Both angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor blockers (ARBs) have been shown to be of benefit in patients with heart failure, and in patients who have reduced ventricular function following a myocardial infarction. However, it is less well known whether they provide benefit in patients with ischaemic heart disease (IHD) and preserved ventricular function. […]
Category: Electrophysiology
ICD implant risks highlight increasing sub-specialisation
Should cardiologists who are not electrophysiologists be inserting implantable cardioverter-defibrillators (ICDs)? Curtis et al. performed a retrospective cohort study of patients who had an ICD fitted between January 2006 and June 2007. Patients were grouped according to whom had implanted their device: electrophysiologists, nonelectrophysiologist cardiologists, thoracic surgeons, and other specialists. The main outcome measures examined […]
A new test for Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
The diagnosis and management of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) can be problematic – the disease has a highly variable clinical presentation, and cardiac arrhythmias and sudden cardiac death occur frequently. Currently the diagnosis is usually made clinically using criteria that have been defined by an international task force -whilst these are specific they are […]
A new anti-arrhythmic for the treatment of AF
Dronedarone is a benzofuran derivative with an electropharmacological profile similar to amiodarone but with different effects on individual ion channels. In two previous randomised controlled trials dronedarone was shown to be more effective than placebo in maintaining sinus rhythm and controlling ventricular rate during recurrences of AF. […]
No role for intermittent amiodarone in AF
Although amiodarone maintains sinus rhythm in 45% to 70% of patients during 12 to 54 months follow-up, it is also associated with many serious non-cardiac side effects. To investigate if episodic treatment with amiodarone could still be effective in preventing atrial fibrillation (AF), but without causing significant side-effects, Ahmed et al. randomised 209 patients with […]
A return to rhythm? PVI proves superior in low EF CHF
Atrio-ventricular node ablation has been used to treat symptomatic atrial fibrillation with poor rate control although these studies have contained few subjects with low ejection fractions. Biventricular pacing has recently been shown to be superior to right ventricular pacing following atrio-ventricular node ablation. […]