theHeart.org - Arrhythmia/EP

Enrollment halts in randomized trial of CPR for out-of-hospital arrest

Fri, 06 Nov 2009 16:00:39 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.

Another in-hospital CV risk marker: 24-hour shifts with overnight on-call duty

Wed, 04 Nov 2009 09:45:43 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.

US updates advice on perioperative beta-blocker use in noncardiac surgery

Tue, 03 Nov 2009 14:30:32 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.

Benefits of targeted lead placement with CRT devices supported by long-term mortality data

Thu, 29 Oct 2009 15:00:55 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?

Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows

Wed, 28 Oct 2009 16:45:37 EDT

Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

NT-proBNP "remarkable predictor" of incident atrial fibrillation

Fri, 23 Oct 2009 16:30:37 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.

Simple cooling methods improve neurologic outcomes after cardiac arrest, new review confirms

Thu, 22 Oct 2009 11:00:03 EDT

A new literature review confirms that conventional cooling methods work safely to improve survival and reduce brain damage after cardiac arrest.

No link seen between heart failure and coffee intake

Fri, 16 Oct 2009 10:15:02 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.

Racial background woefully underreported in CV trials

Thu, 15 Oct 2009 13:15:10 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.

A fish tale with merit: Omega-3 PUFAs underrated for heart failure

Wed, 14 Oct 2009 12:30:27 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.

Glucocorticoids seen to double risk of atrial arrhythmias

Mon, 12 Oct 2009 16:00:00 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.

Vernakalant converts AF to sinus rhythm postsurgery

Fri, 09 Oct 2009 17:15:03 EDT

The drug, however, is still not yet approved by the Food and Drug Administration.

IRIS confirms: No survival gains from early post-MI primary-prevention ICDs

Wed, 07 Oct 2009 17:00:00 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.

Acute heart-failure prediction model blends clinical gestalt with natriuretic peptides

Mon, 05 Oct 2009 17:00:00 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.

Philips recalls thousands of AEDs

Mon, 05 Oct 2009 14:00:59 EDT

The automatic external defibrillators were distributed by Philips Medical and Laerdal Medical with model numbers M3860A, M3861A, M3840A, and M3841A.

Stroke reduction with dronedarone shown in post hoc analysis

Fri, 02 Oct 2009 17:15:19 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.

New "principles" on authorship and COI from PhRMA get mixed response

Fri, 02 Oct 2009 12:00:10 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.

REVERSE, MADIT-CRT make case for extending CRT to mild heart failure: Should guidelines change?

Thu, 01 Oct 2009 10:30:49 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.

Doctor-led "hospital-at-home" care subs for hospitalization in acute heart failure

Tue, 29 Sep 2009 12:00:05 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.

Diabetes: An independent risk factor for AF

Tue, 29 Sep 2009 00:00:23 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.

New biomarker, galectin-3, shows risk-stratification potential in chronic heart failure

Mon, 28 Sep 2009 15:00:18 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.

Mixed start to planned MARVEL trial of post-MI autologous skeletal-myoblast therapy

Tue, 22 Sep 2009 14:00:42 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.

Upping duration of CPR compressions improves survival

Mon, 21 Sep 2009 17:30:00 EDT

Added to diuretics, low-dose dopamine renoprotective in small acute-HF trial

Mon, 21 Sep 2009 12:30:00 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.

Physician, teach thyself: IMPROVE-HF initiative boosts use of evidence-based outpatient care

Wed, 16 Sep 2009 17:45:55 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.

CAD hospitalizations decline, but HF admissions increase

Wed, 16 Sep 2009 15:15:04 EDT

FDA issues class I recall of LifePak CR Plus defibrillators

Wed, 16 Sep 2009 14:15:29 EDT

Black patients less likely to survive in-hospital cardiac arrest

Tue, 15 Sep 2009 16:00:00 EDT

Black patients who have an in-hospital cardiac arrest are 12% less likely than white patients to survive until discharge—largely due to interhospital differences, researchers report.

FAST enough? Intrathoracic monitor bests weight gain in predicting worsening heart failure

Tue, 15 Sep 2009 14:30:51 EDT

Can an intrathoracic fluid-status monitor, added to an already-indicated ICD or CRT-D device in patients with heart failure, serve as the decompensation early-warning system now provided—unreliably but as recommended in the guidelines—by the bathroom scale?

New ASCOT analysis: Beta blockers not beneficial in hypertensives with tachycardia

Tue, 15 Sep 2009 14:15:57 EDT

Pulse rate should not be the determinant of which drugs are used in hypertension, conclude the authors of a new subgroup analysis of the ASCOT trial.

Conflicts of interest affect best practices in both industry-funded and non-industry-funded trials

Tue, 15 Sep 2009 12:00:19 EDT

Clinicians and researchers need to be more aware before signing on to studies about what potential conflicts might arise with the sponsor and set the ground rules for such areas as access to data, manuscript preparation, and right to publish.

Who should get CRT? Resynchronization benefits seen in heart failure with LVEF >35%

Mon, 14 Sep 2009 17:15:00 EDT

Heart-failure patients with ejection fractions >35% aren't necessarily excluded from the clinical and reverse-remodeling benefits of cardiac resynchronization therapy, suggests yet another study questioning the limits of CRT's current eligibility criteria.

ICDs in women with heart failure? Won't work, suggests meta-analysis

Mon, 14 Sep 2009 16:00:00 EDT

Implantable defibrillators don't cut all-cause mortality in women with systolic heart failure, proclaim five major clinical trials speaking in unison. An editorial writer cries "foul" on the frequent assumption in clinical practice that outcomes data from randomized trials conducted primarily in men should also apply to women.

Medtronic issues advisory over device battery life

Mon, 14 Sep 2009 15:00:00 EDT

Sponsorship of med-school textbooks in Denmark exposes vulnerable minds to commercial bias

Mon, 14 Sep 2009 11:45:00 EDT

Results of a new survey showed that a surprising 15% of textbooks had one or more drug or device sponsors and, in two cases, those sponsors had tried to influence the content of the textbooks.

Spin not uncommon in negative RCTs, study shows

Mon, 14 Sep 2009 11:30:00 EDT

French researchers who systematically quantified the prevalence of spin across 72 negative randomized controlled trials say half of the studies put a positive spin on the negative findings in the conclusion sections of the papers.

B-CONVINCED: Maintain beta blockers during acute heart-failure management

Mon, 14 Sep 2009 10:30:00 EDT

Short-term outcomes are the same whether beta blockers are continued or withheld at hospitalization for acute decompensated heart failure, and there are good reasons to continue them, according to researchers.

US cardiologists in short supply; problem could get worse

Fri, 11 Sep 2009 13:15:22 EDT

The US is short roughly 1600 general cardiologists and 2000 interventional cardiologists. The problem is expected to get worse unless the shortage is addressed, according to an ACC task force.

Ghost authorship on the wane, but guest authorship still common

Fri, 11 Sep 2009 11:00:38 EDT

UPDATED // Compared with a 1996 survey by JAMA editors, a 2008 survey indicates that the practice of having ghost writers pen papers, then not appear as authors, is down to 8%, from 12% in 1996. The practice of inviting a prominent name to appear in the list of authors, without requiring that person to contribute to the research, has held steady at roughly 20%.

Dronedarone in atrial fib trades efficacy for safety in meta-analysis

Fri, 11 Sep 2009 10:15:53 EDT

The finding, based on eight randomized trials, supports the view that dronedarone is less effective than amiodarone at preventing the arrhythmia's recurrence but doesn't have the older drug's serious toxicities, as suggested by the DIONYSOS trial.

Taser shocks said to pose little CV risk

Wed, 09 Sep 2009 17:30:14 EDT

Their heart rates jumped by about 11 bpm and blood pressures rose, but volunteers who received multiple shocks didn't otherwise show abnormal heart rhythms or changes in QRS or corrected-QT intervals.

Implantable ECG loop recorder differentiates between syncope and epilepsy

Wed, 09 Sep 2009 11:00:16 EDT

Is it syncope? Or is it epilepsy? When there's doubt, an implantable ECG loop recorder can help make the correct diagnosis.