Research Topics
| S ConnollySummaryCountry: Canada Publications
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Publications
Preventing stroke in patients with atrial fibrillation: current treatments and new conceptsStuart J Connolly
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
Am Heart J 145:418-23. 2003..A direct thrombin inhibitor, ximelagatran, has been shown to have an excellent pharmacokinetic profile and is being developed as an oral agent for stroke prevention in AF, and it will not need regular monitoring...
Dabigatran versus warfarin in patients with atrial fibrillationStuart J Connolly
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
N Engl J Med 361:1139-51. 2009..Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor...
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 rangeStuart J Connolly
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
Circulation 118:2029-37. 2008..This report examines how differences in time in therapeutic range (TTR) between centers and between countries affect the outcomes of OAC therapy...
Dronedarone in high-risk permanent atrial fibrillationStuart J Connolly
Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada
N Engl J Med 365:2268-76. 2011..It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events in high-risk permanent atrial fibrillation...
Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trialS Connolly
Health Research Institute, Hamilton, ON, Canada
Lancet 367:1903-12. 2006..However, long-term monitoring is necessary and many patients cannot achieve optimum anticoagulation. We assessed whether clopidogrel plus aspirin was non-inferior to oral anticoagulation therapy for prevention of vascular events...
Challenges of establishing new antithrombotic therapies in atrial fibrillationStuart J Connolly
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
Circulation 116:449-55. 2007
Analysis of stroke in ATHENA: a placebo-controlled, double-blind, parallel-arm trial to assess the efficacy of dronedarone 400 mg BID for the prevention of cardiovascular hospitalization or death from any cause in patients with atrial fibrillation/atrial Stuart J Connolly
FRCPC, Division of Cardiology, Hamilton Health Sciences, General Site, 502 237 Barton St E, Hamilton, Ontario L8L 2X2, Canada
Circulation 120:1174-80. 2009....
Depression and risk of sudden cardiac death after acute myocardial infarction: testing for the confounding effects of fatigueJ Irvine
Toronto General Hospital, University Health Network, Department of Psychiatry, University of Toronto, Ontario, Canada
Psychosom Med 61:729-37. 1999..This study examined the impact of depressive symptoms and social support on 2-year sudden cardiac death (SCD) risk, controlling for fatigue symptoms...
Rationale and design of ACTIVE: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular eventsS Connolly
Population Health Research Institute, Hamilton, Ontario, Canada
Am Heart J 151:1187-93. 2006..Irbesartan is an angiotensin receptor-blocking agent that reduces blood pressure and has other vascular protective effects...
Randomised, parallel-group, multicentre, multinational phase 2 study comparing edoxaban, an oral factor Xa inhibitor, with warfarin for stroke prevention in patients with atrial fibrillationJeffrey I Weitz
Thrombosis and Atherosclerosis Research Institute, Hamilton General Hospital, Ontario, Canada
Thromb Haemost 104:633-41. 2010..In contrast, the edoxaban bid regimens were associated with more bleeding than warfarin. These results suggest that in this three-month study, edoxaban 30 or 60 mg qd are safe and well-tolerated...
Rationale and design of AVERROES: apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatmentJohn W Eikelboom
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada L8L 2X2
Am Heart J 159:348-353.e1. 2010..Apixaban may be an attractive alternative to ASA for prevention of stroke in patients with AF who cannot or will not take a VKA...
Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE-W)Jeff S Healey
Population Health Research Institute, McMaster University, 237 Barton St E, Hamilton, Ontario, Canada
Stroke 39:1482-6. 2008..However, because OAC carries important bleeding complications, risk stratification schemes have been devised to identify patients for whom the absolute benefits of OAC exceed its risks...
Prevention of vascular events in patients with atrial fibrillation: evidence, guidelines, and practiceStuart J Connolly
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
J Cardiovasc Electrophysiol 14:S52-5. 2003..Many patients do not receive anticoagulation therapy despite its proven benefits...
Long-term amiodarone therapy and the risk of complications after cardiac surgery: results from the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial (CAMIAT)Eugene Crystal
Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
J Thorac Cardiovasc Surg 125:633-7. 2003....
Poor adherence to placebo or amiodarone therapy predicts mortality: results from the CAMIAT study. Canadian Amiodarone Myocardial Infarction Arrhythmia TrialJ Irvine
The Toronto Hospital, Department of Psychiatry, University of Toronto, Ontario, Canada
Psychosom Med 61:566-75. 1999..This study examined the relationship between adherence, mortality, and psychosocial factors...
Atrial fibrillation in 2010: advances in treatment and managementStuart J Connolly
McMaster University, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario, Canada
Nat Rev Cardiol 8:67-8. 2011..In 2010, important advances have been made in stroke prevention with new anticoagulants and in atrial fibrillation rhythm management...
Underuse of evidence-based warfarin dosing methods for atrial fibrillation patientsRobby Nieuwlaat
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
Thromb Res 125:e128-31. 2010..We assessed to what extent generalist and specialist physicians use evidence-based methods for warfarin maintenance dosing...
Apixaban in patients with atrial fibrillationStuart J Connolly
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
N Engl J Med 364:806-17. 2011..Apixaban, a novel factor Xa inhibitor, may be an alternative treatment for such patients...
Symptoms at the time of arrhythmia recurrence in patients receiving azimilide for control of atrial fibrillation or flutter: results from randomized trialsStuart J Connolly
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Am Heart J 146:489-93. 2003..There was another effect of azimilide: an average reduction of 0.38 symptoms (P <.01) that was independent of heart rate. CONCLUSION: Azimilide (125 mg/day) reduces the number of symptoms reported at the time of AF recurrence...
Effects of CYP2C19 genotype on outcomes of clopidogrel treatmentGuillaume Pare
Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
N Engl J Med 363:1704-14. 2010....
Prognostic differences between atrial fibrillation and atrial flutterPaul Lelorier
Division of Cardiology, University of Western Ontario, London, Ontario, Canada
Am J Cardiol 93:647-9. 2004..We also evaluated warfarin use over time and compared left atrial dimensions in patients with atrial flutter with those with atrial fibrillation...
Role of oral anticoagulation in management of atrial fibrillationEugene Crystal
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Heart 90:813-7. 2004
Comparison of beta-blockers, amiodarone plus beta-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators: the OPTIC Study: a randomized trialStuart J Connolly
Department of Medicine, McMaster University, Hamilton, Ontario
JAMA 295:165-71. 2006..Implantable cardioverter defibrillator (ICD) therapy is effective but is associated with high-voltage shocks that are painful...
Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: a meta-analysisEugene Crystal
Division of Cardiology, Faculty of Health Sciences, McMaster University, Ontario, Hamilton, Canada
Circulation 106:75-80. 2002..To better understand the role of various prophylactic therapies against postoperative AF, a systematic review of evidence from randomized trials was performed...
Atrial fibrillation after cardiac surgery: update on the evidence on the available prophylactic interventionsEugene Crystal
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Card Electrophysiol Rev 7:189-92. 2003..Amiodarone and bi-atrial pacing may decrease the length of hospital stay...
Quality of life improves with treatment in the Canadian Trial of Atrial FibrillationPaul Dorian
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Am Heart J 143:984-90. 2002..The impact of atrial fibrillation (AF) and its treatment on health-related quality of life (QOL) is not well understood. We assessed QOL in patients with symptomatic AF participating in the Canadian Trial of Atrial Fibrillation...
Therapies for the prevention of stroke and other vascular events in atrial fibrillation and atrial flutterStuart J Connolly
McMaster University, Hamilton, Ontario
Can J Cardiol 21:71B-73B. 2005..Acetylsalicylic acid is less effective than oral anticoagulants but better tolerated. Anticoagulants are recommended for AF patients with risk factors for stroke...
Left Atrial Appendage Occlusion Study (LAAOS): a randomized clinical trial of left atrial appendage occlusion during routine coronary artery bypass graft surgery for long-term stroke preventionEugene Crystal
McMaster University, Hamilton, Ontario, Canada
Am Heart J 145:174-8. 2003..CONCLUSIONS: The clinical trial designed to evaluate LAA occlusion at the time of routine CABG surgery is currently in the pilot phase...
Double-blind, placebo-controlled, randomized trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: the beta-Blocker Length Of Stay (BLOS) studyStuart J Connolly
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Am Heart J 145:226-32. 2003..No previous trials have been primarily directed at demonstrating that the use of drugs that prevent AF would shorten length of stay and reduce the costs of postoperative care...
A systematic review of randomized trials comparing radiofrequency ablation with antiarrhythmic medications in patients with atrial fibrillationGirish M Nair
Division of Cardiology, Arrhythmia Service, McMaster University and Hamilton Health Sciences, Ontario, Canada
J Cardiovasc Electrophysiol 20:138-44. 2009..Several randomized trials comparing RF ablation with antiarrhythmic medications have now been published...
Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trialStuart J Connolly
Department of Medicine, McMaster University, Hamilton, Ontario
JAMA 289:2224-9. 2003..However, because these trials were not double blind, they may have been biased in their assessment of outcomes and had a placebo effect of surgery...
Quality of life in the Canadian Implantable Defibrillator Study (CIDS)Jane Irvine
Department of Psychology, York University, University of Toronto, Ontario, Canada
Am Heart J 144:282-9. 2002..A secondary aim was to evaluate the effects on quality-of-life outcomes of receiving shocks from the device...
Role of the renin-angiotensin-aldosterone system in atrial fibrillation and cardiac remodelingJeff S Healey
McMaster University, Hamilton, Ontario, Canada
Curr Opin Cardiol 20:31-7. 2005..Ongoing research will establish whether ACE inhibitors or ARBs have specific benefits in patients with atrial fibrillation...
Postoperative low-molecular-weight heparin bridging is associated with an increase in wound hematoma following surgery for pacemakers and implantable defibrillatorsMarlene Robinson
Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, Ontario, Canada
Pacing Clin Electrophysiol 32:378-82. 2009..Low-molecular-weight heparin (LMWH) is often used; however, wound hematoma is a common complication...
Atrial overdrive pacing in sleep apnoea: a meta-analysisAdrian Baranchuk
Cardiac Electrophysiology and Pacing, Kingston General Hospital, Queen s University, FAPC 3, 76 Stuart Street, Kingston, ON, Canada
Europace 11:1037-40. 2009....
Cardiovascular outcomes with atrial-based pacing compared with ventricular pacing: meta-analysis of randomized trials, using individual patient dataJeffrey S Healey
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada, L8L 2X2
Circulation 114:11-7. 2006..No trial has shown a mortality reduction, and only 1 small trial suggested a reduction in stroke. The goal of this review was to determine whether atrial-based pacing prevents major cardiovascular events...
Stroke prevention in patients with atrial fibrillation: the diagnosis and management of hypertension by specialistsJeff S Healey
McMaster University, Hamilton, Ontario
Can J Cardiol 22:485-8. 2006..Hypertension is common in patients with atrial fibrillation (AF) and is an important cause of stroke...
Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysisJeff S Healey
Population Health Research Institute, McMaster University, and Hamilton Health Sciences, Hamilton, Ontario, Canada
J Am Coll Cardiol 45:1832-9. 2005....
The association of left atrial size and occurrence of atrial fibrillation: a prospective cohort study from the Canadian Registry of Atrial FibrillationRatika Parkash
University of Ottawa, Ottawa, Ontario, Canada
Am Heart J 148:649-54. 2004..Patients with no or paroxysmal recurrence had no change in LA dimension over a 4-year period. These findings have implications in tailoring modes of therapy in patients with AF...
Diminishing proportional risk of sudden death with advancing age: implications for prevention of sudden deathAndrew D Krahn
Division of Cardiology, University of Western Ontario, London, Ontario, Canada
Am Heart J 147:837-40. 2004..We sought to determine the effect of advancing age on the mode of death in the Amiodarone Trialists Metanalysis...
Atrial fibrillation: hypertension as a causative agent, risk factor for complications, and potential therapeutic targetJeff S Healey
McMaster University, Hamilton, Ontario, Canada
Am J Cardiol 91:9G-14G. 2003..Specific pharmacotherapy could potentially play a major role in the primary and secondary prevention of atrial fibrillation and its complications...
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 strokeJeff S Healey
McMaster University, Hamilton, Ontario, Canada
Am Heart J 150:288-93. 2005..This pilot study assessed the safety and efficacy of left atrial appendage (LAA) occlusion, performed at the time of coronary artery bypass grafting (CABG)...
Canadian Trial of Physiological Pacing: Effects of physiological pacing during long-term follow-upCharles R Kerr
Room 344, Division of Cardiology, St Paul s Hospital, 1081 Burrard St, Vancouver, BC, Canada, V6Z 1Y6
Circulation 109:357-62. 2004..However, the occurrence of atrial fibrillation was significantly less frequent with physiological pacemakers. To assess a potential delayed benefit of physiological pacing, follow-up of patients in this study was extended to 6 years...
Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trialsGreg C Flaker
Department of Medicine, University of Missouri-Columbia, Columbia, MO, USA
Am Heart J 152:967-73. 2006..6% per year. No increased major bleeding occurred with aspirin and ximelagatran. These results suggest that the risks associated with addition of aspirin to anticoagulation in patients with AF outweigh the benefit...
Combined antiplatelet therapy in atrial fibrillation: review of the literature and future avenuesStefan H Hohnloser
Department of Medicine, J W Goethe University Hospital, Frankfurt, Germany
J Cardiovasc Electrophysiol 14:S60-3. 2003..The ACTIVE program began patient enrollment in spring 2003...
Antithrombotic drug development for atrial fibrillation: proceedings, Washington, DC, July 25-27, 2005Kevin Jackson
Duke Clinical Research Institute, Durham, NC 27705, USA
Am Heart J 155:829-40. 2008..With this summary document, we hope to provide a helpful resource for future drug development for AF...
Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W SubstudyStefan H Hohnloser
Department of Cardiology, Division of Electrophysiology, J W Goethe University, Frankfurt, Germany
J Am Coll Cardiol 50:2156-61. 2007..Our goal was to determine the risk of stroke or non-cerebral embolism associated with paroxysmal compared with sustained atrial fibrillation (AF)...
Effect of amiodarone and sotalol on ventricular defibrillation threshold: the optimal pharmacological therapy in cardioverter defibrillator patients (OPTIC) trialStefan H Hohnloser
Department of Medicine, Division of Cardiology, J W Goethe University, Theodor Stern Kai 7, 60590 Frankfurt, Germany
Circulation 114:104-9. 2006..The effects of these drugs on defibrillation energy requirements have not been previously assessed in a randomized controlled trial...
Progression to chronic atrial fibrillation after the initial diagnosis of paroxysmal atrial fibrillation: results from the Canadian Registry of Atrial FibrillationCharles R Kerr
Department of Medicine, University of British Columbia, Vancouver, BC, Canada
Am Heart J 149:489-96. 2005..After its initial diagnosis, atrial fibrillation (AF) may progress from paroxysmal to chronic AF (CAF). The rate of progression and risk factors for progression are not clearly defined...
Asymptomatic or "silent" atrial fibrillation: frequency in untreated patients and patients receiving azimilideRichard L Page
Cardiovascular Division, Clinical Cardiac Electrophysiology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, USA
Circulation 107:1141-5. 2003....
Atrial fibrillation: guiding lessons from epidemiologyEugene Crystal
University of Toronto, Schulich Heart Centre, Sunnybrook and Women s College Health Science Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
Cardiol Clin 22:1-8. 2004..Hypertension may be the most common primary etiology of AF, and the possibility of effective primary prevention of AF by strict control of hypertension needs to be evaluated adequately...
ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT)Stefan H Hohnloser
Division of Electrophysiology, Department of Cardiology, J W Goethe University, Frankfurt, Germany
Am Heart J 152:442-7. 2006..This substudy will determine if atrial electrical remodeling is detectable in pacemaker patients and if it is associated with the development of AF...
Efficacy of azimilide for the maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation in the presence and absence of structural heart diseaseCharles R Kerr
St Paul s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Am J Cardiol 98:215-8. 2006..56, p=0.11), and overall group (hazard ratio 1.22, 95% confidence interval 1.00 to 1.49, p=0.053). No patient died. In conclusion, azimilide showed a nonsignificant trend toward efficacy in maintaining sinus rhythm in patients with AF...
Worsening of symptoms before presentation with vasovagal syncopeRobert S Sheldon
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
J Cardiovasc Electrophysiol 18:954-9. 2007..Much of the natural history of vasovagal syncope is unknown. We determined whether patients presenting for care have had a recently worsened syncope frequency...
Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutterBramah N Singh
Cardiology Division, Veterans Affairs Greater Los Angeles Healthcare System and the David Geffen School of Medicine at UCLA, Los Angeles, CA 90073, USA
N Engl J Med 357:987-99. 2007..Dronedarone is a new antiarrhythmic agent pharmacologically related to amiodarone but developed to reduce the risk of side effects...
Rationale and design of ATHENA: A placebo-controlled, double-blind, parallel arm Trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular Hospitalization or death from any cause in patiENts with Atrial fibrillation/atriaStefan H Hohnloser
J W Goethe University, Department of Cardiology, Frankfurt, Germany
J Cardiovasc Electrophysiol 19:69-73. 2008..There is a continued need for new antiarrhythmic drugs to treat the ever-increasing number of patients with this arrhythmia. Dronedarone is a new antiarrhythmic compound currently being developed for treatment of AF...
Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillationRobert G Hart
Stroke 39:1901-10. 2008..Additional research to identify an optimum scheme for primary prevention and subsequent standardization of recommendations may lead to more uniform selection of patients for anticoagulant prophylaxsis...
Atrial deformation: the key to maintenance of sinus rhythm in patients with atrial fibrillation?Hisham Dokainish
Eur Heart J 29:1483-4. 2008
Effects of azimilide on heart rate and ECG conduction intervals during sinus rhythm in patients with a history of atrial fibrillationEdward L C Pritchett
Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
J Clin Pharmacol 42:388-94. 2002..It was concluded that in patients with a history of atrial fibrillation or flutter, azimilide was associated with statistically significant increases in RR, QT, QTc(Bazett), and QTc(Fridericia) when patients were in sinus rhythm...
Rationale and design of a randomized placebo-controlled trial assessing the effects of etiologic treatment in Chagas' cardiomyopathy: the BENznidazole Evaluation For Interrupting Trypanosomiasis (BENEFIT)Jose Antonio Marin-Neto
Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Am Heart J 156:37-43. 2008..However, the efficacy of trypanocidal therapy in preventing clinical complications in patients with preexisting cardiac disease is unknown...
Rhythm control versus rate control for atrial fibrillation and heart failureDenis Roy
Montreal Heart Institute and the Université de Montréal, Montreal, QC H1T 1C8, Canada
N Engl J Med 358:2667-77. 2008..However, the benefits and risks of this approach have not been adequately studied...
