Approximately 6-20% of patients with severe sepsis develop new-onset atrial fibrillation (AF). Although the risks of chronic AF are well documented, the relationship between new-onset AF in the setting of sepsis and prognosis has not previously been well studied, partly due to the complex nature of this group of patients. […]
Category: Electrophysiology
Rocket AF – rivaroxaban shows efficacy
While warfarin has served as the oral anticoagulant of choice for decades, its time in widespread clinical use may finally be drawing to a close. A variety of new agents are in late stage development which hold several advantages: fewer interactions with other drugs, no need for therapeutic drug monitoring, and simpler dosing regimes. […]
ARB not found to benefit AF
Whilst reducing blood pressure reduces the risk of heart failure and stroke this relationship has thus far not been demonstrated in patients with atrial fibrillation. This is despite the fact that recent mechanistic work and retrospective analyses have suggested that both ACE inhibitors and ARBs have specific properties that alter atrial mechanical and electrical remodelling […]
Many US ICD implants not evidence based
For patients with severe systolic heart failure, several randomised trials have shown the ability of implantable cardioverter-defibrillator (ICD) devices to prevent sudden cardiac death. However, current US guidelines recommend against ICD insertion within 3 months of an initial heart-failure diagnosis, or within forty days of a myocardial infarction. […]
No benefit seen from using omega-3 fatty acids for atrial fibrillation
Fish oils, principally omega-3 fatty acids, have previously been investigated as a potential anti-arrhythmic agent for patients suffering from atrial fibrillation. However, the results of several small trials performed to date have been unclear. Therefore this randomised trial was designed to assess the effect of omega-3 fatty acids on patients with paroxysmal or persisting atrial […]
Stringent AF rate control fails to show benefit.
Guidelines for the treatment of atrial fibrillation (AF) suggest that, where rate control is the preferred management stratey, a resting heart rate of less than 80 bpm and an exercise heart rate of less than 110 bpm should be targeted. These values are based on the belief that lower heart rates will result in fewer […]
Success of Subcutaneous Defibrillator
Although Implantable Cardioverter-Defibrillators (ICDs) are an established treatment for the prevention of death from ventricular arrhythmia, they require transvenous lead implantation and thus their insertion is prone to complications. If cardiac pacing is not also required, then potentially transvenous electrodes can be avoided altogether. The authors report the results of a novel subcutaneous ICD system […]
Public Defibrillators Improve Outcomes
Sudden death from cardiac arrest remains a major public health problem with generally dismal outcomes. Although early defibrillation plays a key role, it is difficult to further reduce the time from a patient’s collapse to defibrillation by emergency medical personnel, and so recent efforts have turned to increasing access to automatic external defibrillators (AEDs) in […]
VTACH: Ablation beneficial prior to ICD insertion
Patients who suffer from ventricular tachycardia following myocardial infarction are at a high risk of sudden death. This risk can be reduced by implantable cardioverter defibrillator (ICD) insertion, however patients with an ICD who receive ICD shocks have a decreased quality of life and increased mortality compared with patients who do not receive shocks, even […]
The maze procedure and type of mitral valve surgery.
Atrial fibrillation (AF) is found in 40 to 60% of patients who require mitral valve surgery, with the treatment of choice being the maze procedure accompanied by mitral valve repair where it is technically feasible. The efficacy of the maze operation in patients undergoing MV replacement is unclear, in that anticoagulation after MV replacement may […]