Abstract:
:Given the preventable morbidity and mortality associated with atrial fibrillation (AF), increased awareness of undiagnosed AF, and advances in mobile electrocardiogram (ECG) technology, there is a critical need to assess the effectiveness of using such technology to routinely screen for AF in clinical practice. VITAL-AF is a pragmatic trial that will test whether screening for AF using a single-lead handheld ECG in individuals 65 years or older during primary care visits will lead to an increased rate of AF detection. The study is a cluster-randomized trial, with 8 primary care practices randomized to AF screening and 8 primary care practices randomized to usual care. We anticipate studying approximately 16,000 patients in each arm. During the 1-year enrollment period, practice medical assistants will screen eligible patients who agree to participate during office visits using a single-lead ECG device. Automated screening results are documented in the electronic health record, and patients can discuss screening results with their provider during the scheduled visit. All single-lead ECGs are overread by a cardiologist. Screen-detected AF is managed at the discretion of the patient's physician. The primary study end point is incident AF during the screening period. Key secondary outcomes include new oral anticoagulation prescriptions, incident ischemic stroke, and major hemorrhage during a 24-month period following the study start. Outcomes are ascertained based on electronic health record documentation and are manually adjudicated. The results of this pragmatic trial may help identify a model for widespread adoption of AF screening as part of routine clinical practice.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Ashburner JM,Atlas SJ,McManus DD,Chang Y,Trisini Lipsanopoulos AT,Borowsky LH,Guan W,He W,Ellinor PT,Singer DE,Lubitz SAdoi
10.1016/j.ahj.2019.06.011subject
Has Abstractpub_date
2019-09-01 00:00:00pages
147-156eissn
0002-8703issn
1097-6744pii
S0002-8703(19)30156-5journal_volume
215pub_type
杂志文章,多中心研究,随机对照试验abstract::Coronary atherosclerosis may cause acute and chronic ischemic syndromes; the former are caused by "acute plaque events," mostly thrombosis complicating vulnerable ruptured plaques, namely severe lesions with large core, thin cap, and weak shoulder infiltrated by activated inflammatory cells. Plaque rupture may also oc...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70321-2
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:The Amplatzer septal occluder (ASO) allows the percutaneous closure of small to very large atrial septal defects (ASDs). The CardioSEAL/STARflex (CS/SF) can be used only for closure of small to moderate ASDs (stretch size up to 18 mm). These 2 devices are widely used in clinical practice. Therefore, a compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.013
更新日期:2004-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.03.022
更新日期:2012-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2009.02.017
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Three landmark trials involving 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) were published between 1994 and 1996 (the Scandinavian Simvastatin Survival Study [4S], the West of Scotland Coronary Prevention Study, and the Cholesterol and Recurrent Events trial). These trials provided e...
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doi:10.1067/mhj.2001.115587
更新日期:2001-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90118-0
更新日期:1980-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90262-0
更新日期:1986-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2018.06.018
更新日期:2018-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90175-9
更新日期:1993-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90669-z
更新日期:1993-11-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-8703(97)70113-3
更新日期:1997-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90023-x
更新日期:1994-07-01 00:00:00
abstract::Percutaneous coronary interventions have been performed for 20 years. Despite the success and progress of these interventions, abrupt vessel closure has been a dramatic adverse event of coronary interventions. Closure has frequently led to the major complications of death, myocardial infarction, and emergency coronary...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70069-3
更新日期:1997-09-01 00:00:00
abstract::Antiplatelet therapy is the current criterion standard for the treatment of patients undergoing percutaneous coronary intervention and patients who have acute coronary syndromes. Clopidogrel in combination with aspirin is the current standard of care for reducing cardiovascular events in these patients. However, patie...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.06.003
更新日期:2008-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.09.009
更新日期:2011-12-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(99)70262-0
更新日期:1999-07-01 00:00:00
abstract::ECGs taken from four patients with concealed atrial bigeminy were analyzed to find the mechanisms of disappearance and reappearance of extrasystoles. Observations in three patients showing the classic form of concealed bigeminy suggest that when the extrasystole disappeared, the first sinus impulse after the last mani...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90828-7
更新日期:1984-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2014.05.014
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation remains a frequent complication after heart surgery. The optimal strategy to treat the condition has not been established. Several retrospective studies have suggested that a primary rate-control strategy may be equivalent to a strategy that restores sinus rhythm. METHODS:Fifty patients ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2000.111104
更新日期:2000-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80407-3
更新日期:1976-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90025-d
更新日期:1991-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90515-x
更新日期:1983-02-01 00:00:00
abstract::Electrical ablation techniques (ECT) have had limited success in achieving control of arrhythmias originating in the right atrial free wall (RAFW). To ascertain determinants for successful ECT, we studied the clinical and cellular electrophysiologic effects of electrical ablation of the RAFW. After performing electric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90655-7
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Low-molecular weight heparins have different pharmacokinetic and pharmacodynamic characteristics and may vary in efficacy. We compared the efficacy of enoxaparin with that of tinzaparin in the management of non-ST-segment elevation acute coronary syndromes (NSTACS). METHODS:A total of 438 patients with NSTA...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/S0002-8703(03)00179-0
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:ST-elevation myocardial infarctions (STEMI) caused by proximal left-anterior descending (LAD) lesions have more myocardium at risk and worse outcomes than those located in other segments. The aim is to compare outcomes of patients with STEMI and proximal-LAD lesions treated with bare-metal stents (BMS) versu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2013.04.012
更新日期:2013-07-01 00:00:00
abstract::Limited data are available on mitral valve replacement in the elderly patient. Therefore we report our 10-year experience including predictors of perioperative mortality and subsequent long-term cardiac mortality in elderly patients with mitral valve replacement compared to younger patients. Of the 126 consecutive pat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90934-n
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Knowledge of pressure gradients across valves, arteries, and ventricular septal defects (VSD) is important in patient management. It was determined how well such gradients can be estimated by auscultation of a murmur's frequencies. METHODS:In 151 patients with pulmonary stenosis (PS) (n = 77), aortic stenos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113222
更新日期:2001-03-01 00:00:00
abstract::Combination therapy with mexiletine (MEX) and quinidine (Q) may be more efficacious than monotherapy with either drug in suppressing ventricular arrhythmias, but its effects on ventricular performance are not known. Thus, right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) and wall...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(88)90072-5
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Multidisciplinary disease management programs (MDMP) have demonstrated reduced hospitalizations in motivated pretransplant heart failure populations, but little is known about their effectiveness in largely indigent patients who are not transplant candidates. METHODS AND RESULTS:We studied 35 patients with ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.111956
更新日期:2001-02-01 00:00:00
abstract::We have explored the systolic time intervals of 52 patients with angina pectoris at the time of their hospitalization in our wards. Our results are in close agreement with published data, essentially indicating prolongation of the preejection time and shortening of the ejection time. These alterations of systolic time...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90237-5
更新日期:1983-05-01 00:00:00