Clinical Cardiology Alert – December 1, 2021

December 1, 2021

• Intensive Monitoring for Asymptomatic Atrial Fibrillation Did Not Prevent Strokes

  Screening with an implantable loop recorder resulted in dramatically higher rates of atrial fibrillation detection and ensuing anticoagulation, but without a significant decrease in risk of stroke or systemic embolism by six years of follow-up.

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• Coronary CT Angiography in the General Population

  Coronary artery CT angiography in asymptomatic, middle-aged subjects without known coronary artery disease showed coronary atherosclerosis is common but mostly mild and appears in women after a 10-year delay.

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• Importance of Age in the Application of Coronary Artery Calcium Detection

  Using coronary CT strategy as a diagnostic first line in patients with symptoms suggestive of coronary artery obstruction revealed relying on the coronary calcium score alone is inadequate for younger patients with a higher frequency of non-calcified obstructions.

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• Long-Term Post-TAVR Survival and Permanent Pacemaker Implantation

  An analysis of a real-world database revealed 14% of patients undergoing routine transfemoral transcatheter aortic valve replacement required permanent pacemaker implantation within 30 days of the valve procedure. There was no difference in long-term survival between patients who did and did not undergo pacemaker implant.

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• Left-Sided Breast Cancer Radiation Therapy and Coronary Artery Disease

  A study of breast cancer survivors revealed left breast radiation therapy doubles the subsequent risk of coronary heart disease vs. right-sided radiation.

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