Beware that extra glass of winewomen consuming more than two alcoholic drinks per day are at increased risk of developing atrial fibrillation compared with their nondrinking counterparts, a new US study has found. (Conen D et al. JAMA 2008; 300:2489-2496.)
Twenty years of research show that generic CVD drugs across nine classes are just as good as brand-name agents, yet editorials often boost superiority of brand-name agents. (Kesselheim AS et al. JAMA 2008; 300:2514-2526.)
Specialized teams trained to recognize and respond to early signs of cardiopulmonary arrest, thereby preventing "code blues" before they happen, are popping up at hospitals around the US, but a new study suggests there may be no evidence to support their use. (Chan PS et al. JAMA 2008; 300:2506-2513.)
It tripled the patient's chances for surviving to hospital discharge in a retrospective study; discharge was five times more likely if there was also bystander cardiopulmonary resuscitation. (Bobrow BJ et al. Circulation; published online before print November 24, 2008.)
There had previously been few prospective data to support the increasingly common strategy for following patients with the devices. (American Heart Association 2008 Scientific Sessions.)
UPDATED // The new device, known as the NaviStar ThermoCool radiofrequency ablation catheter, would be the first approved for the treatment of atrial fibrillation.
In the large randomized trial that compared the drug with placebo, even patients who never achieved sinus rhythm on the drug had a reduced risk of hospitalization. (American Heart Association 2008 Scientific Sessions.)
ECGs or exercise ECGs have little incremental value over and above clinical assessment for prognosis in patients with suspected angina, a new study has found. Hence, such tests should not be used to rule out future events in these patients, researchers say. (Sekhri N et al. BMJ; published online before print November 13, 2008.)
A randomized comparison shows weekly home monitoring is safe but did not reduce stroke, major bleeds, or death vs monthly clinic INR testing, as had been suggested by previous studies. (American Heart Association 2008 Scientific Sessions.)
A phase 2 trial has shown that interferon beta-1ba drug currently used to treat multiple sclerosismay be effective in chronic viral cardiomyopathy. But a phase 3 trial is needed for definitive proof of concept, say the study investigators and discussant. (American Heart Association 2008 Scientific Sessions.)
The microvolt TWA test's battered imaged as a risk stratifier for ICD candidates suffered several more blows in the past few weeks with publication of two major studies that conclude against it as a predictor of sudden cardiac death in low-LVEF patients. But the noninvasive test has its proponents who see the data a bit differently. (Chow T et al. J Am Coll Cardiol 2008; 52:1607-1615. Gold MR et al. Circulation; published online before print October 27, 2008.)
A phase 2 trial has demonstrated the feasibility of the novel oral factor Xa inhibitor rivaroxaban in patients with acute coronary syndromes already treated with aspirin and clopidogrel. A phase 3 study with the drug, beginning next month, will reveal whether the benefits outweigh the bleeding risks. (American Heart Association 2008 Scientific Sessions.)
Investigators say that as long as patients keep their headphones on their ears and out of their breast pockets, there is no chance of causing damage to their devices that could have clinical repercussions. (American Heart Association 2008 Scientific Sessions.)
Individuals who receive implantable cardiac defibrillators after a sudden cardiac event are more than twice as likely to die within five years if they experience symptoms of posttraumatic stress disorder, regardless of disease severity. (Ladwig et al. Arch Gen Psychiatry 2008; 65:1324-1330.)
The statement outlines situations in which benefits of contrast outweigh risks and could ultimately improve patient outcomes, experts say. (Mulvagh SL et al. J Am Soc Echocardiogr 2008; 21:1179-1201.)
Physicians and patients need to be aware that sudden death is more common during the first few weeks post-MI and that the development of heart failure, at any time, increases the risk of sudden death in MI survivors. (Adabag AS et al. JAMA 2008; 300:2022-2029.)
Rest easy for now: MI rates appear to increase in the spring but dip marginally with the end of DST in autumn, due likely to the extra hour of sleep. (Janszky et al. N Engl J Med 2008; 359:1966-1967.)
The Holter-based technique is especially effective in the post-MI setting and may be useful in patients with heart failure, according to a state-of-the-art review. (Bauer A et al. J Am Coll Cardiol 2008; 52:1353-1365.)
An "episodic" amiodarone regimen was less safe and effective and didn't reduce complications from the drug's toxicity. (Ahmed S et al. JAMA 2008; 300:1784-1792.)
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.)
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 pumpwidely available in Europewill soon be approved for use in the US. (Gandhi SK et al. Circulation 2008; 118:S89-S93.)
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.)
Join Drs Yancy, Jessup, Lindenfeld, Saxon, and Stevenson as they discuss how similar databases can be interpreted differently. Device-based therapy is effective when selected for the right patient; but there is considerable underuse of devices, in part due to ambiguity in the guidelines.
The overall heart failure-related mortality rate in the United States has almost doubled in the past two decades. Which patients will benefit the most from the use of ICDs? Join our panel of experts, Drs Abraham, Fonarow, Francis, and Gold as they discuss the latest evidence from clinical trials.
The Sudden Cardiac Arrest Association is the nations largest public advocacy organization singularly dedicated to sudden cardiac arrest (SCA) awareness and prevention. Its network of chapters, affiliates and volunteers include SCA survivors, patients at risk, physicians, nurses, EMTs and others touched by SCA. SCAA and its members work to expand public knowledge of SCA, improve emergency response to SCA victims, and encourage access to preventative medical care to patients at risk.
What is the prevalence and clinical impact of lead failure on the patient and their QOL? Our panel of experts, Drs Ellenbogen, Epstein, Wilkoff, and Auricchio discuss evidence-based strategies for managing this important issue.