Cardiology
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Echocardiographic Estimation of Left Atrial Pressure in Atrial Fibrillation Patients
A study of patients undergoing catheter ablation for atrial fibrillation with periprocedural echocardiograms and directly measured left atrial pressure (LAP) has shown that mean LAP can be estimated with a high degree of accuracy by a hierarchical algorithm using three Doppler echocardiographic parameters.
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Arrhythmias in the Holiday Heart Syndrome
A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occured in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excess blood alcohol concentrations.
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Catheter Ablation for Ischemic Ventricular Tachycardia
A multicenter, randomized trial of initial catheter ablation vs. antiarrhythmic drug therapy for ventricular tachycardia in ischemic cardiomyopathy patients with an implantable cardioverter defibrillator resulted in fewer subsequent ventricular tachycardia episodes with ablation.
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Antiplatelet Therapy for Coronary Stent Patients Undergoing Noncardiac Surgery
A larger randomized controlled trial of aspirin monotherapy vs. no antiplatelet therapy in patients more than one year post-drug-eluting coronary stent placement failed to show a difference in ischemic outcomes or major bleeding, but minor bleeding was more common in the aspirin group.
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Angiography-Based QFR Analysis Falls Short Compared with FFR
In this large, multicenter, randomized trial, use of the angiography-based quantitative flow ratio method to guide revascularization of intermediate coronary stenoses resulted in a higher incidence of major adverse cardiac events at one year compared with pressure wire-based fractional flow reserve.
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Flank Pain and ‘Heartburn?’
The electrocardiogram (ECG) in the figure was obtained from a man in his 60s who presented to the emergency department for a suspected kidney stone. The patient also noted some intermittent heartburn in recent weeks. How would you interpret his ECG? Should you activate the cath lab?
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Acoramidis Tablets (Attruby)
The U.S. Food and Drug Administration has approved acoramidis, an oral drug for the treatment of transthyretin-related amyloid cardiomyopathy.
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Cardioprotective Therapy Initiation in Chemotherapy Patients
An international study of patients undergoing cancer chemotherapy or left chest radiation therapy showed that those who showed isolated reductions in echocardiography left ventricular global longitudinal strain but not ejection fraction during follow-up who were randomized to neurohormonal therapy vs. usual care showed better preservation of 12-month cardiac magnetic resonance-determined ejection fraction.
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Prognostic Value of Stress Echocardiography
A UK National Health Service database study of stress echocardiography has shown the degree of ischemia accurately predicts the risk of future cardiovascular events over five years. The same study also showed that a negative test in patients without a history of cardiac disease identifies patients with no more than the expected background risk of an event for patients in this demographic for five years.
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EARLY TAVR Study Reports a Win for TAVR in Asymptomatic Severe AS
In this multicenter, randomized trial comparing transcatheter aortic valve replacement (TAVR) with active surveillance in patients with asymptomatic severe aortic stenosis (AS), early TAVR showed an advantage regarding the composite endpoint of death, stroke, or unplanned hospitalization for cardiovascular causes. This result was driven primarily from the progression to severe symptomatic AS among the surveillance group, with no significant difference in mortality.