Cardiology

Calkins, H., G. Hindricks, R. Cappato, Y. H. Kim, E. B. Saad, L. Aguinaga, J. G. Akar, V. Badhwar, J. Brugada, J. Camm, P. S. Chen, S. A. Chen, M. K. Chung, J. C. Nielsen, A. B. Curtis, D. Wyn Davies, J. D. Day, A. d’Avila, N. de Groot, L. Di Biase, M. Duytschaever, J. R. Edgerton, K. A. Ellenbogen, P. T. Ellinor, S. Ernst, G. Fenelon, E. P. Gerstenfeld, D. E. Haines, M. Haissaguerre, R. H. Helm, E. Hylek, W. M. Jackman, J. Jalife, J. M. Kalman, J. Kautzner, H. Kottkamp, K. H. Kuck, K. Kumagai, R. Lee, T. Lewalter, B. D. Lindsay, L. Macle, M. Mansour, F. E. Marchlinski, G. F. Michaud, H. Nakagawa, A. Natale, S. Nattel, K. Okumura, D. Packer, E. Pokushalov, M. R. Reynolds, P. Sanders, M. Scanavacca, R. Schilling, C. Tondo, H. M. Tsao, A. Verma, D. J. Wilber and T. Yamane (2017). “2017 hrs/ehra/ecas/aphrs/solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary.” J Interv Card Electrophysiol: 2017 Sep [Epub ahead of print].

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During the past three decades, catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF, using either standard, minimally invasive, or hybrid techniques, is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure.

Sannino, A., R. C. Stoler, R. F. Hebeler, Jr., M. Szerlip, M. J. Mack and P. A. Grayburn (2017). “Clinical relevance of baseline tcp in transcatheter aortic valve replacement.” J Invasive Cardiol 29(10): 353-358.

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AIMS: To investigate the influence of baseline thrombocytopenia (TCP) on short-term and long-term outcomes after transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: A total of 732 consecutive patients with severe, symptomatic aortic stenosis undergoing TAVR from January 2012 to December 2015 were included. Primary outcomes of interest were the relationship of baseline TCP with 30-day and 1-year all-cause mortality. Secondary outcomes of interest were procedural complications and in-hospital mortality in the same subgroups. The prevalence of TCP (defined as platelet count <150 x 109/L) at baseline was 21.9%, of whom 4.0% had moderate/severe TCP (defined as platelet count <100 x 109/L). Compared to no or mild TCP, moderate/severe TCP at baseline was associated with a significantly higher 30-day mortality (23.3% vs 2.3% and 3.1%, respectively; P<.001) and 1-year mortality (40.0% vs 8.3% and 13.4%, respectively; P<.001). In Cox regression analysis, moderate/severe baseline TCP was an independent predictor of 30-day and 1-year mortality (hazard ratio [HR], 13.18; 95% confidence interval [CI], 4.49-38.64; P<.001 and HR, 5.90; 95% CI, 2.68-13.02; P<.001, respectively). CONCLUSIONS: In conclusion, baseline TCP is a strong predictor of mortality in TAVR patients, possibly identifying a specific subgroup of frail patients; therefore, it should be taken into account when addressing TAVR risk.

Roberts, W. C. (2017). “Cardiology 1919-1941 and cardiology today.” Am J Cardiol 120(6): 1040-1041.

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My father, Stewart Ralph Roberts, MD (1878–1941) ( Figure 1 ), probably the first cardiologist in the South, 1 2 is shown in 1924, the year he was president of the Southern Medical Association. The American Heart Journal , the first cardiology journal in the world, started in 1926, and he was soon on its editorial board. In 1932, the year I was born, he was president of the American Heart Association. In 1937, he had a large acute myocardial infarction (AMI) and was hospitalized at Emory University Hospital, where he was clinical professor of medicine, for 1 month, followed by total bed rest at home for 2 months, then gentle activities at home for 3 months, and then gradually increasing activities outside the home for 6 months…

Azzalini, L., L. Candilio, P. A. McCullough and A. Colombo (2017). “Current risk of contrast-induced acute kidney injury after coronary angiography and intervention: A reappraisal of the literature.” Can J Cardiol 33(10): 1225-1228.

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Contrast-induced acute kidney injury (CI-AKI) is the acute impairment of renal function further to the intravascular administration of iodinated contrast media, and occurs most frequently after coronary angiography, percutaneous coronary intervention, and contrast-enhanced computed tomography. CI-AKI has been associated with the development of acute renal failure, worsening of chronic kidney disease, requirement for dialysis, prolonged hospital stay, and higher mortality rates and health care costs. Recently, a number of studies suggested that contrast media exposure might not be the causative agent in the occurrence of acute kidney injury, particularly in stable patients who receive small to moderate amounts of contrast media. However, those who undergo coronary angiography and intervention are indeed subject to an increased hazard of CI-AKI, in view of a more significant contrast media exposure as well as the presence of concomitant risk factors. Solid randomized clinical trials are therefore required to identify preventative strategies to reduce the risk of CI-AKI and its complications in these patients.

Calkins, H., G. Hindricks, R. Cappato, Y. H. Kim, E. B. Saad, L. Aguinaga, J. G. Akar, V. Badhwar, J. Brugada, J. Camm, P. S. Chen, S. A. Chen, M. K. Chung, J. C. Nielsen, A. B. Curtis, D. Wyn Davies, J. D. Day, A. d’Avila, N. de Groot, L. Di Biase, M. Duytschaever, J. R. Edgerton, K. A. Ellenbogen, P. T. Ellinor, S. Ernst, G. Fenelon, E. P. Gerstenfeld, D. E. Haines, M. Haissaguerre, R. H. Helm, E. Hylek, W. M. Jackman, J. Jalife, J. M. Kalman, J. Kautzner, H. Kottkamp, K. H. Kuck, K. Kumagai, R. Lee, T. Lewalter, B. D. Lindsay, L. Macle, M. Mansour, F. E. Marchlinski, G. F. Michaud, H. Nakagawa, A. Natale, S. Nattel, K. Okumura, D. Packer, E. Pokushalov, M. R. Reynolds, P. Sanders, M. Scanavacca, R. Schilling, C. Tondo, H. M. Tsao, A. Verma, D. J. Wilber and T. Yamane (2017). “2017 hrs/ehra/ecas/aphrs/solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary.” J Interv Card Electrophysiol: 2017 Sep [Epub ahead of print].

Full text of this article.

During the past three decades, catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF, using either standard, minimally invasive, or hybrid techniques, is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure.