You searched for subject:(Atrial fibrillation).
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Wake Forest University
1.
Jefferson, Margie Elaine.
ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY.
Degree: 2018, Wake Forest University
URL: http://hdl.handle.net/10339/92384 
Background and Purpose – Atrial Fibrillation (AF) increases the risk of cardiovascular disease, stroke, dementia; yet, the relationships between AF, incident stroke and cognitive decline remain unclear, especially among ethnic diverse populations.
Subjects/Keywords: Atrial fibrillation
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APA (6th Edition):
Jefferson, M. E. (2018). ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY. (Thesis). Wake Forest University. Retrieved from http://hdl.handle.net/10339/92384
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Jefferson, Margie Elaine. “ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY.” 2018. Thesis, Wake Forest University. Accessed March 01, 2021.
http://hdl.handle.net/10339/92384.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Jefferson, Margie Elaine. “ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY.” 2018. Web. 01 Mar 2021.
Vancouver:
Jefferson ME. ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY. [Internet] [Thesis]. Wake Forest University; 2018. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10339/92384.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Jefferson ME. ATRIAL FIBRILLATION, STROKE AND COGNITIVE DECLINE IN THE REASONS FOR GEOGRAPHIC AND RACIAL DIFFERENCES IN STROKE (REGARDS) STUDY. [Thesis]. Wake Forest University; 2018. Available from: http://hdl.handle.net/10339/92384
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Arizona
2.
Buth, Nicollette Sokoeun.
Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
.
Degree: 2020, University of Arizona
URL: http://hdl.handle.net/10150/641385
► Background: Atrial fibrillation (AF) is the most common arrhythmia that affects 33.5 million people worldwide. AF is a $6 billion dollars economic burden and contributes…
(more)
▼ Background:
Atrial fibrillation (AF) is the most common arrhythmia that affects 33.5 million people worldwide. AF is a $6 billion dollars economic burden and contributes to 700,000 hospital admissions annually to the United States. AF leads to the development of strokes and thrombo-embolic events. The risk of stroke increases five times with AF. Some 75% of these strokes lead to severe disability and death. These strokes are 68% preventable with anticoagulants.
However, evidence indicates that anticoagulants are underused in 83% of AF patients. Provider education is would to improve anticoagulation usage in AF.
Objective: This is a quality improvement project to provide CHA2DS2-VASc and HAS-BLED education to hospital providers. The purpose is to improving appropriate anticoagulation ordering in
atrial fibrillation, increase safety and improve patient outcomes.
Design: A quality improvement project using a quantitative descriptive design with a post program evaluation after educational video.
Intervention: A 10-minute educational video on CHA2DS2-VASc and HAS-BLED delivered electronically. The education includes indication for using the CHA2DS2-VASc/HAS-BLED scales and anticoagulation decision-making
Measurements: Self-reported knowledge gains and clinical practice changes after educational intervention on CHA2DS2-VASc/HAS-BLED using a Likert Scale via the Qualtrics platform.
Setting: Yavapai Regional Medical Center in Prescott, Arizona.
Participants: A total of 14 out of 36 providers of the Northern Arizona Hospitalist group participated in this quality improvement project.
Results: The majority of participants of this quality improvement project self-reported knowledge enhancement on CHA2DS2-VASC (92.7%) and HASBLED (92.7%). Similarly, the majority of participants reported planned clinical practice changes based on CHA2DS2-VASC (85.7%) and HAS-BLED (78.6%). The majority of participants in this project reported intended clinical practice changes by evaluating risk stroke in
atrial fibrillation with CHA2DS2-VASC (100%) and HAS-BLED (85.7%).
Conclusions: This project showed CHA2DS2-VASc/HASBLED education to enhance knowledge of the risk evaluation scales and self-reported future changes in clinical practice changes due to the activities of this project in the majority of providers.
Advisors/Committee Members: Carlisle, Heather l (advisor), Trinidad, David R (advisor), Martin Plank, Lorraine M. (committeemember).
Subjects/Keywords: Atrial Fibrillation
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APA (6th Edition):
Buth, N. S. (2020). Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
. (Doctoral Dissertation). University of Arizona. Retrieved from http://hdl.handle.net/10150/641385
Chicago Manual of Style (16th Edition):
Buth, Nicollette Sokoeun. “Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
.” 2020. Doctoral Dissertation, University of Arizona. Accessed March 01, 2021.
http://hdl.handle.net/10150/641385.
MLA Handbook (7th Edition):
Buth, Nicollette Sokoeun. “Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
.” 2020. Web. 01 Mar 2021.
Vancouver:
Buth NS. Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
. [Internet] [Doctoral dissertation]. University of Arizona; 2020. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10150/641385.
Council of Science Editors:
Buth NS. Improving Hospitalist Knowledge of Anticoagulation Therapy in Atrial Fibrillation
. [Doctoral Dissertation]. University of Arizona; 2020. Available from: http://hdl.handle.net/10150/641385
3.
Jere, Methuselah.
Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia.
Degree: 2015, University of Zimbabwe
URL: http://dspace.unza.zm/handle/123456789/4398
► Introduction: Atrial fibrillation (AF) and congestive heart failure (CHF) have emerged as major global epidemics. These two conditions share common risk factors and frequently coexist.…
(more)
▼ Introduction: Atrial fibrillation (AF) and congestive heart failure (CHF) have emerged as major global epidemics. These two conditions share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two has additive adverse effects. This study examined the clinical factors associated with AF in CHF patients admitted at the University Teaching Hospital (UTH), Lusaka, Zambia.
Methods: A hospital-based cross-sectional study was conducted at UTH adult medical wards. The data and anthropometric measurements were collected from patients who consented for enrolment from June 2014 to August 2014. A structured interview schedule was used to capture the socio-demographic and related historical data; and an Omron HEM 780 automated Blood Pressure machine was used to measure Blood Pressure and pulse. Then all patients had a standard 12-lead ECG done on them using Schiller AT-102 ECG machine to detect the presence or absence of atrial fibrillation. Those participants whose standard 12-lead ECG results did not show the presence of AF, had 24-hours ECG DR180+ Digital Recorder applied to try to pick-up paroxysmal atrial fibrillation. Then finally all participants with any form of AF were assessed for clinical factors such as NYHA class, age, obesity, coronary heart disease, coexistence with non-cardiovascular diseases (e.g. chest diseases, diabetes mellitus), and smoking. Pearson chi-square of independence of the data was carried out using IBM® SPSS® Statistics for Windows version 20.0 to determine clinical factors of atrial fibrillation in congestive heart failure patients.
Results: A total of 49 patients were included in the study and out of these, 13 (26.5%) had atrial fibrillation. The prevalence of atrial fibrillation in congestive heart failure was found to be strongly associated with age 65 years and above, obesity, smoking, excessive alcohol intake, hypertension, dilated cardiomyopathy, diabetes mellitus and chronic lung disease. These findings suggest the need for clinicians taking care of the congestive heart failure patients to consider full scale use of ambulatory ECG monitors in all congestive heart failure patients with the above conditions.
Keywords: ECG DR180+ Digital Recorder, smoking, cardiomyopathy, diabetes, lung disease
Subjects/Keywords: Atrial Fibrillation; Atrial Fibrillation-Therapy; Heart Failure
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APA (6th Edition):
Jere, M. (2015). Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia. (Thesis). University of Zimbabwe. Retrieved from http://dspace.unza.zm/handle/123456789/4398
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Jere, Methuselah. “Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia.” 2015. Thesis, University of Zimbabwe. Accessed March 01, 2021.
http://dspace.unza.zm/handle/123456789/4398.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Jere, Methuselah. “Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia.” 2015. Web. 01 Mar 2021.
Vancouver:
Jere M. Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia. [Internet] [Thesis]. University of Zimbabwe; 2015. [cited 2021 Mar 01].
Available from: http://dspace.unza.zm/handle/123456789/4398.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Jere M. Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia. [Thesis]. University of Zimbabwe; 2015. Available from: http://dspace.unza.zm/handle/123456789/4398
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Adelaide
4.
Schultz, Carlee Deanne.
Thrombogenesis in substrates of atrial fibrillation.
Degree: 2014, University of Adelaide
URL: http://hdl.handle.net/2440/97880
► Background: Atrial Fibrillation (AF) is the most common atrial arrhythmia affecting Australia and the world, with patients with AF known to be at a 5times…
(more)
▼ Background:
Atrial Fibrillation (AF) is the most common
atrial arrhythmia affecting Australia and the world, with patients with AF known to be at a 5times higher risk of stroke than that of the normal population. The substrates of AF are also known to significantly impact of this risk of stroke. Mitral stenosis (MS) is one of the leading causes of valvular AF in the developing world. Enlargement of the LA is one of the most common structural changes that occurs in MS and is known to lead to fibrosis and oxidative stress. These alterations can also cause
atrial electrical remodelling leading to the development of AF. Patients with MS have been shown to have an increase in thrombogenic properties which include platelet reactivity, inflammation and endothelial dysfunction. The precise mechanisms which underlie this phenomenon of
atrial thrombus formation in AF are still unknown, furthermore it is also unknown if the substrate (cause) of AF influences the thromboembolic profile in AF patients. This thesis aims to evaluate the peripheral and
atrial thrombogenic profile of both AF and the major substrate MS and their differing disease states alter the thrombus potential. Methods: A total of 166 patients were collected for this study, 55 patients undergoing a radiofrequency ablation as a curative procedure for paroxysmal AF, at the Royal Adelaide Hospital, Adelaide, 59 patients with mitral stenosis (MS)undergoing a balloon valvuloplasty at the Christian Medical Centre in Vellore, India, and 52 with aged matched control subjects, diagnosed with left sided accessory pathway supraventricular tachycardia (SVT) undergoing a routine elective electrophysiological study. Blood samples were collected from the peripheral, RA and LA circulation, during each of these procedures, for further analysis through flow cytometry, platelet aggregation and ELISA tests. Echocardiographic studies were used for
atrial structure measurements. Results: We found that within the AF population there is increase in thrombogenic markers within the heart compared to the peripheral circulation. More interestingly when comparing the MS and AF populations each of the different factors involved in thrombogenesis is altered differently, with AF having an increase in platelet reactivity and endothelial function (ADMA and ET-1) and inflammation through VCAM-1 and ICAM-1. However of inflammation through MPO, CD40L and IL-6 and structural remodelling (MMP-9 and TIMP-1) were more pronounced within the MS population. Conclusion: This study has shown that AF and the valvular AF substrate mitral stenosis (MS) have two distinctly different mechanisms leading to
atrial thrombus formation. This shows that MS as a substrate for valvular AF impacts on
atrial thrombus formation through remodelling and inflammation whereas non valvular AF affects endothelial function and tissue inflammation. This illustrates that the pathophysiology of each of the diseases states is different when comparing it to the normal haemostatic properties of the heart within a control (SVT)…
Advisors/Committee Members: Willoughby, Scott Richard (advisor), Brooks, Anthony Graham (advisor), John, Bobby (advisor), Gasean, Anand (advisor), Sanders, Prash (advisor), School of Medicine (school).
Subjects/Keywords: thrombogenesis; atrial fibrillation
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APA ·
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Manager
APA (6th Edition):
Schultz, C. D. (2014). Thrombogenesis in substrates of atrial fibrillation. (Thesis). University of Adelaide. Retrieved from http://hdl.handle.net/2440/97880
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Schultz, Carlee Deanne. “Thrombogenesis in substrates of atrial fibrillation.” 2014. Thesis, University of Adelaide. Accessed March 01, 2021.
http://hdl.handle.net/2440/97880.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Schultz, Carlee Deanne. “Thrombogenesis in substrates of atrial fibrillation.” 2014. Web. 01 Mar 2021.
Vancouver:
Schultz CD. Thrombogenesis in substrates of atrial fibrillation. [Internet] [Thesis]. University of Adelaide; 2014. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2440/97880.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Schultz CD. Thrombogenesis in substrates of atrial fibrillation. [Thesis]. University of Adelaide; 2014. Available from: http://hdl.handle.net/2440/97880
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Melbourne
5.
LEE, GEOFFREY.
Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers.
Degree: 2012, University of Melbourne
URL: http://hdl.handle.net/11343/37788
► Atrial fibrillation is thought to involve an interaction between initiating factors, usually in the form of ectopic impulses from the pulmonary veins (PVs) and an…
(more)
▼ Atrial fibrillation is thought to involve an interaction between initiating factors, usually in the form of ectopic impulses from the pulmonary veins (PVs) and an abnormal atrial substrate capable of maintaining the arrhythmia. However, the underlying pathophysiology of atrial fibrillation remains poorly understood. The main aims of this thesis are to evaluate the mechanisms of pulmonary vein arrhythmogenesis and to determine the mechanisms of persistent atrial fibrillation in humans.
Chapters 2 and 3 examine important aspects of pulmonary vein electrophysiology in the context of atrial fibrillation ablation. In Chapter 2, we use double and single lung transplant surgery as models of unilateral and bilateral pulmonary vein antral isolation akin to catheter based pulmonary vein isolation approaches to determine the impact of enduring PV isolation on the maintenance of sinus rhythm. We demonstrate in a large cohort of patients undergoing lung transplantation that double but not single lung transplantation is associated with a very low incidence (0.5%) of atrial fibrillation during long-term follow up. This study highlights the importance of enduring four-vein pulmonary vein isolation in the maintenance of sinus rhythm. In Chapter 3 we demonstrate that dissociated pulmonary vein potentials occurring at the time of acute pulmonary vein isolation are common and usually manifest as slow cycle length activity or isolated ectopic beats. We demonstrate that dissociated pulmonary vein potentials are not associated with worse ablation outcomes during long-term follow up.
Chapter 4 examines the underlying electrophysiological properties of the pulmonary veins. By performing high-density epicardial mapping in patients undergoing open-heart surgery without a history of AF, we demonstrate that the PV-LA junction is the area with the most marked functional conduction delay, compared to the LA and the PV itself. We demonstrate areas of slowed and blocked conduction, fractionated electrograms at the PV-LA junction and observe circuitous activation patterns across this area during programmed extra stimulation. These findings suggest that functional conduction block at the PV-LA junction may facilitate reentry and may be an important mechanism of PV arrhythmogenesis.
Complex fractionated atrial electrograms (CFAE) have emerged as targets for substrate-based ablation. This is based on the premise that they identify critical sites important in the perpetuation of AF. They can be defined by electrogram morphology or purely by atrial fibrillation cycle length (AFCL<120ms). In Chapter 5 we perform high-density epicardial mapping in patients with persistent AF and demonstrate that the prevalence of CFAE is highly dependent on the definition used. We show there is poor anatomical overlap between CFAE defined by multicomponent electrograms and CFAE defined by an AFCL <120ms. Sites of multicomponent electrograms…
Subjects/Keywords: atrial fibrillation; mechanisms
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APA ·
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APA (6th Edition):
LEE, G. (2012). Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/37788
Chicago Manual of Style (16th Edition):
LEE, GEOFFREY. “Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers.” 2012. Doctoral Dissertation, University of Melbourne. Accessed March 01, 2021.
http://hdl.handle.net/11343/37788.
MLA Handbook (7th Edition):
LEE, GEOFFREY. “Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers.” 2012. Web. 01 Mar 2021.
Vancouver:
LEE G. Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers. [Internet] [Doctoral dissertation]. University of Melbourne; 2012. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11343/37788.
Council of Science Editors:
LEE G. Mechanisms of atrial fibrillation in man: importance of pulmonary veins and left atrial drivers. [Doctoral Dissertation]. University of Melbourne; 2012. Available from: http://hdl.handle.net/11343/37788
Victoria University of Wellington
6.
Hayes, Greg.
Automatic detection of Atrial Fibrillation.
Degree: 2014, Victoria University of Wellington
URL: http://hdl.handle.net/10063/8969
► Atrial Fibrillation is an abnormal arrhythmia of the heart and is a growingconcern in the health sector affecting 1% of the population. The incidenceof atrial…
(more)
▼ Atrial Fibrillation is an abnormal arrhythmia of the heart and is a growingconcern in the health sector affecting 1% of the population. The incidenceof
atrial fibrillation increases with age and has been found to be more detri-mental to long term cardiac health than previously thought. Sufferers arefive times more likely to experience a stroke than others. Often,
atrial fib-rillation is asymptomatic and is frequently discovered only when a patient visits a hospital for other reasons. The detection of paroxysmal
atrial fib-rillation can be difficult. Holter monitors are used to record the ECG overlong periods of time, but the resulting recording still needs to be analysed.This can be a time consuming task and one prone to errors. If a miniature,low-power, wearable device could be designed to detect and record whena heart experiences
atrial fibrillation, then health professionals would havemore timely information to carry out better, more cost effective courses of treatment. This thesis presents progress towards development of such a device.
Atrial fibrillation is characterised by random RR interval, missing Pwave and presence of
atrial activity. The detection of the P wave and atrialactivity can be unreliable due to low signal levels and differences in wave-form morphology between subjects. The random RR interval appears tobe a more reliable method of detection. By analysing the ECG signal inboth the frequency and time domains, feature sets can be extracted for thedetection process. In this research, the Discrete Wavelet Transform is used to generate several sub-bands for analysing wave form morphology, and anumber of RR interval metrics are created for analysing the rhythm. All features are further processed and presented to a support vector machine classification stage for the ultimate detection of
atrial fibrillation. Forty eight files from the MITDB database of the PhysioNet online ECG reposi-tory were downloaded and processed to form separate training and test-ing data sets. Overall classification accuracy for normal sinus rhythm was93% sensitivity and 95% specificity, and for
atrial fibrillation, 95% sensitiv-ity and 93% specificity. These results were found to be sensitive to the ECG morphology of the individual subjects. This means that the system either needs to be trained on a greater number of ECG morphologies or perhaps trained on the morphology of the individual under investigation. Putting this issue aside, the research to date shows that it is reasonable to expect a small, low powered, wearable device, to be capable of automatically detecting whena heart experiences
atrial fibrillation.
Advisors/Committee Members: Teal, Paul.
Subjects/Keywords: Atrial; Fibrillation; Detection
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APA ·
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APA (6th Edition):
Hayes, G. (2014). Automatic detection of Atrial Fibrillation. (Masters Thesis). Victoria University of Wellington. Retrieved from http://hdl.handle.net/10063/8969
Chicago Manual of Style (16th Edition):
Hayes, Greg. “Automatic detection of Atrial Fibrillation.” 2014. Masters Thesis, Victoria University of Wellington. Accessed March 01, 2021.
http://hdl.handle.net/10063/8969.
MLA Handbook (7th Edition):
Hayes, Greg. “Automatic detection of Atrial Fibrillation.” 2014. Web. 01 Mar 2021.
Vancouver:
Hayes G. Automatic detection of Atrial Fibrillation. [Internet] [Masters thesis]. Victoria University of Wellington; 2014. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10063/8969.
Council of Science Editors:
Hayes G. Automatic detection of Atrial Fibrillation. [Masters Thesis]. Victoria University of Wellington; 2014. Available from: http://hdl.handle.net/10063/8969
University of Melbourne
7.
Teh, Andrew W.
Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate.
Degree: 2011, University of Melbourne
URL: http://hdl.handle.net/11343/36602
► Atrial fibrillation (AF) remains the most common clinical arrhythmia in humans, causing significant morbidity and mortality. Current understanding involves contributions from initiating triggers and remodelled…
(more)
▼ Atrial fibrillation (AF) remains the most common clinical arrhythmia in humans, causing significant morbidity and mortality. Current understanding involves contributions from initiating triggers and remodelled atrial substrate, however the precise nature of these remains elusive. This thesis evaluates the nature of pulmonary vein (PV) triggers and atrial substrate that contribute towards AF mechanism and the potential for reversal of atrial remodelling.
Chapters 2 and 3 are introductory chapters examining the relative importance of triggers (focal PV tachycardia) and atrial substrate (flutter following atrial septal defect (ASD) surgery) by studying the incidence of AF after catheter ablation (RFA). These studies demonstrate that although AF does not occur after elimination of PV triggers in patients without atrial substrate (PV tachycardia), it commonly occurs in patients with atrial substrate (ASD surgery).
Chapters 4 and 5 examine the electrophysiologic substrate of the PVs. Chapter 4 demonstrates that the PVs of both paroxysmal (PAF) and persistent AF (PeAF) patients possess lower voltage, shorter muscle sleeves, slowed conduction, altered refractoriness and more complex electrograms compared to controls. Some of the substrate remodelling was more marked in PeAF than PAF patients. Chapter 5 demonstrates that ageing is associated with a reduction in PV voltage, conduction slowing and increased signal complexity without changes in refractoriness. Together, these chapters provide insights into the mechanisms responsible for PV arrhythmogenesis and the increasing prevalence of AF with age.
Although complex fractionated electrograms (CFE) are commonly targeted as AF substrate, their significance remains controversial. Chapters 6 and 7 evaluate the significance of CFE in the coronary sinus (CS) and the relationship between CFE seen during AF and paced-rhythm. Chapter 6 demonstrates that both PAF and PeAF patients demonstrate a higher prevalence of CFE and short cycle length activation and slower conduction in the CS than control patients with induced AF. There was no difference in dominant frequency and CFE were also common in the control group. Chapter 7 demonstrates that low-voltage and the proportion of CFE were significantly greater during AF than paced-rhythm. CFE during AF did not correlate with abnormal atrial substrate in paced-rhythm. Together, these chapters highlight that CFE may not always reflect abnormal atrial substrate.
Chapter 8 evaluates the left atrial substrate associated with AF and demonstrates that patients with AF have lower voltage, slowed conduction and increased complex signals compared with a control population. Most of these changes were more pronounced in the PeAF than PAF group, providing further insights into the progressive nature of AF.
Chapter 9 evaluates the…
Subjects/Keywords: atrial fibrillation; electroanatomic mapping; atrial remodelling; mechanisms
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APA ·
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Manager
APA (6th Edition):
Teh, A. W. (2011). Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/36602
Chicago Manual of Style (16th Edition):
Teh, Andrew W. “Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate.” 2011. Doctoral Dissertation, University of Melbourne. Accessed March 01, 2021.
http://hdl.handle.net/11343/36602.
MLA Handbook (7th Edition):
Teh, Andrew W. “Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate.” 2011. Web. 01 Mar 2021.
Vancouver:
Teh AW. Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate. [Internet] [Doctoral dissertation]. University of Melbourne; 2011. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11343/36602.
Council of Science Editors:
Teh AW. Mechanisms of atrial fibrillation in humans: contributions from triggers and substrate. [Doctoral Dissertation]. University of Melbourne; 2011. Available from: http://hdl.handle.net/11343/36602
University of Melbourne
8.
Pathik, Manaswi Bhupesh.
New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques.
Degree: 2017, University of Melbourne
URL: http://hdl.handle.net/11343/194696
► Advances in our understanding of the pathophysiology of atrial fibrillation (AF) and atrial macro-reentry through improvements in technology has led to the development of treatment…
(more)
▼ Advances in our understanding of the pathophysiology of atrial fibrillation (AF) and atrial macro-reentry through improvements in technology has led to the development of treatment approaches involving catheter ablation. However, outcomes have been suboptimal possibly due to an incomplete understanding of the underlying mechanisms of these arrhythmias. Using novel three-dimensional (3D) mapping techniques, this thesis aims to answer unresolved questions in our understanding of the mechanisms of human persistent AF and atrial macro-reentry.
Recent work using phase mapping has suggested that rotors may act as drivers for persistent AF with studies from different centers reporting promising findings of acute termination and long term freedom from AF with ablation at the rotor center. However, these encouraging results have not been observed consistently possibly due to the two-dimensional (2D) representation of the left atrium (LA) in this mapping technique. In Chapter 2, we used a novel 3D phase mapping technology that takes into account patient-specific left atrial geometry to display phase to determine the dominant propagation patterns in patients with persistent AF. We observed transient rotors in the majority of patients, however, they were present for only a small fraction of the total recording time with the dominant propagation pattern overall being single broad wavefronts.
An additional assumption of the abovementioned 2D phase mapping system is that the 64 electrodes of the Constellation basket catheter are arranged in a uniform 8x8 grid in a fixed position within the 2D representation of the LA. These spatial assumptions may lead to errors in phase animation as the actual 3D locations of the basket catheter are not taken into consideration. In Chapter 3, we therefore determined whether rotational activity detected in 2D phase maps were observed in corresponding 3D phase maps. We found that none of the rotors observed in 2D phase maps were seen in the same time segments and anatomical locations in 3D phase maps. The 2D phase detected rotors either corresponded in 3D phase maps to wavefronts (single or multiple), disorganized activity or an absence of basket coverage at the corresponding 3D anatomical site.
With the increasing clinical use of the Constellation basket catheter in currently available mapping systems, Chapter 4 evaluated the efficacy of this catheter. We found that there were significant limitations of the basket catheter in terms of electrode contact and coverage of the LA. In addition, there was regional variation of coverage with preferential coverage of the lateral wall and absence of contact with the septum. These findings suggest that there is a need for the development of high density basket catheters which provide uniform LA coverage.
Prior to the current focus on AF, atrial macro-reentry was the subject of extensive research. The recent development of high-density high-resolution 3D mapping provides an opportunity to study atrial macro-reentry to a level of detail not…
Subjects/Keywords: atrial fibrillation; atrial flutter; phase mapping
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APA (6th Edition):
Pathik, M. B. (2017). New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/194696
Chicago Manual of Style (16th Edition):
Pathik, Manaswi Bhupesh. “New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques.” 2017. Doctoral Dissertation, University of Melbourne. Accessed March 01, 2021.
http://hdl.handle.net/11343/194696.
MLA Handbook (7th Edition):
Pathik, Manaswi Bhupesh. “New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques.” 2017. Web. 01 Mar 2021.
Vancouver:
Pathik MB. New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques. [Internet] [Doctoral dissertation]. University of Melbourne; 2017. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11343/194696.
Council of Science Editors:
Pathik MB. New insights into the mechanisms of atrial arrhythmias using novel three dimensional mapping techniques. [Doctoral Dissertation]. University of Melbourne; 2017. Available from: http://hdl.handle.net/11343/194696
University of Hong Kong
9.
Long, Meijing.
Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS).
Degree: 2008, University of Hong Kong
URL: http://hdl.handle.net/10722/55181
Subjects/Keywords: Atrial
fibrillation.
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APA ·
Chicago ·
MLA ·
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CSE |
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APA (6th Edition):
Long, M. (2008). Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS). (Thesis). University of Hong Kong. Retrieved from http://hdl.handle.net/10722/55181
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Long, Meijing. “Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS).” 2008. Thesis, University of Hong Kong. Accessed March 01, 2021.
http://hdl.handle.net/10722/55181.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Long, Meijing. “Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS).” 2008. Web. 01 Mar 2021.
Vancouver:
Long M. Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS). [Internet] [Thesis]. University of Hong Kong; 2008. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10722/55181.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Long M. Prevalence and risk factor
of atrial fibrillation in older Chinese: the Guangzhou biobank
cohort study (GBCS). [Thesis]. University of Hong Kong; 2008. Available from: http://hdl.handle.net/10722/55181
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Hong Kong
10.
Siu, Chung-wah,
David.
Current perspective of
new-onset atrial fibrillation.
Degree: 2010, University of Hong Kong
URL: http://hdl.handle.net/10722/132148
Subjects/Keywords: Atrial
fibrillation.
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Siu, C. (2010). Current perspective of
new-onset atrial fibrillation. (Thesis). University of Hong Kong. Retrieved from http://hdl.handle.net/10722/132148
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Siu, Chung-wah,. “Current perspective of
new-onset atrial fibrillation.” 2010. Thesis, University of Hong Kong. Accessed March 01, 2021.
http://hdl.handle.net/10722/132148.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Siu, Chung-wah,. “Current perspective of
new-onset atrial fibrillation.” 2010. Web. 01 Mar 2021.
Vancouver:
Siu C. Current perspective of
new-onset atrial fibrillation. [Internet] [Thesis]. University of Hong Kong; 2010. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10722/132148.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Siu C. Current perspective of
new-onset atrial fibrillation. [Thesis]. University of Hong Kong; 2010. Available from: http://hdl.handle.net/10722/132148
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Tasmania
11.
Bista, D.
Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience.
Degree: 2016, University of Tasmania
URL: https://eprints.utas.edu.au/23415/1/Bista_whole_thesis.pdf
► Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder and is increasing in incidence and prevalence in ageing populations. It is estimated that…
(more)
▼ Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder and is increasing in incidence and prevalence in ageing populations. It is estimated that 1.5-2% of the developed world suffers from AF. The risk of stroke and thromboembolism (TE) is increased 4-5 fold by non-valvular atrial fibrillation (NVAF) and nearly 15% of all strokes are caused by AF. Judicious use of antithrombotic therapy significantly reduces the risk of stroke for most patients who have AF. Conversely, underuse of antithrombotic therapy is associated with an increase in the rates of death and ischaemic events (stroke, transient ischaemic attack [TIA], or myocardial infarction [MI]). Despite the proven benefits of anticoagulant therapy among high-risk patients with AF, there have been frequent reports of discordance between guideline recommendations and anticoagulant prescribing patterns leading to problem of underutilisation in patients with AF in real-world practices.
During the time period of this study there were limited data available on the characteristics, clinical management and outcomes of patients with AF from an Australian perspective. The available literature suggested that there was underutilisation of anticoagulant therapy, although this data came from relatively small observational trials in selected patient groups. The Commonwealth Review of Anticoagulation Therapies in AF in Australia identified that stroke prevention in individuals with AF required improvement, and highlighted a range of issues to be addressed related to the assessment of patients for stroke and bleeding risk, appropriate choice of antithrombotic agent(s) in patients with multiple comorbidities, and the monitoring of patients. The review stressed the need for local data on which to base recommendations regarding the treatment of AF. Meanwhile, little was known about the clinical outcomes and safety of direct oral anticoagulants (DOACs) outside the trial setting. In 2011, dabigatran’s sponsor launched a patient familiarisation program in which over 28,000 Australians were enrolled. Thus, we established that there was a critical need for local data regarding the safety of antithrombotic medications, including the DOACs, in the treatment of AF. We designed this study, the Tasmanian AF (TAF) Study, as a starting point to providing comprehensive data describing the outcomes of stroke prevention strategies in Tasmanian patients with AF. The TAF study is an ongoing retrospective study that enrols patients from 3 different hospitals in Tasmania, Australia; the Royal Hobart Hospital (RHH), Launceston General Hospital (LGH) and North West Regional Hospital (NWRH). The rationale behind this project was to derive local data on usage pattern of antithrombotic therapy, clinical outcomes and their safety profile in Australian sub-population - initially prior to the Pharmaceutical Benefits Scheme (PBS) listing of DOACs, and then to use the established database to monitor the impact of the introduction of the DOACs into clinical practice.
Our main objectives…
Subjects/Keywords: atrial fibrillation; anticoagulants; bleeding; thromboembolism
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APA ·
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CSE |
Export
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Manager
APA (6th Edition):
Bista, D. (2016). Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience. (Thesis). University of Tasmania. Retrieved from https://eprints.utas.edu.au/23415/1/Bista_whole_thesis.pdf
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Bista, D. “Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience.” 2016. Thesis, University of Tasmania. Accessed March 01, 2021.
https://eprints.utas.edu.au/23415/1/Bista_whole_thesis.pdf.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Bista, D. “Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience.” 2016. Web. 01 Mar 2021.
Vancouver:
Bista D. Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience. [Internet] [Thesis]. University of Tasmania; 2016. [cited 2021 Mar 01].
Available from: https://eprints.utas.edu.au/23415/1/Bista_whole_thesis.pdf.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Bista D. Antithrombotic therapy in patients with atrial fibrillation : the Tasmanian experience. [Thesis]. University of Tasmania; 2016. Available from: https://eprints.utas.edu.au/23415/1/Bista_whole_thesis.pdf
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Manchester
12.
Law, Phillip Robert.
Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation.
Degree: 2011, University of Manchester
URL: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:111902
► Cardiovascular disease is prevalent across the western world and is a major cause of morbidity and mortality, accounting for approximately a third of all fatalities.…
(more)
▼ Cardiovascular disease is prevalent across the
western world and is a major cause of morbidity and mortality,
accounting for approximately a third of all fatalities.
Investigating the heart by simulating its electrophysiology via the
aid of mathematical models has advanced significantly over the past
60 years and is now a well established field. While much of the
research focus is placed on the ventricles, the study of the atria
is in comparison neglected. Therefore this Thesis is focused on the
genesis and maintenance of
atrial fibrillation (AF). A series of
case studies are performed whereby established biophysically
detailed mathematical models are implemented and modified to
incorporate electrophysical alterations of
atrial cells resulting
from a variety of external conditions. The opening section of this
Thesis is dedicated to developing a background to the field,
including a discussion into the clinical aspect of the diagnosis
and management of AF. The suitability of two
atrial cell models is
discussed and the development of single cell, 1D, 2D, and 3D
multi-scale simulation protocols are described in detail. In
addition measurements taken to quantify the arrhythmogenic
properties of the cells susceptibility to AF are outlined. The
second section is focused on the incorporation of conditions
thought to enhance
atrial tissues ability to initiate and maintain
the genesis of AF. Included is a case study into the missence S140G
gene mutation, and elevated physiological levels of the hormone
Homocystein. The third section investigates the effectiveness of
well established and widely used pharmacological treatments such as
Beta-Blockers. In addition possible avenues of investigations for
the development of
atrial specific drugs are explored. These
include blocking of the ultra rapid potassium channel and a more
novel target for therapy via the targeting of 5HT4 receptors; which
is transcribed solely in the atria and alters the electrophysical
properties of the L-type Calcium current. The final part of this
Thesis is dedicated to the development of a 2D
atrial sheet model
which includes electrical and spatial heterogeneities via the
inclusion of multiple cell types and basic fiber orientation
respectively. This allows for an investigation into the role that
heterogeneities play in role genesis and maintenance of AF. The
main finding of this Thesis is that alterations to the
electrophysiology of
atrial cells, due to external factors, can be
successfully simulated via the implementation of mathematically
detailed
atrial cell models. It is concluded that simulations of
the KENQ1 mutation and elevated levels of Homocystein successfully
reproduce conditions which increase the onset of AF. Established
treatments such as Beta-Blockers are found to have limited
effectiveness. Possible theoretical treatments, such as the
blocking of IKur, are found to provide a small amount of
therapeutic benefit. In contrast, investigations into the effects
of Serotonin were inconclusive. The study into the 2D atria
indicated the importance…
Advisors/Committee Members: Zhang, Henggui.
Subjects/Keywords: Atrial Fibrillation; Cardiac Modeling
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APA ·
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Manager
APA (6th Edition):
Law, P. R. (2011). Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:111902
Chicago Manual of Style (16th Edition):
Law, Phillip Robert. “Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation.” 2011. Doctoral Dissertation, University of Manchester. Accessed March 01, 2021.
http://www.manchester.ac.uk/escholar/uk-ac-man-scw:111902.
MLA Handbook (7th Edition):
Law, Phillip Robert. “Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation.” 2011. Web. 01 Mar 2021.
Vancouver:
Law PR. Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation. [Internet] [Doctoral dissertation]. University of Manchester; 2011. [cited 2021 Mar 01].
Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:111902.
Council of Science Editors:
Law PR. Tissue Engineering of the Human Atrium – Approaching
Mechanisms of Genesis and Control of Atrial Fibrillation. [Doctoral Dissertation]. University of Manchester; 2011. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:111902
13.
Maan, Abhishek.
Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the.
Degree: School of Public Health, 2018, Brown University
URL: https://repository.library.brown.edu/studio/item/bdr:792665/
► The United States Preventive Services Task Force (USPSTF) recommends aspirin for primary prevention of coronary artery disease (CAD) in adults aged 50-69 years. The objective…
(more)
▼ The United States Preventive Services Task Force
(USPSTF) recommends aspirin for primary prevention of coronary
artery disease (CAD) in adults aged 50-69 years. The objective of
our study was to examine the association between household income
and aspirin use for primary prevention of CAD in this population.
We used the population-based 2015 Behavioral Risk Factor
Surveillance System (BRFSS) database, which is designed to measure
behavioral risk factors in US adults across all 50 states. We
performed univariate comparison of demographic variables between
aspirin users and aspirin non-users. We then conducted
multivariable logistic regression to assess the association between
household income and aspirin use for primary prevention of CAD. In
unadjusted logistic regression analyses, US adults with household
income <15,000$ were significantly less likely to use aspirin
for primary prevention of CAD (Odds ratio: 0.33, 95% CI: 0.23-0.46,
p < 0.0001) than the participants with household income >
50,000$. This association remained after adjusting for gender,
marital status, educational status, race/ethnicity and access to
healthcare insurance (adjusted OR: 0.54, 95% CI: 0.32-0.92, p =
0.02) to take aspirin for prevention of CAD. In conclusion, we
observed a significant disparity in the use of aspirin for
prevention of CAD based on household income.
Advisors/Committee Members: Gjelsvik, Dr. Annie (Advisor), Shah, Dr. Nishant (Advisor).
Subjects/Keywords: Aspirin; cardiovascular disease; atrial
fibrillation
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APA ·
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Export
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Manager
APA (6th Edition):
Maan, A. (2018). Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the. (Thesis). Brown University. Retrieved from https://repository.library.brown.edu/studio/item/bdr:792665/
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Maan, Abhishek. “Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the.” 2018. Thesis, Brown University. Accessed March 01, 2021.
https://repository.library.brown.edu/studio/item/bdr:792665/.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Maan, Abhishek. “Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the.” 2018. Web. 01 Mar 2021.
Vancouver:
Maan A. Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the. [Internet] [Thesis]. Brown University; 2018. [cited 2021 Mar 01].
Available from: https://repository.library.brown.edu/studio/item/bdr:792665/.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Maan A. Association Between Household Income and Aspirin Use for
Primary Prevention of Coronary Artery Disease: Insights from the
Behavioral Risk Factor Surveillance System (BRFSS) Database
Comparison of Rate and Rhythm Control Treatment Strategies in
the. [Thesis]. Brown University; 2018. Available from: https://repository.library.brown.edu/studio/item/bdr:792665/
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Toronto
14.
Izaddoustdar, Farzad.
Mechanisms Underlying Exercise-induced Atrial Fibrillation.
Degree: 2013, University of Toronto
URL: http://hdl.handle.net/1807/35120
► Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia that can present without cardiovascular disease (lone AF). Frequent high-intensity endurance exercise is a risk factor…
(more)
▼ Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia that can present without cardiovascular disease (lone AF). Frequent high-intensity endurance exercise is a risk factor for lone AF, and the pathophysiology of AF induced by intense endurance exercise is unknown. We found that after 6 weeks of intense swimming and running, mice were far more susceptible to AF, but not ventricular arrhythmias. Exercise induced atrial fibrosis, inflammation and slowed conduction without detectible changes in ventricles. Since AF is associated with stretch and since a tumor necrosis factor-α (TNFα) is a mechanosensitive inflammatory factor, mice were treated with the TNFα inhibitor etanercept. Etanercept treatment blocked inflammation, fibrosis, and AF vulnerability in the exercised mice. Consistent with these findings, we found that exercise caused large elevations in atrial pressures. Our findings support the conclusion that mechanical loading of atria during exercise induces TNFα release, leading to structural remodeling and enhanced AF vulnerability.
MAST
Advisors/Committee Members: Backx, Peter, Physiology.
Subjects/Keywords: atrial fibrillation; athletes; exercise; 0719
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APA ·
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APA (6th Edition):
Izaddoustdar, F. (2013). Mechanisms Underlying Exercise-induced Atrial Fibrillation. (Masters Thesis). University of Toronto. Retrieved from http://hdl.handle.net/1807/35120
Chicago Manual of Style (16th Edition):
Izaddoustdar, Farzad. “Mechanisms Underlying Exercise-induced Atrial Fibrillation.” 2013. Masters Thesis, University of Toronto. Accessed March 01, 2021.
http://hdl.handle.net/1807/35120.
MLA Handbook (7th Edition):
Izaddoustdar, Farzad. “Mechanisms Underlying Exercise-induced Atrial Fibrillation.” 2013. Web. 01 Mar 2021.
Vancouver:
Izaddoustdar F. Mechanisms Underlying Exercise-induced Atrial Fibrillation. [Internet] [Masters thesis]. University of Toronto; 2013. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/1807/35120.
Council of Science Editors:
Izaddoustdar F. Mechanisms Underlying Exercise-induced Atrial Fibrillation. [Masters Thesis]. University of Toronto; 2013. Available from: http://hdl.handle.net/1807/35120
University of Adelaide
15.
Varzaly, Jason Arya.
The surgical management of atrial fibrillation.
Degree: 2018, University of Adelaide
URL: http://hdl.handle.net/2440/114066
► Atrial fibrillation (AF) is the most common atrial arrhythmia with an increasing prevalence identified worldwide. Symptomatic episodes have resulted in increasing hospitalisations such that this…
(more)
▼ Atrial fibrillation (AF) is the most common
atrial arrhythmia with an increasing prevalence identified worldwide. Symptomatic episodes have resulted in increasing hospitalisations such that this is now one of the dominant cardiovascular reasons for hospital admission in Australia. Beyond this, AF predisposes to heart failure, stroke and increasing cognitive decline. While medical therapy is available for the treatment of this condition the use of medication has not always proven sufficient for its management leading to the development of catheter and surgical ablation therapies. However, while surgical ablation procedures are widely utilised, the true efficacy of these approaches has not been well understood due to the wide variety of methodologies, concomitant procedures, technologies utilised and follow-up implemented. This thesis evaluates the current state of surgical ablation for AF. Chapter 1 provides an overview of the burden of AF on our community, the mechanisms of arrhythmia, a summary of medical and catheter based therapies and an in-depth analysis of how surgical therapies for
atrial fibrillation were developed and the current approaches to surgical ablation with the current technologies available for use. Chapters 2 through 5 examine the efficacy and safety of the surgical ablation of AF when performed concurrent to mitral valve disease intervention, concomitant cardiac surgery in general, as a standalone procedure and as part of an emerging technique of hybrid ablation (joint surgical and cardiology electrophysiology) procedure. This evaluation has been performed through systematic literature review and meta-analyses identifying that surgical ablations procedures offer good medium term results in sinus rhythm maintenance (SRM) on and off antiarrhythmic drugs(AAD) achieving 79.6% SRM concurrent to mitral valve intervention, 79.6% on AAD and 65.3% off AAD concurrent to general cardiac surgical procedures, 85.3% on and 65.5% off AAD as a standalone procedure, and 79.4% on AAD and 70.7% off AAD when performed as a hybrid ablation procedure. The complication rates were low across all series, with the lowest complication rates associated with the hybrid procedure. Chapter 6 then presents the results of a series of experiments analysing the properties of surgical bipolar RF clamps and how ablation lesions are formed, with the identification that the efficacy of these surgical ablative tools is
subject to the effects of contact force for the delivery of transmural lesions, increased numbers of ablation increase the likelihood of a transmural lesion irrespective of the device indicating transmurality, the presence of fat significantly attenuates the ability to deliver of a transmural lesion and these effects are amplified with increased thickness of the tissue being ablated. The observations of this thesis thus provide insight into the optimal conditions under which the surgical ablation of AF may obtain the best results in sinus rhythm maintenance.
Advisors/Committee Members: Sanders, Prashanthan (advisor), Worthington, Michael (advisor), Lau, Dennis Hui Sung (advisor), Adelaide Medical School (school).
Subjects/Keywords: atrial fibrillation; surgery; cardiac
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APA ·
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MLA ·
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Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Varzaly, J. A. (2018). The surgical management of atrial fibrillation. (Thesis). University of Adelaide. Retrieved from http://hdl.handle.net/2440/114066
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Varzaly, Jason Arya. “The surgical management of atrial fibrillation.” 2018. Thesis, University of Adelaide. Accessed March 01, 2021.
http://hdl.handle.net/2440/114066.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Varzaly, Jason Arya. “The surgical management of atrial fibrillation.” 2018. Web. 01 Mar 2021.
Vancouver:
Varzaly JA. The surgical management of atrial fibrillation. [Internet] [Thesis]. University of Adelaide; 2018. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2440/114066.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Varzaly JA. The surgical management of atrial fibrillation. [Thesis]. University of Adelaide; 2018. Available from: http://hdl.handle.net/2440/114066
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Vermont
16.
Benson, Bryce Eric.
Mapping the Substrate of Atrial Fibrillation: Tools and Techniques.
Degree: PhD, Bioengineering, 2016, University of Vermont
URL: https://scholarworks.uvm.edu/graddis/634
► Atrial fibrillation (AF) is the most common cardiac arrhythmia that affects an estimated 33.5 million people worldwide. Despite its prevalence and economic burden, treatments…
(more)
▼ Atrial fibrillation (AF) is the most common cardiac arrhythmia that affects an estimated 33.5 million people worldwide. Despite its prevalence and economic burden, treatments remain relatively ineffective. Interventional treatments using catheter ablation have shown more success in cure rates than pharmacologic methods for AF. However, success rates diminish drastically in patients with more advanced forms of the disease.
The focus of this research is to develop a mapping strategy to improve the success of ablation. To achieve this goal, I used a computational model of excitation in order to simulate
atrial fibrillation and evaluate mapping strategies that could guide ablation. I first propose a substrate guided mapping strategy to allow patient-specific treatment rather than a one size fits all approach. Ablation guided by this method reduced AF episode durations compared to baseline durations and an equal amount of random ablation in computational simulations. Because the accuracy of electrogram mapping is dependent upon catheter-tissue contact, I then provide a method to identify the distance between the electrode recording sites and the tissue surface using only the electrogram signal. The algorithm was validated both in silico and in vivo. Finally, I develop a classification algorithm for the identification of activation patterns using simultaneous, multi-site electrode recordings to aid in the development of an appropriate ablation strategy during AF.
These findings provide a framework for future mapping and ablation studies in humans and assist in the development of individualized ablation strategies for patients with higher disease burden.
Advisors/Committee Members: Peter Spector, Jason Bates.
Subjects/Keywords: Atrial Fibrillation; computer modeling; electrophysiology
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APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
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APA (6th Edition):
Benson, B. E. (2016). Mapping the Substrate of Atrial Fibrillation: Tools and Techniques. (Doctoral Dissertation). University of Vermont. Retrieved from https://scholarworks.uvm.edu/graddis/634
Chicago Manual of Style (16th Edition):
Benson, Bryce Eric. “Mapping the Substrate of Atrial Fibrillation: Tools and Techniques.” 2016. Doctoral Dissertation, University of Vermont. Accessed March 01, 2021.
https://scholarworks.uvm.edu/graddis/634.
MLA Handbook (7th Edition):
Benson, Bryce Eric. “Mapping the Substrate of Atrial Fibrillation: Tools and Techniques.” 2016. Web. 01 Mar 2021.
Vancouver:
Benson BE. Mapping the Substrate of Atrial Fibrillation: Tools and Techniques. [Internet] [Doctoral dissertation]. University of Vermont; 2016. [cited 2021 Mar 01].
Available from: https://scholarworks.uvm.edu/graddis/634.
Council of Science Editors:
Benson BE. Mapping the Substrate of Atrial Fibrillation: Tools and Techniques. [Doctoral Dissertation]. University of Vermont; 2016. Available from: https://scholarworks.uvm.edu/graddis/634
University of Adelaide
17.
Alasady, Muayad.
Atrial arrhythmogenesis during myocardial infarction.
Degree: 2015, University of Adelaide
URL: http://hdl.handle.net/2440/93914
► Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in the clinical practice. However, the underlying mechanism or pathophysiology is not fully understood despite…
(more)
▼ Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in the clinical practice. However, the underlying mechanism or pathophysiology is not fully understood despite our extensive research on AF. Furthermore, AF is commonly complicated by myocardial infarction (MI) with an incidence rate as high as 22%.
Atrial fibrillation is also associated with poor short and long-term outcome after acute myocardial infarction. Although the association between myocardial infarction and AF is well established, our knowledge of the underlying mechanism by which MI leads to AF remains incomplete. This thesis focused on the pathophysiology of AF during MI in the clinical and bench-side setting. It also examined the prognostic value of AF post MI. Chapter 2 is a systematic review and meta-analysis showing us the trend in AF incidence and prognosis over the last three decades with our advancement in both intervention and pharmacological therapy. The study reveals a significant declining in AF incidence post MI; however, mortality remains higher compared to non-AF even during the interventional era (2000s). This may be attributed to the fact that AF patients are older with more comorbidities and had less invasive procedures compared to non-AF patients but clearly more work is required in this area. Chapter 3 focused on the mechanism of AF during the acute phase (60 minutes) of myocardial infarction. This was ovine model of myocardial infarction which was induced by percutaneous approach via the right femoral artery using angioplasty technique to induce infarct. The study involved 36 sheep divided into 3 groups; the first group included 12 animals with proximal left circumflex occlusion (LCX) to induce myocardial infarction with left
atrial infarction or ischaemia. The second group included 12 animals with proximal occlusion of the left anterior descending artery (LAD) to induce myocardial infarction without left
atrial ischaemia or infarction, and the third group included 12 sham animals which underwent the same procedure without induction of myocardial infarction. This model was unique as both LAD and LCX supply almost equivalent myocardium but the LCX only supplies the left atrium. The study found that occlusion of the LCX (MI with LA ischaemia) resulted in significant conduction slowing, greater inhomogeneity in conduction and more AF inducibility and duration compared to LAD group or controls. On the other hand, occlusion of LAD resulted in only moderate conduction slowing with a slight inhomogeneity in conduction compared to controls. The study concludes that
atrial ischaemia is the dominant substrate for AF after MI. However, there is additional contribution to this substrate due to raised intra-
atrial pressure with diastolic dysfunction which is associated with left ventricular infarction. Chapter 4 examined the role of
atrial branches (left
atrial ischaemia) disease on AF genesis during acute myocardial infarction in humans. This is a case-control study in which cases and controls were selected from a pool of…
Advisors/Committee Members: Sanders, Prashanthan (advisor), Abhayaratna, Walter (advisor), Saint, David Albert (advisor), Brooks, Anthony Graham (advisor), Worthley, Matthew Ian (advisor), School of Medicine (school).
Subjects/Keywords: atrial fibrillation; myocardial infarction
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Alasady, M. (2015). Atrial arrhythmogenesis during myocardial infarction. (Thesis). University of Adelaide. Retrieved from http://hdl.handle.net/2440/93914
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Alasady, Muayad. “Atrial arrhythmogenesis during myocardial infarction.” 2015. Thesis, University of Adelaide. Accessed March 01, 2021.
http://hdl.handle.net/2440/93914.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Alasady, Muayad. “Atrial arrhythmogenesis during myocardial infarction.” 2015. Web. 01 Mar 2021.
Vancouver:
Alasady M. Atrial arrhythmogenesis during myocardial infarction. [Internet] [Thesis]. University of Adelaide; 2015. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2440/93914.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Alasady M. Atrial arrhythmogenesis during myocardial infarction. [Thesis]. University of Adelaide; 2015. Available from: http://hdl.handle.net/2440/93914
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Adelaide
18.
Lim, Han Sung.
Mechanisms of thrombogenesis in atrial fibrillation.
Degree: 2012, University of Adelaide
URL: http://hdl.handle.net/2440/95884
► Atrial fibrillation (AF) is the commonest sustained heart rhythm disorder in clinical practice. Non-valvular AF confers a 5-fold increased risk of stroke. Stroke in AF…
(more)
▼ Atrial fibrillation (AF) is the commonest sustained heart rhythm disorder in clinical practice. Non-valvular AF confers a 5-fold increased risk of stroke. Stroke in AF is mainly due to thromboembolic phenomenon from the left atrium (LA). It is well known that
atrial mechanical dysfunction contributes to thrombus formation. However, patients with AF are also known to exhibit a prothrombotic state and endothelial dysfunction, further contributing to this thromboembolic risk. There is debate as to whether the prothrombotic state and endothelial dysfunction seen in patients with AF are due to AF per se or the patients’ concurrent comorbidities. Chapter 2 examined the LA milieu in patients with lone non-valvular AF compared to patients with AF and comorbidities and controls. The study demonstrated increased platelet activation in the LA compared to the periphery in patients with lone AF. There was a step-wise increase in endothelial dysfunction in the lone AF cohort and AF with comorbidities compared to controls, indicating that both AF per se and its concurrent comorbidities contribute to endothelial dysfunction and thrombotic risk. Chapter 3 investigated the effect of rapid
atrial rates in patients with AF compared to patients with supraventricular tachycardia. The study demonstrated rapid
atrial rates increased LA platelet activation and thrombin generation in patients with AF. Left
atrial thrombogenesis was markedly accentuated with atrio-ventricular dyssynchrony. In contrast, rapid
atrial rates did not result in abnormal changes in patients with supraventricular tachycardia. These findings suggest rapid
atrial rates, atrio-ventricular dyssynchrony and the abnormal substrate in patients with AF contribute to LA thrombogenesis in these patients. The relative contribution of the
atrial rate or rhythm to LA thrombogenesis is unknown. Chapter 4 examined the effects of
atrial rate and abnormal rhythm on LA thrombogenesis and demonstrated both rapid
atrial rates and AF result in increased platelet activation and thrombin generation in the LA. However, AF also induced endothelial dysfunction and inflammation, not seen with rapid
atrial rates alone. These findings suggest that while rapid
atrial rates increase the thrombogenic risk, abnormal rhythm may further potentiate this risk. Catheter ablation therapy has emerged as an effective strategy for rhythm control in patients with AF. However, radiofrequency ablation is known to cause an increase in various markers of inflammation and patients are at risk of peri-procedural thromboembolic events. Chapter 5 examined inflammatory, myocardial injury and prothrombotic markers in AF patients undergoing catheter ablation during the peri-procedural period. The study demonstrated that patients exhibit an inflammatory response within the first few days post-ablation, and that this response predicted immediate AF recurrence. Prothrombotic markers were elevated one week post-ablation and may contribute to the increased peri-procedural thrombotic risk. Whether catheter ablation for AF…
Advisors/Committee Members: Sanders, Prashanthan (advisor), Willoughby, Scott Richard (advisor), Worthley, Matthew Ian (advisor), School of Medical Sciences (school).
Subjects/Keywords: atrial fibrillation; stroke; thrombogenesis
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Lim, H. S. (2012). Mechanisms of thrombogenesis in atrial fibrillation. (Thesis). University of Adelaide. Retrieved from http://hdl.handle.net/2440/95884
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Lim, Han Sung. “Mechanisms of thrombogenesis in atrial fibrillation.” 2012. Thesis, University of Adelaide. Accessed March 01, 2021.
http://hdl.handle.net/2440/95884.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Lim, Han Sung. “Mechanisms of thrombogenesis in atrial fibrillation.” 2012. Web. 01 Mar 2021.
Vancouver:
Lim HS. Mechanisms of thrombogenesis in atrial fibrillation. [Internet] [Thesis]. University of Adelaide; 2012. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2440/95884.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Lim HS. Mechanisms of thrombogenesis in atrial fibrillation. [Thesis]. University of Adelaide; 2012. Available from: http://hdl.handle.net/2440/95884
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Debrecen
19.
Khojasteh-Del, Milad.
Up-to-date management of atrial fibrillation
.
Degree: DE – Általános Orvostudományi Kar, University of Debrecen
URL: http://hdl.handle.net/2437/195524
► This essay tires to simplify the disease process of atrial fibrillation, classify current subtypes and introduce the most commonly used diagnostic approaches. Furthurmore I discuss…
(more)
▼ This essay tires to simplify the disease process of
atrial fibrillation, classify current subtypes and introduce the most commonly used diagnostic approaches. Furthurmore I discuss in details the most up-to-date drug therapy that are available for patients with
atrial fibrillation with the biggest emphasis on stroke prevention.
Advisors/Committee Members: Pórszász, Róbert (advisor), Farmakológiai és Farmakoterápiai Intézet (advisor).
Subjects/Keywords: Atrial;
fibrillation
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Khojasteh-Del, M. (n.d.). Up-to-date management of atrial fibrillation
. (Thesis). University of Debrecen. Retrieved from http://hdl.handle.net/2437/195524
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Khojasteh-Del, Milad. “Up-to-date management of atrial fibrillation
.” Thesis, University of Debrecen. Accessed March 01, 2021.
http://hdl.handle.net/2437/195524.
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Khojasteh-Del, Milad. “Up-to-date management of atrial fibrillation
.” Web. 01 Mar 2021.
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Vancouver:
Khojasteh-Del M. Up-to-date management of atrial fibrillation
. [Internet] [Thesis]. University of Debrecen; [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2437/195524.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
No year of publication.
Council of Science Editors:
Khojasteh-Del M. Up-to-date management of atrial fibrillation
. [Thesis]. University of Debrecen; Available from: http://hdl.handle.net/2437/195524
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
No year of publication.
University of Plymouth
20.
Davies, Edward John.
Current challenges in atrial fibrillation ablation.
Degree: Thesis (M.D.), 2016, University of Plymouth
URL: http://hdl.handle.net/10026.1/8067
► The ablative management of atrial fibrillation, despite a number of landmark discoveries, remains one of the most challenging fields in interventional electrophysiology. It is generally…
(more)
▼ The ablative management of atrial fibrillation, despite a number of landmark discoveries, remains one of the most challenging fields in interventional electrophysiology. It is generally accepted that successful isolation of the pulmonary veins is a highly effective way of managing paroxysmal forms of AF. However, despite almost a decade of research into alternative lesion patterns, the solution to persistent AF remains beyond our grasp. A variety of strategies have been proposed to target key areas in the atria; these use various complex mapping systems, usually based on tailored lesion sets to try and improve outcomes. None have proven to be the golden bullet. We have investigated the role of a lesion set intended to alter the electrical properties of the posterior wall of the left atrium. Commonly known as the ‘box-set’, this pattern has shown promise in early studies and may provide some key insights into future developments. Surgical ablation using the Epicor system aims to deliver the box-set lesion, outcomes have previously been documented but each series has its limitations. In our series, very late outcomes are reported to show an 80% freedom from AF rate in patients with paroxysmal AF pre-operatively and only 20% in those with long-standing persistent forms. The reason behind this dramatic variation is explored through the invasive electrophysiologal assessment of both successful and unsuccessful cases. We report a clear correlation between the successful isolation of the posterior wall and long-term freedom from AF. Though surgical ablation may be an acceptable approach for some, the ultimate goal is a lesion set that can be delivered purely endocardially. We explore the outcome of one such empirical pattern based on the box-set concept delivered through linear catheter technology and report outcomes broadly similar to alternative patterns.
Subjects/Keywords: 616.1; Atrial Fibrillation; Ablation; Cardiology
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Davies, E. J. (2016). Current challenges in atrial fibrillation ablation. (Doctoral Dissertation). University of Plymouth. Retrieved from http://hdl.handle.net/10026.1/8067
Chicago Manual of Style (16th Edition):
Davies, Edward John. “Current challenges in atrial fibrillation ablation.” 2016. Doctoral Dissertation, University of Plymouth. Accessed March 01, 2021.
http://hdl.handle.net/10026.1/8067.
MLA Handbook (7th Edition):
Davies, Edward John. “Current challenges in atrial fibrillation ablation.” 2016. Web. 01 Mar 2021.
Vancouver:
Davies EJ. Current challenges in atrial fibrillation ablation. [Internet] [Doctoral dissertation]. University of Plymouth; 2016. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10026.1/8067.
Council of Science Editors:
Davies EJ. Current challenges in atrial fibrillation ablation. [Doctoral Dissertation]. University of Plymouth; 2016. Available from: http://hdl.handle.net/10026.1/8067
University of Manchester
21.
Law, Phillip Robert.
Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation.
Degree: PhD, 2011, University of Manchester
URL: https://www.research.manchester.ac.uk/portal/en/theses/tissue-engineering-of-the-human-atrium –
approaching-mechanisms-of-genesis-and-control-of-atrial-fibrillation(18cd949c-6a4d-4c91-8551-a17bb56991ce).html
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529215
► Cardiovascular disease is prevalent across the western world and is a major cause of morbidity and mortality, accounting for approximately a third of all fatalities.…
(more)
▼ Cardiovascular disease is prevalent across the western world and is a major cause of morbidity and mortality, accounting for approximately a third of all fatalities. Investigating the heart by simulating its electrophysiology via the aid of mathematical models has advanced significantly over the past 60 years and is now a well established field. While much of the research focus is placed on the ventricles, the study of the atria is in comparison neglected. Therefore this Thesis is focused on the genesis and maintenance of atrial fibrillation (AF). A series of case studies are performed whereby established biophysically detailed mathematical models are implemented and modified to incorporate electrophysical alterations of atrial cells resulting from a variety of external conditions. The opening section of this Thesis is dedicated to developing a background to the field, including a discussion into the clinical aspect of the diagnosis and management of AF. The suitability of two atrial cell models is discussed and the development of single cell, 1D, 2D, and 3D multi-scale simulation protocols are described in detail. In addition measurements taken to quantify the arrhythmogenic properties of the cells susceptibility to AF are outlined. The second section is focused on the incorporation of conditions thought to enhance atrial tissues ability to initiate and maintain the genesis of AF. Included is a case study into the missence S140G gene mutation, and elevated physiological levels of the hormone Homocystein. The third section investigates the effectiveness of well established and widely used pharmacological treatments such as Beta-Blockers. In addition possible avenues of investigations for the development of atrial specific drugs are explored. These include blocking of the ultra rapid potassium channel and a more novel target for therapy via the targeting of 5HT4 receptors; which is transcribed solely in the atria and alters the electrophysical properties of the L-type Calcium current. The final part of this Thesis is dedicated to the development of a 2D atrial sheet model which includes electrical and spatial heterogeneities via the inclusion of multiple cell types and basic fiber orientation respectively. This allows for an investigation into the role that heterogeneities play in role genesis and maintenance of AF. The main finding of this Thesis is that alterations to the electrophysiology of atrial cells, due to external factors, can be successfully simulated via the implementation of mathematically detailed atrial cell models. It is concluded that simulations of the KENQ1 mutation and elevated levels of Homocystein successfully reproduce conditions which increase the onset of AF. Established treatments such as Beta-Blockers are found to have limited effectiveness. Possible theoretical treatments, such as the blocking of IKur, are found to provide a small amount of therapeutic benefit. In contrast, investigations into the effects of Serotonin were inconclusive. The study into the 2D atria indicated the importance…
Subjects/Keywords: 612.1; Atrial Fibrillation; Cardiac Modeling
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Law, P. R. (2011). Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation. (Doctoral Dissertation). University of Manchester. Retrieved from https://www.research.manchester.ac.uk/portal/en/theses/tissue-engineering-of-the-human-atrium – approaching-mechanisms-of-genesis-and-control-of-atrial-fibrillation(18cd949c-6a4d-4c91-8551-a17bb56991ce).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529215
Chicago Manual of Style (16th Edition):
Law, Phillip Robert. “Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation.” 2011. Doctoral Dissertation, University of Manchester. Accessed March 01, 2021.
https://www.research.manchester.ac.uk/portal/en/theses/tissue-engineering-of-the-human-atrium – approaching-mechanisms-of-genesis-and-control-of-atrial-fibrillation(18cd949c-6a4d-4c91-8551-a17bb56991ce).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529215.
MLA Handbook (7th Edition):
Law, Phillip Robert. “Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation.” 2011. Web. 01 Mar 2021.
Vancouver:
Law PR. Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation. [Internet] [Doctoral dissertation]. University of Manchester; 2011. [cited 2021 Mar 01].
Available from: https://www.research.manchester.ac.uk/portal/en/theses/tissue-engineering-of-the-human-atrium – approaching-mechanisms-of-genesis-and-control-of-atrial-fibrillation(18cd949c-6a4d-4c91-8551-a17bb56991ce).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529215.
Council of Science Editors:
Law PR. Tissue engineering of the human atrium : approaching mechanisms of genesis and control of atrial fibrillation. [Doctoral Dissertation]. University of Manchester; 2011. Available from: https://www.research.manchester.ac.uk/portal/en/theses/tissue-engineering-of-the-human-atrium – approaching-mechanisms-of-genesis-and-control-of-atrial-fibrillation(18cd949c-6a4d-4c91-8551-a17bb56991ce).html ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529215
National University of Ireland – Galway
22.
McGrath, Emer.
Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
.
Degree: 2013, National University of Ireland – Galway
URL: http://hdl.handle.net/10379/5032
► Stroke is a leading cause of adult disability and the third leading cause of mortality in developed countries. Atrial fibrillation is a major risk factor…
(more)
▼ Stroke is a leading cause of adult disability and the third leading cause of mortality in developed countries.
Atrial fibrillation is a major risk factor for ischaemic stroke, associated with a five-fold increase in risk. When patients with
atrial fibrillation suffer an ischaemic stroke, they have a two-fold increased risk of subsequent disability and death, compared to patients without
atrial fibrillation. Oral anticoagulants (e.g. warfarin) reduce the risk of ischaemic stroke in patients with
atrial fibrillation by two-thirds. However, they also increase bleeding risk, most importantly intracerebral haemorrhage.
Employing a number of approaches to statistical analyses, this thesis addresses the following areas: 1) the comparative importance of risk factors for ischaemic stroke and intracerebral haemorrhage in patients with stroke and
atrial fibrillation, with a particular emphasis on risk factors common to both stroke types, 2) the natural history of acute ischaemic stroke in patients with
atrial fibrillation and the clinical factors which explain the association between
atrial fibrillation and increased mortality and disability following acute ischaemic stroke, and 3) the association between different antithrombotic regimens on discharge and risk of major vascular events and bleeding in patients with
atrial fibrillation following acute ischaemic stroke, with a particular focus on patients with severe stroke and those with coronary artery disease. This thesis also evaluates the association between participation in Heartwatch, a risk factor modification program for the secondary prevention of cardiovascular disease, and subsequent risk of stroke and other major vascular events in patients with prior stroke or coronary artery disease.
This content provides novel information which furthers our understanding of the association between
atrial fibrillation and poor stroke outcomes, helps to optimise selection of antithrombotic therapy in patients with
atrial fibrillation, and investigates the potential of Heartwatch as a primary-care based programme for the secondary prevention of stroke and cardiovascular disease.
Advisors/Committee Members: O'Donnell, Martin (advisor).
Subjects/Keywords: Stroke;
Atrial fibrillation;
Medicine
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❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
McGrath, E. (2013). Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
. (Thesis). National University of Ireland – Galway. Retrieved from http://hdl.handle.net/10379/5032
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
McGrath, Emer. “Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
.” 2013. Thesis, National University of Ireland – Galway. Accessed March 01, 2021.
http://hdl.handle.net/10379/5032.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
McGrath, Emer. “Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
.” 2013. Web. 01 Mar 2021.
Vancouver:
McGrath E. Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
. [Internet] [Thesis]. National University of Ireland – Galway; 2013. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10379/5032.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
McGrath E. Atrial fibrillation and stroke: natural history, risk factors and clinical consequences
. [Thesis]. National University of Ireland – Galway; 2013. Available from: http://hdl.handle.net/10379/5032
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
National University of Ireland – Galway
23.
McGrath, E.
Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
.
Degree: 2013, National University of Ireland – Galway
URL: http://hdl.handle.net/10379/3748
► Stroke is a leading cause of adult disability and the third leading cause of mortality in developed countries. Atrial fibrillation is a major risk factor…
(more)
▼ Stroke is a leading cause of adult disability and the third leading cause of mortality in developed countries.
Atrial fibrillation is a major risk factor for ischaemic stroke, associated with a five-fold increase in risk. When patients with
atrial fibrillation suffer an ischaemic stroke, they have a two-fold increased risk of subsequent disability and death, compared to patients without
atrial fibrillation. Oral anticoagulants (e.g. warfarin) reduce the risk of ischaemic stroke in patients with
atrial fibrillation by two-thirds. However, they also increase bleeding risk, most importantly intracerebral haemorrhage.
Employing a number of approaches to statistical analyses, this thesis addresses the following areas: 1) the comparative importance of risk factors for ischaemic stroke and intracerebral haemorrhage in patients with stroke and
atrial fibrillation, with a particular emphasis on risk factors common to both stroke types, 2) the natural history of acute ischaemic stroke in patients with
atrial fibrillation and the clinical factors which explain the association between
atrial fibrillation and increased mortality and disability following acute ischaemic stroke, and 3) the association between different antithrombotic regimens on discharge and risk of major vascular events and bleeding in patients with
atrial fibrillation following acute ischaemic stroke, with a particular focus on patients with severe stroke and those with coronary artery disease. This thesis also evaluates the association between participation in Heartwatch, a risk factor modification program for the secondary prevention of cardiovascular disease, and subsequent risk of stroke and other major vascular events in patients with prior stroke or coronary artery disease.
This content provides novel information which furthers our understanding of the association between
atrial fibrillation and poor stroke outcomes, helps to optimise selection of antithrombotic therapy in patients with
atrial fibrillation, and investigates the potential of Heartwatch as a primary-care based programme for the secondary prevention of stroke and cardiovascular disease.
Advisors/Committee Members: O'Donnell, Martin (advisor).
Subjects/Keywords: Stroke;
Atrial fibrillation;
Medicine
Record Details
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❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
McGrath, E. (2013). Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
. (Thesis). National University of Ireland – Galway. Retrieved from http://hdl.handle.net/10379/3748
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
McGrath, E. “Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
.” 2013. Thesis, National University of Ireland – Galway. Accessed March 01, 2021.
http://hdl.handle.net/10379/3748.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
McGrath, E. “Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
.” 2013. Web. 01 Mar 2021.
Vancouver:
McGrath E. Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
. [Internet] [Thesis]. National University of Ireland – Galway; 2013. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10379/3748.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
McGrath E. Atrial Fibrillation and Stroke: Natural History, Risk Factors and Clinical Consequences
. [Thesis]. National University of Ireland – Galway; 2013. Available from: http://hdl.handle.net/10379/3748
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Debrecen
24.
Kav-Or, Aviv.
Pharmacotherapy of Atrial Fibrillation
.
Degree: DE – Általános Orvostudományi Kar, University of Debrecen
URL: http://hdl.handle.net/2437/280323
► Atrial Fibrillation is the most common cardiac arrhythmia seen in clinical practice worldwide. The current pharmacological treatment is composed of rate control and rhythm control…
(more)
▼ Atrial Fibrillation is the most common cardiac arrhythmia seen in clinical practice worldwide. The current pharmacological treatment is composed of rate control and rhythm control approaches. These are combined with anticoagulation to prevent thromboembolic events. Their clinical uses based on the presence or absence of structural heart disease and their side effects are discussed in this thesis.
Advisors/Committee Members: Porszasz, Robert (advisor), Debreceni Egyetem::Általános Orvostudományi Kar::Farmakológiai és Farmakoterápiai Intézet (advisor).
Subjects/Keywords: Atrial Fibrillation
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APA (6th Edition):
Kav-Or, A. (n.d.). Pharmacotherapy of Atrial Fibrillation
. (Thesis). University of Debrecen. Retrieved from http://hdl.handle.net/2437/280323
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Kav-Or, Aviv. “Pharmacotherapy of Atrial Fibrillation
.” Thesis, University of Debrecen. Accessed March 01, 2021.
http://hdl.handle.net/2437/280323.
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Kav-Or, Aviv. “Pharmacotherapy of Atrial Fibrillation
.” Web. 01 Mar 2021.
Note: this citation may be lacking information needed for this citation format:
No year of publication.
Vancouver:
Kav-Or A. Pharmacotherapy of Atrial Fibrillation
. [Internet] [Thesis]. University of Debrecen; [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2437/280323.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
No year of publication.
Council of Science Editors:
Kav-Or A. Pharmacotherapy of Atrial Fibrillation
. [Thesis]. University of Debrecen; Available from: http://hdl.handle.net/2437/280323
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
No year of publication.
University of Melbourne
25.
Walters, Tomos Evan Rhys.
Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life.
Degree: 2015, University of Melbourne
URL: http://hdl.handle.net/11343/54858
► Atrial fibrillation (AF) exists on a clinical spectrum from paroxysmal to persistent and eventually permanent AF. Progression through this spectrum is well described, but is…
(more)
▼ Atrial fibrillation (AF) exists on a clinical spectrum from paroxysmal to persistent and eventually permanent AF. Progression through this spectrum is well described, but is not universal. Mechanistically, paroxysmal AF is driven by fast electrical triggers most commonly located in the myocardial sleeves of the pulmonary veins, whilst persistent AF is dependent on perpetuating electrical mechanisms rooted in an abnormal atrial substrate. The nature of these mechanisms remains a subject of debate, with recent evidence pointing towards rotors, a form of functional reentry, providing a driving source for human persistent AF. Various studies have ascribed quite different properties to these rotors. More severe abnormalities in the electroanatomic properties of the left atrium (LA) have been demonstrated in persistent than in paroxysmal AF, and improvement in such properties has been described after catheter ablation of AF, but there is little data describing the rate of deterioration in LA properties with ongoing AF, or the key drivers of change. Finally, it is recognized that AF is frequently associated with significant quality of life impairment, but there is a wide spectrum of clinical severity and the factors governing this variation are incompletely understood.
Chapters 2 and 3 of this thesis examine the atrial substrate. The extent of remodeling of the LA is a key determinant of the success of catheter ablation, and so non-invasive techniques with which to assess remodeling are keenly sought. In chapter 2, the association between the extent of LA electroanatomic remodeling and the fibrillatory cycle length derived from lead V1 of the surface electrocardiogram during AF is characterized. It is demonstrated that a longer AF cycle length in lead V1 is associated with more advanced LA remodeling, specifically slower atrial conduction and more extensive electrogram fractionation. Given that gender-based differences in clinical behaviour of multiple cardiac arrhythmias are well described, the presence of systematic gender-based differences in the pulmonary vein and atrial substrate is examined in chapter 3. No such between-gender differences were observed, either in those with or without a history of AF, and with a similar prevalence of AF-related comorbidities seen in both male and female groups.
Chapters 4, 5 and 6 move to an exploration of the electrical mechanisms underlying AF, through detailed epicardial mapping studies of the LA and its junction with the pulmonary vein (PV-LA junction). Chronic stretch is fundamental to atrial remodeling in human AF, and conditions associated with acute stretch are recognized triggers for episodes of AF. In chapter 4 the response of the PV-LA junction to acute stretch was characterized, with the observation that acute stretch results in conduction slowing across the PV-LA junction and a greater degree of signal complexity, providing conditions suitable for reentry. Chapters 5 and 6 involved epicardial mapping in patients with longstanding persistent AF, with the aim of…
Subjects/Keywords: atrial fibrillation; mapping; rotors; remodeling
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APA (6th Edition):
Walters, T. E. R. (2015). Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/54858
Chicago Manual of Style (16th Edition):
Walters, Tomos Evan Rhys. “Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life.” 2015. Doctoral Dissertation, University of Melbourne. Accessed March 01, 2021.
http://hdl.handle.net/11343/54858.
MLA Handbook (7th Edition):
Walters, Tomos Evan Rhys. “Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life.” 2015. Web. 01 Mar 2021.
Vancouver:
Walters TER. Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life. [Internet] [Doctoral dissertation]. University of Melbourne; 2015. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11343/54858.
Council of Science Editors:
Walters TER. Mechanisms and consequences of atrial fibrillation: insights into the electrical mechanisms sustaining atrial fibrillation, the drivers of underlying atrial remodeling, and the factors governing symptom severity and quality of life. [Doctoral Dissertation]. University of Melbourne; 2015. Available from: http://hdl.handle.net/11343/54858
University of Minnesota
26.
Maheshwari, Ankit.
Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score.
Degree: MS, Epidemiology, 2018, University of Minnesota
URL: http://hdl.handle.net/11299/215011
► Introduction: In people with atrial fibrillation (AF), periods of sinus rhythm present an opportunity to detect pro-thrombotic atrial remodeling through measurement of P-wave indices (PWIs)—prolonged…
(more)
▼ Introduction: In people with atrial fibrillation (AF), periods of sinus rhythm present an opportunity to detect pro-thrombotic atrial remodeling through measurement of P-wave indices (PWIs)—prolonged P-wave duration, abnormal P-wave axis, advanced inter-atrial block, and abnormal P-wave terminal force in lead V1. We hypothesized that addition of PWIs to the CHA2DS2-VASc score would improve its ability to predict AF-related ischemic stroke. Methods: We included 2229 Atherosclerosis Risk in Communities (ARIC) study and 700 Multi-Ethnic Study of Atherosclerosis (MESA) participants with incident AF and without anticoagulant use within 1 year of AF diagnosis. PWIs were obtained from study visit ECGs before development of AF. AF was ascertained using study visit ECGs and hospital records. Ischemic stroke cases were based on physician adjudication of hospital records. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of PWIs for ischemic stroke. Improvement in 1-year stroke prediction was assessed by C-statistic, categorical net reclassification improvement (NRI), and relative integrated discrimination improvement (IDI). Results: Abnormal P-wave axis was the only PWI associated with increased ischemic stroke risk (HR, 1.84; 95% CI, 1.33-2.55) independent of CHA2DS2-VASc variables and that resulted in meaningful improvement in stroke prediction. The beta estimate was approximately twice that of the CHA2DS2-VASc variables, thus abnormal P-wave axis was assigned 2 points to create the P2-CHA2DS2-VASc score. This improved the C-statistic (95% CI) from 0.60 (0.51-0.69) to 0.67 (0.60-0.75) in ARIC and 0.68 (0.52-0.84) to 0.75 (0.60-0.91) in MESA (validation cohort). In ARIC and MESA, the categorical NRI (95% CI) were 0.25 (0.13-0.39) and 0.51 (0.18-0.86), respectively, and the relative IDI (95% CI) were 1.19 (0.96-1.44) and 0.82 (0.36-1.39), respectively. Conclusions: Abnormal P-wave axis—an ECG correlate of left atrial abnormality— improves ischemic stroke prediction in AF. Compared with CHA2DS2-VASc, the P2-CHA2DS2-VASc is a better prediction tool for AF-related ischemic stroke.
Subjects/Keywords: atrial fibrillation; p wave; stroke
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APA (6th Edition):
Maheshwari, A. (2018). Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score. (Masters Thesis). University of Minnesota. Retrieved from http://hdl.handle.net/11299/215011
Chicago Manual of Style (16th Edition):
Maheshwari, Ankit. “Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score.” 2018. Masters Thesis, University of Minnesota. Accessed March 01, 2021.
http://hdl.handle.net/11299/215011.
MLA Handbook (7th Edition):
Maheshwari, Ankit. “Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score.” 2018. Web. 01 Mar 2021.
Vancouver:
Maheshwari A. Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score. [Internet] [Masters thesis]. University of Minnesota; 2018. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11299/215011.
Council of Science Editors:
Maheshwari A. Refining Prediction Of Atrial Fibrillation-Related Stroke Using The P2-Cha2Ds2-Vasc Score. [Masters Thesis]. University of Minnesota; 2018. Available from: http://hdl.handle.net/11299/215011
University of Texas – Austin
27.
Hulvershorn, Sarah Elizabeth.
Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation.
Degree: MSin Pharmaceutical Sciences, Pharmaceutical Sciences, 2014, University of Texas – Austin
URL: http://hdl.handle.net/2152/26481
► Objectives: To describe patient characteristics and evaluate costs and outcomes of novel oral anticoagulants compared to clinic-monitored warfarin for the prevention of stroke and systemic…
(more)
▼ Objectives: To describe patient characteristics and evaluate costs and outcomes of novel oral anticoagulants compared to clinic-monitored warfarin for the prevention of stroke and systemic embolism in patients with
atrial fibrillation within the Scott & White Healthcare system. Methods: Patients with
atrial fibrillation, CHADS₂ score ≥ 1, and a prescription claim for dabigatran, rivaroxaban, or warfarin between 2010 and 2012 were evaluated over 12 months. Patients in the warfarin cohort were enrolled in an Anticoagulation Clinic. Patients were matched 1:1 for age, CHADS₂, and gender for comparisons between groups. Baseline characteristics, medication adherence, occurrence of adverse events, and treatment costs were compared using inferential statistics. Anticoagulation control was assessed for patients in the warfarin cohort. Results: 141 and 471 patients met criteria for the novel cohort group and the warfarin group, respectively. After matching, 136 remained in each cohort. Prior to matching, compared to the warfarin cohort, the novel anticoagulant cohort had a higher proportion of male patients (63% versus 49%), and lower average CHADS₂ score (2.65 versus 3.30), while average age in both cohorts was similar (75 years). Matched cohorts had similar adherence rates (88% for novel versus 87% for warfarin). After matching, annual medication cost in 2014 US dollars for dabigatran or rivaroxaban averaged 2,658 (SD 1,494) compared to 1,066 (SD 633) for warfarin, including monitoring costs. Annual total all-cause healthcare costs averaged 23,711 (SD 22,910) for dabigatran or rivaroxaban, compared to 18,248 (SD 24,184) for warfarin. For the 95 warfarin patients with INR values, time in therapeutic range averaged 70.4%. Conclusion: Compared to clinic-monitored warfarin, more men than women were prescribed new oral anticoagulants and these patients averaged a lower CHADS₂ score. After matching, patient adherence was high and comparable between groups. Anticoagulation control for warfarin patients was similar to clinical trials. Annual medication cost was significantly greater for new oral anticoagulants than clinic-monitored warfarin, including INR monitoring costs. Total annual all-cause healthcare costs were significantly greater for patients taking new oral anticoagulants compared to warfarin, although too few adverse events occurred to draw conclusions regarding event rates and costs of ischemic stroke and major bleeds.
Advisors/Committee Members: Rascati, Karen L. (advisor), Wilson, James P. (advisor).
Subjects/Keywords: Atrial fibrillation; Warfarin; Oral anticoagulant
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APA (6th Edition):
Hulvershorn, S. E. (2014). Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation. (Masters Thesis). University of Texas – Austin. Retrieved from http://hdl.handle.net/2152/26481
Chicago Manual of Style (16th Edition):
Hulvershorn, Sarah Elizabeth. “Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation.” 2014. Masters Thesis, University of Texas – Austin. Accessed March 01, 2021.
http://hdl.handle.net/2152/26481.
MLA Handbook (7th Edition):
Hulvershorn, Sarah Elizabeth. “Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation.” 2014. Web. 01 Mar 2021.
Vancouver:
Hulvershorn SE. Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation. [Internet] [Masters thesis]. University of Texas – Austin; 2014. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/2152/26481.
Council of Science Editors:
Hulvershorn SE. Outcomes and direct treatment costs with novel oral anticoagulants compared to clinic-monitored warfarin for stroke prevention in atrial fibrillation. [Masters Thesis]. University of Texas – Austin; 2014. Available from: http://hdl.handle.net/2152/26481
Rutgers University
28.
Swerdel, Joel, 1960-.
Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.
Degree: PhD, Public Health, 2019, Rutgers University
URL: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
► Heart failure (HF) and atrial fibrillation (AF) are chronic diseases with high costs, both in human and monetary terms in the US and the world.…
(more)
▼ Heart failure (HF) and
atrial fibrillation (AF) are chronic diseases with high costs, both in human and monetary terms in the US and the world. While the cost of each disease is high, the cost of the two as comorbid conditions is exceedingly high. To be able to predict, early on, which patients with newly diagnosed AF will go on to develop HF will allow clinicians the opportunity to address the problem and prevent or delay the onset of HF. The goal of this research was to develop predictive models for incident HF in subjects with newly diagnosed AF.
HF is a clinical syndrome wherein the heart is unable to supply sufficient blood flow for the body’s needs. HF can be due to a deficit on either the left or the right side of the heart. Left side HF is the focus of this research. The prevalence of HF is nearly 6 million in the US and over 23 million people worldwide, with yearly costs over 20B in the US and over 100B worldwide. There are 2 types of HF based on the proportion of blood ejected from the left ventricle during systole. Normally, 50-70% of the blood in the left ventricle is ejected during systole. In HF with reduced ejection fraction (HFrEF), the heart ejects less than 40% of the blood volume in the left ventricle during the contractile phase of the cardiac cycle. In HF with preserved ejection fraction (HFpEF), a normal proportion of the ventricular volume is ejected during systole. In this form of HF, the total volume of blood ejected is insufficient for the body’s needs due to lower ventricular filling during diastole, the relaxation phase of the heart cycle.
AF is the most common form of cardiac arrythmia. It is an abnormal
atrial rhythm initiated by ectopic foci in the atria and pulmonary veins and manifested by circular, uncoordinated depolarization of the
atrial muscle, ineffective
atrial contraction, and rapid irregular conduction of depolarizations through the atrioventricular node to the ventricles. Worldwide, it is estimated that AF occurs in about 0.5% or 33.5M people. The rates are higher in the US and western Europe with estimates of 3.3% in men and 2.6% in women.
AF by itself tends to reduce cardiac output and is a risk factor for HF. The function of the atria, which normally aid ventricular filling by contracting just before ventricular systole, is lost; and filling time may be shortened by too rapid a pulse. Over time, tachycardia from the abnormal rhythm may lead to cardiomyopathy which may progress into HF. Outcomes for patients who develop HF after AF are poor. In a study involving the Framingham cohort, the mortality rate in patients with AF who developed HF was 3 times that of subjects who did not develop HF. The ability to predict, early on, those who will develop HF after AF may reduce the health burden from these diseases.
There are many examples of predictive model use in health care. For example, the Charlson index is used to predict mortality using 19 indicators. These models provide additional information for the clinician and the patient on risk assessment…
Advisors/Committee Members: Rhoads, George G (chair), Kostis, William (internal member), Marshall, Elizabeth (internal member), Ryan, Patrick (outside member), School of Graduate Studies.
Subjects/Keywords: Heart failure; Atrial fibrillation
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APA (6th Edition):
Swerdel, Joel, 1. (2019). Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. (Doctoral Dissertation). Rutgers University. Retrieved from https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
Chicago Manual of Style (16th Edition):
Swerdel, Joel, 1960-. “Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.” 2019. Doctoral Dissertation, Rutgers University. Accessed March 01, 2021.
https://rucore.libraries.rutgers.edu/rutgers-lib/60068/.
MLA Handbook (7th Edition):
Swerdel, Joel, 1960-. “Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation.” 2019. Web. 01 Mar 2021.
Vancouver:
Swerdel, Joel 1. Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. [Internet] [Doctoral dissertation]. Rutgers University; 2019. [cited 2021 Mar 01].
Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/.
Council of Science Editors:
Swerdel, Joel 1. Predictive modeling of incident heart failure in subjects with newly diagnosed atrial fibrillation. [Doctoral Dissertation]. Rutgers University; 2019. Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/60068/
University of Melbourne
29.
MEDI, CAROLINE.
The remodelled atrium: causes, and implications for curative ablation.
Degree: 2012, University of Melbourne
URL: http://hdl.handle.net/11343/37296
► Atrial fibrillation has been described as an evolving epidemic in the setting of an aging population. Ongoing research into the atrial substrate responsible for maintaining…
(more)
▼ Atrial fibrillation has been described as an evolving epidemic in the setting of an aging population. Ongoing research into the atrial substrate responsible for maintaining atrial fibrillation is fundamental to therapeutic advances. There have been considerable advances in ablation techniques aimed at treating and potentially curing atrial fibrillation. To date success has been achieved predominantly in patients with paroxysmal atrial fibrillation with structurally normal hearts where presumably the triggers are more important than the substrate. The developments of technology and ablation techniques are currently evolving more rapidly than an understanding of their impact on the remodeled atria. It remains unclear whether “sinus rhythm begets sinus rhythm” a key premise in AF ablation strategies.
The aims of this thesis were to provide important original insights into both the electrical and structural remodeling responsible for atrial arrhythmias; and to the therapeutic implications for a procedure targeting this arrhythmia that is becoming increasingly performed in an expanding patient population.
Hypertension is the most prevalent, independent and potentially modifiable risk factor for atrial fibrillation. In Chapter 2 conventional electrophysiologic studies were performed in patients with hypertension and no prior history of atrial fibrillation. The aim of this study was to gain insight into the underlying substrate before it is modified by the arrhythmia itself. This has been recognized as “atrial remodeling of a different sort”.
In Chapter 3 we studied a population of patients with idiopathic pulmonary hypertension to study the atrial effects of pulmonary hypertension in the absence of the confounding effects of other disease states, such as obstructive sleep apnoea and chronic obstructive pulmonary disease. A better understanding of the atrial effects of pulmonary hypertension may help dissect out the relevant pathophysiologic factors responsible for the vulnerability to AF in these varied clinical conditions.
In Chapter 4 the comparison of atrial substrate changes between patients with atrial fibrillation and atrial flutter are presented. Atrial fibrillation and atrial flutter are the most common sustained arrhythmias seen in clinical practice. Whilst there may be alternate expression of both AF and AFL in an individual patient, clinically one of these arrhythmias often predominates. Although it has been well recognized that both arrhythmias are associated with atrial substrate remodeling, to date there has been no direct comparison of atrial substrate changes in patients with AFL vs. AF.
It has recently been recognized that atrial fibrillation is a risk factor for dementia in an aging population. However, the prevalence of neurocognitive abnormalities in a young low-risk population of…
Subjects/Keywords: atrial fibrillation; atrial arrhythmias; catheter ablation; atrial flutter; atrial tachycardia
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APA (6th Edition):
MEDI, C. (2012). The remodelled atrium: causes, and implications for curative ablation. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/37296
Chicago Manual of Style (16th Edition):
MEDI, CAROLINE. “The remodelled atrium: causes, and implications for curative ablation.” 2012. Doctoral Dissertation, University of Melbourne. Accessed March 01, 2021.
http://hdl.handle.net/11343/37296.
MLA Handbook (7th Edition):
MEDI, CAROLINE. “The remodelled atrium: causes, and implications for curative ablation.” 2012. Web. 01 Mar 2021.
Vancouver:
MEDI C. The remodelled atrium: causes, and implications for curative ablation. [Internet] [Doctoral dissertation]. University of Melbourne; 2012. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/11343/37296.
Council of Science Editors:
MEDI C. The remodelled atrium: causes, and implications for curative ablation. [Doctoral Dissertation]. University of Melbourne; 2012. Available from: http://hdl.handle.net/11343/37296
30.
Hasegawa, Kanae.
A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる.
Degree: 博士（医学）, 2014, Niigata University / 新潟大学
URL: http://hdl.handle.net/10191/27327
► 学位の種類: 博士（医学）. 報告番号: 甲第3861号. 学位記番号: 新大院博（医）甲第601号. 学位授与年月日: 平成26年3月24日
Heart Rhythm. 2014, 11(1), 67-75
Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias,…
(more)
▼ 学位の種類: 博士（医学）. 報告番号: 甲第3861号. 学位記番号: 新大院博（医）甲第601号. 学位授与年月日: 平成26年3月24日
Heart Rhythm. 2014, 11(1), 67-75
Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and in some patients, the disease is inheritable. Hereditary aspects of AF, however, remain not fully elucidated. Objective: The purpose of this study was to identify genetic backgrounds contributed to juvenile-onset AF and to define the mechanism. Methods: In 30 consecutive juvenile-onset AF patients (onset age <50 year-old), we screened AF-related genes (KCNQ1, KCNH2, KCNE1-3 and 5, KCNJ2, and SCN5A). We analyzed the function of mutant channels using whole-cell patch-clamp techniques and computer simulations. Results: Among the juvenile-onset AF patients, we identified three mutations (10%), SCN5A-M1875T, KCNJ2-M301K, and KCNQ1-G229D. Since KCNQ1 variant (G229) identified in a 16-year-old boy was novel, we focused on the proband. The G229D-IKs was found to induce a large instantaneous activating component without deactivation after repolarization to –50 mV. In addition, WT/G229D-IKs (WT and mutant co-expression) displayed both instantaneous and time-dependent activating currents. Compared to WT-IKs, the tail current densities in WT/G229D-IKs were larger at test potentials between –130 and –40 mV, but smaller at test potentials between 20 and 50 mV. Moreover, WT/G229D-IKs resulted in a negative voltage shift for current activation (−35.2 mV) and slower deactivation. WT/G229D-IKs conducted a large outward current Hasegawa et al. A novel KCNQ1 mutation in Juvenile-Onset AF 4 induced by an atrial action potential waveform, and computer simulation incorporating the WT/G229D-IKs results revealed that the mutation shortened atrial but not ventricular action potential. Conclusion: A novel KCNQ1-G229D mutation identified in a juvenile-onset AF patient altered the IKs activity and kinetics, thereby increasing the arrhythmogenicity to AF.
Subjects/Keywords: atrial fibrillation; juvenile-onset atrial fibrillation; ion channel; Iks; KCNQ1
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APA (6th Edition):
Hasegawa, K. (2014). A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる. (Thesis). Niigata University / 新潟大学. Retrieved from http://hdl.handle.net/10191/27327
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Hasegawa, Kanae. “A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる.” 2014. Thesis, Niigata University / 新潟大学. Accessed March 01, 2021.
http://hdl.handle.net/10191/27327.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Hasegawa, Kanae. “A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる.” 2014. Web. 01 Mar 2021.
Vancouver:
Hasegawa K. A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる. [Internet] [Thesis]. Niigata University / 新潟大学; 2014. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10191/27327.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Hasegawa K. A Novel KCNQ1 Missense Mutation Identified in a Patient with Juvenile-Onset Atrial Fibrillation Causes Constitutively Open IKs Channels : 若年性心房細動患者に同定された新たなKCNQ1ミスセンス変異はIKsチャネルを持続的に開口させる. [Thesis]. Niigata University / 新潟大学; 2014. Available from: http://hdl.handle.net/10191/27327
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
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Open Access Theses and Dissertations