Arrhythmia/EP & Electrophysiology news, trials & more | theheart.org

Apixaban cuts stroke risk in all types of AF, says ARISTOTLE

Wed, 16 May 2012 09:30:43 EDT

The trial also had something to say about the degree of stroke risk according to type of atrial fibrillation—that is, whether paroxysmal or permanent/persistent.

Resuscitation rates in out-of-hospital arrests are woeful

Tue, 15 May 2012 11:30:05 EDT

Resuscitation rates in out-of hospital cardiac arrest are woefully low, new US research finds, fueled by poor use of bystander CPR and AED employment, which does show some variability according to the race of the victim. But focusing on the "race thing" oversimplifies the problem, say researchers, who also found that AEDs were located too far away from victims in 75% of cases.

FDA: MS drug fingolimod gets CVD warnings

Tue, 15 May 2012 10:30:36 EDT

The agency completed review of a patient death after the first dose of fingolimod and has updated contraindications and monitoring recommendations for patients with multiple sclerosis.

Without warfarin, Watchman still prevents strokes, says registry

Tue, 15 May 2012 10:15:50 EDT

Patients with AF implanted with the left atrial appendage occluder in the earlier PROTECT-AF trial took warfarin the first six weeks; but in warfarin-contraindicated patients, Watchman still protects against stroke, suggests an observational study.

"Sweet spot" for echo-guided CRT lead placement explored in trial

Mon, 14 May 2012 15:45:37 EDT

Device therapy meets personalized medicine: optimal lead positions are different for every patient, but once the leads are in, how close is close enough?

New guidance for young people with Wolff-Parkinson-White (WPW) syndrome

Mon, 14 May 2012 10:00:11 EDT

The "first-of-its-kind" consensus statement should help clarify which young people should undergo catheter ablation, authors of the document say.

Data gathering for Sunshine Act delayed

Fri, 11 May 2012 17:15:19 EDT

The CMS says that drug and device makers will not have to start collecting data on payments to physicians until 2013.

RAAFT 2: Catheter ablation can be first line of defense against paroxysmal AF

Fri, 11 May 2012 16:30:16 EDT

Recurrences were less common for patients who underwent catheter ablation vs antiarrhythmic drug therapy, but it took the right connections for catheter therapy to come out on top.

Riata revelations: ICD lead failure rates, mechanisms take HRS center stage

Fri, 11 May 2012 10:30:34 EDT

Next chapter in the Riata recall story: how often do the leads fail, and why? In one of many Riata-related presentations at the Heart Rhythm Society meeting, the rate was about 2% per patient year. Why is less easily determined.

MRI with pacers, ICDs: Safe, a few minor issues, says MagnaSafe registry

Thu, 10 May 2012 10:00:44 EDT

Although MRI in device patients may alter some programming and impedance levels temporarily, the scans are associated with few if any important clinical problems, interim analysis of the study suggests.

Waist-hip ratio excels at SCD risk prediction in ARIC cohort

Thu, 10 May 2012 08:45:07 EDT

Greater waist-to-hip ratio—but not two more common obesity measures—meant a higher sudden death risk independently of diabetes, CV disease, and heart failure in the community-based cohort study.

Older female AF patients have higher stroke risk

Wed, 09 May 2012 17:00:02 EDT

Less aggressive care following warfarin prescription is a possible explanation, researchers say.

ICD shutoff? Yes, say patients, in certain end-of-life scenarios

Wed, 09 May 2012 16:00:00 EDT

Nearly three-quarters of patients with an ICD would consider shutting it off in specific situations.

Dr David Rosenbaum dies, age 54, of pancreatic cancer

Tue, 08 May 2012 11:00:51 EDT

On Wednesday, Rosenbaum will be awarded a Heart Rhythm Society Lifetime Achievement Award at the HRS 2012 meeting; his name is found throughout the HRS program, where he was scheduled to give a number of lectures.

Dr Douglas Zipes explains his rare Riata editorial

Mon, 07 May 2012 17:50:30 EDT

In the latest twist in the Riata lead story, the Heart Rhythm editor in chief published a rare editorial saying he was "compelled to speak out" in defense of the peer-review process that led to his decision to stand by the publication of Hauser et al's paper, after St Jude called for its retraction.

WHF defends Dubai WCC, reimburses Israelis denied visas

Fri, 04 May 2012 13:35:21 EDT

The World Heart Federation is apologizing to Israeli cardiologists who, at the last minute, were denied visas to attend the WCC 2012 in Dubai. One of the Israelis who attended, however, has spoken out to clarify that he and his colleagues "only have good words to say" about their visit to the Emirate city.

More adverse events seen on dabigatran vs warfarin

Fri, 04 May 2012 13:15:32 EDT

UPDATED // A new study in patents switched from warfarin to dabigatran has shown a high rate of events necessitating discontinuation of the new drug.

Energy drinks up BP and heart rate; calls for regulation

Thu, 03 May 2012 12:00:00 EDT

UPDATED WITH COMMENTARY // A small study illustrates that energy drinks can cause increased blood pressure, tachycardia, and arrhythmias, with those who consume these beverages on a habitual basis being most at risk. The author calls for more research and believes sales of these products should be regulated.

Lives, money saved by protocol-guided transfusion use at cardiac surgery

Wed, 02 May 2012 16:00:08 EDT

The bottom line can benefit, if clinical gains aren't enough reason for wide-scale implementation of guidelines for blood-product use with cardiac surgery.

Ideal blood-pressure goals? "We have no idea"

Wed, 02 May 2012 14:00:36 EDT

Evidence is lacking for many of the issues that need to be addressed in the field of hypertension, not least the ideal blood-pressure goal for different groups of individuals, experts told the ESH meeting this past weekend.

Small study links Tasers to cardiac arrest

Tue, 01 May 2012 15:45:16 EDT

UPDATED // Several case reports have cast doubt on the safety of electronic control devices, commonly known by the brand name Taser. A new study looks at eight cases where a person subdued by one of these devices lost consciousness.

CURE-AF: Success up as LA size declines for RF ablation at cardiac surgery

Tue, 01 May 2012 13:15:05 EDT

But arguably the trial's most important results, according to one expert, underscored a key difficulty in studying surgical procedures.

Beware valve involvement in device-related infective endocarditis

Fri, 27 Apr 2012 17:00:42 EDT

A number of factors were related to higher mortality, but all seemed to have a common thread, in a large international study of infective endocarditis associated with implanted devices.

Positive vote from FDA advisors for subcutaneous ICD

Thu, 26 Apr 2012 17:35:59 EDT

The FDA's Circulatory System Devices Panel voted seven to one in favor of Cameron Health's premarket approval application for its subcutaneously implanted defibrillator.

CHA2DS2-VASc score gives best prediction of stroke risk in AF

Thu, 26 Apr 2012 09:30:55 EDT

Another study has suggested that the newer CHA₂DS₂-VASc score may be more suitable than the CHADS₂ score, particularly in those at lower risk.

Variation in dual- vs single-chamber-ICD use highlights missing data

Wed, 25 Apr 2012 16:45:11 EDT

For patients without an indication for a pacemaker, expert opinions vary on the merits of dual- vs single-chamber implantable defibrillators. One expert says there is a critical need for more research on which device is best.

Topol is most influential physician executive in new US poll

Tue, 24 Apr 2012 12:00:09 EDT

Dr Eric Topol, editor in chief of theheart.org, has been voted the number one most influential physician executive of 2012 in a poll run by Modern Healthcare, a US publication covering healthcare business news and research.

Dabigatran cuts ICH mortality vs warfarin: RE-LY analysis

Tue, 24 Apr 2012 11:00:21 EDT

Actually, once intracranial hemorrhage struck, mortality was about the same in the trial's different groups. But fewer ICHs with dabigatran made for big drop in ICH mortality overall.

ACE inhibitors better ARBs in new meta-analysis in hypertensives

Mon, 23 Apr 2012 16:45:41 EDT

UPDATED WITH COMMENTARY // ACE inhibitors reduced deaths by 10% in a new meta-analysis in hypertensive patients already receiving good, contemporary therapy. In contrast, ARBs had a neutral effect on all-cause mortality. The researchers say the findings provide additional support for the use of ACE inhibitors as first-line treatment for high blood pressure.

Hands off my wife! Bahrain AED survey points to CPR barriers

Fri, 20 Apr 2012 13:00:49 EDT

Controversial findings from a small, survey-based study conducted in the Middle East suggest that Arab men would "not accept" men of other nationalities performing CPR, chest compressions, or applying an AED on a female companion.

Lung cancer? Yep, but smokers, globally, are less aware of CVD risks

Fri, 20 Apr 2012 09:30:10 EDT

Even more striking, smokers were largely unaware that secondhand smoke increases the risk of heart disease and stroke among nonsmokers, a number that spiked even higher when nonsmokers were questioned.

Marked gender disparities in CVD treatment, outcomes seen in CREATE registry

Thu, 19 Apr 2012 02:00:00 EDT

Not only are women experiencing ACS in India less likely to receive appropriate care, they are also more likely to die following treatment, a new analysis shows.

SCD risk increased in blacks with HTN, genetics may be key: LIFE analysis

Wed, 18 Apr 2012 09:30:18 EDT

Their elevated sudden-death risk was independent of a range of clinical and ECG risk factors, suggesting that "other factors must be playing a role," concluded researchers from the decade-old trial.

Tough sell: WCC 2012 course coaxes trainees toward preventive cardiology

Wed, 18 Apr 2012 09:15:57 EDT

How to convince young doctors to get involved in CVD prevention, when other areas of cardiology are so alluring—and more lucrative? That's a central conundrum underpinning a trainee course that kicked off this year's meeting, in a region where soaring CV risk factors make it a life-and-death question.

Italian soccer player dies on the pitch

Mon, 16 Apr 2012 13:00:03 EDT

An Italian soccer player died of cardiac arrest during a match, just a few weeks after a player in England survived a similar incident.

AF patients admitted to the hospital on weekends have worse outcomes

Fri, 13 Apr 2012 17:00:34 EDT

Previous studies have found that MI patients admitted to the hospital on the weekend generally fare worse than patients arriving during the week, so researchers looked at the same question with regard to atrial-fibrillation patients.

Abiomed's newest Impella pump earns CE Mark

Thu, 12 Apr 2012 17:00:09 EDT

Abiomed has announced that its Impella cVAD temporary circulatory support device has been approved for sale in Europe.

Five OSU cardiologists earned $1-million bonuses in 2011

Thu, 12 Apr 2012 16:45:56 EDT

The five electrophysiologists earned $1.3 million in bonus pay in 2011, pushing two of the cardiologists over the $2-million mark in total compensation that year. Only Thad Matta, the men's basketball coach, earned more than the doctors.

CPR training sessions offered during the Boston Marathon race exposition

Thu, 12 Apr 2012 15:00:00 EDT

The Boston Athletic Association, in conjunction with the American Heart Association and the American Red Cross, will be providing free CPR demonstrations for runners, family members, and spectators as they wander through the race exposition. There will be brief sessions to teach compression-only CPR in an attempt to reduce the risk of sudden cardiac death while running the marathon.

No mortality risk for losartan vs candesartan seen in heart failure

Thu, 12 Apr 2012 10:00:24 EDT

UPDATED WITH COMMENTARY // Nothing is rotten in the state of Denmark when it comes to the ARB losartan, compared with candesartan, in patients with heart failure—unlike what had seemed true in Sweden.

ECGs refine risk prediction in seniors, but clinical benefit and cost uncertain

Wed, 11 Apr 2012 17:00:18 EDT

Traditional coronary disease risk factors provide a less accurate estimate of risk in older adults than in middle-aged adults, so researchers tested whether electrocardiographic abnormalities that are common in older adults might aid coronary heart disease event prediction.

Hospitals launch medical practices to lure well-insured

Tue, 10 Apr 2012 16:00:00 EDT

America's hospitals are busier than ever expanding into new and affluent geographic markets to lure well-insured patients, a strategy that could drive up costs as well as jeopardize independent physician practices, according to a new study.

FDA: Medtronic CRT-Ds get NYHA 2 HF indication

Tue, 10 Apr 2012 13:30:04 EDT

Following the majority opinion of an advisory panel last year, the FDA has expanded the indication for Medtronic CRT-D devices to patients with NYHA class 2 heart failure, an LVEF of 30% or less, left bundle branch block, and a QRS duration of 130 ms or more.

St Jude: Retract "Riata deaths" journal report

Mon, 09 Apr 2012 17:30:24 EDT

UPDATED // It's urging the peer-reviewed Heart Rhythm to pull a recent analysis of deaths associated with the company's Riata ICD leads, which alleged they are prone to shorting out. The company has even issued its own review of an FDA database, saying it cannot replicate the numbers in the published analysis.

Dr Gary Gibbons named director of the NHLBI

Thu, 05 Apr 2012 11:30:00 EDT

Currently at the Morehouse School of Medicine in Atlanta, Gibbons will begin his new role as director of the NHLBI this summer. He is taking over for Dr Susan Shurin, who was named acting director after Dr Elizabeth Nabel left in January 2010.

Medical societies list 45 dubious tests, therapies

Wed, 04 Apr 2012 16:00:00 EDT

The American College of Cardiology is one of nine societies that each identified five tests and procedures that are common but often unnecessary, running up the cost of care and sometimes harming a patient's health.

heartwire's Lisa Nainggolan picks up AHCJ award

Wed, 04 Apr 2012 14:15:00 EDT

Nainggolan's feature story "Lost in transition: The looming epidemic of grown-up congenital heart disease" has placed third in the Association of Health Care Journalists' annual journalism awards in the trade-publication category.

St Jude stops sales of CRT leads with possible insulation problem

Wed, 04 Apr 2012 13:15:00 EDT

St Jude Medical is warning physicians to look out for externalized conductors on some of its QuickSite and QuickFlex CRT leads and will stop selling the models possibly affected by this issue.

CPR may save people with unshockable arrhythmias

Mon, 02 Apr 2012 16:30:25 EDT

The 2010 American Heart Association cardiopulmonary-resuscitation guidelines emphasize uninterrupted chest compressions, an approach shown in several studies to save lives of people in so-called "shockable" cardiac arrest. A new study evaluates the benefits of this approach for "unshockable" cardiac arrest.

Arrhythmic risk can stay elevated even after improved LVEF

Mon, 02 Apr 2012 15:00:59 EDT

Could an LVEF that has risen above 35% since ICD implantation indicate less need for a replacement device?

Oral anticoagulants in the real world: Bleeding rates and medical costs compared

Mon, 02 Apr 2012 11:45:35 EDT

Two separate experiences with dabigatran from different US centers showing very different results, and new cost-effectiveness analyses with the new drugs were reported in a poster session at last week's ACC meeting.

Low BMI may up complication, mortality risk at ICD implantation

Mon, 02 Apr 2012 11:15:52 EDT

Some simple precautions might help prevent the two most common complications that were seen in underweight patients.

Rivaroxaban gets NICE nod in UK for AF

Mon, 02 Apr 2012 09:30:31 EDT

In its final draft guidance, the UK National Institute for Clinical Excellence has recommended rivaroxaban as an option for the prevention of stroke and systemic embolism in people with atrial fibrillation.

New analysis extends dabigatran MI signal to other thrombin inhibitors

Fri, 30 Mar 2012 11:00:00 EDT

A new meta-analysis of trials of dabigatran and its almost-forgotten, long-lost cousin, ximelagatran, shows that there is a signal of increased MI with use of direct thrombin inhibitors. The novel findings were dissected and digested at the ACC Scientific Sessions earlier this week.

Low rate of residual stroke with warfarin

Thu, 29 Mar 2012 17:10:44 EDT

A contemporary meta-analysis of trial data shows a 1.66% annual rate of stroke with current use of warfarin in patients with nonvalvular atrial fibrillation.

Riata ICD lead failures: Focus shifts to short-circuit risk

Thu, 29 Mar 2012 13:45:29 EDT

Abraded insulation and exposed cables were only the beginning of the leads' safety issues. They haven't been implanted in well over a year, but lots of people still have them.

New oral anticoagulants in AF: What to do in clinical practice

Tue, 27 Mar 2012 15:45:51 EDT

In a talk entitled "Putting it all together: What should we do now?" Prof John Camm attempted to make some recommendations on how the new drugs should be incorporated into clinical practice.

ISSUE-3: DDD pacing can help suppress asystolic neurally mediated syncope

Mon, 26 Mar 2012 19:10:00 EDT

Patient selection was likely the key to the success of pacemaker therapy, according to researchers: all randomized patients had shown what was considered likely to be that form of syncope during implantable-loop-recorder monitoring.

Most ICD implants appropriate, more detailed chart notes may be needed

Mon, 26 Mar 2012 16:00:00 EDT

An audit of a suburban New York hospital highlighted a gap between national coverage determination directives for ICD implants and clinical practice based on medical judgment and more updated professional society guidelines. Despite this, less than 2% of implants were deemed inappropriate at the hospital.

Black and white athletes need separate screening guidelines

Sun, 25 Mar 2012 17:30:04 EDT

Preparticipation cardiac screening for athletes leads too many false positives, especially in black athletes, so a group in England has refined the screening process to account for racial differences in training-related cardiac changes that are sometimes mistaken for dangerous heart conditions.

TAVI registry updates ADVANCE the field, raise hopes for lower stroke rates

Sat, 24 Mar 2012 16:25:34 EDT

Low stroke rates in two registries tracking outcomes for the two leading transcatheter valves are raising hopes that the cerebrovascular events that concerned people in the pivotal PARTNER trial may not necessarily represent the real-world occurrence of this problem going forward.

Cardiologists are happy(ish), married non-tweeters, survey reveals

Thu, 22 Mar 2012 17:00:00 EDT

Cardiologists, for the most part, drive Japanese cars, believe in a higher power, and are moderately savvy when it comes to social media. Those are just some of the cardiology pearls from a recent "lifestyle survey" of physicians.

Latest Canadian AF guidelines encourage new oral anticoagulants

Wed, 21 Mar 2012 16:30:07 EDT

The Canadian Cardiovascular Society has updated its guidelines on atrial fibrillation to reflect some major new findings that have been reported during the past year or so.

Another study questions epinephrine for out-of-hospital cardiac arrest

Tue, 20 Mar 2012 16:30:00 EDT

Any short-term gains from giving the drug come with a high cost later, suggest adjusted analyses of a massive national CPR registry.

Merck abandons oral vernakalant

Mon, 19 Mar 2012 16:30:23 EDT

The decision is based on its "assessment of the regulatory environment and projected development timeline," according to company officials.

What's going to be hot at ACC 2012

Mon, 19 Mar 2012 14:00:51 EDT

There are 18 late-breaking clinical trials, many addressing unresolved issues with already-approved products or procedures. Outside the main tent, the program offers debates, live and taped cases, a new Q&A series with "legends" in cardiology, plus a novel gambit for attracting attendees to the exposition: a "thought leaders' theater" located in the exhibit hall.

Soccer star's cardiac arrest�prompts screening questions

Mon, 19 Mar 2012 11:00:00 EDT

The dramatic collapse and resuscitation attempts following the cardiac arrest of a 23-year-old UK soccer player, Fabrice Muamba, this weekend have prompted calls for wider cardiac screening of athletes here. But as a top-class player, Muamba is likely to have been screened, experts told heartwire, with one theorizing that his arrest was likely caused by a rare condition.