Daily Archive: November 20, 2011

Nov 20

Atrial Fibrillation –Unmet Challenges

Dr Bharat B Kukreti, Dr K C Goswami, All India Institute of Medical Sciences Atrial Fibrillation is a most common sustained arrhythmia and treatment of this has remained frustrating. The newer drugs for anticoagulation are being developed for safer and more effective anticoagulation. Although new safer ant arrhythmic drugs have been developed, the efficacy is …

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Nov 20

AHA Update: Drug eluting balloons for patients who are on warfarin

Drug-eluting balloons can be used in place of stenting in patients at high risk of bleeding said Dr Mariusz Zadura of the Heart and Diabetes Center in Karlsburg, Germany. They are particularly useful for patients on warfarin. The balloons also offer a solution for bare-metal in stent restenosis.  

Nov 20

Treat acute prosthetic valve thrombosis with thrombolysis or surgery

Prosthetic valve thrombosis is a life-threatening complication. Inadequate anticoagulation is the most common predisposing factor. Both Surgery and Thrombolysis are more effective than conservative medical management in improving survival.  These are the conclusions from cardiologists at at the Sree Chitra Institute who will be presenting their data in the forthcoming 63rd Annual CSI meet being …

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Nov 20

Do not use nesiritide in acute heart failure?

Nesiritide (recombinant human brain natriuretic peptide, BNP 1-32) is a vasodilator that has undergone clinical trials in patients with acute HF. While earlier trails found that nesiritide acutely reduced pulmonary capillary wedge pressure and dyspnea in patients with acute HF, the largest randomized trial, ASCEND-HF, found that nesiritide increased rates of hypotension, did not alter rates …

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Nov 20

AHA Update: Fear of ICD Shock impairs Sex Life

The notion of experiencing a shock from an ICD during sex is enough to hamper performance in the bedroom among men with congenital heart disease. There was no difference, however, in scores for women with and without ICDs when assessed with the Female Sexual Function Index [Dr Stephen C. Cook, from Children’s Hospital of Pittsburgh]

Nov 20

Start Aldosterone antagonist in all patients with mild heart failure

Aldosterone antagonist therapy reduces mortality in patients with moderate to severe heart failure. The new recommendation is that one should also start aldosterone antagonists to treat HF in patients who have NYHA functional class II HF and an LVEF ≤30 percent, or NYHA functional class III to IV HF and an LVEF <35 percent, who …

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Nov 20

Medical therapy vs CABG for coronary disease with reduced left ventricular function

For most patients with LVEF of 35 percent or less and CAD amenable to CABG surgery the current recommendation is to give an initial course of optimal medical therapy alone rather than medical therapy plus CABG surgery . Over 50% of patients with LV systolic dysfunction ( EF<35%) due to CAD have a significant amount …

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Nov 20

New test to measure PAH prognosis

For patients with pulmonary arterial hypertension (PAH), the risk of clinical worsening can be predicted in a heartbeat. Measure the difference between the heart rate at the end of a six-minute walk test and the rate 60 seconds later. Normal > 16 beats\ Slower heart rate recovery: If the difference is less than 16 beats …

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