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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?
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.
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.
Arrhythmia/EP
IRIS confirms: No survival gains from early post-MI primary-prevention ICDs
1 COMMENT - Oct 7, 2009 17:00 EDT
Defibrillators implanted within a month of acute MI may prevent sudden cardiac deaths, but they don't reduce overall mortality, according to a trial that supports current guidelines based primarily on the smaller 2004 trial DINAMIT.
Heart failure
Acute heart-failure prediction model blends clinical gestalt with natriuretic peptides
Oct 5, 2009 17:00 EDT
Its developers say the prediction model for guiding management of patients presenting with dyspnea can make a difference when clinicians aren't sure about the diagnosis based on clinical signs. An editorial takes issue.
heartbriefs
Philips recalls thousands of AEDs
Oct 5, 2009 14:00 EDT
The automatic external defibrillators were distributed by Philips Medical and Laerdal Medical with model numbers M3860A, M3861A, M3840A, and M3841A.
Arrhythmia/EP
Stroke reduction with dronedarone shown in post hoc analysis
1 COMMENT - Oct 2, 2009 17:15 EDT
Investigators say that although the analysis raises the possibility that a drug with antiarrhythmic activity could reduce the risk of stroke, dronedarone is not a replacement for oral anticoagulant therapy or a treatment for stroke prevention.
Clinical cardiology
New "principles" on authorship and COI from PhRMA get mixed response
3 COMMENTS - Oct 2, 2009 12:00 EDT
The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.
Heart failure
REVERSE, MADIT-CRT make case for extending CRT to mild heart failure: Should guidelines change?
2 COMMENTS - Oct 1, 2009 10:30 EDT
Now in print after having been presented at meetings, the REVERSE randomized trial's European-cohort two-year results are consistent with the recently published, much larger MADIT-CRT trial in showing both clinical and LV structural benefits from resynchronization therapy in patients with NYHA class 1-2 heart failure.
Heart failure
Doctor-led "hospital-at-home" care subs for hospitalization in acute heart failure
5 COMMENTS - Sep 29, 2009 12:00 EDT
They lived just as long, but in a small randomized trial, patients with acute decompensated heart failure who received hospital-quality care in their homes as an alternative to hospital admission after presentation to the emergency department benefited in ways missed by those managed as inpatients in the traditional manner.
Lipid/Metabolic
Diabetes: An independent risk factor for AF
1 COMMENT - Sep 29, 2009 00:00 EDT
Atrial fibrillation was more likely to develop in diabetics than in nondiabetics in a new observational study, and the link was particularly strong in women.
Heart failure
New biomarker, galectin-3, shows risk-stratification potential in chronic heart failure
2 COMMENTS - Sep 28, 2009 15:00 EDT
The proposed biomarker, which seems to apparently play a role in the progression of cardiomyopathy and heart failure, predicted mortality or HF hospitalization in a post hoc analysis from the already published COACH randomized trial.
Heart failure
Mixed start to planned MARVEL trial of post-MI autologous skeletal-myoblast therapy
Sep 22, 2009 14:00 EDT
A pilot analysis suggests the cell therapy can improve functional capacity, but amiodarone may be needed to prevent ventricular arrhythmias; its investigators say they plan to switch gears on the remainder of the study.
Arrhythmia/EP
Upping duration of CPR compressions improves survival
1 COMMENT - Sep 21, 2009 17:30 EDT
Heart failure
Added to diuretics, low-dose dopamine renoprotective in small acute-HF trial
Sep 21, 2009 12:30 EDT
Better late than never in the age of evidence-based medicine, a randomized test of an established strategy might have confirmed the value of adding dopamine to loop diuretics to allow the latter at reduced, less kidney-damaging dosages.
Heart failure
Physician, teach thyself: IMPROVE-HF initiative boosts use of evidence-based outpatient care
Sep 16, 2009 17:45 EDT
The two-year prospective registry-based study of a performance-improvement initiative's effectiveness saw significant jumps, >70% in some cases, in the appropriate use of six out of seven measured evidence-based treatments for patients with chronic heart failure.

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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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Inside: Arrhythmia/EP
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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.
More