Clinical Cardiology
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Management of Spontaneous Coronary Artery Dissection
In the largest study to date about patients with spontaneous coronary artery dissection who underwent follow-up angiography, 95% of those who underwent repeat cath more than 30 days later showed spontaneous angiographic healing.
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Impact of Atrial Fibrillation on Survival in Patients With Severe Mitral Regurgitation
A large observational study of patients with severe mitral valve regurgitation due to flail leaflets revealed that atrial fibrillation at entry was associated with excess mortality.
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Who Needs a TEE Prior to Atrial Fibrillation Cardioversion?
A study of patients with atrial fibrillation or flutter undergoing transesophageal echocardiography showed a left atrial appendage thrombus in 8% overall and 4% in those appropriately anticoagulated.
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Medication First? Ablation First? Either Way, Make Weight Loss a Priority
Weight loss management and aggressive risk factor modification associated with slowing or even reversal of atrial fibrillation progression.
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Withdrawal of Medical Therapy Associated With Relapse in Recovered Dilated Cardiomyopathy
In patients with dilated cardiomyopathy and recovered ejection fraction, discontinuation of heart failure medical therapies was associated with a 44% risk of relapse within six months.
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Left Ventricular Unloading During Venoarterial ECMO in Cardiogenic Shock
In a series of patients with cardiogenic shock, the use of venoarterial extracorporeal membrane oxygenation with a percutaneous left ventricular unloading device was associated with better-than-expected outcomes.
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Combination Drug Therapy for Hypertension
A large regional database study from Italy demonstrated that initial combination therapy for newly diagnosed hypertension results in fewer major adverse cardiovascular events at one year compared to monotherapy.
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Safety and Efficacy of HEART Score Use in the ED
A prospective observational study of 30-day outcomes in patients with suspected acute coronary syndromes triaged in EDs before and after the implementation of the HEART score showed that there were fewer hospitalizations and a very low risk of death or myocardial infarction among low-risk patients who were discharged without further cardiac testing.
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An Update to the Management of Atrial Fibrillation
This focused update to the 2014 guidelines for the management of atrial fibrillation (AF) includes revisions to anticoagulation recommendations and the role of catheter ablation of AF in patients with heart failure.
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Volume-Outcome Relationship With Newer-Generation TAVR Devices?
This large-scale retrospective analysis of all balloon-expandable transcatheter aortic valve replacement valves revealed no apparent relationship between procedure volume and outcomes after an initial learning curve of 200 procedures.