Allessie, “Atrial fibrillation begets atrial fibrillation: a study in awake chronically instrumented goats,” Circulation, vol. 92, no. 7, pp. 1954–1968, 1995.
[37]
M. Ha？ssaguerre, P. Ja？s, D. C. Shah et al., “Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins,” The New England Journal of Medicine, vol. 339, no. 10, pp. 659–666, 1998.
[38]
H. Oral, C. Pappone, A. Chugh et al., “Circumferential pulmonary-vein ablation for chronic atrial fibrillation,” The New England Journal of Medicine, vol. 354, no. 9, pp. 934–941, 2006.
[39]
M. N. Khan, P. Ja？s, J. Cummings et al., “Pulmonary-vein isolation for atrial fibrillation in patients with heart failure,” The New England Journal of Medicine, vol. 359, no. 17, pp. 1778–1785, 2008.
[40]
O. M. Wazni, N. F. Marrouche, D. O. Martin et al., “Radiofrequency ablation versus antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial,” Journal of the American Medical Association, vol. 293, no. 21, pp. 2634–2640, 2005.
[41]
J. Cosedis Nielsen, A. Johannessen, P. Raatikainen, et al., “Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation,” The New England Journal of Medicine, vol. 367, pp. 1587–1595, 2012.
[42]
P. Kirchhof, L. Eckardt, P. Loh et al., “Anterior-posterior versus anterior-lateral electrode positions for external cardioversion of atrial fibrillation: a randomised trial,” The Lancet, vol. 360, no. 9342, pp. 1275–1279, 2002.
[43]
D. W. Holt, G. T. Tucker, P. R. Jackson, and G. C. A. Storey, “Amiodarone pharmacokinetics,” The American Heart Journal, vol. 106, no. 4, pp. 840–847, 1983.
[44]
S. Kanji, D. R. Williamson, B. M. Yaghchi, M. Albert, and L. McIntyre, “Epidemiology and management of atrial fibrillation in medical and noncardiac surgical adult intensive care unit patients,” Journal of Critical Care, vol. 27, pp. 326.e1–326.e18, 2012.
[45]
M. St？ubli, J. Bircher, R. L. Galeazzi, H. Remund, and H. Studer, “Serum concentrations of amiodarone during long term therapy: relation to dose, efficacy and toxicity,” European Journal of Clinical Pharmacology, vol. 24, pp. 485–494, 1983.
[46]
A. Mayr, N. Ritsch, H. Knotzer et al., “Effectiveness of direct-current cardioversion for treatment of supraventricular tachyarrhythmias, in particular atrial fibrillation, in surgical intensive care patients,” Critical Care Medicine, vol. 31, no. 2, pp. 401–405, 2003.
[47]
G. Opolski, J. Stanisawska, A. Gorecki, G. S. Wiecicka, A. Torbicki, and T. Kraska, “Amiodarone in restoration and maintenance of sinus rhythm in patients with chronic atrial fibrillation after unsuccessful direct-current cardioversion,” Clinical Cardiology, vol. 20, no. 4, pp. 337–340, 1997.
[48]
C. Sticherling, S. Behrens, W. Kamke, A. Stahn, and M. Zabel, “Comparison of acute and long-term effects of single-dose amiodarone and verapamil for the treatment of immediate recurrences of atrial fibrillation after transthoracic cardioversion,” Europace, vol. 7, no. 6, pp. 546–553, 2005.
[49]
B. M. Glover, S. J. Walsh, C. J. McCann et al., “Biphasic energy selection for transthoracic cardioversion of atrial fibrillation. The BEST AF Trial,” Heart, vol. 94, no. 7, pp. 884–887, 2008.
[50]
M. M. Gallagher, Y. G. Yap, M. Padula, D. E. Ward, E. Rowland, and A. J. Camm, “Arrhythmic complications of electrical cardioversion: relationship to shock energy,” International Journal of Cardiology, vol. 123, no. 3, pp. 307–312, 2008.
[51]
A. L. Klein, R. A. Grimm, R. D. Murray et al., “Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 344, no. 19, pp. 1411–1420, 2001.
[52]
I. C. Van Gelder, H. F. Groenveld, H. J. G. M. Crijns et al., “Lenient versus strict rate control in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 362, no. 15, pp. 1363–1373, 2010.
[53]
D. G. Wyse, A. L. Waldo, J. P. DiMarco et al., “A comparison of rate control and rhythm control in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 347, no. 23, pp. 1825–1833, 2002.
[54]
I. C. Van Gelder, V. E. Hagens, H. A. Bosker et al., “A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation,” The New England Journal of Medicine, vol. 347, no. 23, pp. 1834–1840, 2002.
[55]
D. Roy, M. Talajic, S. Nattel, et al., “Rhythm control versus rate control for atrial fibrillation and heart failure,” The New England Journal of Medicine, vol. 358, pp. 2667–2677, 2008.
[56]
J. Dunning, T. Treasure, M. Versteegh, and S. A. M. Nashef, “Guidelines on the prevention and management of de novo atrial fibrillation after cardiac and thoracic surgery,” European Journal of Cardio-thoracic Surgery, vol. 30, no. 6, pp. 852–872, 2006.
[57]
D. J. Tarditi and S. M. Hollenberg, “Cardiac arrhythmias in the intensive care unit,” Seminars in Respiratory and Critical Care Medicine, vol. 27, no. 3, pp. 221–229, 2006.
[58]
P. Seguin and Y. Launey, “Atrial fibrillation is not just an artefact in the ICU,” Critical Care, vol. 14, no. 4, article 182, 2010.
[59]
S. Miller, E. Crystal, M. Garfinkle, C. Lau, I. Lashevsky, and S. J. Connolly, “Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis,” Heart, vol. 91, no. 5, pp. 618–623, 2005.
[60]
D. C. Burgess, M. J. Kilborn, and A. C. Keech, “Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis,” European Heart Journal, vol. 27, no. 23, pp. 2846–2857, 2006.
[61]
M. E. Sleeswijk, J. E. Tulleken, T. Van Noord, J. H. J. M. Meertens, J. J. M. Ligtenberg, and J. G. Zijlstra, “Efficacy of magnesium-amiodarone step-up scheme in critically ill patients with new-onset atrial fibrillation: a prospective observational study,” Journal of Intensive Care Medicine, vol. 23, no. 1, pp. 61–66, 2008.
[62]
H. V. Ganga, A. Noyes, C. M. White, and J. Kluger, “Magnesium adjunctive therapy in atrial arrhythmias,” Pacing and Clinical Electrophysiology, vol. 36, pp. 1308–1318, 2013.
[63]
J. L. Moran, J. Gallagher, S. L. Peake, D. N. Cunningham, M. Salagaras, and P. Leppard, “Parenteral magnesium sulfate versus amiodarone in the therapy of atrial tachyarrhythmias: a prospective, randomized study,” Critical Care Medicine, vol. 23, no. 11, pp. 1816–1824, 1995.
[64]
V. S. Murthy, T. F. Hwang, and M. E. Zagar, “Cardiovascular pharmacology of ASL-8052, an ultra-short acting β blocker,” European Journal of Pharmacology, vol. 94, no. 1-2, pp. 43–51, 1983.
[65]
K. P. Garnock-Jones, “Esmolol: a review of its use in the short-term treatment of tachyarrhythmias and the short-term control of tachycardia and hypertension,” Drugs, vol. 72, no. 1, pp. 109–132, 2012.
[66]
S. R. Ommen, J. A. Odell, and M. S. Stanton, “Atrial arrhythmias after cardiothoracic surgery,” The New England Journal of Medicine, vol. 336, no. 20, pp. 1429–1434, 1997.
[67]
E. Crystal, S. J. Connolly, K. Sleik, T. J. Ginger, and S. Yusuf, “Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: a meta-analysis,” Circulation, vol. 106, no. 1, pp. 75–80, 2002.
[68]
A. N. Mooss, R. L. Wurdeman, S. M. Mohiuddin et al., “Esmolol versus diltiazem in the treatment of postoperative atrial fibrillation/atrial flutter after open heart surgery,” The American Heart Journal, vol. 140, no. 1, pp. 176–180, 2000.
[69]
G. Delle Karth, A. Geppert, T. Neunteufl et al., “Amiodarone versus diltiazem for rate control in critically ill patients with atrial tachyarrhythmias,” Critical Care Medicine, vol. 29, no. 6, pp. 1149–1153, 2001.
[70]
P. Zimetbaum, “Amiodarone for atrial fibrillation,” The New England Journal of Medicine, vol. 356, no. 9, pp. 935–941, 2007.
[71]
E. S. Kaufman, P. A. Zimmermann, T. Wang et al., “Risk of proarrhythmic events in the atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study: a multivariate analysis,” Journal of the American College of Cardiology, vol. 44, no. 6, pp. 1276–1282, 2004.
[72]
E. H. Yang, S. Shah, and J. M. Criley, “Digitalis toxicity: a fading but crucial complication to recognize,” The American Journal of Medicine, vol. 125, no. 4, pp. 337–343, 2012.
[73]
R. W. Jelliffe, “Some comments and suggestions concerning population pharmacokinetic modeling, especially of digoxin, and its relation to clinical therapy,” Therapeutic Drug Monitoring, vol. 34, pp. 368–377, 2012.
[74]
E. M. Antman, T. L. Wenger, V. P. Butler Jr., E. Haber, and T. W. Smith, “Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. Final report of a multicenter study,” Circulation, vol. 81, no. 6, pp. 1744–1752, 1990.
[75]
S. H. Hohnloser, H. J. G. M. Crijns, M. van Eickels et al., “Effect of dronedarone on cardiovascular events in atrial fibrillation,” The New England Journal of Medicine, vol. 360, no. 7, pp. 668–678, 2009.
[76]
D. Dobrev and S. Nattel, “New antiarrhythmic drugs for treatment of atrial fibrillation,” The Lancet, vol. 375, no. 9721, pp. 1212–1223, 2010.
[77]
S. J. Connolly, A. J. Camm, J. L. Halperin et al., “Dronedarone in high-risk permanent atrial fibrillation,” The New England Journal of Medicine, vol. 365, no. 24, pp. 2268–2276, 2011.
[78]
S. Nattel, “Dronedarone in atrial fibrillation: jekyll and hyde?” The New England Journal of Medicine, vol. 365, no. 24, pp. 2321–2322, 2011.
[79]
M. D. Ezekowitz, “Maintaining sinus rhythm: making treatment better than the disease,” The New England Journal of Medicine, vol. 357, no. 10, pp. 1039–1041, 2007.
[80]
L. K？ber, C. Torp-Pedersen, J. J. V. McMurray, et al., “Increased mortality after dronedarone therapy for severe heart failure,” The New England Journal of Medicine, vol. 358, pp. 2678–2687, 2008.
[81]
D. S. Echt, P. R. Liebson, L. B. Mitchell et al., “Mortality and morbidity in patients receiving encainide, flecainide, or placebo: the cardiac arrhythmia suppression trial,” The New England Journal of Medicine, vol. 324, no. 12, pp. 781–788, 1991.
[82]
G. Y. H. Lip, L. Frison, J. L. Halperin, and D. A. Lane, “Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort,” Stroke, vol. 41, no. 12, pp. 2731–2738, 2010.
[83]
D. Roy, C. M. Pratt, C. Torp-Pedersen et al., “Vernakalant hydrochloride for rapid conversion of atrial fibrillation: a phase 3, randomized, placebo-controlled trial,” Circulation, vol. 117, no. 12, pp. 1518–1525, 2008.
[84]
C. M. Pratt, D. Roy, C. Torp-Pedersen et al., “Usefulness of vernakalant hydrochloride injection for rapid conversion of atrial fibrillation,” The American Journal of Cardiology, vol. 106, no. 9, pp. 1277–1283, 2010.
[85]
A. J. Camm, A. Capucci, S. H. Hohnloser et al., “A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation,” Journal of the American College of Cardiology, vol. 57, no. 3, pp. 313–321, 2011.
[86]
P. R. Kowey, P. Dorian, L. B. Mitchell et al., “Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery a randomized, double-blind, placebo-controlled trial,” Circulation, vol. 2, no. 6, pp. 652–659, 2009.
[87]
T. Watson, E. Shantsila, and G. Y. Lip, “Mechanisms of thrombogenesis in atrial fibrillation: virchow's triad revisited,” The Lancet, vol. 373, no. 9658, pp. 155–166, 2009.
[88]
B. F. Gage, A. D. Waterman, W. Shannon, M. Boechler, M. W. Rich, and M. J. Radford, “Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation,” Journal of the American Medical Association, vol. 285, no. 22, pp. 2864–2870, 2001.
[89]
G. Y. H. Lip, R. Nieuwlaat, R. Pisters, D. A. Lane, and H. J. G. M. Crijns, “Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation,” Chest, vol. 137, no. 2, pp. 263–272, 2010.
[90]
J. B. Olesen, C. Torp-Pedersen, M. L. Hansen, and G. Y. H. Lip, “The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study,” Thrombosis and Haemostasis, vol. 107, pp. 1172–1179, 2012.
[91]
T. P. van Staa, E. Setakis, G. L. di Tanna, D. A. Lane, and G. Y. H. Lip, “A comparison of risk stratification schemes for stroke in 79 884 atrial fibrillation patients in general practice,” Journal of Thrombosis and Haemostasis, vol. 9, no. 1, pp. 39–48, 2011.
[92]
E. Abu-Assi, F. Otero-Ravi？a, G. Allut Vidal et al., “Comparison of the reliability and validity of four contemporary risk stratification schemes to predict thromboembolism in non-anticoagulated patients with atrial fibrillation,” International Journal of Cardiology, vol. 166, no. 1, pp. 205–209, 2013.
[93]
J. S. Healey, S. J. Connolly, M. R. Gold et al., “Subclinical atrial fibrillation and the risk of stroke,” The New England Journal of Medicine, vol. 366, no. 2, pp. 120–129, 2012.
[94]
R. G. Hart, L. A. Pearce, and M. I. Aguilar, “Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation,” Annals of Internal Medicine, vol. 146, no. 12, pp. 857–867, 2007.
[95]
J. Mant, F. R. Hobbs, K. Fletcher et al., “Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial,” The Lancet, vol. 370, no. 9586, pp. 493–503, 2007.
[96]
R. Pisters, D. A. Lane, R. Nieuwlaat, C. B. de Vos, H. J. G. M. Crijns, and G. Y. H. Lip, “A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the euro heart survey,” Chest, vol. 138, no. 5, pp. 1093–1100, 2010.
[97]
G. Y. H. Lip, L. Frison, J. L. Halperin, and D. A. Lane, “Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile INR, elderly, drugs/alcohol concomitantly) score,” Journal of the American College of Cardiology, vol. 57, no. 2, pp. 173–180, 2011.
[98]
S. J. Connolly, M. D. Ezekowitz, S. Yusuf et al., “Dabigatran versus warfarin in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 361, no. 12, pp. 1139–1151, 2009.
[99]
M. R. Patel, K. W. Mahaffey, J. Garg et al., “Rivaroxaban versus warfarin in nonvalvular atrial fibrillation,” The New England Journal of Medicine, vol. 365, no. 10, pp. 883–891, 2011.
[100]
S. J. Connolly, J. Eikelboom, C. Joyner et al., “Apixaban in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 364, no. 9, pp. 806–817, 2011.
[101]
C. B. Granger, J. H. Alexander, J. J. V. McMurray et al., “Apixaban versus warfarin in patients with atrial fibrillation,” The New England Journal of Medicine, vol. 365, no. 11, pp. 981–992, 2011.
[102]
P. G. Danias, T. A. Caulfield, M. J. Weigner, D. I. Silverman, and W. J. Manning, “Likelihood of spontaneous conversion of atrial fibrillation to sinus rhythm,” Journal of the American College of Cardiology, vol. 31, no. 3, pp. 588–592, 1998.
[103]
O. Wazni, B. Wilkoff, and W. Saliba, “Catheter ablation for atrial fibrillation,” The New England Journal of Medicine, vol. 365, no. 24, pp. 2296–2304, 2011.
[104]
J. L. Cox, R. D. B. Jaquiss, R. B. Schuessler, and J. P. Boineau, “Modification of the maze procedure for atrial flutter and atrial fibrillation. II. Surgical technique of the maze III procedure,” Journal of Thoracic and Cardiovascular Surgery, vol. 110, no. 2, pp. 485–495, 1995.
[105]
N. A. Chatterjee, G. A. Upadhyay, K. A. Ellenbogen, F. A. McAlister, N. K. Choudhry, and J. P. Singh, “Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review,” Circulation, vol. 5, no. 1, pp. 68–76, 2012.
[106]
N. A. Chatterjee, G. A. Upadhyay, K. A. Ellenbogen, D. L. Hayes, and J. P. Singh, “Atrioventricular nodal ablation in atrial fibrillation: a meta-analysis of biventricular vs. right ventricular pacing mode,” European Journal of Heart Failure, vol. 14, pp. 661–667, 2012.
[107]
D. R. Holmes, V. Y. Reddy, Z. G. Turi et al., “Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial,” The Lancet, vol. 374, no. 9689, pp. 534–542, 2009.
