Heart failure news, trials, articles & opinions | 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.

TAVI to treat surgical valve failure shows potential, with caveats

Tue, 15 May 2012 13:00:30 EDT

The largest series to date looking at use of a transcatheter valve to treat the failure of a surgically implanted prosthetic has found high rates of survival at one year, but enough in the way of safety signals that investigators are cautioning against widespread use of the practice.

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?

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.

Ixmyelocel-T cell therapy may help DCM patients

Fri, 11 May 2012 14:00:28 EDT

Cell therapy could be an attractive adjunct for patients with ongoing heart-failure symptoms despite optimal medical and device therapy. A new study shows that a therapy derived from the patient's own bone-marrow cells could fill this role.

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.

Whistleblower suit claiming pioglitazone cover-up implicates Nissen, Cleveland Clinic

Thu, 10 May 2012 16:15:38 EDT

Dr Helen Ge, a former employee at Takeda, alleges she was fired for repeatedly trying to flag as "serious" the congestive heart failure event reports she was reviewing for the company. She has filed a False Claims Act complaint seeking damages and civil penalties from Takeda on behalf of the US government, which has declined to intervene in the case.

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.

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 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.

No advantage for warfarin in heart failure: WARCEF published

Fri, 04 May 2012 15:00:27 EDT

The authors of a commentary say this large randomized study has provided clinicians with clear answers regarding aspirin vs warfarin in heart failure.

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.

Bypass moderate coronary lesions? Taking sides in the debate

Fri, 04 May 2012 11:30:07 EDT

When is it worth bypassing moderate coronary lesions? In the pathophysiology of CAD progression, as in politics, whether right or left seems to make a difference.

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.

Older LVAD risk score not effective in current era

Tue, 01 May 2012 14:30:34 EDT

The destination therapy risk score provided poor discrimination of mortality for LVAD patients receiving the device as a bridge to transplant and modest discrimination for patients who receive LVADs as destination therapy.

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.

Friend or foe? Uric acid a "probable cause" of CVD

Mon, 30 Apr 2012 10:00:47 EDT

Using a unique approach, Israeli researchers have shown that people with so-called "normal" levels of uric acid have a 50% higher risk of hypertension and an almost doubling of diabetes, compared with those with naturally very low uric-acid levels.

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.

FDA advisors: Benefits trump risks for HeartWare ventricular assist pump

Wed, 25 Apr 2012 18:15:27 EDT

The agency revealed little beforehand about which way it was leaning, but its advisory panel, despite disappointment with some of the data, ultimately favored the device's approval.

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.

CARGO 2: AlloMap transplant-rejection test works in Europe

Tue, 24 Apr 2012 17:00:38 EDT

Researchers hope the findings will lead to wider European use of the gene-expressing profiling test, which they say could mean fewer surveillance endomyocardial biopsies.

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.

Cutting, taxing salt would trim CVD deaths by 3% in half the world

Mon, 23 Apr 2012 15:30:10 EDT

A new study modeling the impact of a mere 10% reduction in sodium content in processed foods, combined with adding a 40% tax to salty products in 19 low- and middle-income countries, could lead to 250�000 fewer deaths per year.

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.

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.

Higher HbA1c levels predict better outcomes in advanced heart failure with diabetes

Thu, 12 Apr 2012 14:15:10 EDT

But not in patients with heart failure without diabetes, observed researchers, who suggest that a midrange rather than very low HbA_1c target may be reasonable in some patients with heart failure.

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.

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.

PCI bests meds in stable CAD, but message is "do better meds"

Thu, 05 Apr 2012 18:30:00 EDT

Is optimal medical therapy a pipe dream, at least right now? An analysis of clinical-practice data from NY State reopens the COURAGE-oriented debate.

FDA reiterates warning on HeartMate II outflow graft hazard

Thu, 05 Apr 2012 17:30:00 EDT

Thoratec is advising customers of potential for malfunction of the HeartMate II LVAD's outflow graft and has updated the device's labeling to help surgeons avoid the problem.

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.

Mitral regurgitation: Early hazard, later gains following TAVI

Wed, 04 Apr 2012 17:00:00 EDT

Mortality in the first 30 days is higher among patients with moderate to severe mitral regurgitation undergoing transcatheter valve implantation. After the first month, however, MR tends to be diminished, supporting a role for TAVI in this high-risk group.

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.

Longer HF hospitalizations cut risk of readmission in analysis

Tue, 03 Apr 2012 16:45:09 EDT

Within and outside the US, hospital length of stay was inversely related to 30-day readmissions. But another country had both the longest hospitalizations and the lowest readmission rate.

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?

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.

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.

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.

Transcatheter valves in inoperable patients at two years: PARTNER B

Mon, 26 Mar 2012 09:00:00 EDT

Two-year outcomes in the PARTNER B trial, testing transcatheter aortic-valve replacement against best medical care in inoperable patients, have now been published.

PARTNER A: Even mild paravalvular leaks linked with higher mortality at two years

Mon, 26 Mar 2012 09:00:00 EDT

UPDATED // A phenomenon virtually unheard of in the surgical valve-replacement era, paravalvular leaks were linked with higher mortality, although overall mortality rates were no different between surgery- and TAVR-treated patients. Investigators are calling paravalvular regurgitation a new "target" that could potentially further improve TAVI results.

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.

FOCUS-CCTRN: Negative trial, but hints for future of cell therapy in heart failure

Sat, 24 Mar 2012 09:00:00 EDT

The largest study to date of autologous bone-marrow-cell therapy in patients with chronic ischemic heart failure has shown no significant effect on the prespecified end points but did suggest an improvement in LVEF that was related to the number of progenitor cells in the bone marrow.

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.

Orthostatic hypotension ups risk of HF by 50%

Wed, 21 Mar 2012 12:00:44 EDT

New data from the ARIC study show that those with orthostatic hypotension have a higher risk of developing heart failure over 17 years of follow-up.

No benefit of vitamin E in heart failure

Tue, 20 Mar 2012 16:00:00 EDT

The addition of vitamin E did reduce the risk of developing heart failure with a normal ejection fraction, but these results need to be confirmed in larger studies, say investigators.

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.

Life on a 12-hour charge: Seeking community in the LVAD age

Mon, 19 Mar 2012 11:45:08 EDT

For people living with a left ventricular assist device, knowing a few simple tricks can make life a bit easier. Others with LVADs make good teachers, but increasingly, LVAD recipients are looking online for answers to their questions.