Implantable cardioverter-defibrillators (ICDs) are now the standard of care in primary and secondary prevention of malignant arrhythmias, however with their increasing use it has been noted that ICD therapies – both appropriate and inappropriate – are associated with an increased risk of death and worsening of heart failure. The recent Multicenter Automatic Defibrillator Implantation Trial […]
Category: Electrophysiology
Long QT syndrome mutations and intrauterine fetal death
Intrauterine fetal death occurs in approximately 1 in every 160 pregnancies; postmortem evaluation often fails to find an underlying cause. The objective of this paper was to determine the spectrum and prevalence of mutations in the three most common Long QT syndrome (LQTS) susceptible genes in a cohort of cases of unexplained intrauterine death. […]
Novel ICD programming reduces mortality
The implantable cardioverter-defibrillator (ICD) has consistently demonstrated benefit in reducing sudden cardiac death in patients at high risk of ventricular arrhythmias, but inappropriate ICD activations are a common occurrence with potential adverse effects on patient well-being and increased costs for health services. Strategies to reduce the frequency of inappropriate device activation without reducing efficacy in […]
Apixaban shows safety in secondary analysis
The decision to anticoagulate a patient with atrial fibrillation involves a balance between the risks of thromboembolism against those of haemorrhage, with both risks imperfectly predicted by even the best stratification scoring systems. Although warfarin reduces the risk of stroke in patients with atrial fibrillation, its use remains limited by several limitations. Apixaban is a […]
Fish Oils Don’t Decrease Post-Op AF
Both clinical and experimental evidence have suggested an anti-arrhythmic effect of long-chain n-3 polyunsaturated fatty acids (n-3-PUFAs) in fish oil. However, the effect of n-3-PUFAs on atrial arrhythmias such as postoperative atrial fibrillation (AF) remain uncertain. The Omega-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) trial was designed to test whether perioperative n-3-PUFA […]
Catheter ablation for paroxysmal AF
Atrial fibrillation is the commonest cardiac arrhythmia. While a number of established drug therapies are often successful in achieving satisfactory control, more recently radiofrequency catheter ablation has emerged as an effective therapy for patients with paroxysmal AF. However, the place of catheter ablation remains unclear with limited data comparing ablation with antiarrhythmic drug therapy as […]
Flec-SL: short- vs. long-term flecainide after AF cardioversion
The goal of antiarrhythmic therapy following cardioversion for atrial fibrillation (AF) is to prevent further recurrences for as long as possible. However, it is known that the atrial action potential normalises after 2-4 weeks of sinus rhythm, suggesting that drugs may not be essential in the long-term. The goal of this study was to investigate […]
Atrial Fibrillation: Women at higher stroke risk
Patients with atrial fibrillation (AF) have a risk of stroke that is five times greater than that of the general population. Moreover, it has previously been described that women with atrial fibrillation have a higher annual rate of stroke than men (3% vs. 1.6%). The reasons for this remain unclear, although previous studies have […]
Infective endocarditis caused by cardiac devices
The number of electronic cardiac devices, including pacemakers and cardioverter-defibrillators, being implanted each year is increasing. As a result, there has been a 210% increase in the incidence of device infection between 1993 and 2008 in the United States. Cardiac device infective endocarditis (CDIE) is significant in that it is associated with a higher mortality […]
Subclinical AF significantly increases stroke risk
Approximately 25% of all strokes are of unknown cause, and it has long been hypothesised that short subclinical episodes of atrial fibrillation (AF) may be an important common etiologic factor. While several studies have attempted to detect episodes of subclinical AF, most have been hampered by the infrequency of such episodes and the unlikelihood of […]