Interventional/Surgery
Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows
1 COMMENT - Oct 28, 2009 16:45 EDT
Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

Edmonton, AB - A 13-year study of bypass-surgery patients in Nova Scotia shows that only about one in 10 patients who are eligible for an implantable defibrillator ever got one, and the rate is particularly low in women and the elderly, due mainly to inconsistent patient follow-up [1].

Results of the study were presented here by medical student Ryan Kelly (Dalhousie University, Halifax, NS) at the Canadian Cardiovascular Congress 2009.Read full article »

Inside: Arrhythmia/EP
Accredited educational programs, supported by industry, developed by theheart.org

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Arrhythmia/EP
Evaluation and Treatment of Patients With Atrial Fibrillation
Oct 21, 2009 11:32 EDT
Dr. Anne Curtis offers 2 cases of high-risk patients who present with shortness of breath. How are these patients diagnosed and treated?
Arrhythmia/EP
Treating Atrial Fibrillation: A Multidisciplinary Approach
Oct 16, 2009 09:05 EDT
Rate control, rhythm control, new drugs and devices for anticoagulation -- the armamentarium of treatment options is expanding rapidly. Drs. Yancy, Cannon, and Boehmer discuss the latest treatment modalities for patients with AF.
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Arrhythmia/EP
Expanding Role of HF-Device Therapy?
Sep 28, 2009 14:20 EDT
The results of MADIT-CRT suggest patients with early stage (NYHA class I/II) symptomatic heart failure (HF) indicated for an implantable cardioverter defibrillator (ICD) may benefit from the addition of cardiac resynchronization therapy (CRT). How likely are these results to increase device implant rates? Take our poll and see how your colleagues responded.
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Arrhythmia/EP
Enrollment halts in randomized trial of CPR for out-of-hospital arrest
Nov 6, 2009 16:00 EST
No survival differences after out-of-hospital cardiac arrest were seen at a preliminary DSMB review in the ROC PRIMED trial, which compared early vs delayed post-CPR assessment for defibrillation and tested the effectiveness of a device for optimizing intrathoracic pressure during CPR.
Prevention
Another in-hospital CV risk marker: 24-hour shifts with overnight on-call duty
1 COMMENT - Nov 4, 2009 09:45 EST
Long work shifts with nighttime on-call duty, with the inevitable interruptions of sleep, are associated with ECG, blood-pressure, and biochemical changes associated with increased cardiovascular risk, suggests a randomized crossover study that hints at a sustained effect on the risk markers if the 24-hour shifts happen too frequently.
Interventional/Surgery
US updates advice on perioperative beta-blocker use in noncardiac surgery
5 COMMENTS - Nov 3, 2009 14:30 EST
A US update on the perioperative use of beta blockers for noncardiac surgery is, says the lead author, "similar" to recent European guidance on this issue.
Heart failure
Benefits of targeted lead placement with CRT devices supported by long-term mortality data
Oct 29, 2009 15:00 EDT
An additional year of data from the INCREMENTAL study showed that echo-targeted LV lead positioning increased the likelihood of a response to device therapy by about 40% over standard lead placement. But does that difference translate into better long-term outcomes for the patient?
Arrhythmia/EP
NT-proBNP "remarkable predictor" of incident atrial fibrillation
1 COMMENT - Oct 23, 2009 16:30 EDT
The fact that elevated baseline NT-proBNP levels predict a diagnosis of AF even 16 years later suggests that peptide elevations precede the onset of arrhythmia, according to the researchers.
Clinical cardiology
Simple cooling methods improve neurologic outcomes after cardiac arrest, new review confirms
Oct 22, 2009 11:00 EDT
A new literature review confirms that conventional cooling methods work safely to improve survival and reduce brain damage after cardiac arrest.
Heart failure
No link seen between heart failure and coffee intake
Oct 16, 2009 10:15 EDT
With few studies in the literature specifically looking at the issue, a prospective, population-based study in Sweden has found no significant rise or fall in risk of heart-failure hospitalization or death at increasing levels of coffee intake.
Acute Coronary Syndromes
Racial background woefully underreported in CV trials
1 COMMENT - Oct 15, 2009 13:15 EDT
Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.
Heart failure
A fish tale with merit: Omega-3 PUFAs underrated for heart failure
18 COMMENTS - Oct 14, 2009 12:30 EDT
Are the data not shouting loud enough, or is cardiology hard of herring? Omega-3 fatty acids may have only a modest treatment effect in heart failure, but they've performed swimmingly in randomized and observational studies considering how few new HF drugs have been reeled in lately.
heartbriefs
Glucocorticoids seen to double risk of atrial arrhythmias
Oct 12, 2009 16:00 EDT
In a case-control study from Denmark, the risk of atrial fibrillation or flutter was significantly increased with current but not previous use of glucocorticoids for chronic obstructive pulmonary disease, rheumatoid arthritis, and other conditions.
heartbriefs
Vernakalant converts AF to sinus rhythm postsurgery
Oct 9, 2009 17:15 EDT
The drug, however, is still not yet approved by the Food and Drug Administration.
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Editorial Programs
Editorial series
Clinical research: Comparing regulatory pathways in US and UK
Oct 30, 2009 12:35 EDT
How do regulatory pathways differ in the US and UK? Drs Harrington, Bhatt, and Cleland share their experiences and offer insight on how to support innovative research.
Editorial series
Afib treatment: The five-year plan
Oct 23, 2009 10:40 EDT
Dr Melissa Walton-Shirley talks to Dr Nassir Marrouche about the results of RE-LY, the impact of dronedarone on the treatment of atrial fibrillation, and his hopes for the future of MRI-guided ablation.
Editorial series
Cardiac resynchronization therapy: Update from ESC
Oct 2, 2009 13:45 EDT
Join 'heartwire's Steve Stiles as he talks to Drs Nassir Marrouche and Clyde Yancy about MADIT-CRT, the potential benefits and costs for the heart-failure population in light of the trial, and about why the Europeans seem to be ahead of the guidelines in the European CRT Survey.
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ARRHYTHMIA/EP
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Poll
The results of MADIT-CRT suggest patients with early stage (NYHA class I/II) symptomatic heart failure (HF) indicated for an implantable cardioverter defibrillator (ICD) may benefit from the addition of cardiac resynchronization therapy (CRT). How likely are these results to increase device implant rates? Take our poll and see how your colleagues responded.

How do you think the results of the MADIT-CRT trial (and other studies suggesting benefits of CRT device-based therapy in earlier-stage HF patients) will affect implant CRT rates in the next 3 years?
See: MADIT-CRT: Resynchronization therapy cuts heart-failure risk in patients with only mild disease
Rates will significantly increase (> 15% increase in primary prevention ICD utilization in congestive HF patients)
Rates will moderately increase (5%-10%)
Rates will slightly increase (2%-5%)
Rates will slightly increase (2%-5%)

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