theHeart.org - Arrhythmia/EP

Sen Grassley questions top medical schools about ghostwriting

Fri, 20 Nov 2009 13:15:28 EST

As part of his mission to see more financial transparency in medicine, Sen Grassley has asked eight top US medical schools about their policies on ghostwriting.

Oral anticoagulants REDEEMed? Daily dabigatran "safe" with dual antiplatelets after MI

Thu, 19 Nov 2009 11:00:11 EST

A dose-finding study saw what were characterized as low bleeding rates associated with triple-drug antithrombotic therapy that included the oral anticoagulant dabigatran in patients with a recent ACS event and other cardiovascular risk factors.

EFFECT: Public reporting of hospital performance improves quality of care?

Thu, 19 Nov 2009 10:00:55 EST

Publicly released report cards based on hospital performance did not result in a measurably greater systemwide improvement in two composite AMI or CHF process-of-care indicators in a Canadian study. But they did appear to stimulate some important changes in delivery of care that could have led to some better outcomes.

RE-LY: Post hoc analysis confirms benefit of dabigatran relative to warfarin at all INR levels

Tue, 17 Nov 2009 16:30:06 EST

A new analysis confirms that regardless of INR control achieved across participating centers, dabigatran remained noninferior at the lower dose and superior at the higher dose to warfarin for prevention of stroke and systemic embolism.

HEAAL: High-dose trumps low-dose ARB for heart failure in the ACE-inhibitor intolerant

Tue, 17 Nov 2009 08:15:58 EST

UPDATED WITH COMMENTARY // The randomized trial, which compared losartan dosages of 150 mg/day and 50 mg/day, "makes a strong case for the value of incremental inhibition of the renin-angiotensin system," its authors say.

RECORD AF: Better success with rhythm control, but no difference in outcomes

Mon, 16 Nov 2009 17:00:40 EST

New registry data presented this week showed that cardiologists are more likely to select rhythm control over rate control for the treatment of atrial fibrillation, and this strategy is more likely to lead to successful treatment of AF than the rate-control-based approach. Both strategies are equivalent in terms of their effect on clinical outcomes.

Medical device correction issued for Cardiac Science AEDs

Mon, 16 Nov 2009 13:00:24 EST

AEDs manufactured by Cardiac Science are undergoing a nationwide voluntary medical device correction because of the potential failure of these devices to deliver therapy during use.

REPLACE registry finds 15.3% six-month complication rate with pacer and ICD lead replacements

Mon, 16 Nov 2009 09:30:42 EST

The REPLACE registry finds "sobering" comprehensive risk rates with pacemaker and ICD upgrades.

PRINCE: Prehospital intranasal cooling after cardiac arrest feasible, may improve survival

Mon, 16 Nov 2009 08:45:41 EST

A device that allows therapeutic hypothermia to begin in the field has been shown to be safe and its use feasible in treating out-of-hospital cardiac arrest.

Good news continues for ticagrelor in PLATO STEMI subanalysis

Sun, 15 Nov 2009 19:30:00 EST

Ticagrelor, an investigational antiplatelet agent, may become a new standard of care for the management of patients with STEMI heading for primary PCI, said the lead investigator of the STEMI subset of the PLATO trial. Reporting the new findings here today, he said they were consistent with the overall PLATO results.

PACE: BiV pacing protects against RV pacing's adverse ventricular effects in randomized trial

Sun, 15 Nov 2009 16:30:23 EST

In patients with conventional indications for pacing and normal systolic function, preservation of synchrony with biventricular pacing prevented the adverse remodeling effects of right-ventricular-only pacing. But some question the trial's methods.

Natural ventricular rate a powerful risk predictor in ICD trial

Thu, 12 Nov 2009 17:15:47 EST

It's routinely assessed but underappreciated as a risk marker: the natural, unpaced heart rate of patients with implanted defibrillators was a strong, independent predictor of poor clinical outcomes in a retrospective analysis.

SGR repair bill failure could cool physician support for healthcare reform

Thu, 12 Nov 2009 15:00:58 EST

Now that the US House of Representatives has passed a healthcare reform bill, organized medicine anticipates another vote—possibly next week—on a second bill that would rewrite Medicare's controversial sustainable-growth-rate formula for physician reimbursement.

FDA investigating external-defib energy levels

Wed, 11 Nov 2009 11:45:30 EST

The agency is following up on 14 reports over the past three years of unsuccessful defibrillation/cardioversion attempts from a 200-J device followed by successful therapy from a 360-J unit.

What's going to be hot at AHA 2009?

Wed, 11 Nov 2009 09:00:54 EST

Anticipation is building for full trial results from ARBITER 6-HALTS, plus a better understanding of what went wrong with cangrelor in the CHAMPION trials. Also in the lineup are updates from PLATO, RE-LY, ALLHAT, BARI 2D, STICH, CASCADE, POPULAR, HEARTMATE II, and many more. Indeed, this year's "late-breaking" sessions include more than 30 trials over five days.

Obesity may top hypertension as risk factor for LA enlargement

Mon, 09 Nov 2009 17:00:00 EST

Obesity and hypertension were major independent risk factors for left atrial enlargement (itself a risk factor for atrial fibrillation) in an observational, population-based study, but obesity was the strongest predictor.

Interventional cardiologist Donald Baim dies

Fri, 06 Nov 2009 18:22:01 EST

UPDATED // Interventional cardiologist Dr Donald Baim, chief medical and scientific officer at Boston Scientific, has died.

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.