S J Connolly

..However, because these trials were not double blind, they may have been biased in their assessment of outcomes and had a placebo effect of surgery...

..No previous trials have been primarily directed at demonstrating that the use of drugs that prevent AF would shorten length of stay and reduce the costs of postoperative care...

..Acetylsalicylic acid is less effective than oral anticoagulants but better tolerated. Anticoagulants are recommended for AF patients with risk factors for stroke...

..Implantable cardioverter defibrillator (ICD) therapy is effective but is associated with high-voltage shocks that are painful...

..A direct thrombin inhibitor, ximelagatran, has been shown to have an excellent pharmacokinetic profile and is being developed as an oral agent for stroke prevention in AF, and it will not need regular monitoring...

..Irbesartan is an angiotensin receptor-blocking agent that reduces blood pressure and has other vascular protective effects...

..These benefits have not been evaluated in a large, randomized, controlled trial...

..The risk of cardiovascular events among patients with atrial fibrillation is high. We evaluated whether irbesartan, an angiotensin-receptor blocker, would reduce this risk...

..The implantable cardioverter defibrillator (ICD) terminates VT or VF, but it is not known whether this device prolongs life in these patients compared with medical therapy with amiodarone...

..Apixaban, a novel factor Xa inhibitor, may be an alternative treatment for such patients...

..This study was done to evaluate pacemaker therapy for severe recurrent vasovagal syncope...

..Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor...

..22, 95% CI 0.39 to 3.77). CONCLUSION: Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality...

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..Atrial fibrillation (AF) is a widespread disease that has only recently received the focused attention of arrhythmia specialists despite being the most frequently occurring significant cardiac arrhythmia...

..9% of patients receiving either of the 2 effective doses. Thus, doses of azimilide <100 mg/day are not effective for control of AF, whereas doses of 100 and 125 mg/day are effective with an acceptable risk of serious toxicity...

..Further research is warranted to identify the indications and patient subgroups for whom ICDs are a cost-effective use of resources...

..increasingly, ICD implantation is performed without defibrillation testing (DT)...

..This substudy will determine if atrial electrical remodeling is detectable in pacemaker patients and if it is associated with the development of AF...

..56, p=0.11), and overall group (hazard ratio 1.22, 95% confidence interval 1.00 to 1.49, p=0.053). No patient died. In conclusion, azimilide showed a nonsignificant trend toward efficacy in maintaining sinus rhythm in patients with AF...

..The effects of these drugs on defibrillation energy requirements have not been previously assessed in a randomized controlled trial...

..No trial has shown a mortality reduction, and only 1 small trial suggested a reduction in stroke. The goal of this review was to determine whether atrial-based pacing prevents major cardiovascular events...

..Hypertension is common in patients with atrial fibrillation (AF) and is an important cause of stroke...

..This pilot study assessed the safety and efficacy of left atrial appendage (LAA) occlusion, performed at the time of coronary artery bypass grafting (CABG)...

..6% per year. No increased major bleeding occurred with aspirin and ximelagatran. These results suggest that the risks associated with addition of aspirin to anticoagulation in patients with AF outweigh the benefit...

..However, its effectiveness in elderly patients is uncertain, given their competing risk of non-arrhythmic death...

..However, the most conservative estimates suggest that no less than 25% of deaths in patients with a diagnosis of ischemic heart disease are due to ventricular fibrillation...

..However, the efficacy of trypanocidal therapy in preventing clinical complications in patients with preexisting cardiac disease is unknown...

..However, the benefits and risks of this approach have not been adequately studied...

..With this summary document, we hope to provide a helpful resource for future drug development for AF...

..However, because OAC carries important bleeding complications, risk stratification schemes have been devised to identify patients for whom the absolute benefits of OAC exceed its risks...

..Our goal was to determine the risk of stroke or non-cerebral embolism associated with paroxysmal compared with sustained atrial fibrillation (AF)...

..There is a continued need for new antiarrhythmic drugs to treat the ever-increasing number of patients with this arrhythmia. Dronedarone is a new antiarrhythmic compound currently being developed for treatment of AF...

..Dronedarone is a new antiarrhythmic agent pharmacologically related to amiodarone but developed to reduce the risk of side effects...

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..Additional research to identify an optimum scheme for primary prevention and subsequent standardization of recommendations may lead to more uniform selection of patients for anticoagulant prophylaxsis...

..After its initial diagnosis, atrial fibrillation (AF) may progress from paroxysmal to chronic AF (CAF). The rate of progression and risk factors for progression are not clearly defined...

..Amiodarone and bi-atrial pacing may decrease the length of hospital stay...

..The ACTIVE program began patient enrollment in spring 2003...

..Many patients do not receive anticoagulation therapy despite its proven benefits...

..There was another effect of azimilide: an average reduction of 0.38 symptoms (P <.01) that was independent of heart rate. CONCLUSION: Azimilide (125 mg/day) reduces the number of symptoms reported at the time of AF recurrence...

..Specific pharmacotherapy could potentially play a major role in the primary and secondary prevention of atrial fibrillation and its complications...

..The impact of atrial fibrillation (AF) and its treatment on health-related quality of life (QOL) is not well understood. We assessed QOL in patients with symptomatic AF participating in the Canadian Trial of Atrial Fibrillation...

..The QOL studies within the Canadian Trial of Physiologic Pacing were performed to assess whether QOL differences exist in patients randomized to these 2 pacing modes...

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..CONCLUSIONS: The clinical trial designed to evaluate LAA occlusion at the time of routine CABG surgery is currently in the pilot phase...

..A secondary aim was to evaluate the effects on quality-of-life outcomes of receiving shocks from the device...

..To better understand the role of various prophylactic therapies against postoperative AF, a systematic review of evidence from randomized trials was performed...

..It was concluded that in patients with a history of atrial fibrillation or flutter, azimilide was associated with statistically significant increases in RR, QT, QTc(Bazett), and QTc(Fridericia) when patients were in sinus rhythm...

..However, the occurrence of atrial fibrillation was significantly less frequent with physiological pacemakers. To assess a potential delayed benefit of physiological pacing, follow-up of patients in this study was extended to 6 years...

..Its effect on paroxysmal supraventricular tachycardia (PSVT) has not been reported...

..Whether benefit occurs in patients early after myocardial infarction is unknown...

..Patients with no or paroxysmal recurrence had no change in LA dimension over a 4-year period. These findings have implications in tailoring modes of therapy in patients with AF...

..Ongoing research will establish whether ACE inhibitors or ARBs have specific benefits in patients with atrial fibrillation...

..We also evaluated warfarin use over time and compared left atrial dimensions in patients with atrial flutter with those with atrial fibrillation...

..The selective use of these devices in patients likely to be pacemaker dependent appears to be cost-effective. Further studies with longer follow-up and which consider the benefit of reducing nonfatal cardiac events would be valuable...

..Contemporary information is lacking on the effect of demographic features and clinical features on the specific mode of mortality after myocardial infarction (MI) in the thrombolytic era...

..Accordingly, we determined the age of the first syncopal spell in adult patients who sought care for syncope...

..However, contemporary data on such information is lacking...

..The present paper critically reviews the latest insights in the pathophysiology, diagnosis and management of CSS...

..We sought to determine the effect of advancing age on the mode of death in the Amiodarone Trialists Metanalysis...

..Much of the natural history of vasovagal syncope is unknown. We determined whether patients presenting for care have had a recently worsened syncope frequency...

..Hypertension may be the most common primary etiology of AF, and the possibility of effective primary prevention of AF by strict control of hypertension needs to be evaluated adequately...

..Risk stratification after myocardial infarction (MI) remains expensive and disappointing. We designed a prognostic indicator using demographic information to select patients at risk of dying after MI...

..The prognostic value of blood pressure measured during hospitalization after acute myocardial infarction (MI) has not been investigated, particularly with regard to arrhythmic death...