theHeart.org - Arrhythmia/EP

ECGs add little when it comes to prognosis in those with chest pain

Tue, 18 Nov 2008 12:45:28 EST

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.)

THINRS: Home INR monitoring as effective as clinic-based care

Thu, 13 Nov 2008 13:30:16 EST

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.)

Interferon hope for chronic viral cardiomyopathy

Tue, 11 Nov 2008 15:15:21 EST

A phase 2 trial has shown that interferon beta-1b—a drug currently used to treat multiple sclerosis—may 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.)

T-wave alternans sudden-death risk stratification strikes out twiceor does it?

Mon, 10 Nov 2008 16:00:00 EST

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.)

New factor Xa inhibitor rivaroxaban moves into phase 3 for ACS

Mon, 10 Nov 2008 14:15:09 EST

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.)

Rock on: Keep iPod headphones away from pacemakers/ICDs to avoid interference

Mon, 10 Nov 2008 12:30:44 EST

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.)

PTSD symptoms more than double mortality risk in patients with ICDs

Fri, 07 Nov 2008 13:30:00 EST

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.)

New statement on appropriate use of echo contrast agents should reassure physicians after year of controversy

Thu, 06 Nov 2008 15:00:24 EST

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.)

Medtronic updates failure rates for Sprint Fidelis ICD leads

Tue, 04 Nov 2008 17:30:43 EST

Sudden cardiac death after MI has declined over the decades, but first 30 days and heart failure up risks

Tue, 04 Nov 2008 16:00:00 EST

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.)

MIs linked to daylight saving time may also help explain MI spikes on Mondays

Wed, 29 Oct 2008 17:00:00 EDT

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.)

Senate committees seek specifics on industry payments to CRF physicians

Fri, 17 Oct 2008 11:30:16 EDT

The request came during the Cardiology Research Foundation's flagship event in the nation's capital, held mere blocks from the Senate offices.

Cheney's AF recurs, electrical defibrillation scheduled

Wed, 15 Oct 2008 13:00:03 EDT

Current risk-stratification role for heart-rate turbulence monitoring defined

Wed, 15 Oct 2008 12:15:54 EDT

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.)

Continuous amiodarone for sinus-rhythm maintenance upheld in randomized AF trial

Wed, 15 Oct 2008 10:30:54 EDT

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.)

Warfarin warning: Shortfalls in anticoagulation for AF up risks of ICH and embolic stroke

Fri, 10 Oct 2008 12:45:00 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.)

Miniaturized heart pumps: Difference between life and death in small children

Tue, 30 Sep 2008 15:45:10 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.)

Out-of-hospital cardiac arrest: Location is all

Tue, 23 Sep 2008 16:00:00 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.)

ICD effectiveness: Do patients appreciate their limits? The debate continues

Mon, 22 Sep 2008 17:00:00 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.)