The AFIB Report

Your premier information resource for atrial fibrillation


EDITORIAL

Number 135
December 2014/January 2015
14th Year

Welcome to our end of year holiday issue with this Dec/Jan edition of The AFIB Report.

Before we begin our brief summary of the topics covered, I want to let all our valued subscribers know that, yet again, this year has brought to my door an unanticipated, and utterly surprising, unwelcomed life event that will require that I take a step back from my duties as editor of The AFIB Report and website, and take a temporary sabbatical.

My dear wife, Magdalena, was diagnosed with kidney cancer this week as an entirely incidental finding from an MRI ordered to search for what was assumed to be garden variety sciatic-like left low back pain that had not resolved under the usual conservative approaches. The potentially complex nature of her diagnosis, and the sudden demand to turn all of my energy, focus and efforts toward her care and well-being, will leave no time for my AFIB-related support efforts, for the time being.

I had finished about ĺ of this issue when the news struck, not yet even a week ago, and itís been a total whirlwind of activity since, as I dive into the world of kidney cancer as I would for the most serious AFIB-related issue here. First, searching for a top tier nephrectomy surgeon and hospital along with all the related minutia and nuance that taking on such a challenge will entail.

Forum stalwarts Jackie Burgess and George Newman, as well as a host of long time regulars will keep the forum humming along without missing a beat, while my wife and I walk down this path where ever it leads to the point where her health and situation stabilizes enough for me to saddle up again here at our wonderful oasis for afibbers everywhere. Many thanks to Hans and Judi too for stepping in here, and interrupting their peaceful retirement this week to help polish off the last couple pages of this issue, and to all of you for your continued support.

This year has been both highly rewarding and challenging for me personally with the stroke and LARIAT leak repair, and now this. I do look forward to perhaps a bit less of a rollercoaster ride in 2015, but most of all, to the return to full health for my lovely Magdalena. Thank you all for your understanding. Iím really not sure how long it will be, but rest assured, when the dust settles and the smoke clears enough and I know that my gal is settled in and well on the mend, Iíll be able to rejoin you all more consistently again.

We wrap up this busy year in the world of AFIB and Electrophysiology (EP) with a focus on a handful of important studies conveying real world practical insights that have been of interest and discussion over the course of this year on our active and dynamic forum at afibbers.net.

In our first three reviews, we look at a few new angles on a very hot topic in EP circles addressing the larger issue of silent cerebral ischemia/events (SCI/SCE) and its association with both AFIB and risk of dementia. We first looked at this topic in detail in a special report in our April/May issue, and now we have even more confirming insights to share, each with a key take home message for all afibbers.

Next up, we take a look at commonly used NSAID anti-inflammatory drugs with a meta-analysis from China underscoring their previously known associations for not only an increased risk of serious bleeding and thromboembolism in AFIB patients (especially for those receiving concomitant anti-coagulation therapy), but also as a direct risk for contributing to AFIB itself.

In a related, and no less important, a set of studies provides more reinforcement for not prescribing low dose aspirin as a general cardiovascular primary prevention medication in most cases. There are specific exceptions where an aspirin may be warranted, but the indications for its use, that not long ago seemed widespread, have shrunk considerably as a wave of new studies in recent years have called into question the wisdom of widespread aspirin use as a daily prophylactic drug for most people with AFIB, and even some other cardiovascular issues. The bleeding risks increasingly seem to outweigh any modest benefit in too many areas that once appeared to be a no-brainer for low dose aspirin use as primary prevention.

Wishing all our readers Happy Holidays and plenty of NSR throughout the coming new year ...

Shannon



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