Patients with afib undergoing elective surgery or invasive procedure who were on coumadin were randomized to bridging with low molecular weight heparin or placebo preoperatively. The incidence of arterial thromboembolism was .03% in the bridge group and 0.4% in the placebo group, demonstrating non-inferiority of placebo. The bleeding complication r
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Electrophysiology/arrhythmia
June 14, 2015
This Swedish study was a retrospective review over a 20-year time period that compared survival after out-of-hospital cardiac arrest between those receiving bystander CPR prior to EMS arrival and those not receiving such. CPR before the arrival of EMS was associated with an increased 30-d survival rate (odds ratio 2.15; 95% CI 1.88-2.45).
May 17, 2015
The question of whether digoxin increases the risk of death in patients with atrial fibrillation (AF) or congestive heart failure (CHF) continues to be a matter of debate. The authors of this manuscript attempt to find an answer with a meta-analysis and systematic review of the literature.
May 10, 2015
Patients with persisent or long-standing atrial fibrillation requiring mitral valve surgery were randomized to either surgical ablation or no ablation. Surgical ablation patients were further randomized to pulmonary vein isolation or biatrial MAZE. More surgical ablation patients were free from atrial fibrillation than control.
April 12, 2015
In this manuscript the authors describe their findings in a meta-analysis of 12 randomized placebo-controlled clinical trials involving 2,980 patients undergoing isolated CABG. They found that statin therapy, particularly atorvastatin, initiated before CABG, was associated with a 58% reduction in the risk of postoperative AF.
April 8, 2015
This thought provoking article by Drew et al., utilized state-of-the art monitoring technology to document the problem of "alarm fatigue" by recording an astounding number of alarm events; 2,558,760 unique alarms were triggered for 461 patients over a 31-day period.
March 17, 2015
The study investigated management of atrial fibrillation existing at the time of mitral valve surgery, randomizing 260 pts to ablation or observation. The end point was freedom from afib at both 6 and 12 mos. Ablation yielded success in 63% compared to 29% of controls, but was associated with a higher risk of pacemaker implant (21% vs 8%).
February 24, 2015
This is an excellent summary of the pros and cons of LAA occlusion for stroke prevention in non valvular AF.
January 10, 2015
The FDA recently approved the fourth new oral anticoagulant, Savaysa for use in non-valvular afib, DVT, and PE. It is another factor Xa inhibitor. Use in non-valvular afib requires renal function assessment prior to prescribing, as the drug is renally excreted. Paradoxically, efficacy may be reduced in patients with better-than-normal renal functi
November 10, 2014
The authors explored a sample of Medicare patients who survived sepsis during hospitalization to assess the impact of afib developing during sepsis on long-term outcomes. Of nearly 139,000 sepsis survivors, 7% had new onset afib during sepsis. Of those pts, 55% were found to have afib after hospitlization. New onset afib during sepsis was associat