Cardiology news: award winning coverage by heartwire

Arrhythmia/EP

Sprint Fidelis ICD leads: Common in kids, account for most of their lead failures

May 24, 2013 16:15 EDT

The lead failure rate was about 14% overall in a registry of young people with ICDs; the slim Fidelis made up more than two-thirds of their failed leads. There are special considerations when selecting ICD leads for this age group.

Arrhythmia/EP

Cardiac-arrest survival highest at hospitals with the fewest

May 21, 2013 11:30 EDT

Hospitals that excel at preventing cardiac arrests also have higher survivor rates when an arrest occurs.

Clinical cardiology

Inhaled long-acting bronchodilators in COPD flagged again for CV hazard

1 COMMENT - May 20, 2013 16:00 EDT

The controversy continues over the cardiovascular side effects of both long-acting beta-agonist and long-acting anticholinergic drugs when newly prescribed for the management of chronic obstructive pulmonary disease.

Arrhythmia/EP

HRS members support charitable ICD/pacemaker donation for reuse overseas

May 16, 2013 17:30 EDT

A survey of the society's physician members shows there is wide support for, although also some concerns about, the practice, which remains controversial in the US.

Arrhythmia/EP

Dabigatran "real-life" results suggest caution needed

4 COMMENTS - May 15, 2013 17:15 EDT

New data from real-life experience of dabigatran for stroke prevention in AF shows that it is often used outside prescribing recommendations, and the risk of both thromboembolism and bleeding may be raised in patients switched from warfarin.

Arrhythmia/EP

No clinical gain, more risk: Preference for dual- vs single-chamber ICD again questioned

May 15, 2013 16:15 EDT

Applying only to primary-prevention patients with no pacing indications, an analysis suggests that more expensive dual-chamber implantable defibrillators, compared with single-chamber devices, pose a higher complication risk without any clinical advantage; yet they seem to be the ICD of choice for such patients, at least in the US.

Interventional/Surgery

Gene-mutation discovery in congenital heart disease spells major shift in care

May 15, 2013 09:15 EDT

The finding will fundamentally alter how congenital cardiac defects are categorized and potentially treated, say the authors of a new report.

Arrhythmia/EP

How close am I? Shocks decline when ICD programmers reminded of evidence-based settings

May 14, 2013 10:45 EDT

When they saw reports documenting shortfalls in their programming of ICDs to guidelines, clinicians cleaned up their act and shock rates safely fell; but this kind of teaching might not accomplish enough, researchers say.

Arrhythmia/EP

Repeat ablation wins out over antiarrhythmic agents for recurrent paroxysmal AF

1 COMMENT - May 13, 2013 15:45 EDT

Not only was reablation more likely to banish recurrences in a randomized study, trying drugs the second time just made it worse for some patients.

Arrhythmia/EP

Few failures show up in Durata, Riata ST Optim defibrillator-lead analysis

1 COMMENT - May 10, 2013 14:30 EDT

It has limitations, but an analysis of St Jude registries suggests the Optim-insulated leads won't suffer the same issues that plagued the company's recalled Riata and Riata ST leads.

Thrombosis

Long-term PROTECT-AF analysis: Watchman attains efficacy superiority over warfarin in AF

May 10, 2013 10:00 EDT

The Watchman left-atrial appendage occluder had previously been found noninferior to warfarin in patients with nonvalvular atrial fibrillation; now, with an average of 45 months of follow-up, it's not only noninferior, it's superior, by some statistical measures.

Interventional/Surgery

In vivo, VERITAS: Live case TAVR just as safe as closed-door procedures

May 9, 2013 14:50 EDT

The FDA forbids the use of investigational transcatheter aortic-valve devices in live-case presentations being broadcast from US centers. A new study is offering some much-needed data into whether the agency's concerns are justified.

Thrombosis

BRUISE CONTROL: Continued warfarin beats heparin bridging in ICD/pacemaker implants

May 9, 2013 11:00 EDT

UPDATED // Guidelines recommend that patients at high risk for thromboembolic events be bridged with heparin therapy, but few randomized trials have compared this strategy with simply maintaining patients on warfarin for their procedures.

Arrhythmia/EP

Oral anticoagulants less used in paroxysmal than persistent AF: NCDR data

4 COMMENTS - May 9, 2013 09:30 EDT

US cardiologists seem to have a double standard when it comes to managing thromboembolic risk in patients with paroxysmal vs persistent atrial fibrillation, despite guidelines calling for equality.

Arrhythmia/EP

No worsening HF seen with Riata-like failure of St Jude QuickSite, QuickFlex CRT leads

May 9, 2013 09:00 EDT

Although nearly half of patients with the pacing leads at one center showed externalizations on fluoroscopy, their heart failure wasn't worse than in those without the problem.

Prevention

No benefit of fish oil in high-risk patients

19 COMMENTS - May 8, 2013 17:00 EDT

N-3 fatty-acid supplementation had no effect on the study's primary end point in this group of patients with multiple cardiovascular risk factors or atherosclerotic disease, but no previous MI. Researchers also saw no effects on the rate of death from coronary causes or sudden death from cardiac causes or major ventricular arrhythmias.

Interventional/Surgery

Treating paroxysmal AF during cardiac surgery improves outcomes

2 COMMENTS - May 8, 2013 13:00 EDT

A new study is shedding key new information on what one expert called an uncommon subject in the literature but a really common clinical problem.

Heart failure

Dick Cheney: "Coronary artery disease is just a part of who I am"

11 COMMENTS - May 8, 2013 10:40 EDT

Speaking at the 2013 AATS meeting, Cheney describes his LVAD procedure the toughest of all his heart surgeries, while his transplant was a walk in the park. He and his cardiologist, Dr Jonathan Reiner, are coauthoring a book about Cheney's four-decade-long CVD odyssey.

Arrhythmia/EP

Apixaban superior to warfarin across range of INR values, ARISTOTLE analysis

1 COMMENT - May 7, 2013 17:00 EDT

The reduction in the primary efficacy end point of stroke or systemic embolism with apixaban was observed across a broad range of INR control in the warfarin-treated patients.

Arrhythmia/EP

Program tweak cuts ICD pacing/shocks in broad population: ADVANCE 3

May 7, 2013 16:00 EDT

The trial "confirms and reinforces" conclusions from last year's MADIT-RIT trial, that ICD programming that delays arrhythmia detection can prevent some inappropriate shocks and other unnecessary device treatments but extends the finding to patients with almost any kind of ICD.

Arrhythmia/EP

ESC issues "practical guide" to new oral anticoagulants in AF

May 2, 2013 16:30 EDT

It used to be easier deciding which oral anticoagulant to use in patients with nonvalvular atrial fibrillation. With all the choices now available, a new document sorts out their differences and can guide their use in various clinical settings.

Arrhythmia/EP

No raised azithromycin CV-death risk seen in young or middle-aged adults

1 COMMENT - May 1, 2013 17:00 EDT

A nationwide cohort study in Denmark helps to soften the message from a 2012 study linking the antibiotic to an increased risk of cardiovascular death in the elderly, likely from ventricular arrhythmias, according to researchers; the hazard doesn't seem to apply to younger people in the general population.

Clinical cardiology

Subclinical hyperthyroidism linked to heart-failure deaths

Apr 30, 2013 14:45 EDT

A massive observational study in half a million individuals has found a link between subclinical hyperthyroidism and cardiovascular death, which appears to be predominantly driven by heart failure.

News

Stopping dabigatran ups stroke risk: New boxed warning

1 COMMENT - Apr 30, 2013 13:30 EDT

It raises the profile of a caution already in the oral anticoagulant's prescribing information.

Thrombosis

FDA okays Kcentra to reverse anticoagulation, stop bleeding

2 COMMENTS - Apr 30, 2013 11:10 EDT

The plasma-derived product, like plasma itself, can stop major bleeding, but it can be deployed more quickly because it does not require blood-group typing or thawing.