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Electrophysiology & Arrhythmia

 - anticoagulants

The beauty of novel oral anticoagulants is that they come in fixed doses and don’t require monitoring, as warfarin does. Still, some circumstances warrant an assay, and clinicians should be aware of the potential pitfalls.

 - Heart Rate

The American Heart Association has made improvements to guideline adherence in the treatment of atrial fibrillation a priority, according to a paper published Sept. 2 in Circulation: Cardiovascular Quality and Outcomes.

 - AF Ablation

A force-sensing ablation treatment for paroxysmal atrial fibrillation (PAF) helped to improve outcomes in the SMART-AF study, according to results published Aug. 19 in the Journal of the American College of Cardiology. But an accompanying editorial raised questions.

 - heart, cardiology, cardiac

Can atrial fibrillation (AF) or flutter during surgery predict stroke? Research published in the Aug. 13 issue of JAMA appears to confirm that it does.

 - Question Direction

Digoxin, for its wide use and history, may not be as safe for use in atrial fibrillation patients as it is assumed to be. Or is it? A study published Aug. 19 in the Journal of the American College of Cardiology attempted to answer this question.

 

More Stories

Complications increase risk for ICD infections

With surgery and introduction of a foreign object into a patient always comes some risk of infection. However, according to a study published online July 31 in Circulation, reducing that risk may involve more than just a clean site.

Older patients with severe dementia 2.9 times more likely to receive pacemaker

A team of researchers reviewing decisions to implant cardiac devices found that older patients with cognitive impairment were more often implanted with pacemakers, according to a study published online July 28 in JAMA Internal Medicine.

Many patients unaware of options, risks with ICD replacement

More than half of patients due for replacement of their implantable cardioverter-defibrillator (ICD) generator did not realize they could opt out and many underestimated the risks of ICD replacement, according to a research letter published online July 28 in JAMA Internal Medicine.

Meta-analysis finds sex differences in acute MI hard to track

We haven’t always spoken the same language in acute MI studies, researchers found when trying evaluate differences and changes to mortality in male and female patients using 46 years of data. The meta-analysis published online July 22 in Circulation found that study differences made comparisons difficult.

Perspective on Pradaxa

Much of the information published this week in BMJ about the oral anticoagulant dabigatran has appeared piecemeal throughout the years. But putting individual events into a narrative paints a more comprehensive picture.

Score predicts patients at risk of ICD testing glitch

Researchers developed and validated a simple risk model that identifies implantable cardioverter-defibrillator (ICDs) patients at risk of an inadequate defibrillation safety margin during defibrillation testing. By predicting who is at risk, physicians may be able to avoid related complications and better manage patients.

Heart-breaking benders: Liquor, wine, binge drinking may raise risk of AF

Jack, Jim and Jose may be doing more than hurting heads; they may be breaking hearts. According to a study published July 22 in the Journal of the American College of Cardiology, what people drink is as important as how much and how often they drink in developing atrial fibrillation (AF).

1 in 38 ICD patients experience major complications to lead revisions

Surgery to revise implantable cardioverter-defibrillator (ICD) leads had the highest overall incidence of major complications compared to initial implantation or procedures that did not involve the leads.

Pacemaker coders: Mind you Ps, Qs and KXs

The Centers for Medicare & Medicaid Services (CMS) initiated a national determination coverage decision July 7 for permanent cardiac pacemakers that will require a modifier to receive Medicare reimbursement for procedures.

Dabigatran on par with warfarin for in-hospital mortality

In-hospital mortality for patients with atrial fibrillation who experienced intracranial bleeding was similar whether they were treated with dabigatran or warfarin in a study published online July 3 in Stroke. The findings may help physicians and patients who are choosing between the two types of anticoagulants.

Device monitoring allows more defined AF classifications

Using data derived from patient monitoring devices, researchers found clearer, more reproducible results on burden and persistence in atrial fibrillation (AF) patients than through clinical observations alone.

It’s not personal: Genotyping may add no value for warfarin dosing

Personalized medicine may not be best means of guiding warfarin therapy, a study published online June 16 in JAMA suggests. In an analysis of outcomes of nine studies across the U.S., Europe and Israel, no benefit to utilizing genetic testing for markers CYP2C9, VKORC1, and CYP4F2 vs.  standard algorithms for dosing were seen.

Early visits may provide key to lowering atrial fibrillation readmissions

Patients with atrial fibrillation and comorbid conditions may benefit from follow-up outpatient visits in the first 14 days following a hospitalization, reducing the risks of 30-, 60-, or 90-day readmissions, according to a study published in the May/June issue of the American Journal of Medical Quality.

Rivaroxaban appears safe, effective for elderly patients

Elderly patients in ROCKET AF saw equal benefits with less risk of intracranial bleeding with rivaroxaban compared with warfarin. But there was a greater risk of noncranial bleeding in these patients.

Medtronic pays $9.9M to settle kickback claims

Medtronic has agreed to pay nearly $10 million to settle a whistleblower case over alleged kickbacks to physicians who treated patients with its pacemakers and defibrillators.

Boehringer earmarks $650M to settle Pradaxa suits

Boehringer Ingelheim will pay $650 million in a comprehensive settlement over its anticoagulant dabigatran. The company faced thousands of lawsuits in the U.S. from patients who claimed the drug caused severe and fatal bleeding.

FDA study weighs in favor of dabigatran

The FDA maintained its position on the safety of the anticoagulant dabigatran after completing a study that included an older patient population. Based on the results, the agency said it would make no changes in its recommendations or to the labeling.

Feds scrutinizing two cardiac device makers

Two manufacturers are under the federal magnifying glass with investigations involving implantable cardiac devices. The investigations are unrelated.

HRS.14: Testing ICDs during implantation isn’t necessary

Keep it simple, … Well, you know the rest. Physicians now can apply that advice to defibrillator testing of cardiac devices during implantation, based on results from the SIMPLE trial presented May 8 at the Heart Rhythm Society’s scientific session in San Francisco. The practice was found to be safe but unnecessary.

Inaccurate INR results prompt recall of test strips

The FDA issued a Class I recall on test strips used to measure a patient’s international normalized ratio (INR) due to reports that ranges found through its product differed significantly from results in tests performed in a laboratory.