Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Efficacy of pulmonary vein isolation by cryoballoon ablation in patients with paroxysmal atrial fibrillation.
Radiofrequency ablation of pulmonary veins (PVs) has emerged as an effective treatment for patients with paroxysmal atrial fibrillation (AF). However, serious complications raise concern about an even wider application. In terms of safety, cryoenergy has advantages compared with radiofrequency. A new cryoenergy balloon catheter has been recently developed to make AF ablation shorter and safer. ⋯ This is the first study that reports the results of the new cryoballoon AF ablation approach showing 86% freedom from AF recurrence after 6 months. Cryoballoon PV ablation promises to be effective for patients with paroxysmal AF and normally sized left atria.
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Sudden cardiac arrest is the leading cause of death in young athletes. However, limited studies have examined survival rates after exercise-related sudden cardiac arrest in the youth. ⋯ Survival following exercise-related sudden cardiac arrest in the youth has been universally poor over the last 7 years in the United States, despite a recent trend toward improved survival. Improved reporting systems are needed to accurately monitor these events, and strategies to improve outcomes from exercise-related sudden cardiac arrest in the youth, such as improved emergency response planning and public access defibrillation programs, should be considered.
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Clinical Trial
Outcomes and costs of implantable cardioverter-defibrillators for primary prevention of sudden cardiac death among the elderly.
The clinical outcomes and costs of implantable cardioverter-defibrillators (ICDs) used for primary prevention of sudden cardiac death in nonexperimental settings are uncertain. ⋯ ICD implantation was associated with reduced mortality in a nonexperimental, elderly, primary-prevention patient population hospitalized for CHF. The additional health-care costs of ICD implantation were substantial but comparable to published cost-effectiveness models that have projected ICDs to be cost-effective.