Clinical Cardiology
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Noninvasive Mapping and Ablation of Ventricular Tachycardia: Evidence Builds for Novel Approach
In 19 patients with treatment-refractory episodes of ventricular tachycardia or frequent premature ventricular contractions, stereotactic body radiation therapy was highly effective at reducing arrhythmia burden without acute toxicity.
Chronic Kidney Disease Discourages Appropriate Use of Angiography and PCI in NSTEMI
This retrospective study of patients presenting with non-ST-segment elevation myocardial infarction showed higher mortality among patients with chronic kidney disease and lower use of coronary angiography and percutaneous coronary intervention.
Cardiac MRI for Prognosis in Aortic Stenosis
The authors of a consortium observational study of patients with severe aortic stenosis undergoing valve replacement found that a pre-procedure cardiac MRI that detects myocardial fibrosis is predictive of post-procedure mortality and may be useful for making decisions about valve replacement in asymptomatic patients.
Testing Safety, Efficacy of Pharmacotherapy in Hospitalized Heart Failure Patients
In patients hospitalized for acute decompensated heart failure with reduced ejection fraction, administering sacubitril-valsartan led to more improvement in levels of cardiac biomarkers compared to enalapril, with no adverse safety signals.
PCSK9 Inhibitors in Acute Coronary Syndrome Patients
Compared to adding placebo, using the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab in post-acute coronary syndrome patients on maximally tolerated, high-intensity statins with low-density lipoprotein (LDL) cholesterol levels higher than 70 mg/dL lowered LDL and reduced the number of major adverse cardiac events.
A Review of Updated Guidelines Regarding Bradycardia and Cardiac Conduction Delay
The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society have established updated guidelines on the evaluation and management of patients with bradycardia and conduction delays. Many key elements remain largely unchanged from prior guideline recommendations on pacemakers published in 2008 and 2012, but there also are important new definitions, recommendations, and areas of emphasis.
Early Identification of Cardiac Amyloidosis in Carpal Tunnel Surgery Patients
In a cohort of older patients undergoing carpal tunnel release surgery, an analysis of tenosynovial tissue revealed amyloid deposits in 10% of patients. This development may facilitate early diagnosis of cardiac amyloidosis.
Mitral Annulus Disjunction and Ventricular Arrhythmias
A patient cohort with mitral annular disjunction (MAD) identified by echo was characterized clinically and by MRI. Ventricular arrhythmias were common in MAD patients and related to the degree of MAD and papillary muscle fibrosis by MRI but not the presence of mitral valve prolapse.
Detection of Prosthetic Heart Valve Endocarditis
A multicenter, retrospective, observational study of patients undergoing 18F-fluorodeoxyglucose PET/CT for prosthetic valve endocarditis or other indications showed that if certain obvious confounders are excluded, this imaging technique offers a high degree of accuracy for diagnosing prosthetic valve endocarditis, especially if performed early in the course of the disease.
Study Adds Complexity to Post-TAVR Anticoagulation
In this large contemporary, prospective transcatheter aortic valve replacement registry, oral anticoagulation appears to be protective against valve degeneration but is associated with increased mortality. The strongest predictors of mortality at three years were male gender, renal failure, and atrial fibrillation.