Arrhythmia/EP
1 COMMENT - Aug 26, 2008 12:00 EDT
Many patients getting the devices today are decades older than those in the clinical trials on which the US guidelines are based. Some say that matters, so it should be explored in clinical trials. Others say there have been trials enough. (Sweeney MO et al. J Cardiovasc Electrophysiol; published online before print June 12, 2008.)

Boston, MA - An 85-year-old presents with symptomatic bradycardia and is considered a likely candidate for a pacemaker. At further evaluation, the patient is found to have an LV ejection fraction of 32%. With the patient meeting the guidelines' LVEF criteria for an implantable cardioverter-defibrillator (ICD), the decision is made on the spot to give the patient, not a single- or dual-chamber pacemaker, but an ICD programmed to manage the sinus-node disease (SND). Read full article »

(Sweeney MO et al. J Cardiovasc Electrophysiol; published online before print June 12, 2008.)
Inside: Arrhythmia/EP
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Arrhythmia/EP
2 COMMENTS - Oct 10, 2008 12:45 EDT
Documentation of the care of patients in a nationwide health plan suggests that less than half of patients with atrial fibrillation are prescribed an anticoagulant. (Walker AM, Bennett D. Heart Rhythm 2008;5:1365-1372.)
Interventional/Surgery
Sep 30, 2008 15:45 EDT
Reporting on his own initial experience with a miniaturized ventricular assist device used as a bridge to transplant in small children, a leading pediatric heart surgeon is hoping that the pump—widely available in Europe—will soon be approved for use in the US. (Gandhi SK et al. Circulation 2008; 118:S89-S93.)
Arrhythmia/EP
Sep 23, 2008 16:00 EDT
A new analysis of out-of-hospital cardiac arrest in 10 areas in North America has found a fivefold difference in survival rates. The researchers say an estimated 15 000 premature deaths could be prevented each year if survival could be increased in those places not performing well. A related article contends that to try to improve outcomes, attention should be focused on those most likely to survive. (Nichol G et al. Sasson C et al. JAMA 20082; 300:1423-1431, 1432-1438.)
Arrhythmia/EP
Sep 22, 2008 17:00 EDT
A review casts a critical eye on how ICDs are used in the US and argues that their benefits have been overstated; a commentary from a key figure behind the latest device-therapy guidelines takes exception. (Tung R et al. J Am Coll Cardiol; published online before print September 22, 2008.)
Acute Coronary Syndrome
Sep 9, 2008 17:30 EDT
The subclinical effects of traffic- and non-traffic-related pollution suggest that patients discharged following MI or acute coronary syndrome would be protected if air-pollution levels were lower or if they avoided needless exposure to pollution, report investigators. (Chuang KJ et al. Circulation; published online before print September 8, 2008.)
Heart failure
Sep 8, 2008 11:45 EDT
The trial's extended follow-up of its European patients strengthens its earlier evidence that CRT can reverse cardiac remodeling even in NYHA class 1-2, and its suggestions of a clinical benefit continue to inspire optimism. (European Society of Cardiology Congress 2008.)
Heart failure
Sep 4, 2008 09:45 EDT
The risk of death from any cause climbed whenever a primary-prevention ICD discharged, but the shocks were a warning, not a killer; another secondary analysis of the trial suggests that patients' quality of life didn't suffer because they had been implanted with ICDs. (Pool JE et al. Mark DB et al. N Engl J Med 2008; 359:1009-1017, 999-1008.)
Arrhythmia/EP
2 COMMENTS - Sep 3, 2008 11:45 EDT
The post hoc finding, which was relative to placebo, is unusual for an antiarrhythmic agent. The investigational drug is envisioned as a potentially safer alternative to amiodarone. (European Society of Cardiology Congress 2008.)
Heart failure
1 COMMENT - Aug 7, 2008 16:00 EDT
Previously more explored as a prognostic marker in the post-MI setting, abnormal heart-rate turbulence is being eyed as a risk stratifier in candidates for primary-prevention ICDs. (Cygankiewicz I et al. Heart Rhythm 2008; 5:1095-1102.)
Arrhythmia/EP
Aug 6, 2008 15:15 EDT
Physical activity has been previously reported to increase the risk of AF, but only intense exercise and endurance training have been evaluated, usually in younger adults. This study, say investigators, suggests that activities such as walking, gardening, and outdoor chores could be employed as a potential preventive measure to reduce the incidence of AF in the particularly high-risk and growing population of older adults. (Mozaffarian D et al. Circulation; published online before print August 5, 2008.)
Arrhythmia/EP
1 COMMENT - Aug 4, 2008 17:00 EDT
Defibrillation-threshold testing in SCD-HeFT had no effect on the efficacy of later appropriate shocks or on mortality. Also, the PREPARE study, of a one-size-fits all ICD-programming strategy, aimed at reducing device-related morbidity, is published. (Blatt JA et al. Wilkoff BL et al. J Am Coll Cardiol 2008; 52:551-556, 541-550.)
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