TAILIEUCHUNG - Ebook Atrial fibrillation - A multidisciplinary approach to improving patient outcomes: Part 2

(BQ) Part 2 book "Atrial fibrillation - A multidisciplinary approach to improving patient outcomes" presents the following contents: LAA excision, ligation and occlusion devices; atrial fibrillation - a surgical approach; anesthesia care for the atrial fibrillation patient; team approach to the care of the AF patient; shared decision making for patients with atrial fibrillation, patient preferences and ecisionaids,. | chapter8 Left Atrial Appendage Excision Ligation and Occlusion Devices Taral K Patel MD and Bradley P Knight MD ATRIAL FIBRILLATION AND STROKE Atrial fibrillation AF currently affects up to 5 million Americans and remains the most common arrhythmia encountered in clinical 2 With an aging population the burden of AF is expected to rise 3-fold by Among the several downstream consequences of AF the most feared is stroke due to thromboembolism. The primary cause of thrombus formation is mechanical dysfunction in the atria leading to impaired blood flow and stasis. AF also promotes endothelial dysfunction inflammation platelet activation and hypercoagulability which further contribute to thrombus Stroke remains the number one cause of major disability and the third leading cause of death in the United AF increases stroke risk 5-fold leading to a 5 annual stroke rate for Seen another way the percentage of strokes attributable to AF ranges from in those aged 50 to 59 years to an impressive in those aged 80 to 89 While these statistics are dramatic the influence of AF on stroke is almost certainly underestimated as AF is commonly silent and LEFT ATRIAL APPENDAGE Johnson and colleagues described the left atrial appendage LAA as our most lethal human attachment. 9 Derived from the embryonic left atrium the LAA forms a blind pouch 2 to 4 cm long and most commonly lies on the anterior surface of the heart. Its narrow neck forms a natural obstacle to normal blood flow. The LAA endocardial surface is highly irregular due to the presence of pectinate muscles. This is in sharp contrast to the true left atrium which is derived from venous tissue and has a smooth endocardial surface. The LAA also has a variable number of lobes an autopsy survey of 500 patients found that 20 had one lobe while 77 had two or three Atrial Fibrillation A Multidisciplinary Approach to Improving Patient .

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