| 1. |
- Almroth, Henrik, 1970-, et al.
(författare)
-
The safety of flecainide treatment of atrial fibrillation : long-term incidence of sudden cardiac death and proarrhythmic events
- 2011
-
Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796. ; 270:3, s. 281-290
-
Tidskriftsartikel (refereegranskat)abstract
- Objective:To assess the safety of long-term treatment with flecainide in patients with atrial fibrillation (AF), particularly with regard to sudden cardiac death (SCD) andproarrhythmic events.Design: Retrospective,observational cohort study.Setting.Single-centre study at Örebro University Hospital, Sweden.Setting: Single-centre study at Orebro University Hospital, Sweden.Subjects: A total of 112 patients with paroxysmal (51%) or persistent (49%) AF (mean age 60 ± 11 years) were included after identifying all patients with AF who initiated oral flecainide treatment (mean dose 203 ± 43 mg per day) between 1998 and 2006. Standard exclusion⁄inclusion criteria for flecainide were used,andflecainidetreatmentwasusually combined withanatrioventricular-blocking agent (89%).Main outcome measure: Death was classified as sudden or nonsudden according to standard definitions. Proarrhythmia was defined as cardiac syncope or lifethreatening arrhythmia.Results: Eight deaths were reported during a mean follow- up of 3.4 ± .4 years. Compared to the general population, the standardized mortality ratios were 1.57 (95% confidence interval (CI) 0.68–3.09) for allcause mortality and 4.16 (95% CI 1.53–9.06) for death from cardiovascular disease. Three deaths were classified as SCDs. Proarrhythmic events occurred in six patients (two each with wide QRS tachycardia, 1 : 1 conducted atrial flutter and syncope during exercise).Conclusion: We found an increased incidence of SCD or proarrhythmic events in this real-world study of flecainide used for the treatment of AF. The findings suggest that further investigation into the safety of flecainide for the treatment of patients with AF is warranted.
|
|
| 2. |
|
|
| 3. |
- Bergh, Cecilia, 1972-, et al.
(författare)
-
Stress resilience and physical fitness in adolescence and risk of coronary heart disease in middle age
- 2015
-
Ingår i: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 101:8, s. 623-629
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Psychosocial stress is a suggested risk for coronary heart disease (CHD). The relationship of stress resilience in adolescence with subsequent CHD risk is underinvestigated, so our objective was to assess this and investigate the possible mediating role of physical fitness.METHODS: In this register-based study, 237 980 men born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Stress resilience was measured at a compulsory military conscription examination using a semistructured interview with a psychologist. Some 10 581 diagnoses of CHD were identified. Cox regression estimated the association of stress resilience with CHD, with adjustment for established cardiovascular risk factors.RESULTS: Low-stress resilience was associated with increased CHD risk. The association remained after adjustment for physical fitness and other potential confounding and mediating factors, with adjusted HRs (and 95% CIs) of 1.17 (1.10 to 1.25), with some evidence of mediation by physical fitness. CHD incidence rates per 1000 person-years (and 95% CIs) for low-stress, medium-stress and high-stress resilience were 2.61 (2.52 to 2.70), 1.97 (1.92 to 2.03) and 1.59 (1.53 to 1.67) respectively. Higher physical fitness was inversely associated with CHD risk; however, this was attenuated by low-stress resilience, shown by interaction testing (p<0.001).CONCLUSIONS: Low-stress resilience in adolescence was associated with increased risk of CHD in middle age and may diminish the benefit of physical fitness. This represents new evidence of the role of stress resilience in determining risk of CHD and its interrelationship with physical fitness.
|
|
| 4. |
- Fengsrud, Espen, 1970-, et al.
(författare)
-
Total endoscopic ablation of patients with long-standing persistent atrial fibrillation : a randomized controlled study
- 2016
-
Ingår i: Interactive Cardiovascular and Thoracic Surgery. - Oxford, United Kingdom : Oxford University Press. - 1569-9293 .- 1569-9285. ; 23:2, s. 292-298
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Total endoscopic ablation of atrial fibrillation is an alternative to catheter ablation, but its clinical role needs further evaluation. The aim of this study was to compare total endoscopic ablation with rate control in patients with long-standing persistent atrial fibrillation and to examine the effect of endoscopic ablation on heart rhythm, symptoms, physical working capacity and myocardial function during 1 year of follow-up.Methods: In a prospective controlled study, 36 patients aged >50 years with symptomatic long-standing persistent atrial fibrillation were randomized to either total endoscopic ablation (n = 17, after two drop-outs before ablation n = 15) or rate control therapy (n = 19). In the ablation group, a box lesion encircling the pulmonary veins was performed, using temperature-controlled radiofrequency energy. Loop recorders were implanted in all patients. Echocardiography and quality-of-life assessment were performed at 6 and 12 months, and physical working capacity assessment at 6 months.Results: There was no mortality or thromboembolic event. In the control group, all patients were in permanent atrial fibrillation during 12 months of follow-up. In the ablation group, the proportion of patients in sinus rhythm without antiarrhythmic drugs was 12/15 (80%) at 12 months. The median freedom of atrial fibrillation at 3-12 months was 95% in the ablation group and the proportion of patients with an atrial fibrillation burden of <5% at 3-12 months was 8/15 (53%). The left ventricular ejection fraction increased during follow-up in the ablation group compared with the control group (from 53.7 ± 8.6 to 58.8 ± 6.5%, P = 0.003), combined with a reduction in the left atrial area (from 29.2 ± 5.5 to 27.2 ± 6.3 cm(2), P = 0.002). The physical working capacity increased in the ablation group compared with the control group (from 94 ± 21.4 to 102.9 ± 14.4%, P = 0.011). The subjective physical and mental capacity scale also improved during follow-up in the ablation group, but not in the control group (P =0.003 and 0.018, respectively).Conclusions: Total endoscopic ablation in patients with long-standing persistent atrial fibrillation significantly reduced atrial fibrillation burden 12 months after intervention compared with controls. The left ventricular function, physical working capacity and subjective physical and mental health were improved. These results need to be confirmed in larger randomized trials.
|
|
| 5. |
- Scander, Henrik, 1976-, et al.
(författare)
-
Fika a new turn in Food studies – an unexplored Swedish meal practice
- 2023
-
Ingår i: Food & Communication: Communicating 'good' foods. - Örebro : Örebro University. ; , s. 97-98
-
Konferensbidrag (refereegranskat)abstract
- Fika has appeared as a contender for the third Swedish word (in addition to ombudsman and smorgasbord) that has been introduced into the English language. We meet to fika in many different social contexts such as in the office morning-break, in a casually arranged business meeting, at homes as a tradition with home-baked pastries, and in cafes when friends meet and catch up. Fika as a cultural phenomenon is used extensively in destination marketing in Sweden and can be regarded as a food (or culinary) tourism experience. We also experience fika as one of the means to market Sweden, and some recent product launches try to build on fika as a value offering. This paper aims to conceptualise the meaning of fika and how it as a complex, cultural phenomenon can be marketed and thereby how a cultural tradition may enhance value created by firms in Sweden to attract customers locally as well as to reach out to other countries. The paper thereby connects fika as a practice and sensory taste with the destination-carrying values of fika for Sweden and firms, and how such values can be used in the marketing of products.This paper is the first output from a project focusing on fika as a practice, destination marketing’s use of fika and how companies use fika to market the value of their products. This research lays a basis for the understanding of how values and tastes are created in relation to the Swedish fika culture. The social practice of fika will help to grasp the product/service combinations’ links to social interaction and what role the combinations play, how they shift both in terms of content and cultural values related to various types of interactions and contexts. This will serve as input to improve destination branding activities as well as fika services of tourism companies and organisations where the local and national values of fika are ingrained. Accordingly, the research result will result in scientific knowledge that used by tourism operators and destination organisations in Sweden can lead to an improved destination image of Swedish destinations as well as more successful tourism companies.
|
|
