The DOI matches its Crossref record; 1,040 of the 1,040 references it cites were found in a registry or an index; 35 of the 814 sources its claims cite were checked for support.
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Open accessAbstract
The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC Endorsed by the European Stroke Organisation (ESO) ... ... Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) and by the European Association for Cardio-Thoracic Surgery (EACTS), as well as by other societies and organisations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC website (http://www.escardio.org/Guidelines-&-Education/Clinical-Practice-Guidelines/Guidelines-development/Writing-ESC-Guidelines). ESC Guidelines represent the official position of the ESC on a given topic and are regularly updated.
Overview
AI snapshot
Written from a shortened version of the paper’s full text (it is longer than we read).
TL;DR
This 2016 ESC/EACTS guideline synthesizes evidence and expert consensus for diagnosis, stroke prevention, rate/rhythm control, and integrated care in atrial fibrillation. It recommends oral anticoagulation by CHA₂DS₂-VASc score, NOACs in preference to VKAs when eligible, and symptom-directed rhythm control including catheter or surgical ablation in selected patients.
Key findings
- AF burden is large: in 2010 an estimated 20.9 million men and 12.6 million women had AF worldwide; one in four middle-aged adults in Europe and the US will develop AF; by 2030, 14–17 million AF patients are anticipated in the European Union; 20–30% of ischaemic strokes have AF diagnosed before, during, or after the event.
- Stroke prevention: VKA therapy reduces stroke by two-thirds and mortality by one-quarter versus control; a NOAC meta-analysis (42,411 NOAC and 29,272 warfarin patients) reduced stroke/systemic embolism by 19% (RR 0.81; 95% CI 0.73–0.91), lowered mortality by 10% (RR 0.90; 95% CI 0.85–0.95), halved intracranial haemorrhage (RR 0.48; 95% CI 0.39–0.59), and increased gastrointestinal bleeding (RR 1.25; 95% CI 1.01–1.55). OAC is recommended for men with CHA₂DS₂-VASc ≥2 and women ≥3; NOACs are preferred over VKAs when eligible; antiplatelet monotherapy is not recommended.
- Integrated AF care in an RCT reduced the composite of cardiovascular hospitalization and cardiovascular death over a mean 22 months (14.3% vs 20.8%; HR 0.65; 95% CI 0.45–0.93; P=0.017).
- Catheter ablation is more effective than antiarrhythmic drugs for maintaining sinus rhythm; sinus rhythm without severely symptomatic recurrences is found in up to 70% of paroxysmal AF and around 50% of persistent AF, with severe complications in 5–7%, life-threatening complications in 2–3%, and intraprocedural death <0.2%. Concomitant AF surgery increased freedom from AF/flutter/tachycardia (RR 1.94; 95% CI 1.51–2.49) but also pacemaker implantation (RR 1.69; 95% CI 1.12–2.54).
Methods
- Guideline development by an ESC Task Force including EHRA, EACTS, and ESO representation, based on comprehensive review of published evidence; three PICOT questions were answered by commissioned external systematic reviews, and recommendations were graded by class and level of evidence.
- Draft recommendations were discussed in web-based conference calls, modified by consensus, and voted on online; only recommendations supported by at least 75% of task force members were included.
- Not a primary study: no single sample or dataset; the document is an evidence synthesis and expert consensus guideline reflecting evidence available at the time of writing.
Limitations
- Stated: gaps in evidence include rate control, which is “in dire need of better studies”; rhythm control, integrated AF management, and lifestyle modification are still developing evidence; trials are needed for LAA occlusion, severe CKD/dialysis, anticoagulation for atrial high-rate episodes, OAC after bleeding or stroke, catheter ablation in persistent/long-standing persistent AF, and other areas.
- Stated: some recommendations are based on consensus rather than prospective data, including initiation/continuation of anticoagulation after stroke/TIA and initiation/resumption after intracranial haemorrhage.
- Evident from the text: many recommendations are Class IIa/IIb with Level B/C evidence, and the guideline notes ongoing trials (e.g., EAST, CABANA, AXAFA, RE-CIRCUIT, ARTESiA, NOAH, LAAOS III) that will inform future practice.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Verification
Claims the paper makes
419 Not checked yet · 21 No basis given · 18 Own interpretation · 10 Partly supported · 4 Supported · 3 Supported so far · 1 Mixed support · 1 Own result · accuracy not yet measured
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Short QT syndrome KCNH2 KCNQ1 KCNJ2 CACNA1C CACNB2b IKr IKs IK1 ICa ICa Up to 70% 853, 856-858”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 2172 2173
What the sources say
- Partly supportedcites [853] Antzelevitch, 2007, Loss-of-function mutations in the cardiac calcium channel underlie a new clinical entity characterized by ST-segment elevation, short QT intervals, and sudden cardiac death, Circulation sourceExperimental — accuracy not yet measured
The Discussion says AF occurs in a similar or higher fraction of short-QT cases than the 20%–30% reported for Brugada syndrome. It does not give a 70% figure, so the specific prevalence attributed to this paper is unsupported. (LLM, conf=0.84)
- Not checked yetcites [856] Brugada, 2004, Sudden death associated with short-QT syndrome linked to mutations in HERG, Circulation source
- Not checked yetcites [857] Gaita, 2003, Short QT Syndrome: a familial cause of sudden death, Circulation source
- Disputedcites [858] Giustetto, 2006, Short QT syndrome: clinical findings and diagnostic-therapeutic implications, Eur Heart J sourceExperimental — accuracy not yet measured
The Clinical characteristics section (page unavailable) reports AF or flutter in seven of 29 patients (24%), not a prevalence approaching 70%. It also reports AF as the first clinical manifestation in five patients (17%). (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“AF detection is not uncommon in unselected stroke patients (6.2%, 95% CI 4.4-8.3),128 but is more likely in patients with cryptogenic stroke implanted with loop recorders or who have had ECG monitors for several weeks.18,128,152”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.2.4. Detection of atrial fibrillation in stroke survivors
What the sources say
- Supportedcites [18] Sanna, 2014, Cryptogenic stroke and underlying atrial fibrillation, N Engl J Med source
The Primary End Point (p. 4) reports substantially higher AF detection with an insertable cardiac monitor than with conventional follow-up in patients with cryptogenic stroke. The Discussion (p. 7) also reports AF detection with external ECG monitoring in this population. The 6.2% figure for unselected stroke patients is attached to a different citation, not this source. (LLM, conf=0.88)
- Supportedcites [128] Gladstone, 2014, Atrial fibrillation in patients with cryptogenic stroke, N Engl J Med source
The Detection of Atrial Fibrillation in the Two Groups section reports higher detection with 30-day ECG monitoring than with 24-hour monitoring in patients with cryptogenic stroke or TIA (16.1% versus 3.2%). The discussion also states that studies using implanted devices show monitoring yield increasing beyond 30 days. The paper did not itself test implanted recorders. (LLM, conf=0.90)
- Partly supportedcites [152] Thijs, 2016, Predictors for atrial fibrillation detection after cryptogenic stroke: Results from CRYSTAL AF, Neurology sourceExperimental — accuracy not yet measured
The Abstract reports 30% AF detection within three years among cryptogenic stroke or TIA patients with an insertable cardiac monitor, supporting the loop-recorder part of the claim. The Study design describes ICM monitoring and an initial 24-hour ECG, but does not report AF detection after several weeks of ECG monitoring; that part is unsupported by this paper. (LLM, conf=0.85)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Furthermore, asymptomatic recurrences of AF are common in patients with symptomatic AF. 120”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Atrial fibrillation pattern
What the sources say
- Supportedcites [120] Kirchhof, 2009, Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference ‘research perspectives in AF’, Eur Heart J source
The Research perspectives section (page not supplied) describes asymptomatic AF episodes as prevalent and discusses AF recurrences. Its reference to a study of asymptomatic arrhythmias in patients with symptomatic paroxysmal AF supports the claim's patient context. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“ACE inhibitors or ARBs may reduce recurrent AF after cardioversion when coadministered with antiarrhythmic drug therapy compared with an antiarrhythmic drug alone.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.2.2. Blood pressure control in patients with atrial fibrillation
What the sources say
- Partly supportedcites [248] Madrid, 2002, Use of irbesartan to maintain sinus rhythm in patients with long-lasting persistent atrial fibrillation: a prospective and randomized study, Circulation sourceExperimental — accuracy not yet measured
The Randomization and Follow-Up section compares amiodarone plus irbesartan, an ARB, with amiodarone alone after cardioversion; the Recurrence of Atrial Fibrillation section reports fewer recurrences with the combination. The trial studied irbesartan in patients with long-lasting persistent AF, not ACE inhibitors or ARBs generally, so the broader drug-class claim is not fully supported. No page number is available in our copy. (LLM, conf=0.86)
- Supportedcites [249] Ueng, 2003, Use of enalapril to facilitate sinus rhythm maintenance after external cardioversion of long-standing persistent atrial fibrillation. Results of a prospective and controlled study, Eur Heart J source
The ‘ACE inhibitors and subacute recurrence of atrial fibrillation’ section states that adding enalapril or irbesartan to amiodarone achieves better maintenance of sinus rhythm than amiodarone alone. The ‘Major findings’ section reports fewer recurrences after cardioversion with enalapril; the paper discusses the irbesartan result as a finding of an earlier study. (LLM, conf=0.92)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“AF worsens prognosis in patients with severe valvular heart disease, 256 including those undergoing surgery or transcatheter interventions for aortic or mitral valve disease.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.3. Valvular heart disease
What the sources say
- Not checked yetcites [256] Moretti, 2014, Prognostic significance of atrial fibrillation and severity of symptoms of heart failure in patients with low gradient aortic stenosis and preserved left ventricular ejection fraction, Am J Cardiol source
- Partly supportedcites [257] Ngaage, 2007, Influence of preoperative atrial fibrillation on late results of mitral repair: is concomitant ablation justified?, Ann Thorac Surg sourceExperimental — accuracy not yet measured
The Conclusion (page not supplied) says preoperative AF predicts adverse cardiac events and stroke after mitral regurgitation repair, though it is not an independent predictor of late mortality. The Abstract (page not supplied) mentions prior findings after aortic valve replacement, but this paper does not address transcatheter interventions. The claim therefore extends beyond the procedures supported by our copy. (LLM, conf=0.87)
- Not checked yetcites [258] Ngaage, 2006, Prognostic implications of preoperative atrial fibrillation in patients undergoing aortic valve replacement: is there an argument for concomitant arrhythmia surgery?, Ann Thorac Surg source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Multiple pathophysiological mechanisms can contribute to AF in obstructive sleep apnoea, including autonomic dysfunction, hypoxia, hypercapnia, and inflammation.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
What the sources say
- Not checked yetcites [96] Schotten, 2011, Pathophysiological mechanisms of atrial fibrillation: a translational appraisal, Physiol Rev source
- Not checked yetcites [304] Vizzardi, 2014, Obstructive sleep apnoea-hypopnoea and arrhythmias: new updates, J Cardiovasc Med (Hagerstown)
- Partly supportedcites [305] Digby, 2012, Sleep apnea and atrial fibrillation; 2012 update, Curr Cardiol Rev sourceExperimental — accuracy not yet measured
The Pathophysiology section identifies impaired autonomic control and inflammation as possible links between OSA and AF, and describes a route from apnea-induced hypoxemia to AF. The Introduction lists hypercapnia as a consequence of OSA, but our copy does not identify it specifically as a mechanism contributing to AF. No page numbers are available in our copy. (LLM, conf=0.82)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“TTR on VKA therapy is an important predictor of major haemorrhage.432,441,494”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.3. Labile international normalized ratio and adequate non-vitamin K antagonist oral anticoagulant dosing
What the sources say
- Supportedcites [432] Connolly, 2008, Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range, Circulation source
The Clinical Perspective (p. 2037) says that several reports associate low time in therapeutic range (TTR) with increased major hemorrhage in patients on oral anticoagulants. The paper’s Effect of TTR on Treatment Effect of OAC section also finds that time above the target INR range is associated with significantly increased bleeding. (LLM, conf=0.91)
- Supportedcites [441] Wan, 2008, Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review, Circ Cardiovasc Qual Outcomes source
The Results report a significant negative correlation between time in therapeutic range (TTR) and major hemorrhage rates. The Conclusion explicitly identifies TTR as a predictor of adverse events in anticoagulated patients with atrial fibrillation, the population studied. (LLM, conf=0.93)
- Supportedcites [494] Björck, 2016, Outcomes in a Warfarin-Treated Population With Atrial Fibrillation, JAMA Cardiology source
The Abstract reports a 3.81% annual rate of major bleeding among patients with individual time in therapeutic range (iTTR) below 70%. The iTTR and INR Variability section reports significantly lower risks for every analyzed event among patients with iTTR of at least 70%, supporting TTR as a predictor of major bleeding in this warfarin-treated cohort. Page numbers are not available in our copy. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“As first-line treatment for paroxysmal AF, randomized trials showed only modestly improved rhythm outcome with catheter ablation compared to antiarrhythmic drug therapy.585,[721][722][723]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.1. Indications
What the sources say
- Supportedcites [585] Cosedis Nielsen, 2012, Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation, N Engl J Med source
The Methods describe a randomized comparison of ablation and antiarrhythmic drugs as initial treatment for paroxysmal atrial fibrillation. The Results report no significant difference in cumulative atrial-fibrillation burden over two years, but better rhythm outcomes with ablation at 24 months. This supports the characterization of a modest improvement. (LLM, conf=0.91)
- Supportedcites [721] Hakalahti, 2015, Radiofrequency ablation vs. antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis, Europace source
The Primary clinical outcome section reports that first-line ablation improved freedom from AF recurrence across three randomized trials (RR 0.63, 95% CI 0.44–0.92), while the difference in symptomatic recurrence was not statistically significant. The Abstract says 98.7% of participants had paroxysmal AF. Together, these findings support the citing sentence’s qualified description of the rhythm benefit. (LLM, conf=0.85)
- Supportedcites [722] Morillo, 2014, Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial, JAMA source
The Primary Efficacy Outcome section reports recurrence in 54.5% of the first-line ablation group versus 72.1% of the drug group. The Conclusions section notes that recurrence remained frequent, at approximately 50% after ablation, supporting the characterization of the rhythm improvement as modest. Our copy provides no page numbers for these sections. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“PVI was initially tested in patients with paroxysmal AF, but appears to be non-inferior to more extensive ablation in persistent AF as well.729,735”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.2. Techniques and technologies
What the sources say
- Partly supportedcites [729] McLellan, 2015, A minimal or maximal ablation strategy to achieve pulmonary vein isolation for paroxysmal atrial fibrillation: a prospective multi-centre randomized controlled trial (the Minimax study), Eur Heart J sourceExperimental — accuracy not yet measured
The Abstract reports no statistically significant difference in freedom from AF between minimal and maximal ablation strategies, but all 234 randomized patients had paroxysmal AF, not persistent AF. Both strategies aimed to achieve PVI, and the paper does not establish non-inferiority of PVI against more extensive ablation in persistent AF. (LLM, conf=0.86)
- Supportedcites [735] Verma, 2015, Approaches to catheter ablation for persistent atrial fibrillation, N Engl J Med source
The Methods describe a trial in patients with persistent atrial fibrillation comparing pulmonary-vein isolation (PVI) alone with PVI plus either complex-electrogram or linear ablation. The Results report freedom from recurrent atrial fibrillation at 18 months in 59% of the PVI-alone group, versus 49% and 46% in the additional-ablation groups, with no significant difference (P=0.15). This supports the hedged claim that PVI appears no worse in this comparison, though the paper does not report a formal noninferiority test. (LLM, conf=0.88)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Anticoagulation with NOACs is an alternative to warfarin.478,[761][762][763][764][765]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.4. Anticoagulation -before, during, and after ablation
What the sources say
- Partly supportedcites [478] Heidbuchel, 2013, European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation, Europace sourceExperimental — accuracy not yet measured
The indexed passage under “Stroke Prevention in Non-Valvular Atrial Fibrillation” says that new oral anticoagulants were at least as effective and safe as warfarin for stroke prevention in that population. It does not address anticoagulation for patients undergoing catheter ablation. The passages also appear to be from a different article that lists the EHRA guide in its references, limiting what they establish about the cited guide itself. (LLM, conf=0.76)
- Not checked yetcites [761] Di Biase, 2015, Feasibility and safety of uninterrupted periprocedural apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: Results from a multicenter study, Heart Rhythm source
- Partly supportedcites [762] Hohnloser, 2013, Safety and efficacy of dabigatran etexilate during catheter ablation of atrial fibrillation: a meta-analysis of the literature, Europace sourceExperimental — accuracy not yet measured
The Discussion calls dabigatran, a NOAC, an attractive alternative to vitamin K antagonists during AF ablation and reports similar outcomes to warfarin in the studies reviewed. The paper evaluates dabigatran specifically and says a large-scale trial is still needed to establish the safety and efficacy of dabigatran and other NOACs; it does not establish the claim for NOACs as a class. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
- Probably not a substantial claim. 40
- It may state two separate claims as one. 143
Every source the paper cites for this claim was checked and supports it.
In the paper
“In contemporary, well-controlled, randomized clinical trials in AF, the average annual stroke rate is about 1.5% and the annualized death rate is around 3%. 40”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Supportedcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
The Rationale for the EAST trial (Table I; page not supplied) gives an annualized stroke rate of 1.5% in the active groups across controlled AF trials. The Abstract also describes a residual stroke rate of 1.5% per year in controlled trials. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“There is good evidence that prolonged ECG monitoring enhances the detection of undiagnosed AF, for 72 hours after a stroke, 27,127 for even longer periods, 18,128 or by daily short-term ECG recording in patients over 75 years of age 129 (Web Addenda Figure 1).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.1. Overt and silent atrial fibrillation
What the sources say
- Not checked yetcites [27] Grond, 2013, Improved detection of silent atrial fibrillation using 72-hour Holter ECG in patients with ischemic stroke: a prospective multicenter cohort study, Stroke source
- Not checked yetcites [127] Rizos, 2012, Continuous stroke unit electrocardiographic monitoring versus 24-hour Holter electrocardiography for detection of paroxysmal atrial fibrillation after stroke, Stroke source
- Supportedcites [18] Sanna, 2014, Cryptogenic stroke and underlying atrial fibrillation, N Engl J Med source
This source is cited for monitoring over longer periods, not for 72-hour monitoring or daily short-term recordings in people over 75. The Methods (p. 1) describe long-term monitoring with an insertable cardiac monitor, and the Conclusions (p. 1) state that it was superior to conventional follow-up for detecting atrial fibrillation after cryptogenic stroke. (LLM, conf=0.94)
- Supportedcites [128] Gladstone, 2014, Atrial fibrillation in patients with cryptogenic stroke, N Engl J Med source
This source supports the 'even longer periods' part of the citing sentence. In Detection of Atrial Fibrillation in the Two Groups, 30-day ECG monitoring detected AF more often than 24-hour monitoring (16.1% versus 3.2%). The sentence assigns the 72-hour and daily short-term recording claims to other citations. (LLM, conf=0.93)
- Supportedcites [129] Friberg, 2013, Population screening of 75- and 76-year-old men and women for silent atrial fibrillation (STROKESTOP), Europace source
Citation 129 is attached to the daily short-term ECG recording in older patients, not the separate claims about monitoring after stroke. The Introduction reports that intermittent ECG screening of people aged 75 or 76 revealed 45% more AF than was previously known; the Electrocardiogram monitoring section specifies 30-second recordings twice daily for two weeks. (LLM, conf=0.91)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Approximately 30% of patients with AF have some form of valvular heart disease, often detected only by echocardiography.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.3. Valvular heart disease
What the sources say
- Partly supportedcites [201] Nabauer, 2009, The Registry of the German Competence NETwork on Atrial Fibrillation: Patient characteristics and initial management, Europace sourceExperimental — accuracy not yet measured
The Results (Patient characteristics on admission or at consultation; page unavailable) report valvular heart disease in 36.3% of registry patients with AF, supporting the approximate prevalence claim. The Results (Diagnostic procedures used; page unavailable) list echocardiography use but do not say that valvular disease was often detected only by echocardiography. (LLM, conf=0.87)
- Partly supportedcites [253] Vahanian, 2012, Guidelines on the management of valvular heart disease (version 2012), Eur Heart J sourceExperimental — accuracy not yet measured
Section 3.1.2 (Echocardiography; page unavailable) says echocardiography is key to confirming valvular heart disease. Section 3.5.2 (Arrhythmias; page unavailable) discusses patients with both AF and valvular disease, but neither section gives a 30% prevalence among patients with AF or says the disease is often detected only by echocardiography. (LLM, conf=0.82)
- Not checked yetcites [254] Nishimura, 2014, 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Observational studies have associated digoxin use with excess mortality in AF patients, [547][548][549] but this association is likely due to selection and prescription biases rather than harm caused by digoxin, [550][551][552][553] particularly as digoxin is commonly prescribed to sicker patients.225”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.3. Digitalis
What the sources say
- Supportedcites [550] Gheorghiade, 2013, Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial, Eur Heart J source
The Discussion (page not provided) calls bias by indication a potential explanation for the unadjusted mortality association and reports that patients with heart failure were more likely to receive digoxin. It also argues that higher mortality in prior analyses may reflect treatment being continued in sicker patients rather than a real treatment effect. The matched analysis found no association between digoxin use and mortality. (LLM, conf=0.92)
- Partly supportedcites [551] Flory, 2012, Observational cohort study of the safety of digoxin use in women with heart failure, BMJ Open sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says the association between higher serum digoxin levels and mortality in heart-failure patients could be confounded if more symptomatic patients received higher levels. It does not establish that selection or prescribing bias explains the association between digoxin use and excess mortality in atrial-fibrillation patients, or rule out harm from digoxin. (LLM, conf=0.79)
- Partly supportedcites [552] Andrey, 2011, Mortality and morbidity of heart failure treated with digoxin, A propensity-matched study. Int J Clin Pract sourceExperimental — accuracy not yet measured
The Baseline characteristics section (page unavailable) reports that, before matching, digoxin recipients with heart failure were older and sicker, and that nearly 60% had atrial fibrillation. The Discussion (page unavailable) acknowledges possible selection bias, but the paper does not establish that bias explains excess-mortality associations specifically in AF patients. (LLM, conf=0.82)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“has been shown to reduce LV outflow gradient and improve symptoms in patients with hypertrophic cardiomyopathy.[662][663][664]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.2.1. Selection of antiarrhythmic drugs for long-term therapy: Safety first!
What the sources say
- Supportedcites [662] Sherrid, 2005, Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy, J Am Coll Cardiol source
The Conclusions state that disopyramide reduces LV outflow tract gradients and controls symptoms in the majority of patients with obstructive HCM. The Discussion reports an almost 50% reduction in average resting gradient after three years, with symptoms improving in parallel. The study concerns obstructive HCM specifically. (LLM, conf=0.93)
- Not checked yetcites [663] Sirak, 2008, Oral disopyramide for the acute treatment of severe outflow obstruction in hypertrophic cardiomyopathy in the ICU setting, Chest source
- Partly supportedcites [664] Sherrid, 2013, Treatment of obstructive hypertrophic cardiomyopathy symptoms and gradient resistant to first-line therapy with beta-blockade or verapamil, Circ Heart Fail sourceExperimental — accuracy not yet measured
The Patients and Treatment Paths section reports that disopyramide lowered resting outflow gradients in 221 patients, and that symptoms improved among the 141 managed without septal reduction. The study concerns patients with obstructive hypertrophic cardiomyopathy whose symptoms and gradients were resistant to first-line therapy; the claim does not state those limits. (LLM, conf=0.84)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
In the paper
“Patients undergoing the Cox maze procedure required pacemaker implantation more often (RR 1.69, 95% CI 1.12-2.54;n = 1631 from 17 RCTs), without a detectable difference in other outcomes or complications.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.1. Concomitant atrial fibrillation surgery
What the sources say
- Not checked yetcites [1040]
plaindirectn = 1,631- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Other interventions such as rhythm control and rate control improve AF-related symptoms and may preserve cardiac function, but have not demonstrated a reduction in long-term morbidity or mortality.40,41”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Not checked yetcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
- Not checked yetcites [41] Al-Khatib, 2014, Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Other interventions such as rhythm control and rate control improve AF-related symptoms and may preserve cardiac function, but have not demonstrated a reduction in long-term morbidity or mortality.40,41”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Not checked yetcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
- Not checked yetcites [41] Al-Khatib, 2014, Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review, Ann Intern Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Other interventions such as rhythm control and rate control improve AF-related symptoms and may preserve cardiac function, but have not demonstrated a reduction in long-term morbidity or mortality.40,41”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Not checked yetcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
- Not checked yetcites [41] Al-Khatib, 2014, Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review, Ann Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“AF is independently associated with a twofold increased risk of all-cause mortality in women and a 1.5-fold increase in men [20][21][22] (Table 3).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.2. Morbidity, mortality, and healthcare burden of atrial fibrillation
What the sources say
- Not checked yetcites [20][21][22]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“between 10% and 40% of AF patients are hospitalized each year.23,34,35”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.2. Morbidity, mortality, and healthcare burden of atrial fibrillation
What the sources say
- Not checked yetcites [23] Kotecha, 2014, Efficacy of beta blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis, Lancet source
- Not checked yetcites [34] Steinberg, 2014, Drivers of hospitalization for patients with atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), Am Heart J source
- Not checked yetcites [35] Kirchhof, 2014, Management of patients wtih atrial fibrillation by primary care physicians in Germany: 1-year results of the ATRIUM registry, Clin Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“A minority of these deaths are related to stroke, while sudden cardiac death and death from progressive heart failure are more frequent, emphasizing the need for interventions beyond anticoagulation.43,44”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Not checked yetcites [43] Marijon, 2013, Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study, Circulation source
- Not checked yetcites [44] Senoo, 2015, Residual risk of stroke and death in anticoagulated patients according to the type of atrial fibrillation: AMADEUS Trial, Stroke source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In contemporary, well-controlled, randomized clinical trials in AF, the average annual stroke rate is about 1.5% and the annualized death rate is around 3%. 40”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.3. Impact of evidence-based management on outcomes in atrial fibrillation patients
What the sources say
- Not checked yetcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Contemporary studies show that 20-30% of patients with an ischaemic stroke have AF diagnosed before, during, or after the initial event.17,26,27”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.2. Morbidity, mortality, and healthcare burden of atrial fibrillation
What the sources say
- Not checked yetcites [17] Kishore, 2014, Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis, Stroke source
- Not checked yetcites [26] Henriksson, 2012, Comparison of cardiovascular risk factors and survival in patients with ischemic or hemorrhagic stroke, Int J Stroke source
- Not checked yetcites [27] Grond, 2013, Improved detection of silent atrial fibrillation using 72-hour Holter ECG in patients with ischemic stroke: a prospective multicenter cohort study, Stroke source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Structural remodelling results in electrical dissociation between muscle bundles and local conduction heterogeneities, 85 favouring reentry and perpetuation of the arrhythmia.86”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 4.2.1. Remodelling of atrial structure and ion channel function
What the sources say
- Not checked yetcites [85] Allessie, 2010, Electropathological substrate of long-standing persistent atrial fibrillation in patients with structural heart disease: longitudinal dissociation, Circ Arrhythm Electrophysiol source
- Not checked yetcites [86] Spach, 1994, Initiating reentry: the role of nonuniform anisotropy in small circuits, J Cardiovasc Electrophysiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Bleeding risk on anticoagulation is similar in both sexes, 49,50,53 but women appear less likely to receive specialist care and rhythm control therapy, 54 while the outcomes of catheter ablation or AF surgery are comparable to those in men.55,56”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 3.4. Gender
What the sources say
- Not checked yetcites [54] Roten, 2009, Gender differences in patients referred for atrial fibrillation management to a tertiary center, Pacing Clin Electrophysiol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, even short episodes of AF lead to myocardial damage and expression of prothrombotic factors on the atrial endothelial surface, and activation of platelets and inflammatory cells, and contribute to a generalized prothrombotic state.88,89”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 4.2.1. Remodelling of atrial structure and ion channel function
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Previously undiagnosed AF was found in 1.4% of those aged > 65 years, suggesting a number needed to screen of 70.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.2.1. Screening for atrial fibrillation by electrocardiogram in the community
What the sources say
- Not checked yetcites [134] Lowres, 2013, Screening to identify unknown atrial fibrillation, A systematic review. Thromb Haemost source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Right atrial isthmus-dependent flutter has a typical ECG pattern and ventricular rate.158”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.3. Electrocardiogram detection of atrial flutter
What the sources say
- Not checked yetcites [158] Bun, 2015, Atrial flutter: more than just one of a kind, Eur Heart J source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Consequently, it is unclear whether AHRE imply the same therapeutic requirements as overt AF, 148 and the benefit of OAC in patients with AHRE is being evaluation in ongoing clinical trials (e.g.ARTESiA [NCT01938248] and NOAH [NCT02618577]).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.2.3. Patients with pacemakers and implanted devices
What the sources say
- Not checked yetcites [148] Lamas, 2012, How much atrial fibrillation is too much atrial fibrillation?, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The prevalence of atrial flutter is less than one-tenth of the prevalence of AF. 159”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 5.3. Electrocardiogram detection of atrial flutter
What the sources say
- Not checked yetcites [159] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In a small proportion of patients, AF will remain paroxysmal over several decades (2-3% of AF patients).161”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Atrial fibrillation pattern
What the sources say
- Not checked yetcites [161] Jahangir, 2007, Long-term progression and outcomes with aging in patients with lone atrial fibrillation: a 30-year follow-up study, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The EHRA scale has been used and validated.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 6.3. Symptom burden in atrial fibrillation 644
What the sources say
- Not checked yetcites [194] Kirchhof, 2014, Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF), Europace source
- Not checked yetcites [195] Lip, 2015, Improved outcomes with European Society of Cardiology guideline-adherent antithrombotic treatment in high-risk patients with atrial fibrillation: a report from the EORP-AF General Pilot Registry, Europace source
- Not checked yetcites [196] Freeman, 2015, Association Between Atrial Fibrillation Symptoms, Quality of Life, and Patient Outcomes: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), Circ Cardiovasc Qual Outcomes source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Genetic predisposition (based on multiple common gene variants associated with AF) 64 HR range 0.4-3.2”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [64] Lubitz, 2014, Novel genetic markers associate with atrial fibrillation risk in Europeans and Japanese, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A modification was proposed in 2014, subdividing EHRA class 2 into mild (2a) or moderate (2b) impact.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 6.3. Symptom burden in atrial fibrillation 644
What the sources say
- Not checked yetcites [199] Wynn, 2014, The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification, Europace source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Older age 19 50-59 years 60-69 years 70-79 years 80-89 years HR: 1.00 (reference) 4.98 (95% CI 3.49-7.10) 7.35 (95% CI 5.28-10.2) 9.33 (95% CI 6.68-13.0)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [19] Schnabel, 2015, 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study, Lancet source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“While some AF patients had no or minimal symptoms (25-40%), many (15-30%) reported severe or disabling symptoms.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 6.3. Symptom burden in atrial fibrillation 644
What the sources say
- Not checked yetcites [194] Kirchhof, 2014, Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF), Europace source
- Not checked yetcites [196] Freeman, 2015, Association Between Atrial Fibrillation Symptoms, Quality of Life, and Patient Outcomes: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), Circ Cardiovasc Qual Outcomes source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“AF-related symptoms are most commonly fatigue/tiredness and exertional shortness of breath, or less frequently palpitations and chest pain.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 6.3. Symptom burden in atrial fibrillation 644
What the sources say
- Not checked yetcites [42] Lip, 2014, Prognosis and treatment of atrial fibrillation patients by European cardiologists: one year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry), Eur Heart J source
- Not checked yetcites [194] Kirchhof, 2014, Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF), Europace source
- Not checked yetcites [200] Meinertz, 2011, Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry, Clin Res Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Thyroid dysfunction 206, 207 hypothyroidism subclinical hyperthyroidism overt hyperthyroidism (reference: euthyroid) HR 1.23 (95% CI 0.77-1.97)RR 1.31 (95% CI 1.19-1.44)RR 1.42 (95% CI 1.22-1.63)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [206] Selmer, 2012, The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study, BMJ source
- Not checked yetcites [207] Kim, 2014, Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study), Am Heart J source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Chronic kidney disease 211 none stage 1 or 2 stage 3 stage 4 or 5 OR: 1.00 (reference) 2.67 (95% CI 2.04-3.48)1.68 (95% CI 1.26-2.24)3.52 (95% CI 1.73-7.15)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [211] Baber, 2011, Association of chronic kidney disease with atrial fibrillation among adults in the United States: REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, Circ Arrhythm Electrophysiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Alcohol consumption 213 None 1-6 drinks/week 7-14 drinks/week 15-21 drinks/week > 21 drinks/week RR: 1.00 (reference) 1.01 (95% CI 0.94-1.09)1.07 (95% CI 0.98-1.17)1.14 (95% CI 1.01-1.28)1.39 (95% CI 1.22-1.58)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [213] Larsson, 2014, Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Obesity 19, 208 none (BMI < 25 kg/m²) overweight (BMI 25-30 kg/m²) obese (BMI ≥ 31 kg/m²) HR: 1.00 (reference) 1.13 (95% CI 0.87-1.46)1.37 (95% CI 1.05-1.78)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [19] Schnabel, 2015, 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study, Lancet source
- Not checked yetcites [208] Vermond, 2015, Incidence of atrial fibrillation and relationship with cardiovascular events, heart failure, and mortality: A community-based study from the netherlands, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Smoking 212 never former current HR: 1.00 (reference) 1.32 (95% CI 1.10-1.57)2.05 (95% CI 1.71-2.47)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [212] Chamberlain, 2011, Smoking and incidence of atrial fibrillation: results from the Atherosclerosis Risk in Communities (ARIC) study, Heart Rhythm source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Chronic obstructive pulmonary disease 209 FEV1 ≥ 80% 60-80% < 60% RR: 1.00 (reference) 1.28 (95% CI 0.79-2.06)2.53 (95% CI 1.45-4.42)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7 Detection and management of risk factors and concomitant cardiovascular diseases
What the sources say
- Not checked yetcites [209] Buch, 2003, Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study, Eur Respir J source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Catheter ablation may be a useful method to restore LV function and quality of life in AF patients with HFrEF, 185,[226][227][228] but further data are needed.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Heart failure 683
What the sources say
- Not checked yetcites [185] Jones, 2013, A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure, J Am Coll Cardiol source
- Not checked yetcites [226] Anselmino, 2014, Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis, Circ Arrhythm Electrophysiol source
- Not checked yetcites [227] Ganesan, 2015, Catheter ablation of atrial fibrillation in patients with concomitant left ventricular impairment: a systematic review of efficacy and effect on ejection fraction, Heart Lung Circ source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“For patients who develop HFrEF as a result of rapid AF (tachycardiomyopathy), a rhythm control strategy is preferred, based on several relatively small patient cohorts and trials reporting improved LV function after restoration of sinus rhythm.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Heart failure 683
What the sources say
- Not checked yetcites [185] Jones, 2013, A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure, J Am Coll Cardiol source
- Not checked yetcites [226] Anselmino, 2014, Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis, Circ Arrhythm Electrophysiol source
- Not checked yetcites [227] Ganesan, 2015, Catheter ablation of atrial fibrillation in patients with concomitant left ventricular impairment: a systematic review of efficacy and effect on ejection fraction, Heart Lung Circ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Natriuretic peptide levels are part of the diagnostic assessment of HFpEF, 222 although natriuretic peptide levels are elevated in AF patients and the optimum diagnostic cut-off is still unknown.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.1.2. Atrial fibrillation patients with heart failure with preserved ejection fraction
What the sources say
- Not checked yetcites [222] Ponikowski, 2016, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, Eur Heart J source
- Not checked yetcites [235] Kelly, 2015, Patient selection in heart failure with preserved ejection fraction clinical trials, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, diagnosis is more difficult in patients with AF, as natriuretic peptides are elevated in AF and LA dilatation is common, regardless of concomitant heart failure.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.1.3. Atrial fibrillation patients with heart failure with mid-range ejection fraction
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“The reduced incidence of AF with ACE inhibitors/ARBs is less evident in patients with HFpEF 239 and is lost in patients without heart failure.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.1.4. Prevention of atrial fibrillation in heart failure
What the sources say
- Not checked yetcites [239] Ducharme, 2006, Prevention of atrial fibrillation in patients with symptomatic chronic heart failure by candesartan in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) program, Am Heart J source
- Not checked yetcites [240] GISSI-AF Investigators, 2009, Valsartan for prevention of recurrent atrial fibrillation, N Engl J Med source
- Not checked yetcites [241] Goette, 2012, Angiotensin II-antagonist in paroxysmal atrial fibrillation (ANTIPAF) trial, Circ Arrhythm Electrophysiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Valvular heart disease can be associated with an increased thromboembolic risk, which probably also adds to the stroke risk in AF patients.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.3. Valvular heart disease
What the sources say
- Not checked yetcites [263] Halperin, 1988, Atrial fibrillation and stroke: new ideas, persisting dilemmas, Stroke source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Meta-analyses driven by these studies suggested a lower risk of recurrent AF, [236][237][238]250 but at least one controlled trial failed to demonstrate benefit.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.2.2. Blood pressure control in patients with atrial fibrillation
What the sources say
- Not checked yetcites [236] Schneider, 2010, Prevention of atrial fibrillation by Renin-Angiotensin system inhibition a meta-analysis, J Am Coll Cardiol source
- Not checked yetcites [237] Healey, 2005, Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis, J Am Coll Cardiol source
- Not checked yetcites [238] Jibrini, 2008, Prevention of atrial fibrillation by way of abrogation of the renin-angiotensin system: a systematic review and meta-analysis, Am J Ther source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Diabetes is a risk factor for stroke and other complications in AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.4. Diabetes mellitus
What the sources say
- Not checked yetcites [284] Fatemi, 2014, Impact of intensive glycemic control on the incidence of atrial fibrillation and associated cardiovascular outcomes in patients with type 2 diabetes mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study), Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In patients with AF, a longer duration of diabetes appears to confer a higher risk of thromboembolism, albeit without greater risk of OAC-related bleeding.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.4. Diabetes mellitus
What the sources say
- Not checked yetcites [285] Overvad, 2015, Duration of Diabetes Mellitus and Risk of Thromboembolism and Bleeding in Atrial Fibrillation: Nationwide Cohort Study, Stroke source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“Obese patients may have more LV diastolic dysfunction, increased sympathetic activity and inflammation, and increased fatty infiltration of the atria.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.1. Obesity as a risk factor
What the sources say
- Not checked yetcites [293] Karason, 1999, Heart rate variability in obesity and the effect of weight loss, Am J Cardiol source
- Not checked yetcites [294] Russo, 2011, Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort, J Am Coll Cardiol source
- Not checked yetcites [295] Visser, 1999, Elevated C-reactive protein levels in overweight and obese adults, JAMA source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Obesity may increase the rate of AF recurrence after catheter ablation, [298][299][300][301] with obstructive sleep apnoea as an important potential confounder.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
What the sources say
- Not checked yetcites [298] Cha, 2008, Catheter ablation for atrial fibrillation in patients with obesity, Circulation source
- Not checked yetcites [299] Jongnarangsin, 2008, Body mass index, obstructive sleep apnea, and outcomes of catheter ablation of atrial fibrillation, J Cardiovasc Electrophysiol source
- Not checked yetcites [300] Guijian, 2013, Impact of body mass index on atrial fibrillation recurrence: a meta-analysis of observational studies, Pacing Clin Electrophysiol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Obesity may also be a risk factor for ischaemic stroke, thromboembolism, and death in AF patients.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.1. Obesity as a risk factor
What the sources say
- Not checked yetcites [292] Overvad, 2013, Body mass index and adverse events in patients with incident atrial fibrillation, Am J Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Obesity increases the risk for AF (risk ratio 1.5-1.8),[288][289][290][291] with a progressive increase according to body mass index.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.1. Obesity as a risk factor
What the sources say
- Not checked yetcites [288] Huxley, 2014, Physical activity, obesity, weight change, and risk of atrial fibrillation: the Atherosclerosis Risk in Communities study, Circ Arrhythm Electrophysiol source
- Not checked yetcites [289] Murphy, 2006, Long-term cardiovascular consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study), Eur Heart J source
- Not checked yetcites [290] Wanahita, 2008, Atrial fibrillation and obesity—results of a meta-analysis, Am Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Agents used to relieve bronchospasm, notably theophyllines and betaadrenergic agonists, may precipitate AF and make control of the ventricular response rate difficult.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Beta-1 selective blockers (e.g.bisoprolol, metoprolol, and nebivolol), diltiazem, and verapamil are often tolerated and effective”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients with chronic obstructive pulmonary disease often suffer from atrial tachycardias, which need to be differentiated from AF by ECG.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Risk factor reduction and continuous positive airway pressure ventilation can reduce AF recurrence.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.5.3. Catheter ablation in obese patients
What the sources say
- Not checked yetcites [308] Patel, 2010, Safety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea: the impact of continuous positive airway pressure, Circ Arrhythm Electrophysiol source
- Not checked yetcites [309] Fein, 2013, Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation, J Am Coll Cardiol source
- Not checked yetcites [310] Naruse, 2013, Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: clinical impact of continuous positive airway pressure therapy, Heart Rhythm source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“AF is present in 15-20% of patients with CKD.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 7.7. Chronic kidney disease
What the sources say
- Not checked yetcites [316] Hart, 2013, Stroke prevention in atrial fibrillation patients with chronic kidney disease, Can J Cardiol
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Integrated AF management in an RCT increased the use of evidence-base care and reduced by approximately one-third the composite outcome of cardiovascular hospitalization and cardiovascular death over a mean follow-up of 22 months (14.3% vs. 20.8%,HR 0.65; 95% CI 0.45-0.93;P = 0.017) compared with usual care in a large tertiary care centre.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.1. Evidence supporting integrated atrial fibrillation care
What the sources say
- Not checked yetcites [330] Hendriks, 2012, Nurse-led care vs. usual care for patients with atrial fibrillation: results of a randomized trial of integrated chronic care vs. routine clinical care in ambulatory patients with atrial fibrillation, Eur Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Technology, such as decision support software, has the potential to enhance the implementation of evidencebased care and improve outcomes, when used to enhance expert advice.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.2.4. Technology use to support atrial fibrillation care
What the sources say
- Not checked yetcites [338] Hendriks, 2010, An integrated chronic care program for patients with atrial fibrillation: study protocol and methodology for an ongoing prospective randomised controlled trial, Int J Nurs Stud source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, an Australian RCT showed only a marginal effect on unplanned admissions and death using integrated AF care limited to the initial care period, possibly emphasizing the need for sustained integration of AF care.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.1. Evidence supporting integrated atrial fibrillation care
What the sources say
- Not checked yetcites [332] Stewart, 2015, Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial, Lancet source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Electronic tools can also ensure coherent communication within the AF team.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.2.4. Technology use to support atrial fibrillation care
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“An integrated, structured approach to AF care, as applied successfully to other domains of medicine, 322-324 will facilitate consistent, guideline-adherent AF management for all patients 325 (Figure 6), with the potential to improve outcomes.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8 Integrated management of patients with atrial fibrillation
What the sources say
- Not checked yetcites [322] Page, 2014, A systematic approach to chronic heart failure care: a consensus statement, Med J Aust source
- Not checked yetcites [323] Stock, 2014, Chronic care model strategies in the United States and Germany deliver patient-centered, high-quality diabetes care, Health Aff (Millwood) source
- Not checked yetcites [324] Lundstrom, 2014, The effectiveness of structured personal care of type 2 diabetes on recurrent outcomes: a 19 year follow-up of the study Diabetes Care in General Practice (DCGP), Diabetologia
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Delayed-enhancement MRI of the left atrium using gadolinium contrast, [345][346][347] T1 mapping using cardiac MRI, 347 and intracardiac echo 348 may help to guide treatment decisions in AF, but require external validation in multicentre studies.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.3.2. Additional investigations in selected patients with atrial fibrillation
What the sources say
- Not checked yetcites [345] Mahnkopf, 2014, [Relevance of magnetic resonance imaging for catheter ablation of atrial fibrillation], Herzschrittmacherther Elektrophysiol source
- Not checked yetcites [346] Haemers, 2012, The use of cardiac magnetic resonance imaging in the diagnostic workup and treatment of atrial fibrillation, Cardiol Res Pract source
- Not checked yetcites [347] Ling, 2012, Diffuse ventricular fibrosis in atrial fibrillation: noninvasive evaluation and relationships with aging and systolic dysfunction, J Am Coll Cardiol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Simple, clinically applicable stroke risk-stratification schemes in AF patients were developed in the late 1990s in small cohort studies and have later been refined and validated in larger populations.[364][365][366][367][368]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.1.1. Clinical risk scores for stroke and systemic embolism
What the sources say
- Not checked yetcites [364] The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators, 1998, Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study, JAMA source
- Not checked yetcites [365] Gage, 2001, Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation, JAMA source
- Not checked yetcites [366] van Walraven, 2003, A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin, Arch Intern Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although biomarkers such as natriuretic peptides are elevated in AF patients, there is insufficient data to suggest that blood-based parameters are independent markers for AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.3.1. Recommended evaluation in all atrial fibrillation patients
What the sources say
- Not checked yetcites [341] Filion, 2015, High-sensitivity cardiac troponin T and the risk of incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study, Am Heart J source
- Not checked yetcites [342] Aviles, 2003, Inflammation as a risk factor for atrial fibrillation, Circulation source
- Not checked yetcites [343] Patton, 2009, N-terminal pro-B-type natriuretic peptide is a major predictor of the development of atrial fibrillation: the Cardiovascular Health Study, Circulation source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“OAC therapy can prevent the majority of ischaemic strokes in AF patients and can prolong life.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.5. Defining goals of atrial fibrillation management
What the sources say
- Not checked yetcites [38] Hart, 2007, Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation, Ann Intern Med source
- Not checked yetcites [39] Ruff, 2014, Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials, Lancet source
- Not checked yetcites [42] Lip, 2014, Prognosis and treatment of atrial fibrillation patients by European cardiologists: one year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry), Eur Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Explaining the expected benefits to each patient at the start of AF management will prevent unfounded expectations and has the potential to optimize quality of life.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.5. Defining goals of atrial fibrillation management
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Rhythm control therapy can be successful if symptoms are controlled, even when AF recurs.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.5. Defining goals of atrial fibrillation management
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Transoesophageal echocardiography (TOE) is useful to further assess valvular heart disease and to exclude intracardiac thrombi, especially in the LAA, to facilitate early cardioversion or catheter ablation.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.3.2. Additional investigations in selected patients with atrial fibrillation
What the sources say
- Not checked yetcites [344] Bartel, 2001, Transoesophageal echocardiography for immediate and safe cardioversion in patients with atrial fibrillation, Eur Heart J source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Ambulatory ECG monitoring in AF patients can assess the adequacy of rate control, relate symptoms with AF recurrences, and detect focal induction of bouts of paroxysmal AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 8.3.2. Additional investigations in selected patients with atrial fibrillation
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“VKA therapy reduces risk of stroke by two-thirds and mortality by one-quarter compared with control (aspirin or no therapy).38”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.1. Vitamin K antagonists
What the sources say
- Not checked yetcites [38] Hart, 2007, Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Rates of haemorrhagic stroke and intracranial haemorrhage, but not of ischaemic stroke, were lower on apixaban.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Apixaban
What the sources say
- Not checked yetcites [402] Hylek, 2014, Major bleeding in patients with atrial fibrillation receiving apixaban or warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes, J Am Coll Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“apixaban significantly reduced stroke or systemic embolism by 55% compared with aspirin, with no significant difference in rates of major bleeding or intracranial haemorrhage.354,403”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Apixaban
What the sources say
- Not checked yetcites [354] Connolly, 2011, Apixaban in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [403] Flaker, 2012, Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin: the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment (AVERROES) trial, Stroke source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial, 319 apixaban reduced stroke or systemic embolism by 21% compared with warfarin, combined with a 31% reduction in major bleeding and an 11% reduction in all-cause mortality (all statistically significant).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Apixaban
What the sources say
- Not checked yetcites [319] Granger, 2011, Apixaban versus warfarin in patients with atrial fibrillation, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Dabigatran 110 mg twice daily was non-inferior to warfarin for prevention of stroke and systemic embolism, with 20% fewer major bleeding events.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Dabigatran
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Both dabigatran doses significantly reduced haemorrhagic stroke and intracranial haemorrhage.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Dabigatran
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There was a non-significant numerical increase in the rate of myocardial infarction with both dabigatran doses, 318,404 which has not been replicated in large post-authorization analyses.396”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Dabigatran
What the sources say
- Not checked yetcites [318] Connolly, 2009, Dabigatran versus warfarin in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [404] Connolly, 2010, Newly identified events in the RE-LY trial, N Engl J Med source
- Not checked yetcites [396] Graham, 2015, Cardiovascular, bleeding, and mortality risks in elderly medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Dabigatran 150 mg twice daily significantly reduced ischaemic stroke by 24% and vascular mortality by 12%, while gastrointestinal bleeding was significantly increased by 50%.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Dabigatran
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Rivaroxaban was non-inferior to warfarin for the prevention of stroke and systemic embolism in the intent-to-treat analysis, while the per-protocol on-treatment analysis achieved statistical superiority with a 21% reduction in stroke or systemic embolism compared with warfarin.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Rivaroxaban
What the sources say
- Not checked yetcites [320] Patel, 2011, Rivaroxaban versus warfarin in nonvalvular atrial fibrillation, N Engl J Med source
plaindirectn = 320- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In an on-treatment analysis, edoxaban 60 mg once daily significantly reduced stroke or systemic embolism by 21% and significantly reduced major bleeding events by 20% compared with warfarin”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Edoxaban
What the sources say
- Not checked yetcites [321] Giugliano, 2013, Edoxaban versus warfarin in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [405] Ruff, 2015, Association between edoxaban dose, concentration, anti-Factor Xa activity, and outcomes: an analysis of data from the randomised, double-blind ENGAGE AF-TIMI 48 trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“NOACs in these dosages significantly reduced stroke or systemic embolic events by 19% compared with warfarin (RR 0.81; 95% CI 0.73-0.91;P < 0.0001), mainly driven by a reduction in haemorrhagic stroke (RR 0.49; 95% CI 0.38-0.64;P < 0.0001).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.3. Non-vitamin K antagonist oral anticoagulants or vitamin K antagonists
What the sources say
- Not checked yetcites [39] Ruff, 2014, Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials, Lancet source
plaindirectn = 42,411 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“while edoxaban 30 mg once daily was non-inferior to warfarin for prevention of stroke and systemic embolism but significantly reduced major bleeding events by 53%.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Edoxaban
What the sources say
- Not checked yetcites [321] Giugliano, 2013, Edoxaban versus warfarin in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [405] Ruff, 2015, Association between edoxaban dose, concentration, anti-Factor Xa activity, and outcomes: an analysis of data from the randomised, double-blind ENGAGE AF-TIMI 48 trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Mortality was 10% lower in patients randomized to NOAC therapy (RR 0.90; 95% CI 0.85-0.95;P = 0.0003) and intracranial haemorrhage was halved (RR 0.48; 95% CI 0.39-0.59;P < 0.0001), while gastrointestinal bleeding events were more frequent (RR 1.25; 95% CI 1.01-1.55;P = 0.04).39”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.3. Non-vitamin K antagonist oral anticoagulants or vitamin K antagonists
What the sources say
- Not checked yetcites [39] Ruff, 2014, Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Rivaroxaban did not reduce the rates of mortality, ischaemic stroke, or major bleeding events compared to VKA.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Rivaroxaban
What the sources say
- Not checked yetcites [320] Patel, 2011, Rivaroxaban versus warfarin in nonvalvular atrial fibrillation, N Engl J Med source
plainn = 320- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both VKAs and NOACs are effective for the prevention of stroke in AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.3. Non-vitamin K antagonist oral anticoagulants or vitamin K antagonists
plaindirectn = 42,411- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There was an increase in gastrointestinal bleeding events, but a significant reduction in haemorrhagic stroke and intracranial haemorrhage with rivaroxaban compared with warfarin.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Rivaroxaban
What the sources say
- Not checked yetcites [320] Patel, 2011, Rivaroxaban versus warfarin in nonvalvular atrial fibrillation, N Engl J Med source
plaindirectn = 320- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There are no randomized trials assessing OAC in haemodialysis patients, 418 and no controlled trials of NOACs in patients with severe CKD (CrCl < 25-30 mL/min).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.5. Oral anticoagulation in atrial fibrillation patients on dialysis
What the sources say
- Not checked yetcites [418] Marinigh, 2011, Severe renal impairment and stroke prevention in atrial fibrillation: implications for thromboprophylaxis and bleeding risk, J Am Coll Cardiol source
- Not checked yetcites [318] Connolly, 2009, Dabigatran versus warfarin in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [319] Granger, 2011, Apixaban versus warfarin in patients with atrial fibrillation, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Antiplatelet therapy increases bleeding risk, especially dual antiplatelet therapy (2.0% vs. 1.3% with antiplatelet monotherapy; P < 0.001), 433 with bleeding rates that are similar to those on OAC.354,362,431,434”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.7. Antiplatelet therapy as an alternative to oral anticoagulants
What the sources say
- Not checked yetcites [433] Connolly, 2009, Effect of clopidogrel added to aspirin in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [354] Connolly, 2011, Apixaban in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [362] Mant, 2007, Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Warfarin use was associated either with a neutral or increased risk of stroke in database analyses of patients on dialysis, [419][420][421] including a population-based analysis in Canada (adjusted HR for stroke 1.14; 95% CI 0.78-1.67,adjusted HR for bleeding 1.44; 95% CI 1.13-1.85).422”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.2.5. Oral anticoagulation in atrial fibrillation patients on dialysis
What the sources say
- Not checked yetcites [419] Wizemann, 2010, Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy, Kidney Int source
- Not checked yetcites [420] Chan, 2009, Warfarin use associates with increased risk for stroke in hemodialysis patients with atrial fibrillation, J Am Soc Nephrol source
- Not checked yetcites [421] Winkelmayer, 2011, Effectiveness and safety of warfarin initiation in older hemodialysis patients with incident atrial fibrillation, Clin J Am Soc Nephrol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In these data sets, LAA occlusion was non-inferior to VKA treatment for the prevention of stroke in AF patients with moderate stroke risk, with a possibility of lower bleeding rates in the patients who continued follow-up. 452,453”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.3.1. Left atrial appendage occlusion devices
What the sources say
- Not checked yetcites [452] Reddy, 2014, Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial, JAMA source
- Not checked yetcites [453] Holmes, 2015, Left Atrial Appendage Closure as an Alternative to Warfarin for Stroke Prevention in Atrial Fibrillation: A Patient-Level Meta-Analysis, J Am Coll Cardiol source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Parenteral anticoagulants seem to be associated with a non-significant reduction in recurrent ischaemic stroke when administered 7 to 14 days after the acute stroke (odds ratio [OR] 0.68; 95% CI 0.44-1.06),with a significant increase in symptomatic intracranial bleeding (OR 2.89; 95% CI 1.19-7.01),and a similar rate of death or disability at final follow-up.477”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.4.2. Initiation of anticoagulation after transient ischaemic attack or ischaemic stroke
What the sources say
- Not checked yetcites [477] Paciaroni, 2007, Efficacy and safety of anticoagulant treatment in acute cardioembolic stroke: a meta-analysis of randomized controlled trials, Stroke source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Multiple observational studies indicate the feasibility and safety of surgical LAA occlusion/exclusion, but only limited controlled trial data are available.[461][462][463][464]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.3.2. Surgical left atrial appendage occlusion or exclusion
What the sources say
- Not checked yetcites [461] Budera, 2012, Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study, Eur Heart J source
- Not checked yetcites [462] Healey, 2005, Left Atrial Appendage Occlusion Study (LAAOS): results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke, Am Heart J source
- Not checked yetcites [463] Tsai, 2015, Surgical left atrial appendage occlusion during cardiac surgery for patients with atrial fibrillation: a meta-analysis, Eur J Cardiothorac Surg source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It seems likely that the bleeding risk on parenteral anticoagulation exceeds the stroke prevention benefit in the first days after a large stroke, whereas patients with a TIA or a small stroke may benefit from early (immediate) initiation or continuation of anticoagulation.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.4.2. Initiation of anticoagulation after transient ischaemic attack or ischaemic stroke
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a meta-analysis of 47 studies, the overall incidence of major bleeding with VKAs was 2.1 (range 0.9-3.4) per 100 patient-years in controlled trials and 2.0 (range 0.2-7.6)per 100 patient-years for observational data sets.488”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5. Strategies to minimize bleeding on anticoagulant therapy
What the sources say
- Not checked yetcites [488] Roskell, 2013, Major bleeding in patients with atrial fibrillation receiving vitamin K antagonists: a systematic review of randomized and observational studies, Europace source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The available evidence indicates that anticoagulation in patients with AF can be reinitiated after 4-8 weeks, especially when the cause of bleeding or the relevant risk factor (e.g.uncontrolled hypertension) has been treated, and that such treatment leads to fewer recurrent (ischaemic) strokes and lower mortality.460,484”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.4.3. Initiation of anticoagulation after intracranial haemorrhage
What the sources say
- Not checked yetcites [460] Kuramatsu, 2015, Anticoagulant reversal, blood pressure levels, and anticoagulant resumption in patients with anticoagulation-related intracerebral hemorrhage, JAMA source
- Not checked yetcites [484] Nielsen, 2015, Restarting Anticoagulant Treatment After Intracranial Hemorrhage in Patients With Atrial Fibrillation and the Impact on Recurrent Stroke, Mortality, and Bleeding: A Nationwide Cohort Study, Circulation source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The risk of gastrointestinal bleeds was comparable to warfarin on dabigatran 110 mg twice daily 490 and on apixaban 5 mg twice daily 319”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.2. Previous bleeding event
What the sources say
- Not checked yetcites [490] Eikelboom, 2011, Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial, Circulation source
- Not checked yetcites [319] Granger, 2011, Apixaban versus warfarin in patients with atrial fibrillation, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“NOACs seem to convey slightly better outcomes, mainly driven by fewer intracranial haemorrhages and haemorrhagic strokes (OR 0.44, 95% CI 0.32-0.62).482”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.4.2. Initiation of anticoagulation after transient ischaemic attack or ischaemic stroke
What the sources say
- Not checked yetcites [482] Ntaios, 2012, Nonvitamin-K-antagonist oral anticoagulants in patients with atrial fibrillation and previous stroke or transient ischemic attack: a systematic review and meta-analysis of randomized controlled trials, Stroke source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No prospective studies have investigated the benefit or risk of the initiation of OAC after intracranial haemorrhage, 483 and patients with a history of intracranial bleeding were excluded from the randomized trials comparing NOACs with VKAs.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.4.3. Initiation of anticoagulation after intracranial haemorrhage
What the sources say
- Not checked yetcites [483] Paciaroni, 2014, Should oral anticoagulants be restarted after warfarin-associated cerebral haemorrhage in patients with atrial fibrillation?, Thromb Haemost source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Compared with warfarin, the risk of gastrointestinal bleeds was increased for dabigatran 150 mg twice daily, 396, 490 rivaroxaban 20 mg once daily, 491 and edoxaban 60 mg once daily.321”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.2. Previous bleeding event
What the sources say
- Not checked yetcites [396] Graham, 2015, Cardiovascular, bleeding, and mortality risks in elderly medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation, Circulation source
- Not checked yetcites [490] Eikelboom, 2011, Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial, Circulation source
- Not checked yetcites [491] Goodman, 2014, Factors associated with major bleeding events: insights from the ROCKET AF trial (rivaroxaban once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation), J Am Coll Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Idarucizumab (approved in 2015 by the US Food and Drug Administration and the European Medicines Agency) is a clinically available humanized antibody fragment that binds dabigatran and rapidly and dose-dependently reverses the effects without over-correction or thrombin generation.475”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.7. Bridging periods off oral anticoagulation
What the sources say
- Not checked yetcites [475] Pollack, 2015, Idarucizumab for Dabigatran Reversal, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Genetic testing has little effect on TTR or bleeding risk on warfarin, and is not recommended for clinical use at present.501”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.6. Genetic testing
What the sources say
- Not checked yetcites [501] Tang, 2015, Genotype-Guided Dosing of Coumarin Anticoagulants: A Meta-analysis of Randomized Controlled Trials, J Cardiovasc Pharmacol Ther source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Reinitiation of anticoagulation after a bleeding event is often clinically justified. 460, 510”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 1484
What the sources say
- Not checked yetcites [460] Kuramatsu, 2015, Anticoagulant reversal, blood pressure levels, and anticoagulant resumption in patients with anticoagulation-related intracerebral hemorrhage, JAMA source
- Not checked yetcites [510] Staerk, 2015, Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: Absolute contraindications to long-term OAC after a bleeding episode are rare.
- Rests on an assumption: Many causes or triggers of major bleeding events can be treated and/or eliminated.
In the paper
“In a randomized trial of 1884 patients with AF, interruption of anticoagulation was non-inferior to heparin administration for the outcome of arterial thromboembolism (incidence of 0.4% and 0.3%, respectively) and resulted in a lower risk of major bleeding (1.3% and 3.2%, respectively).502”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.7. Bridging periods off oral anticoagulation
What the sources say
- Not checked yetcites [502] Douketis, 2015, Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation, N Engl J Med source
plaindirectn = 1,884- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Another agent under development is ciraparantag (PER977), an antidote targeted to reverse both direct thrombin and factor Xa inhibitors as well as the indirect inhibitor enoxaparin.509”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.7. Bridging periods off oral anticoagulation
What the sources say
- Not checked yetcites [509] Crowther, 2015, Antidotes for novel oral anticoagulants: current status and future potential, Arterioscler Thromb Vasc Biol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Andexanet alpha, a modified recombinant human factor Xa that lacks enzymatic activity, reverses the anticoagulant activity of apixaban and rivaroxaban in healthy probands within minutes after administration and for the duration of infusion, with a transient increase in markers of coagulation activity of uncertain clinical relevance.508”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.5.7. Bridging periods off oral anticoagulation
What the sources say
- Not checked yetcites [508] Siegal, 2015, Andexanet Alfa for the Reversal of Factor Xa Inhibitor Activity, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Bleeding was lower in the dual versus triple therapy arm, driven by fewer minor bleeding events.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 9.7.1. Antithrombotic therapy after acute coronary syndromes and percutaneous coronary intervention in patients requiring oral anticoagulation
What the sources say
- Not checked yetcites [524] Dewilde, 2013, Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial, Lancet source
plaindirectn = 573- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The study, which included 3066 participants with HFrEF and AF, showed consistency across all subgroups and outcomes, with no heterogeneity between the 10 RCTs included (I 2 = 0%).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.1. Beta-blockers
What the sources say
- Not checked yetcites [23] Kotecha, 2014, Efficacy of beta blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis, Lancet source
plainn = 3,066- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Verapamil or diltiazem can improve arrhythmia-related symptoms, 526 in comparison with beta-blockers, which reduced exercise capacity and increased B-type natriuretic peptide in one small trial of low-risk patients with preserved LVEF.542”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.2. Non-dihydropyridine calcium channel blockers
What the sources say
- Not checked yetcites [542] Ulimoen, 2014, Calcium channel blockers improve exercise capacity and reduce N-terminal Pro-B-type natriuretic peptide levels compared with beta-blockers in patients with permanent atrial fibrillation, Eur Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Beta-adrenoreceptor blocker monotherapy is often the first-line rate-controlling agent, 539 largely based on observations of better acute heart rate control than digoxin.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.1. Beta-blockers
What the sources say
- Not checked yetcites [539] National Institute for Health and Care Excellence (NICE) guidelines
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Similar results were found in a pooled analysis of the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) and RACE trials (1091 participants), albeit with smaller heart rate differences and without randomization.562”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.4. Amiodarone
What the sources say
- Not checked yetcites [562] Van Gelder, 2006, Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies, Europace source
plainn = 1,091- Asserted: passes — The authors put it forward as true.
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In the paper
“In practice, achieving a heart rate < 110 bpm will often require combination therapy (Figure 15).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.4. Amiodarone
plainconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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In the paper
“There was no difference in a composite of clinical events (14.9% in the strict rate control group, 12.9% in the lenient group), 560 NYHA class, or hospitalizations.560, 561”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.4. Amiodarone
What the sources say
- Not checked yetcites [560] Van Gelder, 2010, Lenient versus strict rate control in patients with atrial fibrillation, N Engl J Med source
- Not checked yetcites [561] Groenveld, 2011, The effect of rate control on quality of life in patients with permanent atrial fibrillation: data from the RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation II) study, J Am Coll Cardiol source
plainn = 614- Asserted: passes — The authors put it forward as true.
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In the paper
“It is a relatively simple procedure with a low complication rate and low long-term mortality risk, 563,564 especially when the pacemaker is implanted a few weeks before the AV nodal ablation and the initial pacing rate after ablation is set at 70-90 bpm.565,566”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.4. Atrioventricular node ablation and pacing
What the sources say
- Not checked yetcites [563] Queiroga, 2003, Ablate and pace revisited: long term survival and predictors of permanent atrial fibrillation, Heart source
- Not checked yetcites [564] Lim, 2007, Ablate and pace strategy for atrial fibrillation: long-term outcome of AIRCRAFT trial, Europace source
- Not checked yetcites [565] Geelen, 1997, Ventricular fibrillation and sudden death after radiofrequency catheter ablation of the atrioventricular junction, Pacing Clin Electrophysiol source
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In the paper
“The procedure does not worsen LV function 567 and may even improve LVEF in selected patients.[568][569][570]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.4. Atrioventricular node ablation and pacing
What the sources say
- Not checked yetcites [567] Chatterjee, 2012, Atrioventricular nodal ablation in atrial fibrillation: a meta-analysis and systematic review, Circ Arrhythm Electrophysiol source
- Not checked yetcites [568] Bradley, 2007, Overview of management of atrial fibrillation in symptomatic elderly patients: pharmacologic therapy versus AV node ablation, Clin Pharmacol Ther source
- Not checked yetcites [569] Wood, 2000, Clinical outcomes after ablation and pacing therapy for atrial fibrillation : a meta-analysis, Circulation source
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In the paper
“In some patients in heart failure treated with biventricular pacing (cardiac resynchronization therapy), AF can terminate, 571 although such a 'rhythm control' effect of cardiac resynchronization therapy is likely to be small and clearly needs confirmation.572”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.4. Atrioventricular node ablation and pacing
What the sources say
- Not checked yetcites [572] Hoppe, 2006, Effect of cardiac resynchronization on the incidence of atrial fibrillation in patients with severe heart failure, Circulation source
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“It is worthwhile to note that many 'adequately ratecontrolled' patients (resting heart rate 60-100 bpm) are severely symptomatic, calling for additional management.194”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 10.2.4. Amiodarone
What the sources say
- Not checked yetcites [194] Kirchhof, 2014, Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF), Europace source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Quinidine and disopyramide have been associated with an increase in all-cause mortality (OR 2.39; 95% CI 1.03-5.59;number needed to harm 109; 95% CI 34-4985) at 1-year follow-up, 580, 661 likely due to ventricular arrhythmias (torsades de pointes).580,661”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.2.1. Selection of antiarrhythmic drugs for long-term therapy: Safety first!
What the sources say
- Not checked yetcites [580] Lafuente-Lafuente, 2012, Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation, Cochrane Database Syst Rev
- Not checked yetcites [661] Freemantle, 2011, Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation, Europace source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The antianginal compound ranolazine inhibits potassium and sodium currents and increases glucose metabolism at the expense of free fatty acid metabolism, thereby enhancing efficient use of oxygen.676, 677”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.2.3. New antiarrhythmic drugs
What the sources say
- Not checked yetcites [676] Schram, 2004, Ranolazine: ion-channel-blocking actions and in vivo electrophysiological effects, Br J Pharmacol source
- Not checked yetcites [677] McCormack, 1996, Ranolazine stimulates glucose oxidation in normoxic, ischemic, and reperfused ischemic rat hearts, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but this finding may be driven by the beneficial effect of rate control, which will render AF more often asymptomatic.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.2.4. Antiarrhythmic effects of non-antiarrhythmic drugs
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“Amiodarone is more effective in preventing AF recurrences than other antiarrhythmic drugs but extracardiac toxic effects are common and increase with time.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.2.4. Antiarrhythmic effects of non-antiarrhythmic drugs
What the sources say
- Not checked yetcites [596] Chevalier, 2003, Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis, J Am Coll Cardiol source
- Not checked yetcites [597] Letelier, 2003, Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis, Arch Intern Med source
- Not checked yetcites [598] Khan, 2003, Amiodarone for pharmacological cardioversion of recent-onset atrial fibrillation, Int J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“This is primarily achieved through isolation of the pulmonary veins, probably requiring complete isolation for full effectiveness, 716”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3. Catheter ablation 1915
What the sources say
- Not checked yetcites [716] Kuck, 2016, Impact of Complete Versus Incomplete Circumferential Lines Around the Pulmonary Veins During Catheter Ablation of Paroxysmal Atrial Fibrillation: Results From the Gap-Atrial Fibrillation-German Atrial Fibrillation Competence Network 1 Trial, Circ Arrhythm Electrophysiol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“achievable by point-by-point radiofrequency ablation, linear lesions encircling the pulmonary veins, or cryoballoon ablation, with similar outcomes.[732][733][734]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.2. Techniques and technologies
What the sources say
- Not checked yetcites [732] Luik, 2015, Cryoballoon Versus Open Irrigated Radiofrequency Ablation in Patients With Paroxysmal Atrial Fibrillation: The Prospective, Randomized, Controlled, Noninferiority FreezeAF Study, Circulation source
- Not checked yetcites [733] Schmidt, 2014, Cryoballoon versus RF ablation in paroxysmal atrial fibrillation: results from the German Ablation Registry, J Cardiovasc Electrophysiol source
- Not checked yetcites [734] Kuck, 2016, Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There is no current indication for catheter ablation to prevent cardiovascular outcomes (or desired withdrawal of anticoagulation), or to reduce hospitalization.40,594”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.1. Indications
What the sources say
- Not checked yetcites [40] Kirchhof, 2013, Improving outcomes in patients with atrial fibrillation: rationale and design of the Early treatment of Atrial fibrillation for Stroke prevention Trial, Am Heart J source
- Not checked yetcites [594] ClinicalTrials.gov, Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial (CABANA)
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Extended ablation procedures (beyond PVI) consistently require longer procedures and more ionizing radiation, potentially creating risk for patients.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.2. Techniques and technologies
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In the paper
“but may occur in up to 25% of patients after left atrial substrate modification ablation, often due to incomplete ablation lines.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.2. Techniques and technologies
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Five to seven per cent of patients will suffer severe complications after catheter ablation of AF, and 2-3% will experience life-threatening but usually manageable complications.727,[748][749][750]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Complications of catheter ablation for AF
What the sources say
- Not checked yetcites [727] Cappato, 2010, Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation, Circ Arrhythm Electrophysiol source
- Not checked yetcites [748] Dagres, 2009, Complications of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern?, J Cardiovasc Electrophysiol source
- Not checked yetcites [749] Deneke, 2015, Silent cerebral events/lesions related to atrial fibrillation ablation: a clinical review, J Cardiovasc Electrophysiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“Sinus rhythm without severely symptomatic recurrences of AF is found in up to 70% of patients with paroxysmal AF, and around 50% in persistent AF. 713,728,735,1042”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.3. Outcome and complications
What the sources say
- Not checked yetcites [713] Calkins, 2009, Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses, Circ Arrhythm Electrophysiol source
- Not checked yetcites [728] Ganesan, 2013, Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis, J Am Heart Assoc source
- Not checked yetcites [735] Verma, 2015, Approaches to catheter ablation for persistent atrial fibrillation, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Multiple variables have been identified as risk factors for recurrence after catheter ablation of AF, but their predictive power is weak.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.3. Outcome and complications
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In general, better rhythm outcome and lower procedure-related complications can be expected in younger patients with a short history of AF and frequent, short AF episodes in the absence of significant structural heart disease.745”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.3. Outcome and complications
What the sources say
- Not checked yetcites [745] Lee, 2011, Low risk of major complications associated with pulmonary vein antral isolation for atrial fibrillation: results of 500 consecutive ablation procedures in patients with low prevalence of structural heart disease from a single center, J Cardiovasc Electrophysiol
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The most important severe complications are stroke/TIA (< 1%), cardiac tamponade (1-2%), pulmonary vein stenosis, and severe oesophageal injury leading to atrio-oesophageal fistula weeks after ablation (Table 18).”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Complications of catheter ablation for AF
What the sources say
- Not checked yetcites Table 18
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Post-procedure complications include stroke, with the highest risk within the first week, 753 late pericardial tamponade several days after catheter ablation, 751 and oesophageal fistulas, which usually become apparent 7-30 days after ablation.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > Complications of catheter ablation for AF
What the sources say
- Not checked yetcites [753] Kosiuk, 2014, Early cerebral thromboembolic complications after radiofrequency catheter ablation of atrial fibrillation: incidence, characteristics, and risk factors, Heart Rhythm source
- Not checked yetcites [751] Cappato, 2011, Delayed cardiac tamponade after radiofrequency catheter ablation of atrial fibrillation: a worldwide report, J Am Coll Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Thereby, the Cox maze procedure creates an electrical labyrinth (maze) of passages through which the sinoatrial node impulse finds a route to the atrioventricular node while preventing fibrillatory conduction.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.1. Concomitant atrial fibrillation surgery
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“and reduced hospitalizations, 720, 777 especially in patients without a previous myocardial infarction.780”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.3.5. Ablation of atrial fibrillation in heart failure patients
What the sources say
- Not checked yetcites [720] Al Halabi, 2015, Catheter Ablation for Atrial Fibrillation in Heart Failure Patients: A Meta-Analysis of Randomized Controlled Trials, JACC Clin Electrophysiol source
- Not checked yetcites [777] Di Biase, Ablation vs. Amiodarone for Treatment of Persistent Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted Device: Results From the AATAC Multicenter Randomized Trial, Circulation
- Not checked yetcites [780] Dagres, 2011, Catheter ablation for atrial fibrillation in patients with left ventricular systolic dysfunction. A systematic review and meta-analysis, J Card Fail source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Predictors of AF recurrence after surgery include left atrial dilatation, older age, > 10-year history of AF, and non-paroxysmal AF. [800][801][802][803][804]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.1. Concomitant atrial fibrillation surgery
What the sources say
- Not checked yetcites [800] Chen, 2004, Preoperative atrial size predicts the success of radiofrequency maze procedure for permanent atrial fibrillation in patients undergoing concomitant valvular surgery, Chest source
- Not checked yetcites [801] Sunderland, 2011, What size of left atrium significantly impairs the success of maze surgery for atrial fibrillation?, Interact Cardiovasc Thorac Surg source
- Not checked yetcites [802] Chaiyaroj, 2008, Predictors of sinus rhythm after radiofrequency maze and mitral valve surgery, Asian Cardiovasc Thorac Ann source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Although preliminary experience with hybrid simultaneous ablation shows promise, procedural time and rates of bleeding complications are higher.812, 823”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.2. Stand-alone rhythm control surgery
What the sources say
- Not checked yetcites [812] Krul, 2011, Thoracoscopic video-assisted pulmonary vein antrum isolation, ganglionated plexus ablation, and periprocedural confirmation of ablation lesions: first results of a hybrid surgical-electrophysiological approach for atrial fibrillation, Circ Arrhythm Electrophysiol source
- Not checked yetcites [823] La Meir, 2013, Minimally invasive surgical treatment of lone atrial fibrillation: early results of hybrid versus standard minimally invasive approach employing radiofrequency sources, Int J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“The average length of hospital stay for thoracoscopic ablation varies from 3.6 to 6.0 days.468,812,813”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.2. Stand-alone rhythm control surgery
What the sources say
- Not checked yetcites [468] Boersma, 2012, Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST): a 2-center randomized clinical trial, Circulation source
- Not checked yetcites [812] Krul, 2011, Thoracoscopic video-assisted pulmonary vein antrum isolation, ganglionated plexus ablation, and periprocedural confirmation of ablation lesions: first results of a hybrid surgical-electrophysiological approach for atrial fibrillation, Circ Arrhythm Electrophysiol source
- Not checked yetcites [813] La Meir, 2012, The hybrid approach for the surgical treatment of lone atrial fibrillation: one-year results employing a monopolar radiofrequency source, J Cardiothorac Surg source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Current technology (e.g.bipolar radiofrequency or cryothermy) renders the procedure easier and more reproducible and feasible via a mini-thoracotomy.786,807,808”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.4.2. Stand-alone rhythm control surgery
What the sources say
- Not checked yetcites [786] Basu, 2012, How effective is bipolar radiofrequency ablation for atrial fibrillation during concomitant cardiac surgery?, Interact Cardiovasc Thorac Surg source
- Not checked yetcites [807] Saint, 2012, Cox-Maze IV results for patients with lone atrial fibrillation versus concomitant mitral disease, Ann Thorac Surg source
- Not checked yetcites [808] Lawrance, 2014, A minimally invasive Cox maze IV procedure is as effective as sternotomy while decreasing major morbidity and hospital stay, J Thorac Cardiovasc Surg source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“AF has many different drivers, which are only partially targeted by antiarrhythmic drug or catheter ablation.96”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 12 Hybrid rhythm control therapy
What the sources say
- Not checked yetcites [96] Schotten, 2011, Pathophysiological mechanisms of atrial fibrillation: a translational appraisal, Physiol Rev source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Many of the published series of patients undergoing AF ablation included those who failed antiarrhythmic drug therapy.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 11.5. Choice of rhythm control following treatment failure
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“In selected patients with sick sinus syndrome and fast ventricular response during AF paroxysms requiring rate control therapy, the addition of a pacemaker not only optimizes rate control but may also help to control rhythm.711,712”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 12.2. Combining antiarrhythmic drugs and pacemakers
What the sources say
- Not checked yetcites [711] Andersen, 1997, Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome, Lancet source
- Not checked yetcites [712] Connolly, 2000, Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes. Canadian Trial of Physiologic Pacing Investigators, N Engl J Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Elderly AF patients are at higher risk of stroke and thus are more likely to benefit from OAC than younger patients, 841”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.1. Frail and 'elderly' patients
What the sources say
- Not checked yetcites [841] Marinigh, 2010, Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis, J Am Coll Cardiol source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Long QT syndrome KCNQ1 KCNH2 SCN5A ANK2 others IKs IKr INa INa,K Various effects 5-10% 846-850”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 2172 2173
What the sources say
- Not checked yetcites [846] Johnson, 2008, Prevalence of early-onset atrial fibrillation in congenital long QT syndrome, Heart Rhythm source
- Not checked yetcites [847] Kirchhof, 2003, Prolonged atrial action potential durations and polymorphic atrial tachyarrhythmias in patients with long QT syndrome, J Cardiovasc Electrophysiol source
- Not checked yetcites [848] Zellerhoff, 2009, Atrial Arrhythmias in long-QT syndrome under daily life conditions: a nested case control study, J Cardiovasc Electrophysiol source
- Not checked yetcites [849] Moss, 1995, ECG T-wave patterns in genetically distinct forms of the hereditary long QT syndrome, Circulation source
- Not checked yetcites [850] Schwartz, 2001, Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“AF prevalence ranges from 5% to 20% in patients with long QT syndrome or Brugada syndrome, and is up to 70% in short QT syndrome (Table 20).853,[856][857][858]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.2.3. Channelopathies and arrhythmogenic right ventricular cardiomyopathy
What the sources say
- Not checked yetcites [853] Antzelevitch, 2007, Loss-of-function mutations in the cardiac calcium channel underlie a new clinical entity characterized by ST-segment elevation, short QT intervals, and sudden cardiac death, Circulation source
- Not checked yetcites [856] Brugada, 2004, Sudden death associated with short-QT syndrome linked to mutations in HERG, Circulation source
- Not checked yetcites [857] Gaita, 2003, Short QT Syndrome: a familial cause of sudden death, Circulation source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“While there is more experience with VKAs, there are no data to suggest that NOACs cannot be used in these patients.845”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 2172 2173
What the sources say
- Not checked yetcites [845] Elliott, 2014, 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC), Eur Heart J source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Hypertrophic cardiomyopathy Sarcomeric genes 5-15% 862-864”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 2172 2173
What the sources say
- Not checked yetcites [862] Lee, 2007, Clinical characteristics and outcomes of hypertrophic cardiomyopathy in Taiwan—a tertiary center experience, Clin Cardiol source
- Not checked yetcites [863] Losi, 2004, Determinants of atrial fibrillation development in patients with hypertrophic cardiomyopathy, Am J Cardiol source
- Not checked yetcites [864] Maron, 2002, Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy, J Am Coll Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Detraining can reduce AF in models 904 and reduces ventricular arrhythmias in athletes, 907”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.3. Sports and atrial fibrillation
What the sources say
- Not checked yetcites [904] Guasch, 2013, Atrial fibrillation promotion by endurance exercise: demonstration and mechanistic exploration in an animal model, J Am Coll Cardiol source
- Not checked yetcites [907] Biffi, 2011, Patterns of ventricular tachyarrhythmias associated with training, deconditioning and retraining in elite athletes without cardiovascular abnormalities, Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Physical activity improves cardiovascular health, which translates into a lower risk of AF. 898”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.3. Sports and atrial fibrillation
What the sources say
- Not checked yetcites [898] Mozaffarian, 2008, Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Electrical cardioversion can be effective for restoration of sinus rhythm when tachyarrhythmia is causing haemodynamic instability, with low rates of adverse outcomes for both mother and foetus.921”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.4.2. Rhythm control
What the sources say
- Not checked yetcites [921] Tromp, 2011, Electrical cardioversion during pregnancy: safe or not?, Neth Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“AF is common after cardiac surgery (occurring in 15-45% of patients), [924][925][926]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5. Postoperative atrial fibrillation
What the sources say
- Not checked yetcites [924] Ahlsson, 2007, Postoperative atrial fibrillation is not correlated to C-reactive protein, Ann Thorac Surg source
- Not checked yetcites [925] Arsenault, 2013, Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery, Cochrane Database Syst Rev
- Not checked yetcites [926] Mathew, 2004, A multicenter risk index for atrial fibrillation after cardiac surgery, JAMA source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and is associated with increased length of hospital stay and higher rates of complications and mortality.927”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5. Postoperative atrial fibrillation
What the sources say
- Not checked yetcites [927] Steinberg, 2014, Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry, Clin Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“None of the agents are teratogenic, but they readily cross the placenta.914”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.4.1. Rate control
What the sources say
- Not checked yetcites [914] Page, 1995, Treatment of arrhythmias during pregnancy, Am Heart J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Diltiazem will be present at high levels and should be considered second-line treatment.918”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.4.1. Rate control
What the sources say
- Not checked yetcites [918] Joint Formulary Committee, British National Formulary (online)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Low-molecular-weight heparins are a safe substitute, as they do not cross the placenta.923”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.4.3. Anticoagulation
What the sources say
- Not checked yetcites [923] Bates, 2012, VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, Chest source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“They are associated with heart failure, syncope, thromboembolic events, and sudden death.[963][964][965][966][967]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6. Atrial arrhythmias in grown-up patients with congenital heart disease
What the sources say
- Not checked yetcites [963] Triedman, 2002, Arrhythmias in adults with congenital heart disease, Heart source
- Not checked yetcites [964] Ammash, 2012, Outcome of direct current cardioversion for atrial arrhythmias in adults with congenital heart disease, Int J Cardiol source
- Not checked yetcites [965] Greason, 2003, Surgical management of atrial tachyarrhythmias associated with congenital cardiac anomalies: Mayo Clinic experience, Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Intracardiac thrombi are common in GUCH patients undergoing cardioversion for AF, but also in patients with atrial tachycardias or atrial flutter.970”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.1. General management of atrial arrhythmias in grown-up patients with congenital heart disease
What the sources say
- Not checked yetcites [970] Feltes, 1994, Transesophageal echocardiographic detection of atrial thrombi in patients with nonfibrillation atrial tachyarrhythmias and congenital heart disease, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Postoperative AF is associated with an increased early stroke risk, increased morbidity, and 30-day mortality.927,951,952”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5.2. Anticoagulation
What the sources say
- Not checked yetcites [927] Steinberg, 2014, Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry, Clin Cardiol source
- Not checked yetcites [951] LaPar, 2014, Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs, Ann Thorac Surg source
- Not checked yetcites [952] Saxena, 2012, Usefulness of postoperative atrial fibrillation as an independent predictor for worse early and late outcomes after isolated coronary artery bypass grafting (multicenter Australian study of 19,497 patients), Am J Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“underpinning that the aim of rhythm control therapy should be to improve AF-related symptoms in postoperative AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5.3. Rhythm control therapy in postoperative atrial fibrillation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Atrial flutter and fibrillation occur in 14-22% of adults with unoperated atrial septal defects, especially in older patients, 971 and can lead to heart failure. 972”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.2. Atrial tachyarrhythmias and atrial septal defects
What the sources say
- Not checked yetcites [971] Nagao, 1995, [Studies on atrial arrhythmias in atrial septal defect. The influences of aging on atrial fibrillation], Nihon Ronen Igakkai Zasshi source
- Not checked yetcites [972] Giamberti, 2008, Surgical treatment of arrhythmias in adults with congenital heart defects, Int J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“OAC at discharge has been associated with a reduced long-term mortality in patients with postoperative AF, 959 without evidence from controlled trials.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5.2. Anticoagulation
What the sources say
- Not checked yetcites [959] El-Chami, 2010, New-onset atrial fibrillation predicts long-term mortality after coronary artery bypass graft, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the long term, patients with an episode of postoperative AF have a twofold increase in cardiovascular mortality and a substantially increased risk of future AF and ischaemic stroke compared with patients that remain in sinus rhythm after surgery.952-958”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.5.2. Anticoagulation
What the sources say
- Not checked yetcites [952] Saxena, 2012, Usefulness of postoperative atrial fibrillation as an independent predictor for worse early and late outcomes after isolated coronary artery bypass grafting (multicenter Australian study of 19,497 patients), Am J Cardiol source
- Not checked yetcites [953] Gialdini, 2014, Perioperative atrial fibrillation and the long-term risk of ischemic stroke, JAMA source
- Not checked yetcites [954] Ahlsson, 2009, Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality, Scand Cardiovasc J source
- Not checked yetcites [955] Ahlsson, 2010, Postoperative atrial fibrillation in patients undergoing aortocoronary bypass surgery carries an eightfold risk of future atrial fibrillation and a doubled cardiovascular mortality, Eur J Cardiothorac Surg source
- Not checked yetcites [956] Mariscalco, 2008, Atrial fibrillation after isolated coronary surgery affects late survival, Circulation source
- Not checked yetcites [957] Villareal, 2004, Postoperative atrial fibrillation and mortality after coronary artery bypass surgery, J Am Coll Cardiol source
- Not checked yetcites [958] Phan, 2015, New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis, Eur J Cardiothorac Surg source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Biatrial volume overload, 974 pulmonary hypertension, 975 and possibly the arrhythmogenic effect of atrial patches can contribute to these arrhythmias.976”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.2. Atrial tachyarrhythmias and atrial septal defects
What the sources say
- Not checked yetcites [974] Yamada, 2007, Pulmonary vein isolation in patients with paroxysmal atrial fibrillation after direct suture closure of congenital atrial septal defect, Circ J source
- Not checked yetcites [975] Van De Bruaene, 2011, The importance of pulmonary artery pressures on late atrial arrhythmia in transcatheter and surgically closed ASD type secundum, Int J Cardiol source
- Not checked yetcites [976] de Salle, 1975, [Rhythm disorders occurring after surgical closure of the interatrial communication], Acta Cardiol
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Atrial arrhythmias occur in up to 40% of patients with a Fontan circulation, and can manifest as atrial flutter, primary atrial tachycardia, AF, and accelerated junctional rhythm or junctional tachycardia 978 with or without sinoatrial node dysfunction.979”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.3. Atrial tachyarrhythmias after Fontan operation
What the sources say
- Not checked yetcites [978] Kanter, 1997, Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease, Pacing Clin Electrophysiol source
- Not checked yetcites [979] Porter, 1993, Incidence and management of dysrhythmias after Fontan procedure, Herz
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with atriopulmonary anastomoses (possibly due to higher atrial volume and pressure load) and those with early postoperative atrial arrhythmias are more likely to develop long-term atrial arrhythmias.980”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.3. Atrial tachyarrhythmias after Fontan operation
What the sources say
- Not checked yetcites [980] Gelatt, 1994, Risk factors for atrial tachyarrhythmias after the Fontan operation, J Am Coll Cardiol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Right atrial thrombus formation is common in Fontan patients with atrial arrhythmias and requires oral anticoagulation.981”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.3. Atrial tachyarrhythmias after Fontan operation
What the sources say
- Not checked yetcites [981] Peters, 1992, Arrhythmias after the Fontan procedure, Br Heart J source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Operative conversion to total cavopulmonary artery connection with concomitant arrhythmia surgery can in some patients improve heart failure symptoms and reduce recurrent arrhythmias, 969,982 with low recurrence rates of clinically apparent atrial arrhythmias in the first few years after repeat surgery.[983][984][985]”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.6.3. Atrial tachyarrhythmias after Fontan operation
What the sources say
- Not checked yetcites [969] Fujita, 2009, Management of late atrial tachyarrhythmia long after Fontan operation, J Cardiol source
- Not checked yetcites [982] Kwak, 2009, Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion, J Card Surg source
- Not checked yetcites [983] Backer, 2008, Maze procedure in single ventricle patients, Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Catheter ablation of left atrial macroreentrant tachycardia is more complex, with lower success rates and higher recurrence rates.1006,1007”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.7. Management of atrial flutter
What the sources say
- Not checked yetcites [1006] Esato, 2009, Color-coded three-dimensional entrainment mapping for analysis and treatment of atrial macroreentrant tachycardia, Heart Rhythm source
- Not checked yetcites [1007] Huo, 2014, Atrial Arrhythmias Following Surgical AF Ablation: Electrophysiological Findings, Ablation Strategies, and Clinical Outcome, J Cardiovasc Electrophysiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It may also reduce AF recurrences in selected patients, 1003,1004 and help to prevent hospitalizations.1004,1005”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.7. Management of atrial flutter
What the sources say
- Not checked yetcites [1003] Schmieder, 2003, Acute and long-term results of radiofrequency ablation of common atrial flutter and the influence of the right atrial isthmus ablation on the occurrence of atrial fibrillation, Eur Heart J source
- Not checked yetcites [1004] Bandini, 2011, Atrial fibrillation after typical atrial flutter ablation: a long-term follow-up, J Cardiovasc Med (Hagerstown) source
- Not checked yetcites [1005] Dewland, 2014, Healthcare utilization and clinical outcomes after catheter ablation of atrial flutter, PLoS One source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Isthmus ablation is comparably safe and more effective than antiarrhythmic drug therapy, and is recommended for recurrent atrial flutter.[585][586][587]713”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.7. Management of atrial flutter
What the sources say
- Not checked yetcites [585] Cosedis Nielsen, 2012, Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation, N Engl J Med source
- Not checked yetcites [586] Wilber, 2010, Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial, JAMA source
- Not checked yetcites [587] Arbelo, 2014, The atrial fibrillation ablation pilot study: a European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association, Eur Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Ibutilide is more effective for conversion of atrial flutter than AF, whereas vernakalant is less effective in converting typical atrial flutter.996,997”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 13.7. Management of atrial flutter
What the sources say
- Not checked yetcites [996] Bronis, 2012, Vernakalant: review of a novel atrial selective antiarrhythmic agent and its place in current treatment of atrial fibrillation, Hosp Chronicles
- Not checked yetcites [997] Nair, 2011, Safety and efficacy of ibutilide in cardioversion of atrial flutter and fibrillation, J Am Board Fam Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients in an active role tend to have better health outcomes and care experiences, and engagement itself can be considered as an intermediate outcome, particularly where related to improved clinical outcomes.1010”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.1. Patient-centred care
What the sources say
- Not checked yetcites [1010] Hibbard, 2013, What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs, Health Aff (Millwood) source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Autonomous, informed patients are better placed to adhere to long-term therapy, and it is very likely that longterm management of chronic conditions such as AF will benefit from informed patients involved in the disease management who are aware of their own responsibilities.328”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.1. Patient-centred care
What the sources say
- Not checked yetcites [328] Nuno, 2012, Integrated care for chronic conditions: the contribution of the ICCC Framework, Health Policy source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Shared decision-making 747 and patient-centred organization of care can help to ensure adherence to management and empower patients, and respect individual patient preferences, needs, and values (see Chapter 7.2).326,1008,1009”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.1. Patient-centred care
What the sources say
- Not checked yetcites [747] Seaburg, 2014, Shared decision making in atrial fibrillation: where we are and where we should be going, Circulation source
- Not checked yetcites [326] Wagner, 1996, Organizing care for patients with chronic illness, Milbank Q source
- Not checked yetcites [1008] Institute of Medicine Committee on Quality of Health Care in America, 2001, Crossing the Quality Chasm: A New Health System for the 21st Century
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Within a multidisciplinary team, allied health professionals can guide this interactive process in which communication, trust, and reciprocal respect foster patient engagement.1021”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.3. Self-management and shared decision-making
What the sources say
- Not checked yetcites [1021] Stiggelbout, 2012, Shared decision making: really putting patients at the centre of healthcare, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Self-management is primarily focused on tasks to manage the condition, such as adhering to a therapeutic regimen or modifying behaviour (e.g.resulting in smoking cessation or weight loss).1020”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.3. Self-management and shared decision-making
What the sources say
- Not checked yetcites [1020] Lorig, 2003, Self-management education: history, definition, outcomes, and mechanisms, Ann Behav Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“It requires understanding of the treatment modalities and goals.350”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.3. Self-management and shared decision-making
What the sources say
- Not checked yetcites [350] Alonso-Coello, 2008, Values and preferences in oral anticoagulation in patients with atrial fibrillation, physicians' and patients' perspectives: protocol for a two-phase study, BMC Health Serv Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Models of care that integrate education, engagement, and shared decision making are now available, 1023 and may be of particular value in the management of AF.”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 14.3. Self-management and shared decision-making
What the sources say
- Not checked yetcites [1023] Elwyn, 2012, Shared decision making: a model for clinical practice, J Gen Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Minimally invasive epicardial ablation surgery for the treatment of stand-alone AF was reported a decade ago.1035”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 15.17. Thoracoscopic 'stand-alone' atrial fibrillation surgery
What the sources say
- Not checked yetcites [1035] Wolf, 2005, Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation, J Thorac Cardiovasc Surg source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The procedure has since evolved towards a totally thoracoscopic procedure, 1036 and lesion sets were extended to a complete left atrial maze.822”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 15.17. Thoracoscopic 'stand-alone' atrial fibrillation surgery
What the sources say
- Not checked yetcites [1036] Yilmaz, 2008, Completely thoracoscopic bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation, J Thorac Cardiovasc Surg source
- Not checked yetcites [822] Weimar, 2012, Approaching a paradigm shift: endoscopic ablation of lone atrial fibrillation on the beating heart, Ann Thorac Surg source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
External stressors such as structural heart disease, hypertension, possibly diabetes, and AF itself induce a slow but progressive process of structural remodelling in the atria.
“External stressors such as structural heart disease, hypertension, possibly diabetes, but also AF itself induce a slow but progressive process of structural remodelling in the atria (Figure 2).”
The paper relies on this without support.
In many patients, AF progresses from short, infrequent episodes to longer and more frequent attacks.
“In many patients, AF progresses from short, infrequent episodes to longer and more frequent attacks.”
The paper relies on this without support.
Over time, many patients will develop sustained forms of AF.
“Over time, many patients will develop sustained forms of AF.”
The paper relies on this without support.
AF may also regress from persistent to paroxysmal AF.
“AF may also regress from persistent to paroxysmal AF.”
The paper relies on this without support.
AF is often asymptomatic.
“As AF is often asymptomatic, these healthcare professionals are important stakeholders to enable adequate detection of AF and to ensure consistent management.”
The paper relies on this without support.
Most patients access the healthcare system initially through pharmacists, community health workers, or primary care physicians.
“Most patients access the healthcare system initially through pharmacists, community health workers, or primary care physicians.”
The paper relies on this without support.
Age 65 years and older conveys a relatively high and continuously increasing stroke risk that also potentiates other risk factors such as heart failure and sex.
“Importantly, age (65 years and older) conveys a relatively high and continuously increasing stroke risk that also potentiates other risk factors (such as heart failure and sex).”
The paper relies on this without support.
All non-vitamin K antagonist oral anticoagulants have a predictable effect (onset and offset) without need for regular anticoagulation monitoring.
“All NOACs have a predictable effect (onset and offset) without need for regular anticoagulation monitoring.”
The paper relies on this without support.
Only the higher dose edoxaban regimen has been approved for stroke prevention in AF.
“Only the higher dose regimen has been approved for stroke prevention in AF.”
The paper relies on this without support.
Absolute contraindications to long-term OAC after a bleeding episode are rare.
“absolute contraindications to long-1481 term OAC after a bleeding episode are rare.”
The paper relies on this without support.
Many causes or triggers of major bleeding events can be treated and/or eliminated.
“Many causes or triggers of major bleeding events can be treated 1483 and/or eliminated, including uncontrolled hypertension, gastrointestinal ulcers, and intracranial aneurysms.”
The paper relies on this without support.
Between 5% and 15% of AF patients will require stenting at some point in their lives.
“Between 5% and 15% of AF patients will require stenting at some point in their lives.”
The paper relies on this without support.
Rate control is often sufficient to improve AF-related symptoms.
“Rate control is an integral part of the management of AF patients, and is often sufficient to improve AF-related symptoms.”
The paper relies on this without support.
All available rate control therapies have the potential for adverse effects.
“All available therapies have the potential for adverse effects and patients should initially be treated with a low dose and uptitrated to achieve symptom improvement.”
The paper relies on this without support.
Amiodarone has a wide array of extracardiac adverse effects.
“The wide array of extracardiac adverse effects associated with amiodarone renders it a reserve agent in patients whose heart rate cannot be controlled with combination therapy (e.g.beta-blocker or verapamil/diltiazem combined with digoxin).”
The paper relies on this without support.
AV nodal ablation renders patients pacemaker-dependent for the rest of their lives.
“AV nodal ablation renders patients pacemaker-dependent for the rest of their lives, limiting AV nodal ablation and pacing to patients whose symptoms cannot be managed by rate controlling medication or by reasonable rhythm control interventions.”
The paper relies on this without support.
The stroke risk estimated from non-ablation atrial fibrillation cohorts is applicable to patients after catheter ablation.
“the expected stroke risk has been adopted from nonablation AF cohorts.”
The paper relies on this without support.
General anticoagulation recommendations are appropriate for patients after catheter ablation regardless of the presumed rhythm outcome.
“In the absence of controlled trial data, OAC after catheter ablation should follow general anticoagulation recommendations, regardless of the presumed rhythm outcome.”
The paper relies on this without support.
Many channelopathies and inherited cardiomyopathies are associated with AF.
“Many channelopathies and inherited cardiomyopathies are associated with AF.”
The paper relies on this without support.
Both shortening as well as prolongation of the atrial action potential have been demonstrated as likely mechanisms underlying AF in these diseases.
“Both shortening as well as prolongation of the atrial action potential have been demonstrated as likely mechanisms underlying AF in these diseases.”
The paper relies on this without support.
There is no clear link between detected mutations and specific outcomes or therapeutic needs in AF.
“Furthermore, there is no clear link between detected mutations and specific outcomes or therapeutic needs.”
The paper relies on this without support.
The role of detraining for AF in human athletes is unknown.
“but the role of detraining for AF in human athletes is unknown.”
The paper relies on this without support.
AF in pregnant women is rare and is usually associated with pre-existing heart disease.
“AF in pregnant women is rare and is usually associated with pre-existing heart disease.”
The paper relies on this without support.
Beta-blockers, verapamil, diltiazem, and digoxin all carry a US Food and Drug Administration pregnancy safety category of C, except for atenolol (category D).
“Owing to a lack of specific data, beta-blockers, verapamil, diltiazem, and digoxin all carry a US Food and Drug Administration pregnancy safety category of C (benefits may outweigh risk), except for atenolol (category D: positive evidence of risk).”
The paper relies on this without support.
There are insufficient data to comment on verapamil or diltiazem for rate control in pregnancy.
“There are insufficient data to comment on verapamil or diltiazem, hence rate control using beta-blockers and/or digoxin is recommended.917”
The paper relies on this without support.
All rate control agents are present in breast milk, although levels of beta-blockers, digoxin, and verapamil are too low to be considered harmful.
“With regards to breastfeeding, all rate control agents are present in breast milk, although levels of beta-blockers, digoxin, and verapamil are too low to be considered harmful.”
The paper relies on this without support.
All of the information on the benefit of OAC has been in patients with AF diagnosed by ECG.
“All of the information on the benefit of OAC has been in patients with AF diagnosed by ECG.”
The paper relies on this without support.
Technological advances allow ready detection of AHRE in patients with implanted devices and an atrial lead.
“Technological advances allow ready detection of AHRE in patients with implanted devices and an atrial lead.”
The paper relies on this without support.
Patients with AHRE detected by implanted devices are at increased stroke risk.
“Such patients are at increased stroke risk, but it is unclear whether they benefit from OAC.”
The paper relies on this without support.
The use of NOACs has not been tested in patients with creatinine clearance < 30 mL/min, and there is very little evidence on the effects of OAC in patients on haemodialysis or on other forms of renal-replacement therapy.
“The use of NOACs has not been tested in patients with creatinine clearance < 30 mL/min, and there is very little evidence on the effects of OAC in patients on haemodialysis or on other forms of renal-replacement therapy.”
The paper relies on this without support.
At least 2% of anticoagulated patients with AF will experience a serious bleeding event per year.
“At least 2% of anticoagulated patients with AF will experience a serious bleeding event per year.”
The paper relies on this without support.
Previous recommendations on the safe time-window in which a cardioversion can be performed in new-onset AF used ≤ 48 hours as the 'gold standard' for non-protected cardioversion.
“Based on retrospective data, previous recommendations on the safe time-window in which a cardioversion can be performed in new-onset AF used ≤ 48 hours as the 'gold standard' for non-protected cardioversion.”
The paper relies on this without support.
Few of the studies of carotid endarterectomy vs stenting included patients with AF.
“However, few of these studies included patients with AF.”
The paper relies on this without support.
The optimal antithrombotic therapy in the first months after biological valve replacement (including after catheter-based valve replacement) is not known.
“The optimal antithrombotic therapy in the first months after biological valve replacement (including after catheter-based valve replacement) is not known.”
The paper relies on this without support.
VKAs remain the mainstay during the initial postoperative period after biological valve replacement.
“VKAs remain the mainstay during the initial postoperative period; NOACs probably deliver the same protection.”
The paper relies on this without support.
NOACs probably deliver the same protection as VKAs during the initial postoperative period after biological valve replacement.
“VKAs remain the mainstay during the initial postoperative period; NOACs probably deliver the same protection.”
The paper relies on this without support.
The safety and efficacy of NOACs in patients with rheumatic mitral valve disease has not been evaluated.
“The safety and efficacy of NOACs in patients with rheumatic mitral valve disease has not been evaluated and should be studied.”
The paper relies on this without support.
Long-term recurrence rates of AF are high after successful catheter ablation.
“In view of the long-term recurrence rates of AF, this Task Force recommends to continue OAC in AF patients after 'successful' catheter ablation.”
The paper relies on this without support.
Robust data comparing rate control therapies are scant, with the majority of studies being small uncontrolled trials over short periods of follow-up.
“Although the use of rate control therapy is very common in AF patients, robust data comparing rate control therapies are scant, with the majority of studies being small uncontrolled trials over short periods of follow-up.”
The paper relies on this without support.
A few recent randomized studies support the use of catheter or surgical ablation in patients with persistent AF and long-standing persistent AF.
“While a few recent randomized studies support the use of catheter or surgical ablation in patients with persistent AF and long-standing persistent AF, there is a clear need for more data evaluating this intervention in adequately powered randomized trials.”
The paper relies on this without support.
PVI emerges as the most important target for catheter ablation of AF.
“PVI emerges as the most important target for catheter ablation of AF.”
The paper relies on this without support.
Many patients are in need of multiple catheter-ablation procedures, and such interventions often follow local or operator-specific protocols without clear evidence to support the choice of ablation target or intervention.
“Many patients are in need of multiple catheter-ablation procedures, and such interventions often follow local or operator-specific protocols without clear evidence to support the choice of ablation target or intervention.”
The paper relies on this without support.
In the follow-up after initially successful catheter ablation, even when done in experienced centres, many patients will experience symptomatic recurrences of AF.
“In the follow-up after initially successful catheter ablation, even when done in experienced centres, many patients will experience symptomatic recurrences of AF.”
The paper relies on this without support.
There is a surprising paucity of data evaluating different rhythm control interventions in patients with recurrent AF after catheter ablation.
“There is a surprising paucity of data evaluating different rhythm control interventions in patients with recurrent AF after catheter ablation.”
The paper relies on this without support.
The progress in rhythm control therapy and observational long-term analyses suggest that rhythm control therapy may have a prognostic benefit.
“The progress in rhythm control therapy (catheter ablation, new antiarrhythmic drugs) and observational longterm analyses suggest that rhythm control therapy may have a prognostic benefit.”
The paper relies on this without support.
Scientific evidence on long-term results of thoracoscopic AF ablation is still limited.
“With such rapid development and the coexistence of different techniques and lesion sets, scientific evidence on long-term results is still limited.”
The paper relies on this without support.
Prospective randomized studies comparing the rate of ischaemic stroke with or without left appendage exclusion are presently lacking.
“Exclusion of the LAA has been performed by cardiothoracic surgeons for decades, but prospective randomized studies comparing the rate of ischaemic stroke with or without left appendage exclusion are presently lacking.”
The paper relies on this without support.
NOACs have a short plasma half-life of approximately 12 hours and improved haemostasis is expected within 12-24 hours after a delayed or omitted dose.
“NOACs have a short plasma half-life of approximately 12 hours and improved haemostasis is expected within 12-24 hours after a delayed or omitted dose.”
The paper relies on this without support.
Dialysis clears dabigatran but is not effective for the other NOACs.
“Dialysis clears dabigatran but is not effective for the other NOACs.”
The paper relies on this without support.
Coagulation tests do not provide much information in patients on NOACs, except for activated partial thromboplastin time in the case of dabigatran.
“Coagulation tests do not provide much information in patients on NOACs, except for activated partial thromboplastin time in the case of dabigatran.”
The paper relies on this without support.
More specific coagulation tests do exist, including diluted thrombin time (HEMOCLOT).
“More specific coagulation tests do exist, including diluted thrombin time (HEMOCLOT) for”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The global burden of AF and its association with stroke, HF and mortality have been well established49.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [49]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 15.9. Competing causes of stroke or transient ischaemic attack in atrial fibrillation patients
“the composite of in-hospital mortality, post-procedural stroke, and cardiac complications was higher in AF patients undergoing carotid stenting (457/7668; 6.0%)”
§ 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with > 15.9. Competing causes of stroke or transient ischaemic attack in atrial fibrillation patients
“compared with endarterectomy (4438/51320; 8.6%; P < 0.0001)”
Citations
Cites
2 retracted
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Metadata
- Authors
- Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., Hindricks, G., Manolis, A. S., Oldgren, J., Popescu, B. A., Schotten, U., Van Putte, B., Vardas, P., ESC Scientific Document Group, Agewall, S., Camm, J., Esquivias, G. B., Budts, W., Carerj, S., Casselman, F., Coca, A., De Caterina, R., Deftereos, S., Dobrev, D., Ferro, J. M., Filippatos, G., Fitzsimons, D., Gorenek, B., Guenoun, M., Hohnloser, S. H., Kolh, P., Lip, G. Y. H., Manolis, A., McMurray, J., Ponikowski, P., Rosenhek, R., Ruschitzka, F., Savelieva, I., Sharma, S., Suwalski, P., Tamargo, J. L., Taylor, C. J., Van Gelder, I. C., Voors, A. A., Windecker, S., Zamorano, J. L., Zeppenfeld, K., Zamorano, J. L., Aboyans, V., Achenbach, S., Agewall, S., Badimon, L., Barón-Esquivias, G., Baumgartner, H., Bax, J. J., Bueno, H., Carerj, S., Dean, V., Erol, Ç., Fitzsimons, D., Gaemperli, O., Kirchhof, P., Kolh, P., Lancellotti, P., Lip, G. Y. H., Nihoyannopoulos, P., Piepoli, M. F., Ponikowski, P., Roffi, M., Torbicki, A., Vaz Carneiro, A., Windecker, S., Hayrapetyan, H. G., Roithinger, F. X., Aliyev, F., Chasnoits, A., Mairesse, G. H., Matičević, D. L., Shalganov, T., Skorić, B., Antoniades, L., Taborsky, M., Pehrson, S., Khaled, S., Kampus, P., Hedman, A., Poposka, L., Le Heuzey, J.-Y., Estadashvili, K., Bänsch, D., Csanádi, Z., Keane, D., Beinart, R., Romeo, F., Koshumbayeva, K., Bajraktari, G., Mirrakhimov, A., Kalejs, O., Nasr, S., Marinskis, G., Dimmer, C., Sammut, M., Grosu, A., Abdelali, S., Hemels, M. E. W., Anfinsen, O.-G., Średniawa, B., Adragao, P., Dan, G.-A., Mikhaylov, E. N., Zavatta, M., Potpara, T., Slovenia, P. H., Zupan, I., Arenal, A., Braunschweig, F., Shah, D., Ouali, A. S., Demir, M., Sychov, O., & Duncan, E.
- Affiliations
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Corresponding author
- Benussi, Stefano
- ORCID
- Benussi, Stefano
- Kotecha, Dipak
- Ahlsson, Anders
- Atar, Dan
- Casadei, Barbara
- Hendriks, Jeroen
- Hindricks, Gerhard
- Manolis, Antonis S
- Oldgren, Jonas
- Popescu, Bogdan Alexandru
- Schotten, Ulrich
- Budts, Werner
- Dobrev, Dobromir
- Ferro, José M
- Manolis, Athanasios
- McMurray, John
- Suwalski, Piotr
- Tamargo, Juan Luis
- Voors, Adriaan A
- Zeppenfeld, Katja
- Aboyans, Victor
- Baumgartner, Helmut
- Bax, Jeroen J
- Bueno, Héctor
- Erol, Çetin
- Gaemperli, Oliver
- Lancellotti, Patrizio
- Piepoli, Massimo F
- Torbicki, Adam
- Hayrapetyan, Hamlet G
- Chasnoits, Alexandr
- Mairesse, Georges H
- Shalganov, Tchavdar
- Antoniades, Loizos
- Pehrson, Steen
- Kampus, Priit
- Poposka, Lidija
- Beinart, Roy
- Bajraktari, Gani
- Mirrakhimov, Aibek
- Marinskis, Germanas
- Grosu, Aurel
- Hemels, Martin E W
- Anfinsen, Ole-Gunnar
- Średniawa, Beata
- Mikhaylov, Evgeny N
- Zavatta, Marco
- Potpara, Tatjana
- Braunschweig, Frieder
- Shah, Dipen
- Demir, Mesut
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-08-27
- Volume
- 37
- Issue
- 38
- Pages
- 2893-2962
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W3004050106
- Semantic Scholar
- 1f0d7a31a8bbb5720b0fa33e3a83fce3ac52dd89
- Cited by
- 6,418
- References
- 1,040
- Citations by year
- 2026: 126 · 2025: 177 · 2024: 277 · 2023: 322 · 2022: 430 · 2021: 786 · 2020: 1265 · 2019: 1105 · 2018: 1073 · 2017: 781 · 2016: 65
- FWCI
- 831.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- University of Birmingham Research Portal (University of Birmingham) (publishedVersion, other-oa)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Open Repository and Bibliography (University of Liège) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (CL-2015-13-006, CDF-2015-08-074)
- British Heart Foundation (FS/13/43/30324, RG/11/15/29375)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, atrial fibrillation management, anticoagulation, stroke prevention, cardioversion, catheter ablation, rhythm control, rate control, risk-benefit assessment
- MeSH terms
- Atrial Fibrillation, Cardiology, Europe, Humans, Societies, Medical
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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