RESUMO
Atrial fibrillation (AF), gastroesophageal reflux disease (GERD) and hiatal hernias are commonly seen in clinical practice. GERD and hiatal hernias have been proposed to be a possible cause of AF. In this paper, we will briefly review GERD, AF and hiatal hernias, consider the available literature covering the association between these diseases and provide further insight into the topic in general.
Assuntos
Fibrilação Atrial/etiologia , Refluxo Gastroesofágico/complicações , Hérnia Hiatal/complicações , Feminino , Humanos , Incidência , Masculino , PrevalênciaRESUMO
Atrial Fibrillation (AF) is the most common sustained arrhythmia and 1/6 strokes is attributed to AF. The cornerstone of treatment remains maintaining sinus rhythm or appropriate ventricular rate control in addition to prevention of stroke. Oral anticoagulation therapy (OAC) with vitamin K antagonists (VKAs) has been the gold standard for almost 50 years and a significant reduction in the risk of stroke in patients with AF has been demonstrated. Nonetheless, only 50% of patients with guideline recommendations for OAC treatment actually receive VKAs and half of these will discontinue therapy within 3 to 5 years with only another half achieving therapeutic ranges more than 50% of the time. The aforementioned limitations in addition with frequent blood monitoring have prompted the development of a series of new OAC therapies. The present review focuses on the current pharmacological management for stroke prevention in patients with AF based on current and emerging evidence.
RESUMO
Atrial fibrillation catheter ablation has gained a significant role in the management of the frequent arrhythmia and has been shown to be safe and effective. As with many other interventional therapies, gender bias is present and females are referred for catheter ablation less frequently than their male counterparts. Women referred for catheter ablation tend to be older, more symptomatic, have failed more antiarrhythmic agents and may have poorer procedure success and increased vascular complication rates. Efforts to close this referral gap are clearly needed and it is likely that early referral will reduce gender differences in atrial fibrillation catheter ablation success rates.