Clinical Cardiology
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Noninvasive Ablation of Ventricular Tachycardia: A Paradigm Shift?
In five patients with recurrent ventricular tachycardia refractory to conventional therapies, relatively short treatments with electrophysiology-guided stereotactic body radiation therapy were highly effective at reducing arrhythmia burden.
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Searching for a Connection Between Silent Myocardial Infarction and Heart Failure
In a large community-based cohort, the development of silent myocardial infarction on ECG was associated with increased risk of future heart failure.
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A Closer Look at the Effects of NSAIDs on Blood Pressure
An ambulatory blood pressure monitoring substudy of the PRECISION trial showed that ibuprofen use significantly increased mean 24-hour systolic blood pressure compared to celecoxib. Further, naproxen produced intermediate results despite equivalent pain relief in patients with arthritis.
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Assessing Device-assisted CPR Safety
A randomized, prospective, noninferiority study of the safety of two automated CPR devices (LUCAS and AutoPulse) against the standard manual chest compressions in cardiac arrest victims showed that in cases of severe or life-threatening complications, the LUCAS device was noninferior to standard CPR, but more organ damage with the AutoPulse cannot be excluded.
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Research Provides More Support for Antiplatelet Therapy De-escalation
The authors of a single-center study randomized post-acute coronary syndrome patients either to remain on higher-potency antiplatelet agents or to change to clopidogrel after one month. The results showed a benefit to de-escalation in terms of both bleeding and ischemic events, regardless of initial platelet reactivity.
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Accuracy of Right Atrial Pressure Estimates by Echocardiography
Researchers compared echocardiographically determined right atrial pressure and characteristics of the inferior vena cava to right heart catheterization-measured values. They concluded that echo estimates reached through this technique should not be used clinically to estimate pulmonary artery pressure.
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CT Calcium Score vs. Stress Testing
A subgroup analysis of the PROMISE trial showed that CT coronary calcium scores in symptomatic patients at low to intermediate risk for coronary artery disease are more sensitive but less specific for major adverse cardiac events over a two-year follow-up period than stress testing. Consequently, both approaches exhibited similar but modest discriminatory ability.
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Patent Foramen Ovale Closure Falls Short in Treatment of Migraines
This randomized trial of patent foramen ovale closure in severe refractory migraine showed no significant difference in responder rate compared to sham control.
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Cardiac MRI Most Valuable Test for Diagnosis and Prognosis in Cardiac Sarcoidosis
Among patients with extracardiac sarcoidosis, cardiac MRI was the best test for diagnosing cardiac involvement and the strongest independent predictor of adverse outcomes.
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ARNI Therapy Associated With Reduction in Ventricular Arrhythmias
In patients with congestive heart failure due to reduced ejection fraction who underwent remote arrhythmia monitoring via an implantable cardioverter defibrillator (ICD), both ventricular arrhythmias and appropriate ICD shocks were reduced while on sacubitril-valsartan compared to an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker alone.